Unrecognized Medical Disorders in Older Psychiatric Inpatients in a Senior Behavioral Health Unit in a University Hospital

Medical disorders may cause psychiatric symptoms. This study investigated the frequency and nature of previously unrecognized medical disorders associated with behavioral disturbances in acute geriatric psychiatry inpatients. Data came from a chart review of 79 consecutive admissions to the University of California, San Diego, Senior Behavioral Health Unit from May 1999 to October 1999. The most common Axis I admission diagnoses were depression and psychosis. At admission, 27 of 79 cases (34%) had unrecognized medical disorders. Comparison of these cases with the cases that did not have unrecognized medical disorders found no differences in age, education, gender, or cognitive abilities. The group with unrecognized medical disorders had more medical disorders (mean 5.0 vs 3.6; P = .002). Unrecognized conditions (n) included constipation (7), urinary infection (7), and hypothyroidism (5). Elderly psychiatric patients are more likely to have physical comorbidity. A large number of medical disorders should alert clinicians to look carefully for unrecognized medical disorders. (J Geriatr Psychiatry Neurol 2003; 16:121-125)