2790 – Management of elderly patients consulting in psychiatry: critical thinking about the study of 159 cases

Abstract

The prescription of psychotropic drugs in the elderly is more common. Doses are increasingly high, with frequent recourse to a combination therapy. Our purpose was to describe treatment strategies in elderly patients consulting in psychiatry, in order to confront them with the latest recommendations. Our study was retrospective and descriptive. It involved all elderly patients aged more than 60 years, who had consulted for the first time in psychiatry since January 2010 until December 2011. We collected, for each patient, the sociodemographic data, the diagnosis(es), the treatment(s), the side effects and the illness evolution under treatment. We collected 159 cases of elderly patients, representing 6.07% of all the consultants in psychiatry during the period of the study. Their average age was 73 with a sex-ratio (M/F) of 1.13. Dementia and mood disorders were the most common diagnoses (respectively 40.2% and 34.6%). As far as drug therapies are concerned, an antidepressant was prescribed to 95 patients (59.7%); an antipsychotic was prescribed to 55.3%. A tranquillizer was prescribed to 40.8%. A combination therapy made of at least two different families of psychotropic drugs was prescribed to 55.9% of the patients. None of the patients benefited from psychotherapy. Our study showed that the treatment strategy of the elderly consulting in psychiatry in the area of the study was not in accordance with the latest recommendations.