Psychiatric disorders among elderly patients in a general hospital

OBJECTIVES: To determine the approximate point prevalence of psychiatric disorders among elderly patients in a general hospital and to ascertain the frequency of mental state examination on admission, psychotropic drug use and documentation of psychiatric disorder in discharge summaries. METHOD: Weekly enrollment of 10 beds until the entire hospital was screened. Patients aged over 65 years were interviewed with the Geriatric Mental State schedule and psychiatric diagnoses were made using the AGECAT computer program. PATIENTS AND SETTING: Inpatients aged 65 years and over in all wards of a metropolitan teaching hospital over 16 months in 1990-1991. RESULTS: Of 495 enrolled patients, 204 were aged over 65 years and 167 of these could be interviewed. Eighteen per cent showed evidence of organic mental impairment, 27% were depressed and 2% had other psychiatric disorders. Some mental state findings were recorded on admission for 25% of patients, 52% of patients were prescribed hypnotic or psychotropic drugs and 30% of the psychiatric disorders identified by the survey were mentioned in the discharge summary. CONCLUSIONS: Screening for psychiatric disorders in this setting is not routine. The frequency of such disorders makes it desirable to conduct prospective evaluation of the use of brief cognitive and depression screening instruments on admission to hospital.