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老年人群神经精神疾病模式:来自尼泊尔的住院患者研究报告。

Pattern of neuropsychiatric illnesses in older age group population: an inpatient study report from Nepal.

机构信息

Department of Psychiatry, Universal College of Medical Sciences, Bhairahawa, Nepal.

出版信息

Indian J Psychiatry. 2012 Jan;54(1):23-31. doi: 10.4103/0019-5545.94641.

Abstract

BACKGROUND

Inpatient institution-based geropsychiatric study reports are rare in the world psychiatric literature.

AIMS

To study the pattern of neuropsychiatric illnesses seen in older age group population and to study how the advancing age influences the pattern of physical and neuropsychiatric illnesses in these geriatric people.

MATERIALS AND METHODS

This was a retrospective review of the charts of all patients of age 60 years and above, during a specified period of 3.5 years. The present study reports the findings of 138 patients (83 males and 55 females) admitted during the said period. For comparison purpose, 194 patients, in the age range of 50-59 years, who were admitted during the same period, were taken up specially to study the changing pattern of diagnosis, if any, as well as to study the significance of increased rate of physical illness in the geriatric study group.

RESULTS

Our geriatric inpatients (138) formed only 3.73% of the total patient population (3698) admitted during the said period, which is in sharp contrast to 23-44% geriatric inpatients, the range that has been usually reported in the western literature. Common clinical diagnoses amongst male geriatric patients were alcohol dependence with or without various complications (27.7%), followed by mood disorder-mania (18.1%), organic mental disorders (18.1%), psychosis (16.9%), and mood disorder-depression (14.5%). Common clinical diagnoses amongst geriatric females were mood disorder-depression (36.4%) and psychosis (25.5%). Comorbid physical illness was seen to be present at a very high percentage (61.4%) in geriatric male patient population than in female patients (40%). Alcohol dependence in male and depressive disorder in female stood out as distinctive illness in patients above 50 years of age (including both study and comparative groups). In sharp contrast to elderly comparison group's 14.9% cases of comorbid physical illness, geriatric study population had a staggering 52.9% cases of additional burden of physical illness diagnosis.

CONCLUSIONS

Being elder by a decade poses a significant threat in developing an additional physical illness to an already existing psychiatric illness in the geriatric community. Though the prevalence of mental illness in the geriatric age group is similar in developed and developing countries, poor inpatient attendance of geriatric neuropsychiatric patients probably indicates a poor delivery of healthcare facilities to our senior citizens.

摘要

背景

在世界精神病学文献中,住院机构为基础的老年精神病学研究报告很少。

目的

研究老年人群中神经精神疾病的模式,并研究随着年龄的增长如何影响这些老年人群中身体和神经精神疾病的模式。

材料和方法

这是对特定 3.5 年期间年龄在 60 岁及以上的所有患者病历的回顾性分析。本研究报告了在此期间住院的 138 名患者(83 名男性和 55 名女性)的发现。为了比较目的,专门选择了同期年龄在 50-59 岁之间的 194 名患者,以研究诊断模式的变化(如有),以及研究老年组中身体疾病发病率增加的意义。

结果

我们的老年住院患者(138 名)仅占同期住院患者(3698 名)的 3.73%,这与西方文献中通常报告的 23-44%的老年住院患者形成鲜明对比。男性老年住院患者的常见临床诊断是酒精依赖伴或不伴各种并发症(27.7%),其次是心境障碍躁狂(18.1%)、器质性精神障碍(18.1%)、精神病(16.9%)和心境障碍抑郁(14.5%)。老年女性患者的常见临床诊断是心境障碍抑郁(36.4%)和精神病(25.5%)。研究发现,老年男性患者的共病身体疾病比例非常高(61.4%),而女性患者(40%)则较低。50 岁以上患者中,男性的酒精依赖和女性的抑郁障碍突出为独特的疾病。与老年对照组 14.9%的共病身体疾病病例形成鲜明对比的是,老年研究人群的身体疾病诊断负担惊人地增加了 52.9%。

结论

在老年人群中,每增加十岁就会对已经存在的精神疾病增加额外的身体疾病的威胁。虽然在发达国家和发展中国家,老年人群中心理疾病的患病率相似,但老年神经精神疾病患者的住院率低可能表明向我们的老年人提供医疗保健设施不足。

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