Characteristics of elderly patients admitted for the first time to a psychiatric facility

There has been little investigation of patients admitted to a psychiatric facility for the first time late in life. We therefore examined characteristics of a group of 100 consecutive patients over the age of 65, admitted for the first time to the psychiatric service of a private, university-affiliated hospital. Almost two thirds of these patients received a primary discharge diagnosis of major depression, while another one fourth received a diagnosis of dementia. Patients with dementia were significantly older and more likely to be men. The frequency of dementia climbed with each decile affecting 15% of those less than 75 years, 39% of those 75 to 84, and 47% of those over age 85. Thirty-six percent of all patients were psychotic on admission, including 28% of those with major depression and 48% of those with dementia. Visual hallucinations were significantly more common in the group with dementia. In turn, eye disease was significantly more common in those with visual hallucinations. Nine patients were admitted with a history of recent assaultive behavior. Four of these were psychotic and eight of nine were demented. Five patients had attempted suicide prior to their admission. All were diagnosed as having major depression.