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


METHODS
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.
Stevenson
Gary S
GS
Department of Psychiatry (Older Adults), NHS Fife - Stratheden Hospital, Cupar, Fife, Scotland. gstevenson@nhs.net
Khan
Muhammad A
MA
Perumal
Nagarajan
N
D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D003704:Dementia / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital; D012606:Scotland