입원노인 정신 장애자에 관한 역학적 고찰 = AN EPIDEMIOLOGIC STUDY OF THE HOSPITALIZED SENILE MENTAL DISORDERS

다국어 초록 (Multilingual Abstract)

For the epidemiologic evaluation of the hospitalized senile mental disorders, it was attempted to reveal the characteristics of the senile psychiatric patients as to their admission rates, mean hospital days, diagnostic classification by age and sex, personal status, personality traits, precipitating factors, hospital status, clinical manifestations and their management.
The ninety cases of senile mental disorders who had been admitted to the department of Neuropsychiatry, Chung-Ang University, College of Medicine, from June 1968 to July 1975 were selected for this study, and the results were as follows:
1. The ninety cases of the senile mental disorders showed the following characteristic pictures comparing with the 3,886 case of total hospitalized psychiatric patients.
a. Majority of the subjects (85.5%) were distributed in the decade of their sixties, and their mean age was 64.3 years.
b. In the diagnostic distribution, 44.4% of the subjects were categorized as affective disorders, 33.4% as organic brain syndrome, 11.1% as psychoses, and 10.0% as neurosies.
c. In the personal history, they showed lower educational level, higher rate of unemployment and middle class socioeconomic level.
d. In the family history, they showed lesser cases of the first child (16.7%), and more cases of being widowed(33.3%).
e. Majority of the senile cases were treated by herb drug (36.7%) or hospital management (35.6%) prior to hospitalization.
2. They were also exhibited following clinical pictures:
a. Many of them were categorized as obsessive-compulsive (31.1%), schizoid (14.4%) or passive-aggressive (12.3%), but only 16.7% of them was stable in their premorbid personality.
b. In the analysis of the precipitating factors, the intrafamilial problems (16.7%), physical illness (16.7%), changes in health (12.2%), or bereavement (11.1%) were more significant factors.
c. 8.9% of them were living alone or with non-relatives.
d. Majority of them had been suffered from cardio-vascular diseases (63.2%) and complained of insomnia (51.1%), cardiac symptoms (45.6%), depressive symptoms (30.0%), gastrointestinal symptoms (27.8%), anxiety (27.8%), or headache (25.6%), whereas 21.1% of them were free from any noteworthy associated physical illnesses.
3. 31 case of senile mental disorders showed the following characteristic pictures according to the diagnostic categories:
a. In affective disorder, they were relatively younger, higher socioeconomical level, more obsessive compulsive, and frequently complaining insomnia, feelings of depression and gastrointestinal symptoms, but their rate of recurrence were relatively higher in spite of favorable improvement.
b. In organic brain syndrome, they were relatively lower socioeconomical level, earlier hospitalization, and their effect of treatment was relatively worse.
c. In psychoses, most of them were male, lower educational level, tended to have no religion and they frequently breakdown due to their intrafamilial problems, especially in the case of schizoid or paranoid personality.
d. In neuroses, they breakdown due to sudden change of financial state, more complaining cardiac symptoms, occasionally having musculoskeletal disease, and their effect of treatment was not so good as other groups, probably due to earlier discharge against medical advices.
4. In the epidemiological studies, it was revealed that the admission rate of senile psychiatric in-patients among total psychiatric in-patients were relatively lower as 2.6% than 5.5% of senile non-psychiatric in-patients among total non-psychiatric in-patients and also it was extremely lower than the reports from Western countries, while the mean duration of hospitalization in senile psychiatric in-patients was also shorter as 12.0 days than 24.4 days in the total psychiatric in-patients. It was suggested that this lower rate and shorter period of hospitalization in this study was probably due to socio-cultural difference such as the respect for the aged in our traditional customs, popular opinions for senile mental disorders as normal aging process, psychiatrist's avoidance to hospitalization of the aged person due to high risk of mortality, and the trends of the aged persons highly inclining to herb medicine or superstitions belief.