A Clinical Study of Psychiatric Consultation for the Inpatients above 65 in a General Hospital

Joo, Eun Jeong; Kim, Young Don

Abstract

OBJECTIVE
This clinical study investigates the current status of geropsychiatric consultation in Korea, as the geriatric population and the needs for geropsychiatric consultation increase. METHOD: Hospital records of all geriatiric patients (> or =65) consulted to psychiatric department during hospital stay in a general hospital for 18 months (1998. 9. 1-2000. 2. 1) were reviewed retrospectively. Data on somatic illness, psychiatric illness and patterns of consultation were collected and analyzed. RESULT: Total number of patients was 136 (M 50, F 86) and mean age was 72.5 years old. Psychiatric consultation rate for patients above 65 was 2.5%, it was 29.5% among the whole psychiatric consultations. 65.4% was consulted by the Internal Medicine, Orthopedic surgery was the second most frequent referral department. Nonpsychiatric consultations were frequent, a geriatric patient was consulted to 2.7 other different departments on average, during the same period of hospital stay. Sleep disturbance, depressive mood, anxiety/agitation, somatization with normal laboratory findings were the main reasons of psychiatric consultation. 40% of these cases were tried to manage psychiatric problems by consultee. 50% of patients were suffered from depression, followed by delirium and dementia in frequency. Mean lagtime for consultation was 8.4 days, drug compliance was 90.5%. 54.4% of consultations has been followed up more than twice, 7.4% of consultations has required to be followed up more than 5 times. Compliance for consultation follow up during hospital stay was 78.7% and complicance for OPD follow up after discharge was 52.4%. Mean number of drugs being used on the day of consultation was 7.8, among them, 0.9 were psychiatric drugs. psychiatric drugs were prescribed for 51.5% of patients before psychiatric consultation. 2.2 drugs were prescribed by consultant. Disorientation was shown at 33.8%, visual hallucination was shown at 18.4%, sleep disturbance was prevalent at 64.0% of patients. Disorientation found to be associated with age, sleep disturbance, number of nonpsychiatric consultations, number of psychiatric follow up consultations.
CONCLUSION
Clinical Variables on geropsychiatric consultation at a general hospital were investigated. Further studies are warranted on geropsychiatric consultation in Korea.