The ageing of the population has led to an increase in the number of elderly people seeking mental health assistance. This study aimed to evaluate the most frequent diagnoses ascribed to elderly patients referred to a mental health emergency service in São Paulo, Brazil. All subjects assessed at the emergency room of the Department of Mental Health of "Santa Casa de São Paulo" between January 1st and December 31, 1997 were included in the study. The classification of patients followed the ICD-10 guidelines for the clinical diagnosis of mental disorders. Out of the 5.434 assessments, 398 were of subjects aged 60 or over. Their mean age was 68.66 (CI=67.88 to 69.43 - range 60 to 96) and there was an excess of women among the elderly group (67.3% vs 51.2%, p<0.001). Mood disorders were the most prevalent diagnosis (40.0%), and were 2.24 times more frequent among women (CIodds=1,42 to 3,54). In 78.2% of these cases a major depressive episode was the main referral cause. Fourteen percent of the elderly suffered from dementia. Other frequent clinical diagnoses included anxiety disorders (15,4%), schizophrenia and related disorders (14.4%), alcohol abuse or dependence (4.1%), and abuse or dependence of hypnotics or sedative drugs (2.6%). Fifty-nine percent of the elderly were referred for further outpatient treatment, whereas 20.3% were admitted as inpatients after the emergency evaluation. The mental health disorders of the elderly make up an important part of the assessments at a psychiatric emergency clinic. It is important that health professionals are able to recognize and manage accordingly the most frequent psychiatric disorders of the elderly.
Elderly; old age; mental health; emergency; depression; mania
