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[综合医院的老年人与联络精神医学]

[The elderly at the General Hospital and liaison psychiatry].

作者信息

Cardoso G, Ismail F, Barbosa A

机构信息

Serviço de Psiquiatria, Hospital de Santa Maria, Lisboa.

出版信息

Acta Med Port. 1994 Nov;7(11):601-5.

PMID:7717098
Abstract

It is known that in general hospitals there is an increasingly high percentage of elderly patients that frequently develop psychiatric morbidity during hospital stay. This has lead the authors to perform a comparative study involving patients referred to Consultation/Liaison Psychiatry, in order to establish guidelines for a future approach. The first 1.000 referrals to the Consultation/Liaison Psychiatry Unit of the Santa Maria Hospital were analysed by comparing patients aged 65 or above to other observed patients. The results indicate a clearly lower percentage of elderly patients referred and a longer average length of stay at the moment of referral. Medical diagnoses show a preponderance of cardiologic, malignant and respiratory diseases, whereas intoxication, the prime diagnosis in the younger group, is much less represented above the age of 65. Identically, referrals due to suicide attempt were significantly less frequent in this group. Psychiatric diagnoses show a greater prevalence of organic mental disorders, followed by mood disorders, while in the younger the latter prevail. The post-discharge plan shows a higher percentage of elderly patients referred to general practitioners and medical specialties and a lower one for psychiatric care, as opposed to the younger group. The conclusions point towards the need for programs directed to early detection and treatment of psychopathological disorders (organic and depressive mental disorders) of elderly people admitted to a general hospital. This will be achieved through a close collaboration between C/L psychiatrists and medical staff, families and community facilities.

摘要

众所周知,在综合医院中,老年患者的比例越来越高,他们在住院期间经常出现精神疾病。这促使作者对转诊至会诊/联络精神病科的患者进行了一项比较研究,以便为未来的治疗方法制定指导方针。通过比较65岁及以上的患者与其他观察到的患者,对圣玛丽亚医院会诊/联络精神病科的前1000例转诊病例进行了分析。结果表明,转诊的老年患者比例明显较低,转诊时的平均住院时间较长。医学诊断显示,心脏病、恶性疾病和呼吸系统疾病占主导地位,而中毒(年轻组的主要诊断)在65岁以上的患者中所占比例要小得多。同样,该组因自杀未遂而转诊的情况也明显较少。精神科诊断显示,器质性精神障碍的患病率更高,其次是情绪障碍,而在年轻患者中,情绪障碍更为普遍。出院后计划显示,转诊至全科医生和医学专科的老年患者比例较高,而转诊至精神科护理的比例较低,这与年轻组相反。结论表明,需要制定针对综合医院老年患者精神病理障碍(器质性和抑郁性精神障碍)早期检测和治疗的项目。这将通过会诊/联络精神病科医生与医务人员、家庭和社区设施之间的密切合作来实现。

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