Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA.
Gen Hosp Psychiatry. 2010 Jan-Feb;32(1):99-101. doi: 10.1016/j.genhosppsych.2009.08.002. Epub 2009 Sep 11.
To determine the prevalence of substance misuse among older patients presented to a psychiatric emergency service (PES) on involuntary bases.
At the time of initial presentation to the PES, all patients received a comprehensive assessment that included a urine toxicology screening. The screening consisted of six substances: barbiturate, benzodiazepine, cocaine, opiate, phencyclidine and amphetamine. Charts of elderly patients (aged 65 and above) with positive urine toxicology were reviewed to ensure that the results were not due to (1) home medications and (2) medications given in the PES.
During the 2-year study period (2006-2007), there were 5914 patients under the age of 65 and 104 patients aged 65 and above. Our findings indicated that 471 (8.0%) and 14 (13.4%) urine toxicology screens were not collected during the PES visits in younger and older patients, respectively (P=.04). The positive urine toxicology rate was 31.5% (1716/5443) and 26.7% (24/90) for younger and older patients, respectively (P=.33).
Substance misuse in the older population presenting with psychiatric emergency is prevalent in the PES. Urine toxicology screens, as well as patient or collateral report of substance usages, should be obtained from this group of patients to ensure quality of care delivered at the PES.
确定因非自愿原因就诊于精神科急诊的老年患者中物质滥用的流行率。
在首次就诊于精神科急诊时，所有患者均接受全面评估，包括尿液毒理学筛查。该筛查包括六种物质：巴比妥酸盐、苯二氮䓬类、可卡因、阿片类、苯环己哌啶和苯丙胺。对尿液毒理学呈阳性的老年患者（年龄≥ 65 岁）的病历进行回顾，以确保结果不是由于（1）家庭用药和（2）在急诊中使用的药物所致。
在为期 2 年的研究期间（2006-2007 年），有 5914 名年龄在 65 岁以下的患者和 104 名年龄在 65 岁及以上的患者。我们的发现表明，分别有 471 名（8.0%）和 14 名（13.4%）年轻患者和老年患者在急诊就诊期间未进行尿液毒理学筛查（P=.04）。年轻患者和老年患者的尿液毒理学阳性率分别为 31.5%（1716/5443）和 26.7%（24/90）（P=.33）。
在精神科急诊就诊的老年人群中，物质滥用较为普遍。应从这组患者中获取尿液毒理学筛查结果，以及患者或其家属对物质使用情况的报告，以确保在急诊提供的护理质量。
