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Keywords:

  • dementia;
  • geriatric patients;
  • mandatory hospitalization;
  • psychiatric emergency;
  • Tokyo metropolitan

Abstract

Background:  To date, there have been few studies about elderly psychiatric patients using psychiatric emergency services. In the present study, we analyze data from the Tokyo metropolitan psychiatric emergency system and the Tokyo Metropolitan Matsuzawa Hospital to examine the clinical features and social factors of elderly psychiatric patients hospitalized in psychiatric emergency units.

Methods:  Over a 4 year period, from April 1998 to March 2001, there were 7971 patients (4520 men, 3451 women) who used the Tokyo Metropolitan Government's psychiatric emergency system. Of these 584 patients (337 men, 247 women) were elderly, over 60 years. Of these geriatric patients, 72 (45 men, average age 74.4 years; 27 women, average age 76.0 years) were received at Tokyo Metropolitan Matsuzawa Hospital from January 1999 to December 2001. The present study examines the reasons for hospitalization, legally mandated admission, diagnosis, psychiatric symptoms at admission, inappropriate behaviors, family status and disease complications.

Results:  Epidemiological data showed that the number of geriatric patients has increased annually and the distribution of elderly patients’ diagnoses is entirely different from that of younger or middle-aged patients’. Almost all geriatric patients were under mandatory hospitalization by Law Related to Mental Health and Welfare of the Person with Mental Disorder. Psychiatric symptoms and inappropriate behaviors were considered to be highly severe, like those of younger patients.

Conclusion:  The importance of psychiatric emergency care for geriatric patients is strongly recognized by the present study. It is necessary to improve the present psychiatric medical system to develop a suitable and desirable system to care for geriatric patients.