FACTORS RELATED TO ADMISSION OF NEW PATIENTS CONSULTING GERIATRIC PSYCHIATRIC-SERVICES IN MONTREAL

The development of and the demand for geriatric psychiatric services ( GPS) have increased over the past decade. Psychopathology, autonomy, p hysical disorders, sociodemographics, social support and caregivers' b urden have all been advanced as influencing the elderly's risk of hosp italization. These factors were examined in a 1-year prospective study of 87 new patients consulting a catchment-area GPS. Standardized asse ssments were used, including both patients' and caregivers' independen t measures of patients' social network. Entry points to the study were as follows: 70.1% of patients came from an outpatient clinic and 25.3 % were admitted directly to psychiatric wards. Subjects were followed up 1 year after discharge or first contact. Overall, 47.1% of the samp le was admitted to a higher-supervision setting during the 1-year foll ow-up, including 20.7% of the total sample admitted to GPS wards. Mult ivariate logistic regression analysis indicated different factors infl uencing admission according to the definition of admission. Loss of au tonomy was a key factor related to both psychiatric and overall admiss ions. Previous admission was a predictor of psychiatric admissions onl y. Relatives' strain and not living with spouse were predictors of ove rall admissions. The results indicate that functional consequences of disease (eg loss of autonomy) and resilience of relatives are key in p redicting the elderly's need for greater supervision.