Gulmann N C
Gerontopsykiatrisk afdeling D., Psykiatrisk Hospital i Arhus.
Ugeskr Laeger. 1993 Mar 8;155(10):714-8.
The psychogeriatric department in the county of Arhus is in a unique position to collect cases of old people treated with psychotropics in various inappropriate ways in hospital wards or by general practitioners. In 1991 the department was in contact with 768 elderly people mostly on an outpatient basis among whom 40 patients exhibited accumulated errors of psychopharmacologic treatment. The treatment episodes were analysed. The patients were very old (mean 80.8 years) with severe somatic morbidity. A majority were demented or delirious. 75% were living in nursing homes. The treatment episodes exhibited polypharmacy and large doses of neuroleptics (mean 0.7 DDD/day) or benzodiazepines (mean 1.41 DDD/day). Psychotropics not suitable for elderly patients were used in 34 patients. Indications for treatment were mostly unspecified behavioural disturbances, sometimes reflecting inappropriate social support. The majority of patients had side effects, sometimes rendering the patient more acceptable to staff and other residents.
奥胡斯郡的老年精神科处于独特地位,能够收集在医院病房或由全科医生以各种不当方式使用精神药物治疗的老年人病例。1991年,该科室主要通过门诊与768名老年人接触,其中40名患者存在精神药物治疗累积错误。对治疗过程进行了分析。这些患者年龄很大(平均80.8岁),伴有严重的躯体疾病。大多数患者患有痴呆或谵妄。75%的患者住在养老院。治疗过程中存在联合用药现象,且使用了大剂量的抗精神病药物(平均0.7限定日剂量/天)或苯二氮䓬类药物(平均1.41限定日剂量/天)。34名患者使用了不适合老年患者的精神药物。治疗指征大多是未明确的行为障碍,有时反映出社会支持不足。大多数患者有副作用,有时这些副作用使患者更容易被医护人员和其他住院患者接受。