BMC Psychiatry. 2011 Jul 15;11:111. doi: 10.1186/1471-244X-11-111.
The impact of an aging population on the psychiatric emergency service (PES) has not been fully ascertained. Cognitive dysfunctions aside, many DSM-IV disorders may have a lower prevalence in the elderly, who appear to be underrepresented in the PES. We therefore attempted to more precisely assess their patterns of PES use and their clinical and demographic characteristics.
Close to 30,000 visits to a general hospital PES (Montreal, Quebec, Canada) were acquired between 1990 and 2004 and pooled with over 17,000 visits acquired using the same methodology at three other services in Quebec between 2002 and 2004.
The median age of PES patients increased over time. However, the proportion of yearly visits attributable to the elderly (compared to those under 65) showed no consistent increase during the observation period. The pattern of return visits (two to three, four to ten, eleven or more) did not differ from that of patients under 65, although the latter made a greater number of total return visits per patient. The elderly were more often women (62%), widowed (28%), came to the PES accompanied (42%) and reported « illness » as an important stressor (29%). About 39% were referred for depression or anxiety. They were less violent (10%) upon their arrival. Affective disorders predominated in the diagnostic profile, they were less co-morbid and more likely admitted than patients under 65.
Although no proportional increase in PES use over time was found the elderly do possess distinct characteristics potentially useful in PES resource planning so as to better serve this increasingly important segment of the general population.
人口老龄化对精神科急诊服务（PES）的影响尚未完全确定。除认知功能障碍外，许多 DSM-IV 障碍在老年人中的患病率可能较低，而老年人在 PES 中的代表性不足。因此，我们试图更准确地评估他们使用 PES 的模式以及他们的临床和人口统计学特征。
在 1990 年至 2004 年间，我们从一家综合医院的 PES（加拿大魁北克省蒙特利尔）获得了近 30000 次就诊记录，并与 2002 年至 2004 年间使用相同方法在魁北克省的另外三个服务机构获得的超过 17000 次就诊记录进行了汇总。
PES 患者的中位年龄随时间推移而增加。然而，在观察期间，老年人（与 65 岁以下者相比）的年就诊次数比例并未持续增加。复诊模式（两次至三次、四至十次、十一次或更多次）与 65 岁以下患者的模式没有区别，尽管后者每位患者的总复诊次数更多。老年人中女性（62%）、丧偶（28%）、有陪伴者（42%）和报告“疾病”是重要压力源（29%）的比例较高。约 39%被转诊为抑郁或焦虑症。他们到达时的暴力程度较低（10%）。在诊断特征中，情感障碍占主导地位，他们的共病率较低，更有可能被收治住院，而不是 65 岁以下患者。
尽管我们没有发现 PES 使用随时间的比例增加，但老年人确实具有独特的特征，这些特征在 PES 资源规划中可能有用，以便更好地为这一日益重要的普通人群服务。
