7-year-follow-up investigations and comparison of the geriatric psychiatric inpatient service in a separated care at a state hospital (obligatory service) and an integrated care at a university hospital in goettingen, Germany - II. Diagnosis and treatment

Objective: By use of a 7-y-follow-up investigation of differences between geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the University Psychiatric Hospital (PUK) compared to those in a separated (only according to age) care in the Psychiatric State Hospital (LKH), which together treat all psychiatric inpatients in Goettingen, Germany, we wanted to show, whether progress can be made visible. Method: We performed standardized chart reviews of randomly selected groups of patients, who had been treated in the PUK (n = 104) and the LKH (n = 100) in the years 1998 and 1999. Results: Again, organic brain diseases/dementia was the most frequent diagnosis in the LKH and depression that of the PUK. Less diagnostics were applied compared to the previous investigation, especially neuroimaging. Non-drug treatments are (documented) more frequently now in the LKH. Both institutions - data with respect to frequent syndromes are given - treated the wide majority of patients with psychoactive drugs, especially neuroleptics, typical antidepressants, benzodiazepines. Anti-dementia drugs were given significantly less. Hospital stays decrease in length. Compared to the respective investigation in Magdeburg there is some evidence supporting specialized care for the elderly. Conclusion: Budgetary restrictions could also be shown in inpatient treatment. Progress in specific drug treatment does not reach the patients as much as necessary.