Characteristics and orientation of elderly patients in the largest French psychiatric emergency centre : a prospective cohort study

Abstract

Background Although there is an increasing number of adults older than 60 years old (>60) suffering from psychiatric disorders, there are only few studies about elderly patients in psychiatric emergencies, and no European data. The goal of our study is to describe the population of patients > 60 consulting in the most important French emergency psychiatric centre, and to identify predictive factors of psychiatric hospitalisation. Methods Our study was monocentric and prospective, including 300 consecutive patients > 60. Results Patients > 60 consulting in psychiatric emergencies were more often females and autonomous. More than 40% had a history of at least one psychiatric hospitalisation, and 44% had consulted a psychiatrist in the 6 preceding months. 75% were taking at least 1 psychotropic drug, and 50% at least 2. The most frequent reasons for consultation were depression, anxiety, sleep disorders and suicidal thoughts. Psychiatric disorders were mainly mood disorders, neurotic, stress-related and somatoform disorders, and schizophrenia, schizotypal and delusional disorders. Organic, including symptomatic, mental disorders were diagnosed in only 10% of the total sample. 39% of elderly patients were hospitalised in psychiatry. Factors predicting hospitalisation were a history of psychiatric hospitalisation, suicidal thoughts, and a diagnosis of mood disorder or schizophrenia / schizotypal / delusional disorder. Conclusion Only psychiatric factors intervene in the decision of psychiatric hospitalisation for elderly people consulting in psychiatric emergencies. Socio-demographic characteristics, level of autonomy at home and MMSE score have no influence on the hospitalisation decision. We need more data to better understand the current and future needs of this population.