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Psychiatric presentations and factors associated with suspected organicity in elderly attending a tertiary care facility in South India
B Srisudha1, Munaf Babajan Nandyal2, Naveen Kolloju3, Rachna George Joseph4, Reka Karuppusami5, Suja Kurian1
1 Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
2 Adult Mental Health Rehabilitation Unit, Sunshine Hospital, Midwest Mental Health Area Services, Melbourne, Victoria, Australia
3 Broadmeadows Hospital, Northwest Mental Health Area Services, Melbourne, Victoria, Australia
4 Department of Child and Adolescent Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
5 Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
Correspondence Address:
Munaf Babajan Nandyal
Adult Mental Health Rehabilitation Unit, Sunshine Hospital, Midwest Mental Health Area Services, St. Albans, Melbourne, Victoria
Australia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jiag.jiag_5_23
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Objectives: The objectives were to determine the proportion of elderly among the new psychiatry outpatient attendees, identify their sociodemographic profile and clinical presentations, and determine risk factors associated with suspected organic conditions in patients presenting with acute onset and chronic presentations. Methodology: This retrospective cross-sectional study focused on the elderly presenting with psychiatric symptoms to a psychiatric setting. The onset of symptoms at presentation was divided into acute and chronic conditions. Clinical symptom clusters and the risk factors associated with organic conditions were identified. The Chi-square and Fisher's exact test were used to find an association between factors and outcome (organic/functional). Results: Elderly seeking consultation constituted < 10% of total new case registration. Acute onset was seen in one-third and chronic presentation constituted nearly two-thirds of the group. The common clinical presentations with acute onset were acute psychosis, altered sensorium, and psychosis due to an organic etiology. The most common clinical presentation with chronic course was chronic psychosis. Nearly 40% had suspected organicity. Increasing age, structural abnormality in brain imaging, and the presence of stressors were risk factors for the onset of psychiatric presentation in the elderly (P = 0.001). Conclusion: Early detection of the clinical syndrome, identification of organic conditions, and appropriate and prompt referral to the general physician should be the rule for the care of the elderly presenting to a psychiatric facility.
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