Psychiatric consultations for nursing home residents: a perspective from Turkey and the implications for comparable countries.
BACKGROUND
No specialized geriatric psychiatry consultation services are available for elderly people in the institutional care system in Turkey. Our aim was to evaluate psychiatric consultations among the residents of three homes for the elderly in a country with a rapidly aging population, and to investigate possible problems regarding psychiatric consultations.


METHODS
The residents of three homes for the elderly, which served partially as "care and rehabilitation centers" (equivalent to nursing homes), were chosen for the study. Data on the use of psychiatric services (mainly patient consultations with a visiting psychiatrist) were collected and analyzed.


RESULTS
The percentage of patients in the three homes for the elderly who had psychiatric consultations between 2005 and 2007 was 31.8% (172/540). The main reasons for referral were forgetfulness (61%), depressive symptoms (37.7%), agitation and disruptive behavior (29.6%), and psychotic symptoms (27.9%). Of these patients, 46.5% were diagnosed with dementia, 20.9% with depression, 20.5% with behavioral and psychotic symptoms of dementia, and 18.6 % with primary psychotic disorders such as schizophrenia.


CONCLUSIONS
Homes for the elderly in Turkey are not adequate in terms of consultations for psychiatric problems. Integration of these institutions with hospitals and organizing routine consultation visits from the psychiatry units would enhance the mental health of the elderly. Supporting the staff, maintaining good cooperation between them, and organizing educational programs in the field of mental health of the elderly are also required.
Cankurtaran
Eylem Sahin
ES
Ankara Oncology Research and Training Hospital, Psychiatry Clinic, Ankara, Turkey. eylemcankurtaran@yahoo.com
Kutluer
Ibrahim
I
Senturk
Murat
M
Erzin
Gulten Bircan
GB
Gursoy
Devrim
D
Tombak
Eray
E
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003299:Cooperative Behavior; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D009735:Nursing Homes; D010348:Patient Care Team; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014421:Turkey
D011619:Psychotropic Drugs