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KCI등재 학술저널

신경정신과 노인환자의 임상적 고찰

A Clinical Study on Elderly Neuropsychiatric Patients

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The objective of this study was to find out the clinical aspects of the elderly neuropsychiatric patients and to analyze the diverse clinical factors associated with those patients illness. We had done a clinical study on 170 elderly neuropsychiatric patients. In this study, the elderly patients were defined those above 60 years old. Among the total patients, 89 were outpatients and 81 were inpatients who had been treated in the neuropsychiatric department of soon chun Hyang University Hospital from Jan. 1979 to Dec. 1985, From the analysis of the psychiatric records of the patients, the following results were obtained. 1) The sex ratio of the patients was quite low. The sex ratio for the total patients was 57: 100. That for the outpatients was 51: 100 and that for the inpatients, 65: 100. 2) Among the total patients, the psychiatric illness showed a different pattern. Outpatients revealed more of neurotic disorders whereas the inpatients showed more of organic mental disorders. According to the individual diagnosis, dysthymic disorder was the most prevalent among the outpatients, 3) The marital status of the patients showed that 62.4% of them were currently married. 4) The educational level of the total patients showed that 54.1% of them completed elementary school, psychotic disorders were related with high education. Among the psychotic disorders, high school graduates were most prevalent. 5) The socioeconomic status of the total patients showed that 50.0% of them were in the middle class. 6) Fourty three and half percent of the total patients had the precipitating factor associated with their psychiatric illness. The most common type of precipitating factor was the family conflict for neurotic disotders where as the family berevement was the main facter for psychotic disorders, and CO intoxication sequelae, traffic accident and cerebrovascular accident were common for the organic mental disorders. 7) Fourty four point seven percent of the total patients had the associated physical illness. Associated illness was more common among organic mental disorders, which marked 56.0%. 8) The most common process of hospitalization was through the outpatient department. Among psychotic disorders, addmission through emergency room was the most common route for hospitzation. 9) Mean day for hospitalization for inpatients was 38 days. That with neurotic disorders was 15 days, that with psychotic disorders was 27 days and that with organic mental disorders had the longest mean day of hospitalization which was 82 days. 10) Fourty seven percent of all hospitalized patients had above moderate improvement as a result of psychiatric inpatient treatment. Organic mental disorders showed the lowest improvement. Only 25.7% of them revealed above moderate improvement. 11) The number of visits to the outpatient department was more frequent among psychotic disoredrs and neurotic disorders than organic mental disorders and other diagnostic types of illness. Organic mental disorders showed the lowest visits to the outpatient department. Sixty eight point eight percent of organic mental disorders had only one visit to the outpatient department. 12) Clinical symptoms of organic mental disorders revealed that memory impairment was the most common symptom followed by disorientation and incoherence. Those of psychotic disorders revealed that insomnia was the most common symptom followed by depression and delusion. Among neurotic disorders, depression, insomnia and anxiey were common. Among other patients, musculoskeletal symptom was the most common symotom

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