Consultation-liaison psychiatric service for elderly inpatients in a general hospital
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    Abstract:

    Objective To provide consultation-liaison psychiatric service (CLPS) after comprehensive geriatric assessment (CGA) in the elderly inpatients in a general hospital in order to explore how to improve psychiatric service for these patients. Methods All the patients over 65 years old or more hospitalized in the demonstration wards of a general hospital during September 2009 to August 2012 were recruited in this study. They were assessed with CGA by Zung’s Self-rating Depression Scale and Zung’s Self-rating Anxiety Scale at admission. Ward round by geriatric multidisciplinary team and CLPS were offered when necessary. Psychiatric diagnoses were made by a psychiatrist according to the International Classification of Diseases-10 (ICD-10). Their outcomes were compared with those of the elderly inpatients aged 65 years old or more in other wards in the same time frame (control group). Results There were 146 patients from geriatric ward receiving psychiatric service, with a consultation rate of 28.2%, while 520 patients from the other wards receiving the service, with a rate of 1.5% (P=0.000). In geriatric ward, the top 3 reasons for referral were emotional problems (44.5%), follow-up problems (16.4%), and medical unexplained symptoms (10.3%). But for those of other wards, the reasons were emotional problems (37.9%), psychiatric problems (20.4%) and medical unexplained symptoms (10.1%) (P=0.000). The major psychiatric diagnoses were neurosis and stress related disorders (29.7%), mood disorders (26.9%) and organic psychiatric disorders (21.4%) in geriatric ward; while, neurosis and stress related disorders (35.0%), organic psychiatric disorders (28.8%) and mood disorders (16.5%) in other wards (P=0.001). Conclusion CLPS based on CGA, psychiatric consultation and ward round of multidisciplinary team can promote consultation rate for psychiatric consultation in the elderly inpatients in a general hospital, and worth of wildly application in clinical practice.

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  • Online: February 13,2015
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