Elderly Psychiatric Inpatients Research Articles

Factors associated with psychotropics adverse effects in elderly psychiatric inpatients

IntroductionAdverse effects (AEs) of psychotropic drugs are more frequent and potentially more dangerous in elderly subjects (ES), probably due to a greater frequency of somatic comorbidities, as well as polymedication.ObjectivesThe aims of this study were to determine the prevalence of AEs of psychotropic treatment among ES hospitalized in psychiatry, and to identify the associated sociodemographic and clinical factors.Methods We conducted a retrospective and descriptive study. It concerned male patients aged at least 60 years, hospitalized in the psychiatry B department at CHU Hedi Chaker (Sfax, Tunisia) between 2018 and 2022. We collected demographic and clinical data from their medical records using a pre-established form.ResultsWe included 30 patients. The average age was 64 years. Addictive behaviors were reported in 60%, and somatic histories were noted in 53.3% of patients. The three most frequent psychiatric diagnoses were schizophrenia (43.3%), bipolar disorder (33.3%) and depressive disorder (13.3%). Among our patients, 10% experienced adverse psychotropic drug reactions: orthostatic hypotension 6.7%; neurological AEs 3.3%. Univariate analysis showed no significant relationship between sociodemographic variables and psychotropic drug AEs. Patients with bipolar disorder were more likely to develop AEs of psychotropic treatment (p=0.04).ConclusionsOur results suggest that special attention should be paid to avoiding psychotropic medication AEs in psychiatric inpatients ES. Indeed, extra precautions need to be taken in this population due to their reduced ability to report their symptoms.Disclosure of InterestNone Declared

Profile of substance use disorders in elderly psychiatric inpatients

IntroductionSubstance abuse is a common problem associated with significant morbidity and mortality, but is often underdiagnosed and unrecognized in geriatric patient populations.Objectivesto determine the prevalence of substance use disorders geriatricic inpatient population.MethodsData from 2010 to 2020 were retrospectively reviewed from a clinical database. 148 admissions of patients older than 60 years were identified. Descriptive statistics were used to group patients with and without a diagnosis of substance use, which included intoxication, withdrawal, abuse, dependence, and substance-induced disorders.ResultsThere were 148 hospital admissions for patients over 60 years of age, with a mean age of 72.38 ± 5.64 years and a mean length of stay of 13.91 ± 14.15 days. Of all admissions, 44% (n=64) were associated with at least one substance use diagnosis. In this group of 64 patients, the most frequently used substance was tobacco with associated disorders ( 65% N=42). The prevalence of other substance use diagnoses was as follows: sedative-hypnotic abuse/dependence 32% (N=21), cannabis abuse 10% (N=6), alcohol-related disorder 12.5% (N=8). Compared with patients without a substance abuse diagnosis, these patients were significantly younger, had shorter lengths of stay, were less likely to be readmitted, and were more likely to be single menConclusionsGiven the inherent difficulties in diagnosing substance use disorders and the retrospective nature of this study, the true prevalence of substance use disorders in elderly psychiatric inpatients is likely higher than found. Cross-sectional or cohort studies are more appropriate to shed light on this condition.Disclosure of InterestNone Declared

Sedatives and analgesics are major contributors to potentially inappropriate duplicate prescriptions in geriatric psychiatry.

This study sought to investigate the frequency and characteristics of duplicate prescriptions (DPs) in elderly psychiatric inpatients using a novel categorisation of DPs that differentiates between appropriate duplicate prescriptions (ADPs) and potentially inappropriate duplicate prescriptions (PIDPs). The study was conducted as a monocentric retrospective cross-sectional pilot study on the gerontopsychiatric ward of the Department of Psychiatry, Social Psychiatry and Psychotherapy of Hannover Medical School, a large university hospital in northern Germany. The outcome measures were the nature and frequency of PIDPs compared with the frequency of ADPs. For 92 individual patients a total of 339 medication chart reviews were conducted between April 2021 and February 2022. The median age of the study population was 73 years (interquartile range (IQR) 68-82 years); 64.6% were female. Patients' medications comprised a median of eight drugs (IQR 6-11 drugs) and 43.1% of the study population were exposed to at least one PIDP (at least one grade-1 PIDP: 39.5%; at least one grade-2 PIDP: 5.0%; at least one grade-3 PIDP: 1.5%). Sedatives were most frequently responsible for grade-1 and grade-2 PIDPs, while grade-3 PIDPs were elicited exclusively by analgesics. Nearly half of the study population (49.0%) displayed at least one ADP. Even though the clinical implications of PIDPs are not fully established to date, we recommend that physicians who treat elderly psychiatric patients pay special attention to PIDPs, especially PIDPs elicited by sedatives. Termination of PIDPs may prevent adverse drug reactions and save healthcare expenditures.

Medication‐related problems in geriatric psychiatry—a retrospective cohort study

Information on medication-related problems (MRPs) in elderly psychiatric patients is scarce. In the present study, we analyzed the frequency and characteristics of MRPs in patients ≥60years treated on the gerontopsychiatric ward of Hannover Medical School in 2019. Taking advantage of an interdisciplinary approach, two independent investigators screened hospital discharge letters of 230 psychiatric inpatients for clinically relevant MRPs, followed by validation through an interdisciplinary expert panel. Drug interactions as a subset of MRPs were analyzed with the aid of two different drug interaction programs. 230 patients (63.0% female, mean age 73.7±8.4years, median length of stay 18days) were prescribed a median of 6 drugs. In total, 2180 MRPs were detected in the study population and 94.3% of the patients exhibited at least one MRP. Patients displayed a median of 7 MRPs (interquartile range 3-15). Pharmacodynamic interactions accounted for almost half of all MRPs (48.1%; 1048/2180). The number of drugs prescribed and the number of MRPs per patient showed a strong linear relationship (adjusted R2 =0.747). An exceedingly high proportion of elderly psychiatric inpatients displayed clinically relevant MRPs in the present study, which may be explained by the multimorbidity prevalent in the study population and the associated polypharmacy. The number of drug interactions was largely in accordance with previous studies. As a novel finding, we detected that a considerable proportion of elderly psychiatric inpatients were affected by potential prescribing omissions, potentially inappropriate duplicate prescriptions, and insufficient documentation.

Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review.

BackgroundFor more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders.MethodsUsing PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected.ResultsA total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented.ConclusionsRecommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders.

Long-term observation of mortality among inpatients evacuated from psychiatric hospitals in Fukushima prefecture following the Fukushima nuclear disaster

The debate regarding the need for hospital evacuation and the evacuation distance remains rather chaotic. Furthermore, the relationship between hospital evacuation and the prognoses of psychiatric inpatients has not yet been investigated. We aimed to reveal the association between the long-term prognosis of psychiatric inpatients evacuated immediately following the Fukushima Daiichi Nuclear Power Plant accident and their backgrounds. In this retrospective cohort study, 777 psychiatric inpatients who were immediately evacuated from their hospitals following the accident were included for analysis. Survival time was the primary outcome. We conducted univariable and multivariable analyses to examine the associations between mortality and linear distance of evacuation and different backgrounds, including psychiatric/physical traits. Univariable analysis showed that the estimated survival time among patients was significantly associated with their evacuation distance. A multivariable analysis showed that a longer evacuation distance had a significantly lower hazard ratio (HR) and resulted in lower mortality. In contrast, older patients with physical complications of respiratory disease (International Statistical Classification of Diseases and Related Health Problems 10th revision, J00–99) and genitourinary disease (N00–99) showed a significantly higher HR and had a higher mortality than patients without these complications. To prevent death among elderly psychiatric inpatients with physical comorbidities during disasters, the evacuation destination should be determined taking into consideration the evacuees’ tolerance for long-distance transportation and the availability of post-evacuation care in the destination hospitals.

Clinical and Epidemiological Characteristics of the Contingent of Elderly in-Patients in a Frame of the Modern Model of Psychogeriatric Care

Background: a system of reforming of psychiatric care in Russia has led to a reduction of beds in psychiatric hospitals. At the same time it is known about permanent high need among elderly patients in the appropriate psychiatric care. In this regard, it became necessary to study the adequacy of the assistance provided to the needs of patients.The aim of the research: to investigate and compare clinic-epidemiological characteristics of the contingent of the elderly and senile inpatients in the city psychiatric care system and at the research institution.Materials and methods: as a material for the research served data from the reports from Moscow Clinical Psychiatric Hospital #13 (MCPH #13) and the clinic of Mental Health Research Centre (MHRC) about the patients older than 65 treated in 2017–2018.The results: this article contains comparative data about contingents of elderly psychiatric in-patients treated in the Moscow City Clinical Psychiatric Hospital #13 and in the Mental Health Research Center (MHRC). Collation of the indicated contingents allowed to determine that city psychiatric care satisfactorily meets needs of the severe psychiatric patients older than 65. However the experience of the clinic of the MHRC differs. This clinic has some peculiarities: it does not use involuntary hospitalization and it gives preference to difficult cases, where diagnosis is unclear, and where there is a challenge to find an appropriate treatment regimen; patients that require special care are also rarely admitted. This experience indicates that there is significant number of cases when hospitalization of patients with moderate mental disorders is also absolutely necessary. The majority of such cases consists of patients, suffering with depression and the necessity of their admission is dictated by the impossibility to adjust proper therapy in out- patient care.Conclusion: the contemporary Moscow city psychiatric service do not meet needs of the discussed category of patients for inpatient care. Whether it is necessary to improve it, or to provide this niche to scientific and commercial institutions is a matter of further research.

Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: Factor analysis and correlation with psychopathology.

Catatonic stupor has been linked to extreme fear. Whether the underlying phenomenology of every catatonic dimension is intense anxiety or fear remains unknown. One hundred and six patients aged ≥64 years were assessed for catatonia and clinical variables during the first 24 hours of admission. Two-sample t test were used to test for group differences. A principal component analysis was developed. Analysis of variance was performed to assess for differences in the diagnostic groups. Correlation coefficients were used to examine the association between catatonic dimensions and psychopathological variables. There were statistically significant differences between catatonic and non-catatonic patients in the Hamilton and NPI scores. The three factor-model accounted for 52.23% of the variance. Factor 1 loaded on items concerned with "excitement," factor 2 on "inhibition" items, and factor 3 on "parakinetic" items. There was a significant effect for factor 1 (F [5.36] = 2.83, P = .02), and not significant for factor 2 and factor 3. Compared with patients with depression, patients with mania scored significantly higher on factor "excitement" (P < .05). Factor 2 showed a moderate correlation with Hamilton total score (r = .346, P = .031) and Hamilton psychic score (r = .380, P = .017). Catatonic patients experienced more anxiety and hyperactivity. A three-factor solution provided best fit for catatonic symptoms. Patients with mania scored highest on Excitement, patients with depression on Inhibition, and patients with schizophrenia on Parakinetic. The main finding in this study was a positive moderate correlation between the Hamilton psychic score and the Inhibition factor score, meaning that not every catatonic dimension is associated to intense anxiety.

Changes in cytokines during treatment of elderly, hospitalized psychiatric patients – a naturalistic study

Immunological abnormalities have been demonstrated in several psychiatric disorders. Predominantly, studies have focused on younger adults, and research on elderly psychiatric in-patients is scant. In this naturalistic study, we investigated changes in cytokine levels during the treatment of diagnostically unselected elderly psychiatric in-patients, and whether these changes could be related to clinical outcomes. Clinical variables, demographic data, lifestyle data, and blood samples, including 27 plasma cytokines representing a broad spectrum of inflammatory mediators, were collected from 81 patients, 60 years and older, at admission and discharge. A subgroup of 49 patients also completed a self-reported clinical, psychiatric status form, indicating their level of recovery during hospitalisation. Statistical analyses demonstrated that a broad range of cytokines fell during treatment, and the fall was associated with clinical improvement, irrespective of psychiatric and somatic diagnoses. Exploiting cytokines as biomarkers of clinical traits might to be of limited use in a general population of elderly psychiatric in-patients as the field stands now.

QTc Time Correlates with Amitriptyline and Venlafaxine Serum Levels in Elderly Psychiatric Inpatients.

Many antidepressants cause QT prolongation but the classification of cardiac risk of these drugs varies markedly in different published lists. This retrospective study analyzed the correlation of QTc time with amitriptyline and venlafaxine serum level in elderly psychiatric inpatients. Elderly inpatients aged≥65 years for whom venlafaxine or amitriptyline serum level had been measured were selected retrospectively from a therapeutic drug monitoring database and screened for an electrocardiogram measurement at the time of blood withdrawal. The correlation of amitriptyline or venlafaxine serum levels with QTc time was examined by using Pearson's correlation analysis. Amitriptyline serum levels (n=11) correlated significantly with QTc time (r=0.918, p<0.001, CI 95%). Venlafaxine serum levels (n=27) also correlated significantly with QTc time (r=0.382, p<0.05, CI 95%). Amitriptyline and venlafaxine induce QT prolongation depending on drug concentrations in blood. Its extent, however, is very low when drug serum levels are within the therapeutic range. Future pharmacokinetic studies that correlate drug serum level and QT time should classify the cardiac risk of drugs based on the grade of the regression line in relation to the therapeutic range.

Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly psychiatric inpatients. A cross-sectional study.

The objectives are to determine the rate of potentially inappropriate psychotropic (PIP) prescription at discharge in the elderly psychiatric inpatients and to determine whether PIP is associated with lowered functioning outcomes. Sociodemographic, clinical, and treatment data for all inpatients aged ≥ 65years consecutively hospitalized during 1year in 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined according to the French-updated Beers criteria. Daily functioning was evaluated by the daily living (ADL) scale. Logistic regression analysis was used to estimate odds ratios for the association between PIP administration at discharge and respectively functioning and potential confounding factors. Data was obtained for 327 patients. Overall, 124 (37.9%) patients were males, and the mean age was 73.9years (SD = 5.6); 163 (49.8%) patients were diagnosed with affective disorders and 89 (27.2%) with schizophrenia/schizotypal/delusional disorders. Overall, 249 (76.1%) had one or more PIP medications, mainly anxiolytics (69.9%) and hypnotics (17.2%). In a multivariate analysis, PIP prescription at discharge has been associated with patient lowered personal care functioning, independently of age, gender, and psychiatric or somatic diagnoses (OR = 0.88 (0.79-0.97, p = 0.01). In the current increasingly fragmented health care systems, special attention must be given to PIP prescription in older population suffering from psychiatric disorders. Using the Beers criteria, the present study demonstrates the high prevalence of PIP prescription, which concerns a large panel of drugs but mostly anxiolytics and hypnotics independently of psychiatric or somatic diagnoses and sociodemographic characteristics. Our study has demonstrated for the first time an association between PIP prescription and lowered patient functioning. Further longitudinal studies should confirm a potential causal relation.

Poster Number: EI 47 - Safety and Tolerability of Leucovorin Augmentation of Antidepressant Therapy in Elderly Psychiatric Inpatients

Poster Number: EI 47 - Safety and Tolerability of Leucovorin Augmentation of Antidepressant Therapy in Elderly Psychiatric Inpatients

Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period.

Objective. There is a paucity of research on substance use disorders (SUDs) in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student's t-test as appropriate using SPSS. Results. 11.7% (N = 210) of patients had a SUD, and the most common substance was alcohol at 73.3% (N = 154) or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%), opiate (2.9%), cannabis (1%), tobacco (1.4%), and unspecified SUD (38.6%). SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%), bipolar disorder (10.5%), and dementia (17.1%). Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients.

Valproate‐associated hyperammonemia in elderly psychiatric inpatients

Valproate is frequently used in the management of various neuropsychiatric disorders, particularly mania. One of the side effects associated with its use is idiosyncratic hyperammonemia in the setting of normal liver enzyme levels, including the aminotransferases and bilirubin.

Evaluation of a risk-scale for drug-induced QT-prolongation in elderly psychiatric inpatients

Introduction: QT-time prolongation is an indicator for adverse events, especially in elderly patients due to polypharmacy and multimorbidity. We rated the influence of prescribed medication on QT-time and compared the theoretical risk with observed effects on repolarization time. Methods: Based on two publications that considered the effect of drugs on QT-time, a risk-scale was established. Elderly patients were selected from ECG records and their medication was obtained from medical files. Risk-points of the drugs were summarized to a total score. Using Spearman's correlation analysis, a suggested correlation between risk-score points and severity of QT-prolongation was determined. Results: 174 patients aged from 64 to 76 years (mean ± SD 68.7 ± 4.7; 50.9% women) were included for analysis. They had 295 ECGs (mean 1.7 per patient). Theoretical risk-points correlated significantly with observed QT-time. The Spearman correlation-coefficient was 0.247 (P < 0.01, CI 95%). A lower threshold associated with an increased risk to exceed the critical QT-time of 460 ms was computed by receiver operating characteristics (ROC) analysis, resulting in 5 risk points (AUC = 0.623). Conclusions: Since the theoretical risk for QT-prolongation correlated well with the observed QT time, we recommend the implementation of the risk-scale in clinical practice to improve the safety of pharmacotherapy in gerontopsychiatry. For practical reasons it can be amalgamated with therapeutic drug monitoring.

1012 – Evaluation of a risk-scale for anticholinergic side-effects in elderly psychiatric inpatients

Introduction Many commonly prescribed drugs have anticholinergic properties which can induce side-effects e.g. delirium, especially in an ageing brain with increased sensitivity. Risk-assessment before starting therapy may prevent such sideeffects. Objectives We rated anticholinergic pharmacological properties of prescribed medication and compared the theoretical risk with side-effects in clinical practice. Aims The scale should improve the safety of pharmacotherapy in gerontopsychiatry. Methods Based on five publications that considered anticholinergic properties of drugs, a risk-scale was established. Riskpoints for all drugs were summarized to a total score. Patients were selected from TDM-requests and data on patients’ sideeffects obtained from medical files. Reported anticholinergic side-effects including delirium were assessed retrospectively by the UKU-rating scale. Using linear regression and Spearman's correlation-analysis a possible correlation between risk-score points and severity of side-effects was determined. Results The screened sample consisted of 53 patients. 38 patients aged from 64 to 89 years (mean 74±6, 63.2% women) could be included for analysis. They had 93 plasma-level determinations (mean 2.4 requests per patient). According to their medication, patients attained by mean 4.51±2.98 risk-points (range 0-16). Mean UKU severity-index of side-effects was 0.81 (±0.99). Risk-points correlated significantly with observed anticholinergic side-effects and delirium (R 2 =.631, P Conclusions Since the established risk-scale correlated well with reported anticholinergic side-effects we recommend to implement this in the planning of psychopharmacological treatment to improve the safety of pharmacotherapy in gerontopsychiatry. For practical reasons it should be amalgamated with therapeutic drug monitoring as Geronto-TDM .

Hypovitaminosis D in psychogeriatric inpatients.

This study investigated the rate of hypovitaminosis D in psychogeriatric inpatients and explored whether any associations exist between vitamin D levels, cognitive function, and psychiatric diagnoses. Retrospective medical record review from November 2000 through November 2010. Geriatric psychiatric ward of an academic tertiary care hospital. Psychiatric inpatients aged 65 years or older. MEASUREMENTS AND ANALYSIS METHODS: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured at admission. Associations between 25(OH)D levels, Mini-Mental State Examination (MMSE) scores were analyzed using Spearman correlations, and psychiatric diagnoses were analyzed using logistic regression models and Fisher's exact tests. In 141 subjects (mean age, 77.8 years; 86 [61%] female; 135 [96%] white), the most frequent diagnoses were major depressive disorder in 81 patients (57%), dementia in 38 (27%), delirium in 13 (9%), anxiety in 12 (8.5%), and bipolar disorder in 11 (8%). Mean MMSE score was 24±6.4 (range, 3-30). Forty-three subjects (30.4%) had mild to moderate vitamin D deficiency [25(OH)D, 10-24 ng/mL], and 6 (4.2%) had severe deficiency [25(OH)D <10 ng/mL]. Hypovitaminosis D was common in elderly psychiatric inpatients. No associations were found between vitamin D levels and global cognitive function or psychiatric diagnoses.

Evaluation of a risk-scale for anticholinergic side-effects in elderly psychiatric inpatients

Introduction and Aims: Many commonly prescribed drugs have anticholinergic properties which can induce side-effects e.g. delirium, especially in an ageing brain with increased sensitivity. Risk-assessment before starting therapy may prevent such side-effects. We rated anticholinergic pharmacological properties of prescribed medication and compared the theoretical risk with side-effects in clinical practice. Methods: Based on five publications that considered anticholinergic properties of drugs, a risk-scale was established. Risk-points for all drugs were summarized to a total score. Patients were selected from TDM-requests and data on patients' side-effects obtained from medical files. Reported anticholinergic side-effects including delirium were assessed retrospectively by the UKU-rating scale. Using linear regression and Spearman's correlation analysis, a possible correlation between risk-score points and severity of side-effects was determined. Results: The screened sample consisted of 53 patients. 38 patients aged from 64 to 89 years (mean 74±6, 63.2% women) could be included for analysis. They had 93 plasma level determinations (mean 2.4 requests per patient). According to their medication, patients attained by mean 4.51±2.98 risk-points (range 0–16). Mean UKU severity-index of side-effects was 0.81 (±0.99). Attaining 12 risk-points, a 86-year old patient was delirious. Risk-points correlated significantly with observed anticholinergic side-effects and delirium (R2=.631, P<0.001, CI 95%). Spearman correlation-coefficient was 0.731 (P<0.01, CI 95%). Conclusions: Since the established risk scale correlated well with reported anticholinergic side-effects, we recommend to implement this in the planning of psychopharmacological treatment to improve the safety of pharmacotherapy in gerontopsychiatry. For practical reasons, it should be amalgamated with therapeutic drug monitoring as Geronto-TDM.

P-720 - Old age involuntary admissions in Greece. Little differences exist between voluntary and involuntary patients

Introduction Involuntary admission is a controversial issue with legislation varying from country to country. Objectives Research on elderly individuals being involuntary admitted is limited. Aim Firstly at assessing whether involuntary admitted (IA) elderly individuals differ from voluntary admitted (VA) patients and secondly to assess whether IA should be treated in a different way. Methods 40 IA were compared to 39 VA with regard to demographic data, DSM-IV diagnosis as well as behavioral issues recorded with the Patient Staff Conflict Checklist Shift Report (PSCCSR). All patients were aged 60 and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period was 12 months. Results VA patients were more likely to be married, working and suffering from mood disorders, whilst IA patients presented with delirium. From the 20 items of the PSCCSR, differences were found only in two: IA presented more aggressive in the first few days of admission and VA had recent suicide attempt just before admission. Conclusions The patients’ characteristics as well as the psychiatric and nursing needs of VA and IA elderly individuals in an acute psychiatric ward do not differ. They tentatively support the argument that since IA and VA elderly psychiatric inpatients exhibit similar behaviour being kept under section for long periods is unwarranted.

P.5.e.006 Lack of depression treatment in elderly psychiatric in-patients with cognitive impairment

P.5.e.006 Lack of depression treatment in elderly psychiatric in-patients with cognitive impairment