Psychiatric disorders as main discharge diagnosis by the Portuguese oldest old from 2000 to 2014: exploring national acute inpatient admissions

Brandão, Daniela; Paúl, Constança; Ribeiro, Óscar

doi:10.1017/s1041610217002034

Cited by 8 publications

(6 citation statements)

References 34 publications

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“…While antipsychotics such as risperidone can have an alleviating effect on aggression and agitation in dementia, 36 caution should be taken in this patient group because of the potentially life-threatening adverse effects 3 and limited evidence of a clinically meaningful benefit. 37 Clinical and sociodemographic differences Although in the total cohort of older adults both gender distribution and mean age were similar to the findings in previous studies, 32,33,[38][39][40] the NPH group were significantly older than the PPH group and a higher proportion were men, the former being a novel finding. One of the very few previous studies that included a subsample of elderly patients with no prior contact with the mental healthcare system reported a similar gender distribution.…”

Section: Diagnostic and Pharmacological Differencessupporting

confidence: 84%

Elderly patients with no previous psychiatric history: suicidality and other factors relating to psychiatric acute admissions

et al. 2020

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Background The common recommendation that adults with onset of mental illness after the age of 65 should receive specialised psychogeriatric treatment is based on limited evidence. Aims To compare factors related to psychiatric acute admission in older adults who have no previous psychiatric history (NPH) with that of those who have a previous psychiatric history (PPH). Method Cross-sectional cohort study of 918 patients aged ≥65 years consecutively admitted to a general adult psychiatric acute unit from 2005 to 2014. Results Patients in the NPH group (n = 526) were significantly older than those in the PPH group (n = 391) (77.6 v. 70.9 years P < 0.001), more likely to be men, married or widowed and admitted involuntarily. Diagnostic prevalence in the NPH and PPH groups were 49.0% v. 8.4% (P < 0.001) for organic mental disorders, 14.6% v. 30.4% (P < 0.001) for psychotic disorders, 30.2% v. 55.5% (P < 0.001) for affective disorders and 20.7% v. 13.3% (P = 0.003) for somatic disorders. The NPH group scored significantly higher on the Health of the Nation Outcome Scale (HoNOS) items agitated behaviour; cognitive problems; physical illness or disability and problems with activities of daily living, whereas those in the PPH group scored significantly higher on depressed mood. Although the PPH group were more likely to report suicidal ideation, those in the NPH group were more likely to have made a suicide attempt before the admission. Conclusions Among psychiatric patients >65 years, the subgroup with NPH were characterised by more physical frailty, somatic comorbidity and functional and cognitive impairment as well as higher rates of preadmission suicide attempts. Admitting facilities should be appropriately suited to manage their needs.

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Section: Diagnostic and Pharmacological Differencessupporting

confidence: 84%

Elderly patients with no previous psychiatric history: suicidality and other factors relating to psychiatric acute admissions

et al. 2020

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“…It would be of interest to compare the present results with those of other countries, as some associations remain controversial. Despite this, the present study reinforces the importance of increasing detail of clinical coding in administrative data bases as this will allow researchers to have available cost‐effective and representative data of a specific population of interest 39,40 …”

Section: Resultsmentioning

confidence: 69%

“…In fact, similar methodologies have already led to important results in different health contexts which can reinforce the pertinence of the present study. 39,40 Despite some limitations, we were able to find factors that were significantly more common among depressive MM patients such as female gender, younger age, higher comorbidity profile, plasma cell leukemia and presence of a transplant procedure. These results may help identify MM inpatients at higher risk of presenting with depression.…”

Section: Hospitalization Outcomesmentioning

confidence: 91%

“…Despite this, the present study reinforces the importance of increasing detail of clinical coding in administrative data bases as this will allow researchers to have available cost-effective and representative data of a specific population of interest. 39,40 In conclusion, depression remains largely disregarded in cancer setting despite its influence on worse outcomes and increased costs.…”

Section: Hospitalization Outcomesmentioning

confidence: 99%

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Trend of depression and its association with sociodemographic and clinical factors among multiple myeloma hospitalizations: A Portuguese nationwide study from 2000 to 2015

et al. 2020

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Objective: Patients hospitalized with multiple myeloma (MM) are particularly vulnerable to depression. The present study aims to determine the frequency of depression among MM hospitalized patients, in order to assess the possible differences between those with and without depression in relation to sociodemographic and clinical variables and to measure the impact of depression on hospitalization outcomes. Methods: An observational retrospective study was performed using an administrative data set of all hospitalizations with a primary diagnosis of MM between 2000 and 2015 in Portuguese mainland public hospitals. Codes related to depressive disorders were grouped to generate the dichotomous variable of depression (yes/no). A multivariate analysis was conducted and adjusted odd ratios (aOR) calculated between different variables and depression. Results: Of a total of 14.575 MM hospitalizations studied, a concurrent code of depression was registered in 666 patients (4.6%). A greater odds of depression was observed in female patients (aOR = 2.26; 95%CI = 1.91-2.66), transplanted patients (aOR = 1.78; 95%CI = 1.44-2.20), patients with plasma cell leukemia (aOR = 1.79; 95%CI = 1.22-2.64) and patients with a higher Charlson Comorbidity Index (CCI) (aOR = 1.10; 95%CI = 1.05-1.15). Length of stay was longer in patients with a registered diagnosis of depression (aOR = 1.01; 95%CI = 1.01-1.02) while the odds of inhospital mortality were lower in these patients (aOR = 0.53; 95%CI = 0.41-0.68). Conclusions: These results may help identify MM inpatients at higher risk of presenting depression (female gender, younger age, high CCI, plasma cell leukemia, transplant procedure). This will enable timely psychological assessment and treatment to prevent worse outcomes and higher healthcare costs associated with depression.

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“…Characterization of health and social care delivery in dementia is paramount. There is Portuguese research in this area [65, 68-70], but improving information systems, e.g., through access to multisectoral data [62], is still overlooked. Meanwhile, to avoid mismatch of resourcing with true needs, one should keep a critical eye on how widely cited estimations of people with dementia are created [32].…”

Section: What Is Next?mentioning

confidence: 99%

How Many People Live with Dementia in Portugal? A Discussion Paper of National Estimates

Gonçalves-Pereira

Verdelho

Prina

et al. 2021

Port J Public Health

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Dementia poses major public health challenges, and high-quality epidemiological data are needed for service planning. Published estimates of numbers of people with dementia in Portugal have been based, in most cases, on prevalence rates derived from international studies or expert consensus. As in many other countries, Portuguese community prevalence studies’ results are nongeneralizable to a country level. Moreover, their prevalence estimates differ (not surprisingly, owing to different methodologies, e.g., design, sampling, and diagnostic criteria). Regardless, the Portuguese 10/66 Dementia Research Group (10/66 DRG) population-based survey fulfilled 10 out of 11 Alzheimer’s Disease International quality criteria for prevalence studies. It relied on cross-culturally validated methods, fostering a wide comparability of results. Therefore, we can provide rough estimates of 217,549 community dwellers with dementia in Portugal according to the 10/66 DRG criteria (that would be only 85,162 according to DSM-IV criteria). This refers to people aged 65 years or older who are not institutionalized. Although broadly consistent with international projections, these estimates must be cautiously interpreted. Particularly in the context of scarce funding, which will probably last for years, we need more efficient, evidence-based dementia policies. Concerning further epidemiological studies, high-quality methods are needed but also their comparability potential should be improved at national and international levels. Most of all, fund allocation in Portugal should now privilege routine dementia information systems in both health and social services.

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Psychiatric disorders as main discharge diagnosis by the Portuguese oldest old from 2000 to 2014: exploring national acute inpatient admissions

Cited by 8 publications

References 34 publications

Elderly patients with no previous psychiatric history: suicidality and other factors relating to psychiatric acute admissions

Elderly patients with no previous psychiatric history: suicidality and other factors relating to psychiatric acute admissions

Trend of depression and its association with sociodemographic and clinical factors among multiple myeloma hospitalizations: A Portuguese nationwide study from 2000 to 2015

How Many People Live with Dementia in Portugal? A Discussion Paper of National Estimates

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