DUAL DIAGNOSIS IN ELDERS DISCHARGED FROM A PSYCHIATRIC-HOSPITAL

Recent evidence indicates persons 60 years and over experience signifi cant alcohol and substance abuse problems. Since a combination of alco holism and depression is likely to increase the relative rsk of suicid e, it is important to examine the prevalence of dual diagnosis in olde r adults. The purpose of this study is to examine the prevalence and c orrelates of dual diagnosis in older psychiatric inpatient populations and compare our results with findings from studies of younger hospita lized dually diagnosed patients. A retrospective chart audit was perfo rmed on 101 elders who were discharged from three psychiatric hospital s. Clinical variables that were examined included length of hospital s tay, psychiatric and medical diagnoses, medications and history of sui cidal ideation or intent. The leading psychiatric disorder diagnosis f or our sample of hospitalized psychiatric elders was depression. Over one-third (37.6%) had a substance abuse disorder in addition to a psyc hiatric disorder, and almost three-fourths (71%) of this 'dual diagnos is' group abused alcohol and 29% abused both alcohol and other substan ces. In addition, significantly more elders in the 'dual diagnosis' gr oup (17.7%) than in the group with only a mental disorder diagnosis (3 .3%) made a suicide attempt prior to admission to the hospital. Becaus e affective disorders in conjunction with alcohol abuse are the most f requently found disorders in completed suicides, our findings have imp ortant relevance for the advocating of routine use of diagnostic asses sment and screening for both substance abuse and mental disorders in t his population. ((C) 1997 by John Wiley & Sons, Ltd.)