Characteristics of elderly psychiatric patients retained in a statehospital during downsizing: A prospective study with replication
L. White
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | Side 474- 480
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| Opplysninger | Objective. This study examined the clinical characteristics ofelderly inpatients associated with retention in a large statehospital during a period of rapid reduction in the inpatient census.Design. During the first year of the study all inpatients age 65 orgreater were individually evaluated, Patients remaining in thehospital during the second year were reevaluated and followed for anadditional year. Separate statistical analysis of the data allowedfor replication of findings. Setting. The study was conducted atPilgrim Psychiatric Center, the largest state hospital in New YorkState. Participants. The entire inpatient population over the age of65 were included in the study (N=806). The average age of the samplewas 76 years and 70% were assigned a lifetime research diagnosis ofschizophrenia. The majority of patients were hospitalized for longperiods (mean=33.9 years) and had significant cognitive impairment.Main outcome measures. Cognitive functioning was assessed on theClinical Dementia Rating Scale. Severity of psychiatric symptoms wasevaluated on the PANSS. Occurrence of dangerous behavior and medicaland psychiatric treatment were obtained from the patients' medicalhistories. Main results. The findings, replicated across assessments,were that patients retained had more severe symptoms of excitement,hostility and impulsive behavior than those discharged, whileuncooperativeness, delusions, grandiosity and suspiciousness werealso more severe in those retained than those discharged.Conclusions. Elderly patients who are very difficult to place are socharacterized because of behavior disorders that are difficult tomanage rather than psychotic symptoms, cognitive impairment ormedical disorders. (C) 1997 by John Wiley & Sons, Ltd.
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