Gerontopsychiatrie versus Allgemeinpsychiatrie bei stationärer Behandlung von Depressionen im höheren Lebensalter

Zusammenfassung

Anliegen Ist die integrative Behandlung depressiver älterer Patienten in einer gerontopsychiatrischen Abteilung (GP) der in einer allgemeinpsychiatrischen Abteilung (AP) überlegen? Methode Retrospektiv wurden Behandlungsergebnisse bei Depressionen im Alter zwischen einer GP und einer AP verglichen. Ergebnisse Das klinische Outcome war vergleichbar. In der GP erfolgten die somatischen Untersuchungen umfassender, die Pharmakotherapie war sicherer. Schlussfolgerungen Die GP zeigte sich bezüglich des Risikomanagements gegenüber den allgemeinpsychiatrischen Stationen überlegen.

Abstract

Objective Is the integrated treatment of depressed elderly patients on a geriatric psychiatry unit superior to the treatment on a general psychiatry unit? Method Retrospective comparison of treatment outcomes of depression in elderly patients on geriatric and general psychiatry units. Results The clinical outcome showed comparable results. Somatic examinations turned out to be more comprehensive on a geriatric psychiatry unit, which also showed better results in pharmacotherapeutic safety. Conclusions Regarding risk management, geriatric psychiatry units proved superior to general psychiatry units.

Schlüsselwörter

Spezialstation - Depressionen im Alter

Keywords

specialist unit - late-life depression

Literatur

• 1 Schwappach D L. The economics of mental health and health care – a blind spot?.  Neuropsychiatr. 2007;  21 18-28
• 2 Riedel-Heller S, Bramesfeld A, Roick C. et al . Call for more health services research.  Psychiat Prax. 2008;  35 157-159
• 3 Reichhart T, Kissling W, Scheuring E. et al . Patient participation in german psychiatry – a critical review.  Psychiat Prax. 2008;  35 111-121
• 4 Baldwin B. Late life Depression – undertreated?.  BMJ. 1988;  296 519
• 5 Vaccarino V, Kasl S V, Abramson J. et al . Depressive symptoms and risk of functional decline and death in patients with heart failure.  J Am Coll Cardiol. 2001;  38 199-205
• 6 Roose S P, Sackeim H A, Krishnan K R. et al. Old-Old Depression Study Group . Antidepressant pharmacotherapy in the treatment of depression in the very old: a randomized, placebo-controlled trial.  Am J Psychiatry. 2004;  161 2050-2059
• 7 Kivela S L, Pahkala K. Depressive disorder as a predictor of physical disability in old age.  J Am Geriatr Soc. 2001;  49 290-296
• 8 Neu P, Kiesslinger U, Schlattmann P. et al . Time-related cognitive deficiency in four different types of depression.  Psychiatry Res. 2001;  103 237-247
• 9 Jorm A F. Is depression a risk factor for dementia or cognitive decline? A review.  Gerontology. 2000;  46 4219-4227
• 10 Bjelland I, Tell G S, Vollset S E. et al . Folate, vitamin B12, homocysteine, and the MTHFR 677C-T polymorphism in anxiety and depression: the Hordaland Homocysteine Study.  Arch Gen Psychiatry. 2003;  60 618-626
• 11 Wilson K, Mottram P. A comparison of side effects of selective serotonin reuptake inhibitors and tricyclic antidepressants in older depressed patients: a meta-analysis.  Int J Geriatr Psychiatry. 2004;  19 754-762
• 12 Baldwin R C, Anderson D, Black S. et al . Faculty of old age psychiatry working group, Royal College of Psychiatrists. Guideline for the management of late-life depression in primary care.  Int J Geriatr Psychiatry. 2003;  18 82-83
• 13 Hautzinger M, Welz S. Cognitive behavioral therapy for depressed older outpatients – a controlled, randomized trial.  Z Gerontol Geriatr. 2004;  37 427-435
• 14 Norquist G, Wells K B, Rogers W H. et al . Quality of care for depressed elderly patients hospitalized in the specialty psychiatric units or general medical wards.  Arch Gen Psychiatry. 1995;  52 695-701
• 15 Yazgan I, Greenwald B S, Kremen N J. et al . Geriatric psychiatry versus general psychiatry inpatient treatment of the elderly.  Am J Psychiatry. 2004;  161 352-355
• 16 Staedt J, Sparfeld F, Otto A. et al . A comparison of geriatric psychiatric inpatients of two German psychiatric university hospitals in integrated or separated care.  Psychiat Prax. 2003;  30 242-247
• 17 Gaebel W, Falkei P. Guidelines in affective disorders. Darmstadt; Steinkopf 2004