Pattern of neuropsychiatric illnesses in older age group population: An inpatient study report from Nepal

Abstract

Background:Inpatient institution-based geropsychiatric study reports are rare in the world psychiatric literature.Aims:To study the pattern of neuropsychiatric illnesses seen in older age group population and to study how the advancing age influences the pattern of physical and neuropsychiatric illnesses in these geriatric people.Materials and Methods:This was a retrospective review of the charts of all patients of age 60 years and above, during a specified period of 3.5 years. The present study reports the findings of 138 patients (83 males and 55 females) admitted during the said period. For comparison purpose, 194 patients, in the age range of 50-59 years, who were admitted during the same period, were taken up specially to study the changing pattern of diagnosis, if any, as well as to study the significance of increased rate of physical illness in the geriatric study group.Results:Our geriatric inpatients (138) formed only 3.73% of the total patient population (3698) admitted during the said period, which is in sharp contrast to 23-44% geriatric inpatients, the range that has been usually reported in the western literature. Common clinical diagnoses amongst male geriatric patients were alcohol dependence with or without various complications (27.7%), followed by mood disorder-mania (18.1%), organic mental disorders (18.1%), psychosis (16.9%), and mood disorder-depression (14.5%). Common clinical diagnoses amongst geriatric females were mood disorder-depression (36.4%) and psychosis (25.5%). Comorbid physical illness was seen to be present at a very high percentage (61.4%) in geriatric male patient population than in female patients (40%). Alcohol dependence in male and depressive disorder in female stood out as distinctive illness in patients above 50 years of age (including both study and comparative groups). In sharp contrast to elderly comparison group's 14.9% cases of comorbid physical illness, geriatric study population had a staggering 52.9% cases of additional burden of physical illness diagnosis.Conclusions:Being elder by a decade poses a significant threat in developing an additional physical illness to an already existing psychiatric illness in the geriatric community. Though the prevalence of mental illness in the geriatric age group is similar in developed and developing countries, poor inpatient attendance of geriatric neuropsychiatric patients probably indicates a poor delivery of healthcare facilities to our senior citizens.

Psychiatric Disorders in Elderly Patients attending OPD of Tertiary Care Centre in Eastern region of Nepal

“…7 Our study is consistent with the finding of another study done by Aich TK et al in which 64.5% were in the age range of 60-69 years, 31.5% of them were in the age range of 70-79 years and the remaining 5.1% patients were aged 80 years or above. 8 In our study, female patients (50.95 %) were slightly more than male patients (49.05 %). This finding is consistent with the study of Pereira YDS et al 5 and also with study by Shakya DR 9 in the same setting in 2009 which showed 54% female patients presenting to psychiatry OPD.…”

“…This data is consistent with the study by Khattri JB et al 11 . Most of the previous studies had shown higher prevalence of psychotic illness like 20.3% in the study by Aich TK et al 8 , 43% in the study by Prasad KMR et al 18 , 43.7% in the study by Bhogale GS et al 19 , 12.2% in the study by Pereira et al 5 , 31% in the study by Gupta S 7 . As in all these studies, the prevalence of psychotic illnesses is much higher than the general community prevalence of about 1%.…”

Pattern of Neuropsychiatric Illnesses in Geriatric Population: An Outpatient Study Report

“…Most Indian studies also did not elaborate much on the prevalence of mania in this age group, although one study reported 7.1% mania in their geropsychiatric patient population 19 . Comparatively, an inpatient study from Bhairahawa reported a much higher (15.9%) attendance of mania amongst their geriatric psychiatric patients 11 .…”

“…INPATIENT DATA COMPARED: 11 . But, current outpatient study revealed Psychosis to be the largest diagnostic group in both male and female geriatric patients, followed by ADS in male and Depression in female patients (Table no 3).…”

“…Some of these studies are Epidemiological field surveys [2][3][4][5] , hospital based outpatient studies [6][7][8][9] as well as inpatient studies [10][11][12] . In the present decade there is resurgence of geropsychiatric study reports from Nepal [13][14][15] .…”