Holroyd S, Duryee J J
Department of Psychiatric Medicine, University of Virginia, Health Sciences Center, Charlottesville 22908, USA.
J Geriatr Psychiatry Neurol. 1997 Oct;10(4):136-41. doi: 10.1177/089198879701000402.
Mental-health service utilization among elderly people has been shown to be low relative to younger age groups. This study was done to determine the current proportion of elderly persons served in a university-affiliated psychiatry outpatient clinic, and to better characterize elderly patients who receive specialized mental-health care in this setting. The proportion of visits from elderly patients (aged 60 and over) was found to be 16%. Demographic and clinical characteristics of a sample of 140 consecutive geriatric patients evaluated at the clinic were obtained. The data revealed that the patients had a mean age of 74.7+/-7.5 (SD) years, and were mostly female (72.1%) and white (78.6%). Surprisingly, the age distribution was found to be bell shaped, with a small upper tail. The three most prevalent psychiatric diagnoses were depression (56.4%), dementia (35.7%), and substance use disorder (20%). Overall, 59.3% of geriatric patients had a history of prior psychiatric treatment. Females were significantly more likely than males to have a psychiatric history (69.3% vs. 33.3%, P = .0001). Among patients with a psychiatric history, females were more likely to have a current diagnosis of major depression (P = .0006), while males were more likely to have a current substance use disorder (P = .03). The prevalence of dementia increased with each successive decade above 60, while the occurrence of bipolar and adjustment disorders was confined to younger geriatric patients. Elderly patients receiving psychiatric treatment in the clinic thus formed a heterogeneous group. Gender, age, and presence of a psychiatric history were all associated with differences in prevalence and distribution of various mental disorders in this geriatric psychiatry outpatient clinic.
与年轻人群体相比，老年人的心理健康服务利用率一直较低。本研究旨在确定一所大学附属医院精神科门诊服务的老年患者的当前比例，并更好地描述在此环境中接受专业心理健康护理的老年患者特征。发现老年患者（60岁及以上）的就诊比例为16%。获取了在该诊所接受评估的140名连续老年患者样本的人口统计学和临床特征数据。数据显示，患者的平均年龄为74.7±7.5（标准差）岁，大多数为女性（72.1%）和白人（78.6%）。令人惊讶的是，年龄分布呈钟形，有一个小的长尾。三种最常见的精神科诊断是抑郁症（56.4%）、痴呆症（35.7%）和物质使用障碍（20%）。总体而言，59.3%的老年患者有过精神科治疗史。女性比男性有精神科病史的可能性显著更高（69.3%对33.3%，P = .0001）。在有精神科病史的患者中，女性更有可能目前被诊断为重度抑郁症（P = .0006），而男性更有可能目前患有物质使用障碍（P = .03）。痴呆症的患病率在60岁以上每连续十年增加，而双相情感障碍和适应障碍的发生局限于较年轻的老年患者。因此，在该诊所接受精神科治疗的老年患者构成了一个异质性群体。在这个老年精神科门诊诊所中，性别、年龄和精神科病史的存在都与各种精神障碍的患病率和分布差异有关。
