Increased Elderly Utilization of Psychiatric Emergency Resources as a Reflection of the Growing Mental Health Crisis Facing Our Aging Population

Lu, Brett Y.; Onoye, Jane; Nguyen, A. H.; Takeshita, Junji; Ahmed, Iqbal Ike K.

doi:10.1016/j.jagp.2017.02.003

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…F00 -organic, including symptomatic, mental disorders were diagnosed only in 10% of our sample, this is the lowest rate of all studies about older patients in psychiatric emergency service. Rates of dementia or organic brain disorders vary greatly across studies: 14% of behaviours due to dementia [9] , 20% of organic brain disease [7] , 10% of cognitive disorders as a primary diagnostic and 15% as comorbid diagnostic [10] , 27% of dementia [8] , 29.9% of dementia [12] , 42.9% F0 [13] , 45.5% of organic brain syndrome [5] , 43% of dementia and 12% of other organic brain syndrome [6] . This lowest rate of organic disorders can be explained by the fact that our psychiatric emergency department is not close to a general emergency department, but is located inside the most famous psychiatric hospital in Paris, our recruitment of patients is therefore quite different (less severe somatic comorbidities, more severe psychiatric comorbidities …).…”

Section: Discussionmentioning

confidence: 99%

“…In New Jersey, patients older than 60 years were responsible for 24% of the consultations in the emergency psychiatric centre [8] ; the most frequent diagnoses were dementia, affective disorders, schizophrenia and alcohol disorders. A recently published American study [9] shown an increase in the number and proportion (6.2%) of consultations by those > 65 years in a psychiatric emergency centre in Hawaii, over the period 2007-2011. The most frequent diagnosis was dementia (14%).…”

Section: Introductionmentioning

confidence: 99%

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

Pham‐Scottez

GALLARDA

CALVEZ

et al. 2023

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Pham‐Scottez

GALLARDA

CALVEZ

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Only 10% of our sample had a diagnosis of organic, including symptomatic, mental disorders, the lowest rate of any study of older patients in psychiatric emergency service. Rates of dementia or organic brain disease vary widely among studies: 14, 27, 29.9 and 43% of behaviors due to dementia (6,8,9,12); 20% to organic brain disorders (7); 10% to cognitive disorders as primary diagnosis and 15% as comorbid diagnosis (10); 42.9% to F0 (13); 45.5% to organic brain syndrome (5), and 12% to other organic brain syndrome (6). Our low rate of organic disorders can be explained by our psychiatric emergency department not being close to a general emergency department but located in the most famous psychiatric hospital in Paris, so our patient recruitment is quite different (less severe somatic comorbidities, more severe psychiatric comorbidities etc.).…”

Section: Discussionmentioning

confidence: 99%

“…In New Jersey, patients over 60 years accounted for 23.8% of emergency psychiatric visits (8); the most common diagnoses were dementia, affective disorders, schizophrenia and alcohol disorders. A recent US study (9) showed an increase in the number and proportion (6.2%) of consultations by people older than 65 years in an emergency psychiatric centre in Hawaii during 2007-2011. The most common diagnosis was dementia (14%).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of older patients in the largest French psychiatric emergency centre

Pham-Scottez,

Gallarda,

Calvez

et al. 2023

Front. Psychiatry

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Despite an increasing number of adults older than 60 years with psychiatric disorders, there are few studies on older patients in psychiatric emergencies and no European data. We aimed to describe the population of patients aged 60 years and older who presented to the main French psychiatric emergency centre and identify predictors of psychiatric hospitalization. This monocentric study included 300 consecutive patients aged 60 years and older. Patients presenting because of psychiatric emergencies were frequently female and lived autonomously. More than 40% had a history of at least one psychiatric hospitalization and 44% had consulted a psychiatrist in the previous 6 months. The most common reasons for consultation were depression, anxiety, sleep disorders and suicidal thoughts. Psychiatric disorders were mainly mood disorders; neurotic, stress-related and somatoform disorders; and schizophrenic, schizotypal and delusional disorders. Only 10% had a diagnosis of organic mental disorders. Overall, 39% of the patients were admitted to the psychiatric hospital. Factors predicting hospitalization were a history of psychiatric hospitalization, suicidal thoughts and a diagnosis of a mood disorder or schizophrenia/schizotypal/delusional disorder. In conclusion, among people aged 60 years and older who consulted for psychiatric emergencies, 39% had to be hospitalized in psychiatry and only psychiatric factors influenced the decision to hospitalize. Our study highlights the need for further studies of older people in psychiatric emergencies in Europe, to anticipate the needs of this specific population and adapt multidisciplinary mental health care.

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“…In recent years, the country has seen an increase in the elderly population seeking psychiatric resources, leading to greater challenges when a crisis hits. 39 Following a disaster, elderly individuals are more likely to develop severe mental health challenges like PTSD and psychiatric morbidity, as highlighted in a population-based study following the 2008 Sichuan earthquake. 40 Prior to COVID-19, 25 percent of the US population 65 years and older was considered to be socially isolated, resulting in increased risks of loneliness.…”

Section: Elderlymentioning

confidence: 99%

The mental state of Americans amid the COVID-19 crisis: How socially vulnerable populations face greater disparities during and after a crisis

Dubois¹,

Yuan²

2021

JEM

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The coronavirus-2019 (COVID-19) public health crisis has accentuated divides and caused millions of Americans to suffer from increased mental health challenges. Although these challenges are seen throughout the country, socially vulnerable populations including frontline workers, older adults, and children, among others, face increased risk of mental health issues. There has been a notable mental health crisis in the country due to the isolation, stay-at-home orders, and preventive measures put in place to curb the spread. This study investigates the mental health challenges that socially vulnerable populations often face during crises and presents the factors affecting these populations during (and following) the COVID-19 pandemic. Based on an analysis of these factors, several recommendations are made to aid emergency managers, public health officials, policymakers, and academics in better addressing mental health challenges as we continue to battle COVID-19 and in preparation for future public health crises.

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Increased Elderly Utilization of Psychiatric Emergency Resources as a Reflection of the Growing Mental Health Crisis Facing Our Aging Population

Cited by 7 publications

References 2 publications

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

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

Characteristics of older patients in the largest French psychiatric emergency centre

The mental state of Americans amid the COVID-19 crisis: How socially vulnerable populations face greater disparities during and after a crisis

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