RESUMEN
OBJECTIVE: The aim of this study was to analyze the possible reasons for acute admission to a department for geriatric psychiatry. The reasons for hospitalization, the psychiatric and somatic comorbidities of the patients over 65 years old with schizophrenia, schizoaffective disorder and delusional disorder were examined to identify patterns and risk profiles. MATERIAL AND METHODS: A retrospective analysis was carried out using paper and electronic patient records of a department of acute care for geriatric psychiatry and psychotherapy. During the assessment period 206 successive patients over 65 years old were included in the study. The patient cohort included 64 patients with schizophrenia according to the international classification of diseases 10 (ICD-10, category F20), 78 patients with persistent delusional disorder (ICD-10, F22) and 64 patients with schizoaffective disorder (ICD-10, F25). RESULTS: The reason for admission for one third of the patients in all three groups was aggressive behavior, whereas delusions and hallucinations were more frequent in the groups of F20 and F22 patients than in patients with schizoaffective disorders (F25). Somatic comorbidities were seen significantly more often in the group of F22 patients than in the other two groups. CONCLUSION: Acute admission was essentially due to acute psychiatric symptoms. Additional somatic comorbidities and psychosocial influencing factors played only a minor role in this study. The patients examined in this study constituted a special group within the acute treatment of inpatient psychiatry because they showed distinctive psychopathological productive symptoms but were relatively healthy from a somatic point of view. Patients with the diagnosis of schizophrenia (F20) or schizoaffective disorder (F25) were significantly different from patients classified into the group of delusional disorders (F22).
Asunto(s)
Admisión del Paciente/estadística & datos numéricos , Servicio de Psiquiatría en Hospital/estadística & datos numéricos , Trastornos Psicóticos/epidemiología , Esquizofrenia Paranoide/epidemiología , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , Anciano , Anciano de 80 o más Años , Agresión/psicología , Austria , Comorbilidad , Estudios Transversales , Femenino , Alucinaciones/diagnóstico , Alucinaciones/epidemiología , Alucinaciones/psicología , Humanos , Masculino , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Estudios Retrospectivos , Factores de Riesgo , Esquizofrenia/diagnóstico , Esquizofrenia Paranoide/diagnóstico , Esquizofrenia Paranoide/psicologíaRESUMEN
The majority of injuries in scuba-divers are attributable to inappropriate behavior under stressful diving conditions, predominantly involving panic reactions emerging from elevated levels of anxiety. Divers with an elevated level of anxiety and poor coping are at higher risk of developing panic reactions than those possessing more adequate stress-coping-mechanisms. In the comparison of two extreme groups of seven divers each with opposite stress coping strategies, prolactin was found to be a hormonal marker with a significant increase in the sub-group of the stress-controllers. This hormonal response was observed in a recreational and a stressful dive, and in the latter with a more distinct elevation. Along with the self-reported emotional conditions under immersion, these data suggest that an increased prolactin level reflects a state of elevated physical and mental activation and vigilance. Facing a stressful situation subjects with more emotional concern and the tendency to surrender react by "blunted responses" and show significantly lower elevations of the prolactin levels in contrast to subjects with the very opposite psychological features. The other observed somatic parameters (epinephrine, norepinephrine) showed significant increases during and after dives (with the exception of saliva cortisol), however without any significant group difference.