Psychiatric symptoms and age dependency

SummaryThe growing populations of the elderly is frequently regarded as a homogeneous entity. In this retrospective study 140 patients above 60 years, first admitted to a psychiatric hospital, were screened for individual psychiatric symptoms. This was done according to the D.S.M.-III-R criteria and with the european ADMP-IV scoring system.As expected dementia and related disorders are characteristic of the “older” categories, depressieve disorders were seen more frequently in the “younger” categories. Screening the elderly for psychiatric symptoms also shows differentiation within the group of the older patients.Symptoms related to dementia increase in frequency, also increasing are e.g. visual hallucinations. A decrease was found for hypochondriasis and phobia. So, the group patients above 60 years is clearly heterogeneous.

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Fever of unknown origin in the elderly: nine years experience in China

Tropical Doctor ◽

10.1258/td.2007.070293 ◽

2008 ◽

Vol 38 (4) ◽

pp. 221-222 ◽

Cited By ~ 4

Author(s):

Minghua Zheng ◽

Hailong Lin ◽

Sheng Luo ◽

Lihua Xu ◽

Yanjun Zeng ◽

...

Keyword(s):

Retrospective Study ◽

Connective Tissue ◽

Connective Tissue Disease ◽

Older Patients ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

The Elderly ◽

Medical College ◽

Frequent Type ◽

Wenzhou Medical College

This is a retrospective study of older patients admitted to the First and Second Affiliated Hospitals of Wenzhou Medical College, China, with a diagnosis of fever of unknown origin. The study took place from January 1998 to December 2006 among 102 patients who fulfilled the criteria. Infections were responsible for 50 cases (49.1%), followed by no diagnosis in 27 (26.5%), miscellaneous in nine (8.8%), neoplasms in eight (7.8%) and connective tissue disease in another eight (7.8%). Mycobacterium TB was the most frequent type of infection diagnosed.

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Características sociodemográficas de las personas admitidas en un centro hospitalario psiquiátrico alemán: un estudio retrospectivo.

ENE 2018 - Revista Española de Enfermería de Salud Mental ◽

10.35761/reesme.2020.10.02 ◽

2020 ◽

pp. 4-10

Author(s):

Blanca Patricia Silva-Barrera ◽

Rocio Juliá-Sanchis ◽

Andrés Montoyo-Guijarro ◽

Rosa Requena-Morales

Keyword(s):

Mental Health ◽

Health Care ◽

Substance Abuse ◽

Retrospective Study ◽

Mental Disorders ◽

Psychiatric Hospital ◽

Psychiatric Symptoms ◽

Clinical History ◽

Severe Mental Disorders ◽

Salud Mental

Resumen En los últimos años se han suscitado cambios en la salud mental de las personas, debido a las diversas problemáticas sociodemográficas actuales. Se requiere de la exploración de los acontecimientos que causan síntomas psiquiátricos en las personas con necesidad de ingreso y hospitalización. Es por eso que se realizó este estudio retrospectivo sobre 1.593 historias clínicas del hospital psiquiátrico Main-Kinzig-Kreis Schlüchtern en Alemania durante el período 2000-2014 en pacientes de 18 a 69 años. Se identificó como motivo de ingreso a un 37.16% de personas como pacientes con síntomas agudos, una relación con consumos de sustancias provocadas por adicciones en un 41.62% y el trastorno depresivo en un 28.75%. Se detecta la descompensación de trastornos mentales graves en 27.05%, en donde el 34.71% de los pacientes fueron derivadas desde otros dispositivos asistenciales y el 32.89% decidió ingresar por sí mismo. El perfil del paciente ingresado es de ser hombre entre 41-50 años, casado o con pareja, derivado por recurso asistencial relacionado con la descompensación de un trastorno mental grave. Abstract In recent years, changes have occurred in people's mental health due to various current socio- demographic issues. The exploration of the events that cause psychiatric symptoms in people who need admission and hospitalization is required. That is why this retrospective study was conducted on 1.593 clinical history from the Main-Kinzig-Kreis Schlüchtern psychiatric hospital in Germany during the period 2000-2014 in patients aged 18 to 69. A total of 37.16% of the patients were identified as having acute symptoms, 41.62% as having substance abuse due to addiction and 28.75% as having a depressive disorder. Decompensation of severe mental disorders was detected in 27.05%, where 34.71% of the patients were referred from other care devices and 32.89% decided to be admitted on their own. The profile of the admitted patient is a man between 41-50 years old, married or with a partner, referred to the psychiatric hospital for health care resources due to a decompensation of some serious mental disorder.

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Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)

International Surgery ◽

10.9738/intsurg-d-13-00010 ◽

2014 ◽

Vol 99 (1) ◽

pp. 2-7 ◽

Cited By ~ 4

Author(s):

Ali İnal ◽

Tulay Akman ◽

Sebnem Yaman ◽

Selcuk Cemil Ozturk ◽

Caglayan Geredeli ◽

...

Keyword(s):

Breast Cancer ◽

Retrospective Study ◽

Elderly Patients ◽

Older Patients ◽

The Elderly ◽

Lymph Node Involvement ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Number Of Patients ◽

Er Positive

Abstract There is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.

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Mental Changes Resulting from Subdural Haematoma

The British Journal of Psychiatry ◽

10.1192/bjp.145.2.200 ◽

1984 ◽

Vol 145 (2) ◽

pp. 200-203 ◽

Cited By ~ 18

Author(s):

Donald W. Black

Keyword(s):

Retrospective Study ◽

Older Patients ◽

Subdural Haematoma ◽

Young Patients ◽

The Elderly ◽

Mental Change

SummaryA retrospective study was carried out of 79 patients with subacute or chronic subdural haematomata. Forty-six (58.2%) had mental changes at admission which were categorised using DSM-III criteria. Delirium was the most frequent mental change, followed by dementia and coma. Three cases of organic affective syndrome were found. In those with mental changes, delirium was significant in older patients (P <.05) and coma in young patients (P <.001). Dementia was more common in the elderly. These findings confirm the presence of common mental syndromes in patients with subdural and haematomata and substantiate time-honoured clinical stereotypes.

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Charles Bonnet Syndrome (CBS): Successful Treatment of Visual Hallucinations Due to Vision Loss with Agomelatine in Three Cases

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2065 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S172-S172 ◽

Cited By ~ 1

Author(s):

H.C. Hsu ◽

Y.S. Huang ◽

W.X. Fan ◽

T.C. Chen

Keyword(s):

Visual Impairment ◽

Vision Loss ◽

Psychiatric Symptoms ◽

Elderly Person ◽

The Elderly ◽

Visual Hallucinations ◽

Charles Bonnet Syndrome ◽

Competing Interest ◽

Guilty Feeling ◽

The Individual

BackgroundCBS becomes more prevalent as the population ages. CBS is characterized by the triad of impairment of vision, complex visual hallucinations with insight, mentally normal people. Although visual hallucinations in the elderly are often associated with dementia with Lewy body, Alzheimer's disease and delirium, they are excluded from the diagnosis of typical CBS. Here, we describe three typical CBS patients whose visual hallucinations developed after bilateral severe visual impairment due to diabetic retinopathy. The effectiveness of agomelatine adds to evidence implicating serotonergic and melatoninergic pathways in the pathogenesis of visual hallucinations.Case reportThe average age of these three patients (2 males and 1 female) is 71. Except for the visual hallucinations, all patients showed no psychiatric symptoms or cognitive decline or neurological focal signs. They were frequently upset by the fact of hallucinating, fearing that they are losing their minds. They lived in fear of impending insanity, guilty feeling, unhappy mood, insomnia. The frequency of visual hallucinations stopped with agomelatine 25 mg/day for 3 weeks in these cases.DiscussionTo our knowledge, this is the first report describing the effectiveness of agomelatine in treating typical CBS patients and indicates that agomelatine is an safer option for the treatment of CBS, especially in the elderly, diabetic population. Therapeutic options for CBS still remain poor and of uncertain benefit for the individual patient. CBS has a high prevalence rate (0.4%–30%) among the visually impaired. Clinicians must ask elderly people with visual impairment whether they have hallucinations. Firm reassurance that the syndrome is not related to mental illness is a major relief to an elderly person burdened already with failing vision.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Complex Visual Hallucinations in the Elderly

Annals of Clinical Psychiatry ◽

10.3109/10401239009150003 ◽

1990 ◽

Vol 2 (1) ◽

pp. 29-32

Author(s):

Balu Kalayam ◽

George Alexopoulos ◽

Norman Miller ◽

Jonathan Holt

Keyword(s):

The Elderly ◽

Visual Hallucinations

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

10.2196/preprints.24676 ◽

2020 ◽

Author(s):

Yu Gong ◽

Jianyuan Zhou

Keyword(s):

Cardiovascular Diseases ◽

General Practitioners ◽

Older Patients ◽

Metabolic Diseases ◽

Treatment Plan ◽

Age Groups ◽

The Elderly ◽

Diagnosis And Treatment ◽

World Health ◽

New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

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Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

BMJ Case Reports ◽

10.1136/bcr-2019-233179 ◽

2020 ◽

Vol 13 (12) ◽

pp. e233179

Author(s):

Eric Garrels ◽

Fawziya Huq ◽

Gavin McKay

Keyword(s):

Cognitive Impairment ◽

Case Report ◽

Potassium Channel ◽

Limbic Encephalitis ◽

Psychiatric Symptoms ◽

Differential Diagnoses ◽

Visual Hallucinations ◽

Voltage Gated ◽

History Of ◽

Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

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