title: Psychiatric hospital admission and long-term care in patients with very-late-onset schizophrenia-like psychosis.
abstract: OBJECTIVE
  In this register-based study the rates and durations of psychiatric hospitalizations were compared between patients with very-late-onset schizophrenia-like psychosis (VLOSLP, n = 918) and elderly patients with illness onset before 60 years (n = 6142). The proportion of patients ending up in long-term care (LTC) or long-lasting psychiatric hospital care (LLP) was also studied.
  
  
  METHODS
  A sample of patients with schizophrenia aged 65 or over was collected from the Finnish Hospital Discharge Register. Psychiatric hospitalizations were calculated per year, and logistic regression was used to compare onset groups and factors associated with ending up in LTC/LLP.
  
  
  RESULTS
  Between 1999 and 2003, 27% of patients with VLOSLP and 23% of patients with earlier onset had at least one psychiatric hospitalization (p = 0.020). When the rates of patients' stays in psychiatric hospital per year were compared, the only difference was that in the first year 14% (141/918) and 11% (679/6142) had at least one day in psychiatric hospital (p < 0.001) respectively. In logistic regression onset group of schizophrenia was not associated with LTC/LLP, except weakly the VLOSLP group in women (p = 0.042, OR 1.23). Patients having any cardiovascular disease (p < 0.001, OR 0.63) or a respiratory disease (p = 0.008, OR 0.73) were less likely to end up in LTC/LLP.
  
  
  CONCLUSIONS
  The patients with VLOSLP needed more psychiatric hospital care than those with earlier illness onset. Ending up in LTC/LLP was equally common in both onset groups, but some physical diseases, such as cardiovascular and respiratory, diminished the likelihood of this.
authors.affiliation: Helsinki University Central Hospital, Department of Psychiatry, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Talaslahti
authors.affiliation: Tampere University Hospital, Department of Psychiatry, Finland.
authors.forename: Hanna-Mari
authors.initials: HM
authors.lastname: Alanen
authors.affiliation: Oulu University Hospital, Department of Psychiatry, Finland.
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
authors.affiliation: University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
authors.affiliation: Seinäjoki Hospital District, Department of Psychiatry, Seinäjoki, Finland.|School of Medicine, University of Tampere, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Kampman
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.affiliation: Tampere University Hospital, Department of Psychiatry, Finland.|School of Medicine, University of Tampere, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Leinonen
mesh_terms: D017668:Age of Onset; D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*
keywords: elderly; long-term care; psychiatric hospital care; schizophrenia; very-late-onset schizophrenia-like psychosis