Comparative study of the profile of elderly served in a tertiary hospital: ambulatory of geriatric psychiatry and unit of psychiatric intervention
DOI:
https://doi.org/10.15448/2357-9641.2019.2.34069Keywords:
Aging, Psychiatry, Depression, Anxiety.Abstract
AIMS: To verify the profile of the elderly and their main diagnoses in the geriatrics psychiatric outpatient clinic and the psychiatric hospitalization unit of a tertiary hospital. METHODS: A cross-sectional study of population-based was performed in a tertiary referral hospital, with individuals aged ≥55 years attending the geriatric psychiatric outpatient clinic and psychiatric hospitalization, from 2014 to 2018. Data were collected through interviews. The studied variables were sociodemographic and clinical aspects. RESULTS: A total of 497 individuals were evaluated, 269 from the psychiatric outpatient clinic and 228 from the psychiatric hospital. The mean age was 69.34±8.87 years. Most of the patients were female (75.8%), had no partner (56.3%), had primary education (50.3%), lived in Porto Alegre (75.6%) and were retired (66.5%). According to the clinical variables studied, 89.6% of the individuals had some morbidity, 36.9% had already been admitted to the psychiatric ward, the most common diagnosis was depression (40.8%), followed by bipolar disorder (19%) and anxiety (14.1%). CONCLUSIONS: With the population aging, it is expected to increase morbidity and mental disorders, requiring more specific diagnostic tools and better treatment approaches. There are still no consistent data on the management of mood disorders in the elderly, so our study can guide a better care for elderly and aging individuals, improving the planning of health services and policies.
Downloads
References
Miranda GMD, Mendes AdCG, da Silva ALA. O envelhecimento populacional brasileiro: desafios e consequências sociais atuais e futuras. Rev Bras Geriatr Gerontol. 2016;19(3):507-19.
Prince MJ, Wu F, Guo Y, Robledo LMG, O’Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet. 2015;385(9967):549-62. https://doi.org/10.1016/s0140-6736(14)61347-7
Sander M, Oxlund B, Jespersen A, Krasnik A, Mortensen EL, Westendorp RGJ, Rasmussen LJ. The challenges of human population ageing. Age Ageing. 2014;44(2):185-7. https://doi.org/10.1093/ageing/afu189
Nunes BP, Chiavegatto Filho AD, Pati S, Teixeira DSC, Flores TR, Camargo-Figuera FA, Munhoz TN, Thumé E, Facchini LA, Batista SRR. Contextual and individual inequalities of multimorbidity in Brazilian adults: a crosssectional national-based study. BMJ Open. 2017;7(6): e015885. https://doi.org/10.1136/bmjopen-2017-015885
Nunes BP, Flores TR, Mielke GI, Thume E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2016;67: 130-8. https://doi.org/10.1016/j.archger.2016.07.008
Rzewuska M, de Azevedo-Marques JM, Coxon D, Zanetti ML, Zanetti ACG, Franco LJ, Santos JL. Epidemiology of multimorbidity within the brazilian adult general population: evidence from the 2013 National Health survey (PNS 2013). PloS One. 2017;12(2):e0171813. https://doi.org/10.1371/journal.pone.0171813
Kingston A, Robinson L, Booth H, Knapp M, Jagger C, MODEM project. Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age Ageing. 2018;47(3):374-80. https://doi.org/10.1093/ageing/afx201
Baxter AJ, Patton G, Scott KM, Degenhardt L, Whiteford HA. Global epidemiology of mental disorders: what are we missing? PLoS One. 2013;8(6):e65514. https://doi.org/10.1371/journal.pone.0065514
Valiengo LdCL, Stella F, Forlenza OV. Mood disorders in the elderly: prevalence, functional impact, and management challenges. Neuropsychiatr Dis Treat. 2016;12:2105-14. https://doi.org/10.2147/ndt.s94643
World Health Organization. Depression and other common mental disorders: global health estimates. geneva: WHO; 2017.
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: WHO; 2013.
Quatrin LB, Galli R, Moriguchi EH, Gastal FL, Pattussi MP. Collective efficacy and depressive symptoms in Brazilian elderly. Arch Gerontol Geriatr. 2014;59(3): 624-9. https://doi.org/10.1016/j.archger.2014.08.001
Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PloS One. 2015;10(2):e0116820. https://doi.org/10.1371/journal.pone.0116820
Yu C, Sylvestre JD, Segal M, Looper KJ, Rej S. Predictors of psychiatric re-hospitalization in older adults with severe mental illness. Int J Geriatr Psychiatry. 2015;30(11): 1114-9. https://doi.org/10.1002/gps.4361
Wang S, Li B, Ungvari GS, Ng CH, Chiu HF, Kou C, Liu Y, Tao Y, Wu Y, Fu Y, Qi Y, Yu Y, Xiang YT. Poor mental health status and its associations with demographic characteristics and chronic diseases in Chinese elderly. Soc Psychiatry Psychiatr Epidemiol. 2016;51(10):1449-55. https://doi.org/10.1007/s00127-016-1271-y
Robards J, Evandrou M, Falkingham J, Vlachantoni A. Marital status, health and mortality. Maturitas. 2012;73(4): 295-9. https://doi.org/10.1016/j.maturitas.2012.08.007
Chen Y, Feeley TH. Social support, social strain, loneliness, and well-being among older adults: An analysis of the Health and Retirement Study. J Soc Pers Relat. 2014;31(2):141-61. https://doi.org/10.1177/0265407513488728
Stahl ST, Beach SR, Musa D, Schulz R. Living alone and depression: the modifying role of the perceived neighborhood environment. Aging Mental Health. 2017; 21(10):1065-71. https://doi.org/10.1080/13607863.2016.
Munhoz TN, Nunes BP, Wehrmeister FC, Santos IS, Matijasevich A. A nationwide population-based study of depression in Brazil. J Affect Disord. 2016;192:226-33. https://doi.org/10.1016/j.jad.2015.12.038
Fujise N, Abe Y, Fukunaga R, Nakagawa Y, Nishi Y, Koyama A, Ikeda M. Comparisons of prevalence and related factors of depression in middle-aged adults between urban and rural populations in Japan. J Affect
Disord. 2016;190:772-6. https://doi.org/10.1016/j.jad.2015.11.020
Breslau J, Marshall GN, Pincus HA, Brown RA. Are mental disorders more common in urban than rural areas of the United States? J Psychiatr Res. 2014; 56:50-5. https://doi.org/10.1016/j.jpsychires.2014.05.004
Weaver A, Himle JA, Taylor RJ, Matusko NN, Abelson JM. Urban vs rural residence and the prevalence of depression and mood disorder among African American women and non-Hispanic white women. JAMA
Psychiatry. 2015;72(6):576-83. https://doi.org/10.1001/jamapsychiatry.2015.10
Sengupta P, Benjamin AI. Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public health. 2015;59(1):3-8. https://doi.org/10.4103/0019-557x.152845
Fernández-Niño JA, Bonilla-Tinoco LJ, Manrique- Espinoza BS, Romero-Martínez M, Sosa-Ortiz AL. Work status, retirement, and depression in older adults: An analysis of six countries based on the Study on Global
Ageing and Adult Health (SAGE). SSM-Popul Health. 2018;6:1-8. https://doi.org/10.1016/j.ssmph.2018.07.008
Ju YJ, Han KT, Lee HJ, Lee JE, Choi JW, Hyun IS, Park EC. Quality of life and national pension receipt after retirement among older adults. Geriatr Gerontol Int. 2017;17(8):1205-13. https://doi.org/10.1111/ggi.12846
Hajat C, Kishore SP. The case for a global focus on multiple chronic conditions. BMJ. 2018;3(3):e000874. https://doi.org/10.1136/bmjgh-2018-000874
Hoogendijk EO, Rijnhart JJ, Kowal P, Pérez-Zepeda MU, Cesari M, Abizanda P, Flores Ruano T, Schop- Etman A, Huisman M, Dent E. Socioeconomic inequalities in frailty among older adults in six lowand
middle-income countries: Results from the WHO Study on global AGEing and adult health (SAGE). Maturitas. 2018;115:56-63. https://doi.org/10.1016/j.maturitas.2018.06.011
Stubbs B, Vancampfort D, Veronese N, Schofield P, Lin PY, Tseng PT, Solmi M, Thompson T, Carvalho AF, Koyanagi A. Multimorbidity and perceived stress: a population-based cross-sectional study among older
adults across six low-and middle-income countries. Maturitas. 2018;107:84-91. https://doi.org/10.1016/j.maturitas.2017.10.007
Ryan A, Wallace E, O’Hara P, Smith SM. Multimorbidity and functional decline in community-dwelling adults: a systematic review. Health Qual Life Outcomes. 2015; 13:168. https://doi.org/10.1186/s12955-015-0355-9
Adams L, Koop P, Quan H, Norris C. A population-based comparison of the use of acute healthcare services by older adults with and without mental illness diagnoses. J Psychiatr Ment Health Nurs. 2015;22(1):39-46. https://doi.org/10.1111/jpm.12169
El-Majzoub S, Behzadi A, Lis E, Moussaoui G, Yu C, Segal M, Looper KJ, Chachamovich E, Rej S. Selfreported psychiatric symptoms associated with anticipated close psychiatry follow-up and/or hospitalization status
in geriatric psychiatry patients: a preliminary study. Psychogeriatrics. 2018;18(1):74-6. https://doi.org/10.1111/psyg.12283
Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis
for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545-602.
Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003; 58(3):M249-M65.
Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009;5:363-89. https://doi.org/10.1146/annurev.clinpsy.032408.153621
Ylli A, Miszkurka M, Phillips SP, Guralnik J, Deshpande N, Zunzunegui MV. Clinically relevant depression in old age: An international study with populations from Canada, Latin America and Eastern Europe. Psychiatry
Res. 2016;241:236-41. https://doi.org/10.1016/j.
psychres.2016.04.096
Dols A, Beekman A. Older age bipolar disorder. Psychiatr Clin North Am. 2018;41(1):95-110. https://doi.org/10.1016/j.psc.2017.10.008
Lima IM, Peckham AD, Johnson SL. Cognitive deficits in bipolar disorders: implications for emotion. Clin Psychol Rev. 2018;59:126-36.
Rej S, Quayle W, Forester BP, Dols A, Gatchel J, Chen P, Gough S, Fox R, Sajatovic M, Strejilevich SA, Eyler LT. Measurement tools for assessment of older age bipolar disorder: a systematic review of the recent global
literature. Bipolar Disord. 2018;20(4):359-69. https://doi.org/10.1111/bdi.12566
Yu W, Singh SS, Calhoun S, Zhang H, Zhao X, Yang F. Generalized anxiety disorder in urban China: Prevalence, awareness, and disease burden. J Affect Disord. 2018;234: 89-96. https://doi.org/10.1016/j.jad.2018.02.012
Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M, Lijuan Cheng, Yukai Dua. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep. 2017;7:40511.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The submission of originals to PAJAR implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite PAJAR as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
