Changes in psychiatric diagnoses from admission to discharge: review of the charts of 159 patients consecutively admitted to a geriatric psychiatry inpatient unit

The diagnosis of psychopathology among geriatric acute inpatients requires comprehensive evaluation. To our knowledge, no recently published papers in the geriatric psychiatry literature have systematically examined diagnosti c changes during single admissions. We reviewed the charts of 159 patients consecutively admitted to an acute geriatric psychiatry unit over 18 months . We recorded admission diagnoses from initial treatment plans, and dischar ge diagnoses from discharge summaries. Mean patient age was 80 years and av erage length of stay was 17 days. The most common primary diagnoses were ps ychotic and depressive disorders. The most common secondary diagnoses were dementias and depressive disorders. Primary diagnoses changed from admissio n to discharge in 31 patients (20%), and secondary diagnoses changed in 76 patients (48%). There was a significant change involving the diagnosis of d ementia, but not that of depressive or psychotic disorders. A large proport ion of inpatients had their diagnoses altered, especially those involving d ementias, during hospitalization. inpatient admission may he valuable for c larifying the diagnoses of elderly psychiatric patients. (C) 2001 Elsevier Science Inc. All rights reserved.