[Reasons for referral to a gerontopsychiatric department].
BACKGROUND
The need of specific gerontopsychiatric wards has not been estimated thus far, although psychiatric disorders are very common among the elderly.


OBJECTIVE
The purpose of this study was to describe reasons for referral of old patients to a psychiatric department providing full services for 252,000 inhabitants.


METHODS
All 975 admissions within 2 years were evaluated in this prospective study.


RESULTS
During the study period 645 patients aged over 64 years were admitted 830 times to the gerontopsychiatric wards. About half of them were referred by physicians in private practice, about 30% came via the emergency room, and 18% were transferred from other departments or hospitals. The most frequent reasons for referral were disorientation, confusion, or delirious states (31.9%), hallucinations or delusion (21.6%), aggression or excitation (17.7%), depression (17.6%), refusal of feeding or drinking (14.4%), agitation or restlessness (13.9%), suicidality or suicide attempt (13.3%), and disruptive behaviour (13.0%). In 81.8% of the cases, behaviour endangering themselves or others was an important cause of referral. The amount of specific gerontopsychiatric beds needed in hospital was estimated as ten beds per 10,000 inhabitants aged 65 or more.


CONCLUSIONS
The greatest proportion of the patients referred to gerontopsychiatric wards showed behaviour endangering themselves or others-typical indications for psychiatric inpatient treatment.
Wetterling
T
T
Klinik für Psychiatrie und Psychotherapie, Vivantes Klinikum Hellersdorf, Myslowitzer Strasse 45, 12621 Berlin. tilman.wetterling@vivantes.de
Gutzmann
H
H
Haupt
K
K
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005852:Geriatric Psychiatry / Q000706:statistics & numerical data*; D005858:Germany; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011157:Population Dynamics; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data