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A psychiatric intensive care unit for older adults: an interval comparison of admissions

Published online by Cambridge University Press:  26 February 2009

Gary S. Stevenson ,
Muhammad A. Khan  and
Nagarajan Perumal
Gary S. Stevenson*
Affiliation:
Department of Psychiatry (Older Adults), NHS Fife – Stratheden Hospital, Cupar, Fife, Scotland
Muhammad A. Khan
Affiliation:
Department of Psychiatry (Older Adults), NHS Fife – Stratheden Hospital, Cupar, Fife, Scotland
Nagarajan Perumal
Affiliation:
Department of Psychiatry (Older Adults), NHS Fife – Stratheden Hospital, Cupar, Fife, Scotland
*
Correspondence should be addressed to: Dr Gary S Stevenson, Medical Offices, Stratheden Hospital, Cupar, Fife KY15 5RR, U.K. Phone: +44 1334 652611; Fax: +44 1334 696042. Email: gstevenson@nhs.net.
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Abstract

Background: Published information on psychiatric intensive care provision and requirements of older adults is limited. This audit aims to describe and compare demographic data, clinical characteristics and outcomes of patients admitted to a Scottish regional psychiatric intensive care unit (PICU) for older adults during two 18-month periods five years apart.

Method: Data on all patients admitted to the PICU for older adults during the two sample periods, commencing 2001 and 2006 respectively, were collected prospectively by the clinical care team, and included information on previous psychiatric contact and detentions under mental health legislation, diagnoses, cognitive ratings, reasons for transfer to the PICU, treatments and outcomes. Continuous variables were subject to statistical analyses.

Results: Twenty-one and 20 male patients were admitted during the 2001 and 2006 cohorts respectively, with equivalent mean ages of 72.9 years. The majority of patients were married, diagnosed with dementia, with similar levels of previous psychiatric admissions and detentions under mental health legislation. The commonest reason for transfer to the PICU was physical aggression. The 2006 cohort exhibited shorter inpatient stays prior to transfer to, and shorter durations of stay in, the PICU.

Conclusions: The PICU for older adults provides a function similar to the PICU for general adults. The cohorts were similar on most recorded variables, with noted differences possibly reflecting increased awareness and acceptance of the service, reduced tolerance by staff of aggressive behaviors by patients, and enhanced community services in the region. These perceptions warrant further study and clarification.

Keywords

mental healthgeriatricintensive careaggressiondementia
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 2 , April 2009 , pp. 278 - 285
Copyright
Copyright © International Psychogeriatric Association 2009

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