title: Health management of older persons with chronically medicated psychotic disorders: the results of a survey in France.
abstract: BACKGROUND
  The medical care of elderly patients with psychotic disorders is a matter of major concern. The aim of the study was to investigate health conditions and treatment of elderly patients with psychotic disorders in France.
  
  
  METHODS
  The SAGE (Schizophrenia AGEd) study (observational, cross-sectional) was a survey conducted among 123 physicians in France, regarding prescriptions of antipsychotic drugs in elderly patients (≥60 years) suffering from psychotic disorders. The survey was based on a questionnaire addressing the mental and somatic health management of the patients.
  
  
  RESULTS
  Data from 930 patients (mean age: 70.4 years) were collected. Most patients (58.5%) suffered from schizophrenia, 20.8% had delusional disorder and 20.6% hallucinatory chronic psychosis (very-late-onset schizophrenia-like psychosis). 70.8% of them were outpatients, while 29.2% were inpatients. The severity of psychotic symptoms was assessed in 97.8% of patients, but cognitive function was only evaluated in 41.6%. Some 46.5% of patients were treated with atypical antipsychotics alone, 36.2% with classical antipsychotics alone and 17.3% received a combination of both, atypical and classical antipsychotics; 36.3% patients were given antiparkinsonian medication, of whom only 17.8% as preventive treatment; 51.1% of patients had somatic comorbidities, particularly cardiovascular disorders (34.0%). Evaluation of renal and/or liver function to adjust the dose of treatment was done in only 32.1% of patients. Over the previous 12 months, almost half of the patients had had no ECG, glycemia or creatininemia investigated and HDL-cholesterol and triglycerides were available for less than one-third of them.
  
  
  CONCLUSIONS
  Antipsychotic and antiparkinsonian drug prescriptions in French aged psychotic patients follow only partially the clinical guidelines and recommendations of consensus conferences. Moreover, cognitive, cardiac and metabolic aspects are not fully managed as expected.
authors.affiliation: University of Toulouse and Paul Sabatier University, Laboratoire du Stress Traumatique-LST (EA 4560), Purpan-Casselardit, Hospital, Toulouse, France. arbus.c@chu-toulouse.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Arbus
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Clement
authors.forename: Thierry
authors.initials: T
authors.lastname: Bougerol
authors.forename: Patrick
authors.initials: P
authors.lastname: Fremont
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lancrenon
authors.forename: Vincent
authors.initials: V
authors.lastname: Camus
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D019983:Guideline Adherence; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008609:Mental Status Schedule; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D014600:Utilization Review
chemical_list: D000978:Antiparkinson Agents; D014150:Antipsychotic Agents