Pattern of psychiatric morbidities among geriatric patients attending tertiary care hospital – A retrospective study

 

Bodke Pradeep S¹, Domple Vijay K^2*, Dhande Vishal S³, Maidapwad Sainath L⁴

 

{¹Associate Professor, Department of Psychiatry} {²Assistant Professor, ³Jr. Resident, ⁴Statistician cum Lecturer, Department of Preventive and Social Medicine} Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, INDIA.

Email: drpradeepbodke@gmail.com, drdigvijay@yahoo.co.in, drvishaldhande15@gmail.com, maidapwadsl.stat07@gmail.com

 

Abstract               Background: The health care needs of elderly population are likely to be different, due to higher prevalence of chronic non communicable diseases and other neuropsychiatric disorders as compared to adult population. Objectives: To study different types of psychiatric morbidities in geriatric patients attending psychiatry outpatient department of tertiary care hospital. Materials and Methods: A retrospective analysis of 1 year psychiatry department records from 1 January 2016 to 31 December 2016 was carried out. Out of total 9338 patients,111 geriatric patients who attended OPD of psychiatry department during the study period for the first time and having age 60 years or older were identified from medical records section. Data of patients age, sex and diagnosis of all the patients were collected. Data was entered in Excel and analyzed by online Medcalc software for chi-square test, odds ratio and confidence interval. Results: Out of 9338 patients who attended OPD of psychiatry department, case records of 111 geriatric patient’s age ranging from 60-98 years were included. The mean age of study group was 65.5±6.87 years, majority of them were <70 yrs (78%). Male geriatric patients (67%) were more than female patients (33%). Out of 111 geriatric patients majority of study subjects were suffering from schizophrenia (22.5%) followed by depressive disorder (20.7%). Delusional disorder and Seizure disorder (0.9%) were the least common. Conclusion: To conclude, the most common diseases were schizophrenia and least common diseases were seizures and delusional disorders among geriatric patients

Key Words: psychiatric morbidities, mental disorders, geriatric patients

 

 

 

INTRODUCTION

An estimate of the world mental health report states that the number of elderly in the world would reach more than 1 billion by the year 2025, of which the proportion of India's geriatric population is expected to reach 18.4%.¹ The health care needs of elderly population are likely to be different, due to higher prevalence of chronic non communicable diseases and other neuropsychiatric disorders as compared to adult population².Improved healthcare promises longevity but social and economic conditions such as poverty, break-up of joint families and poor services for the elderly pose a psychiatric threat to them³. The need of research in geropsychiatry has increased because of growth in the size of the elderly population. Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health. With this background, the present study was conducted to study different types of psychiatric morbidities in geriatric patients attending psychiatry outpatient department of tertiary care hospital.

 

MATERIALS AND METHODS

A retrospective study of one year psychiatry department records from 1 January 2016 to 31 December 2016 was identified. The information of patients’ age, sex and diagnosis of all the patients aged 60 yrs and above attending the psychiatry outpatient department (OPD) of Dr. Shankarrao Chavan Government Medical College, Nanded was collected. The all cases were diagnosed by consultant psychiatrist using International Classification of Diseases-10 (ICD-10) criteria. Out of total 9338 patients, 111 geriatric patients who attended OPD of psychiatry department during the study period for the first time and having age 60 years or older were identified from medical records section. Data was entered in Excel and analyzed by online Medcalc software for chi-square test, odds ratio and confidence interval.

 

RESULTS

Table 1: Distribution of psychiatric disorder among the study population

Psychiatric disorders	N	%
Alcohol dependence	3	2.7
Anxiety disorder	7	6.3
Bipolar affective disorder	10	9.0
Delirium	3	2.7
Delusional disorder	1	0.9
Dementia	12	10.8
Depressive disorder	23	20.7
Opioid dependence	10	9.0
Organic mood disorder	4	3.6
Primary insomnia	2	1.8
Schizophrenia	25	22.5
Seizure disorder	1	0.9
Sexual dysfunction	2	1.8
Somatoform disorder	8	7.2
Total	111	100

Table 2: Relationship between age groups and psychiatric disorders

Table 3: Relationship between gender and psychiatric disorders

 

Out of 9338 patients who attended OPD of psychiatry department, case records of 111 geriatric patient’s age ranging from 60-98 years were included. The mean age of study group was 65.5±6.87 years, majority of them were <70 yrs (78%). Male geriatric patients (67%) were more than female patients (33%). While considering the distribution of psychiatric disorder among the study population, out of 111 geriatric patients majority of study subjects were suffering from schizophrenia (22.5%) followed by depressive disorder (20.7%). Delusional disorder and Seizure disorder (0.9%) were the least common (Table 1) The relationship between age groups and psychiatric disorders showed that opioid dependence, dementia, schizophrenia were having significant association with age. (P value < 0.05) (Table 2). The relationship between gender and psychiatric disorders observed that none of the psychiatric disorders were statistically significant with the sex. (Table 3).

 

DISCUSSION

This retrospective study was planned to study psychiatric morbidities among geriatric patients attending psychiatry outpatient department of tertiary care hospital. Moreover, the average age group of was similar in all referred studies as compared to our study. The average age group of our study was65.5±6.87 years, whereas 69.5±7.36 years in Neetu et al² study, 69.67±5.94 years in Thapa et al⁴ study, 66.08 years in Sharma et al⁵ study, 70.5 years in Sood et al⁶ study. In BJP Mallika et al⁷ study reported 82% geriatric patients from 60-70 years of age group. In our study, males were more than females with respect to frequency and similar results reported by Sood et al⁶. Contrary to our findings, the numbers of females were more than males in Neetu et al² study and almost equal number of male and female geriatric patients were observed by BJP Mallika et al⁷, Thapa et al⁴, Sharma et al⁵. In our study, the most common diseases were schizophrenia and least common diseases were seizures and delusional disorders. Similar findings showed by Neetu et al² with respect to distribution of diseases. Contrary to our findings, depressive disorder was most common in many studies^4-6 and dementia was more common in BJP Mallika et al⁷. In our study, the association between age group of geriatric patients and psychiatric diseases like dementia, opioid dependence and schizophrenia was statistically significant but there was no statistically significant with other psychiatric diseases. Similar findings to our study observed by Thapa et al⁴ i.e. the statistical significant association between age and dementia. Neetu et al² reported the significant positive correlation of age with organic psychiatric disorder and negative correlation with current substance use. Sood et al⁶ showed that no statistical significant association between age and psychiatric disorder, but separate analysis of depressive disorder with age was statistically significant. In our study, there was no statistically significant association between sex and psychiatric disorders. Contrary to our findings, the Sood et al⁶ reported the statistically significant association between sex and psychiatric disorders. Thapa et al⁴ showed that the statistically significant association between sex and psychiatric disorders like dementia, alcohol dependence and also by Sharma et al⁵ observed that the statistically significant association between sex and psychiatric morbidities like depression, sleep disorders, psychosis and phobia To conclude, the most common diseases were schizophrenia and least common diseases were seizures and delusional disorders among geriatric patients.

 

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