Objective: To examine the demographic, prescription, ingestion, and psychiatric diagnostic factors that distinguished elderly from nonelderly patients treated for deliberate self-poisoning (DSP). Method: A prospective case series study of 2,667 patients presenting to a regional referral center for poisoning (Newcastle Mater Hospital, NSW, Australia), January 1991 to July 1998. The sample was stratified into two groups, 65 years or greater (n = 110) and 64 years or less (n = 2,557) at the time of index admission. The groups were compared using a forward stepwise logistic regression model. Uncontrolled comparisons were analyzed by chi-square statistic with Bonferroni-adjusted p values and controlled comparisons by odds ratio (OR) with 95% confidence interval (CI). Results: The elderly group represented 4.1% of the total. The logistic regression analysis found the elderly DSP group was more likely to have a longer length of stay (OR 5.90, CI 3.87–9.00), to have been prescribed “other” drugs (neither benzodiazepines, mood treatment drugs, nor paracetamol) before admission (OR 5.32, CI 3.34–8.48), to have been prescribed benzodiazepines (OR 3.15, CI 2.03–4.89), and to be diagnosed with major depression (OR 2.17, CI 1.41–3.36) than the younger group. The elderly group was less likely to have ingested paracetamol (OR 0.28, CI 0.14–0.54) or “other” drugs (neither benzodiazepines nor mood treatment drugs) in the DSP episode (OR 0.33, CI 0.20–0.54). Discussion: Elderly DSP patients differ in several important respects from younger patients. They have higher morbidity as a result of the DSP. Major depression plays a more important role. The strong relationship between benzodiazepine prescription and DSP in the elderly raises questions and possible prevention strategies.
Two elderly patients suffering from a dementing illness are described. The patients manifested homicidal behaviour in association with dementia. Possible risk factors for such behaviour are explored. Implications arising from the cases are discussed.
Fourteen elderly psychiatric patients who attempted or committed homicide are described. Most were cognitively impaired. None were intoxicated despite many having histories of alcohol abuse. Few patients went to court, had a history of domestic violence or previous psychiatric treatment. The sole patient to complete homicide was the only patient who used a gun. None had attempted suicide. The frequency of neuropsychiatric symptomatology highlights the need for psychiatric assessment of elderly offenders.
SUMMARYReliability studies for the Brief Assessment Schedule between raters trained in England, West Germany and Australia have been carried out, as this instrument is now being widely used for assessing psychiatric morbidity among elderly residents in care in several countries. Interrater reliability for the dementia and depression scales for raters from the different countries working in English was high. However, the interlingual (English-German) reliability for the dementia scale was less satisfactory.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.