Medical care in a geriatric psychiatry unit: impact on psychiatric outcome

The medical care of 49 randomly selected patients admitted to a geriatric psychiatry evaluation unit was assessed to determine the impact on psychiatric care and outcome. Medical factors were identified as directly causing psychiatric symptoms in 12 of the 49 cases, whereas psychiatric decompensation was precipitated by medical illness in 25. Previously undiagnosed significant medical problems were found in ten patients. In 25 cases concomitant medical illness had a major effect on psychiatric treatment, and in 23 the course of the medical illness affected psychiatric outcome. Seventy-nine per cent of the patients had at least moderately improved at the time of discharge, and most were able to return to their homes. Improvement in medical condition was correlated significantly with psychiatric improvement. Implications for the care of geriatric psychiatry patients are discussed.