Psychiatric Consultations in the Elderly in a Geriatric and a Teaching Hospital: Implications for Psychiatric Teaching and Training
A series of 92 consecutive referrals for psychiatric opinion made over a fifteen month period from a geriatric hospital was retrospectively examined in order to ascertain the nature of the advice which the geriatricians requested from psychiatrists. These are compared with a series of 41 consecutive referrals over the same period from a large teaching hospital in the same city, these referrals coming from general physicians, urologists, orthopaedic surgeons and genitourinary surgeons. In the geriatric hospital, assessment and treatment of the depression was the commonest reason for referrals followed by advice on continuing care placement and assessment of confusion. By contrast the commonest reason for referral in the teaching hospital was advice on longstay placement followed by assessment of confused behaviour. In the geriatric hospital group the three commonest diagnoses made by the referrer were: depressive illness, senile dementia and confusional states; the psychiatrists made this last diagnosis much more frequently than the geriatricians. In the teaching hospital group the two most frequent diagnoses made by the referring doctors were dementia and “confusion” used in an unspecified way. In the geriatric hospital acute confusional states were referred much less frequently than in the general hospital. The proportion of patients seen in the teaching hospital with multi-infarct dementia was much greater than in the geriatric hospital. The implications for the appropriate training of psychiatrists and referring doctors in this aspect of liaison psychiatry are discussed as a result of these findings and of a survey conducted prior to the 1982 Cambridge Conference on Recruitment and Training in Psychiatry.
KeywordsTeaching Hospital Personality Disorder Psychiatric Diagnosis Senile Dementia Depressive Illness
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- 1.Arie T. and Isaacs A.D. In: Studies in Geriatric Psychiatry p. 241 Wiley. Chichester and New York (1978)Google Scholar
- 2.Krakowski A.J. Biblthca. Psychiat. No. 159 163–6185 (1979)Google Scholar
- 3.Arie T. Age and Ageing 7. Supplement p. 72 (1978)Google Scholar
- 4.Walton H. Preliminary papers on the Conference on Recruitment and Training in Psychiatry. ‘Liaison Psychiatry’ C. Thomas. (Privately Printed) (1982).Google Scholar