Clinical Characteristics and Length of Hospital Stay among Older Adults with Bipolar Disorder, Schizophrenia or Schizoaffective Disorder, Depression, and Dementia

• Published in: Journal of geriatric psychiatry and neurology 2004-03, Vol.17 (1), p.3-8
• Main Authors: Sajatovic, Martha, Friedman, Susan Hatters, Sabharwal, Josephine, Bingham, C. Raymond
• Format: Article
• Language: English
• Subjects: Academic Medical Centers - utilization; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - drug therapy; Alzheimer Disease - epidemiology; Alzheimer Disease - psychology; Biological and medical sciences; Bipolar Disorder - diagnosis; Bipolar Disorder - drug therapy; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Comorbidity; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Female; Humans; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Neurology; Ohio; Psychiatric Department, Hospital - utilization; Psychotic Disorders - diagnosis; Psychotic Disorders - drug therapy; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Psychotropic Drugs - administration & dosage; Psychotropic Drugs - adverse effects; Schizophrenia - diagnosis; Schizophrenia - drug therapy; Schizophrenia - epidemiology; Schizophrenic Psychology; Utilization Review - statistics & numerical data
• ISSN: 0891-9887; 1552-5708
• DOI: 10.1177/0891988703258821

Although many older adults with serious psychiatric illnesses share common concerns, such as medical comorbidity, personal loss, greater propensity for adverse medication effects, and greater dependence on others for basic needs such as transportation, individualized treatment needs must be differentiated by underlying psychiatric disorders. This retrospective study evaluated clinical characteristics and resource use among 137 older adults with bipolar disorder, schizophrenia or schizoaffective disorder, depression, and dementia who were discharged from an urban, academic medical center’s inpatient geropsychiatric unit. The authors found women to be significantly overrepresented among individuals with schizophrenia or schizoaffective disorder compared to those with bipolar disorder, depression, and dementia (P= .034). Among those with bipolar disorder, anticonvulsant medications were predominantly used as mood stabilizers, with only the rare use of lithium. Individuals with schizophrenia or schizoaffective disorder were the youngest group of patients; individuals with dementia were the oldest group (P< .001). This shows significant differences in clinical characteristics among hospitalized older adults with serious mental illnesses. Additional studies are needed on outcomes of serious chronic psychiatric illnesses in later life to optimize care environments for older adult psychiatric patients.