Substance Abuse in Older Psychiatric Inpatients
Abstract
Abstract.Aim: This study investigates the characteristics of older patients with substance abuse disorders admitted to a psychiatric department serving about 250.000 inhabitants. Methods: The clinical diagnoses were made according to ICD-10. The data of the patients with substance abuse were compared to a matched sample of psychiatric inpatients without substance abuse as well as to a group of former substance abusers with long-term abstinence. Results: 19.3 % of the 941 patients aged > 65 years showed current substance abuse, 9.4 % consumed alcohol, 7.9 % took benzodiazepines or z-drugs (zolpidem and zopiclone), and 7.0 % smoked tobacco. Multiple substance abuse was rather common (30.8 %). About 85 % of the substance abusers had psychiatric comorbidity, and about 30 % showed severe withdrawal symptoms. As with the rest of the patients, somatic multimorbidity was present in about 70 % of the substance abusers. Remarkable was the lower rate of dementia in current substance abusers. Conclusion: These results underscore that substance abuse is still a challenge in the psychiatric inpatient treatment of older people.
Zusammenfassung.Ziel: In dieser Studie wurden ältere Patienten (> 65 Jahre), die in einer psychiatrischen Klinik mit regionaler Versorgungsverpflichtung von 250 000 Einwohnern aufgenommen worden waren, hinsichtlich somatischer und psychiatrischer Komorbidität untersucht. Methodik: Die Diagnosen wurden klinisch anhand der ICD-10-Kriterien gestellt. Die Daten der Patienten mit Substanzmissbrauch wurden verglichen mit denen von Patienten, die im gleichen Zeitraum aufgenommen und hinsichtlich Alter und Geschlecht gematcht worden waren. Ferner wurde die Gruppe von Patienten, bei der eine längere Abstinenz gesichert werden konnte, zum Vergleich herangezogen. Ergebnisse: 19.3 % der 941 älteren Patienten zeigten einen aktuellen Substanzmissbrauch: 9.4 % tranken Alkohol, 7.9 % nahmen Benzodiazepine oder Zolpidem bzw. Zopiclon ein und 7.0 % waren Raucher. Ein Missbrauch von mehreren Substanzen war bei 30.8 % festzustellen. Über 85 % der Substanzmissbraucher wiesen eine psychiatrische Komorbidität auf und etwa 30 % zeigten schwere Entzugssymptome. Wie bei den anderen Patientengruppen waren 70 % der Substanzmissbraucher multimorbide. Auffällig war der vergleichsweise niedrige Anteil von Dementen unter den Substanzmissbrauchern. Schlussfolgerung: Die Ergebnisse dieser Studie zeigen, dass ein Substanzmissbrauch auch bei älteren psychiatrischen Patienten zu bedenken ist.
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