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Health management of older persons with chronically medicated psychotic disorders: the results of a survey in France

Published online by Cambridge University Press:  11 August 2011

Christophe Arbus ,
Jean-Pierre Clement ,
Thierry Bougerol ,
Patrick Fremont ,
Sylvie Lancrenon  and
Vincent Camus
Christophe Arbus*
Affiliation:
University of Toulouse and Paul Sabatier University, Laboratoire du Stress Traumatique–LST (EA 4560), Purpan-Casselardit, Hospital, Toulouse, France
Jean-Pierre Clement
Affiliation:
Adult Psychiatry Service, Hospital Centre Esquirol, Limoges, France
Thierry Bougerol
Affiliation:
Adult Psychiatry Service, CHU Grenoble, France
Patrick Fremont
Affiliation:
Adult Psychiatry Service, Hospital Centre of Lagny-Marne-la-Vallée, Lagny sur Marne, France
Sylvie Lancrenon
Affiliation:
Sylia-Stat, Bourg la Reine, France
Vincent Camus
Affiliation:
CHRU Tours & INSERM U930, University François Rabelais, Tours, France
*
Correspondence should be addressed to: Christophe Arbus, Department of Psychiatry and Medical Psychology, Purpan-Casselardit Hospital, 31059 Toulouse, France. Phone: +33 561772351; Fax: +33 561777646. Email: arbus.c@chu-toulouse.fr.
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Abstract

Background: The medical care of elderly patients with psychotic disorders is a matter of major concern. The aim of the study was to investigate health conditions and treatment of elderly patients with psychotic disorders in France.

Methods: The SAGE (Schizophrenia AGEd) study (observational, cross-sectional) was a survey conducted among 123 physicians in France, regarding prescriptions of antipsychotic drugs in elderly patients (≥60 years) suffering from psychotic disorders. The survey was based on a questionnaire addressing the mental and somatic health management of the patients.

Results: Data from 930 patients (mean age: 70.4 years) were collected. Most patients (58.5%) suffered from schizophrenia, 20.8% had delusional disorder and 20.6% hallucinatory chronic psychosis (very-late-onset schizophrenia-like psychosis). 70.8% of them were outpatients, while 29.2% were inpatients. The severity of psychotic symptoms was assessed in 97.8% of patients, but cognitive function was only evaluated in 41.6%. Some 46.5% of patients were treated with atypical antipsychotics alone, 36.2% with classical antipsychotics alone and 17.3% received a combination of both, atypical and classical antipsychotics; 36.3% patients were given antiparkinsonian medication, of whom only 17.8% as preventive treatment; 51.1% of patients had somatic comorbidities, particularly cardiovascular disorders (34.0%). Evaluation of renal and/or liver function to adjust the dose of treatment was done in only 32.1% of patients. Over the previous 12 months, almost half of the patients had had no ECG, glycemia or creatininemia investigated and HDL-cholesterol and triglycerides were available for less than one-third of them.

Conclusions: Antipsychotic and antiparkinsonian drug prescriptions in French aged psychotic patients follow only partially the clinical guidelines and recommendations of consensus conferences. Moreover, cognitive, cardiac and metabolic aspects are not fully managed as expected.

Keywords

psychosesschizophreniaelderlymedical caresurveyantipychotics
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 3 , March 2012 , pp. 496 - 502
Copyright
Copyright © International Psychogeriatric Association 2011

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