Clinical study of psychiatric inpatients in Juntendo Tokyo Koto Geriatric Medical Center

KUMAGAI RYO, HANZAWA RYO, UTSUMI YUSHI, KOMATSU HIROYUKI, NOZAWA MOTOHIRO, YAMAMOTO RYOKO, MATSUBARA YOICHIRO, SUGIYAMA HIDEKI, MURAYAMA NORIO, ISEKI EIZO, ICHIMIYA YOSUKE

doi:10.14789/pjmj.54.468

Objective : To study the roles of psychiatric wards for the elderly, we assessed the clinical data of psycho-geriatric inpatients in Juntendo Tokyo Koto Geriatric Medical Center and compared findings with those of our previous report at the opening of this center. Materials and Methods : The subjects were 394 psycho-geriatric inpatients admitted to the psychiatric ward of Juntendo Tokyo Koto Geriatric Medical Center between April 2007 and March 2008, and the clinical data (sex, age, clinical diagnose and reasons for admission) were collected. Results : The gender ratio was 178 males to 216 females, and the ages of inpatients ranged between 44 and 100 years (mean age ; 78.8 years). Overall, 74 % of inpatients were diagnosed as having dementia, and the clinical diagnoses of dementia included Alzheimer's disease (201 cases ; 51 %), dementia with Lewy bodies (33 cases ; 8 %), vascular dementia (29 cases ; 7 %), front-temporal dementia (16 cases ; 4 %), mixed type dementia (12cases ; 3 %) and mild cognitive impairment (4 cases ; 1%). In addition, clinical diagnoses of other geriatric psychiatry included mood disorder (30 cases ; 8%), schizophrenia (11 cases ; 3 %), delirium (11 cases ; 3 %) and alcoholism (7 cases ; 2 %). The reasons for admission were treatment of physical complications (185 cases ; 46 %), treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) (100 cases ; 25 %), treatment of other psychiatric symptoms (58 cases ; 15 %), improvement of fatigue for care givers (26 cases ; 7%), diagnostic work-up (7cases ; 2 %) and other reasons. Physical complications that required admission were pneumonia (21 %), fractured femur (11 %), dehydration or malnutrition (9 %), cerebral apoplexy (8 %), malignant tumors (6 %) and so on. Conclusion : Compared with the data of our previous report, the variety of psychiatric diseases had increased during this period. It seemed that these findings were dependent on the adoption of a new examination method and a new conception of dementia, resistance to medication with aging and changes in the residential environment. Furthermore, the number of inpatients admitted for treatment of physical complications increased. This suggests a deficiency of general hospitals with a psychiatric ward that can support such patients with physical diseases. In the future, improvement of the medical system is needed as well as cooperation with the physical therapy department and community medicine.

Clinical study of psychiatric inpatients in Juntendo Tokyo Koto Geriatric Medical Center

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