Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes

Objective A high proportion of patients presenting to Emergency Departments (EDs) consists of vulnerable elderly people. Mental illnesses are frequently related to advancing age, with difficult to detect symptoms. The aim of this study was to investigate psychiatric drug use by geriatric patients in...

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Main Authors: Marianna Mazza, Marcello Covino, Francesco Maria Lisci, Caterina Brisi, Georgios D. Kotzalidis, Giuseppe Marano, Francesca Abate, Maria Benedetta Anesini, Gianluca Boggio, Michele Ciliberto, Valeria De Masi, Cecilia Falsini, Ester Maria Marzo, Sara Rossi, Maria Chiara Spera, Alberto Torresi, Benedetta Simeoni, Francesco Franceschi, Gabriele Sani
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Psychiatric Research and Clinical Practice
Online Access:https://doi.org/10.1176/appi.prcp.20250002
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author Marianna Mazza
Marcello Covino
Francesco Maria Lisci
Caterina Brisi
Georgios D. Kotzalidis
Giuseppe Marano
Francesca Abate
Maria Benedetta Anesini
Gianluca Boggio
Michele Ciliberto
Valeria De Masi
Cecilia Falsini
Ester Maria Marzo
Sara Rossi
Maria Chiara Spera
Alberto Torresi
Benedetta Simeoni
Francesco Franceschi
Gabriele Sani
author_facet Marianna Mazza
Marcello Covino
Francesco Maria Lisci
Caterina Brisi
Georgios D. Kotzalidis
Giuseppe Marano
Francesca Abate
Maria Benedetta Anesini
Gianluca Boggio
Michele Ciliberto
Valeria De Masi
Cecilia Falsini
Ester Maria Marzo
Sara Rossi
Maria Chiara Spera
Alberto Torresi
Benedetta Simeoni
Francesco Franceschi
Gabriele Sani
author_sort Marianna Mazza
collection DOAJ
description Objective A high proportion of patients presenting to Emergency Departments (EDs) consists of vulnerable elderly people. Mental illnesses are frequently related to advancing age, with difficult to detect symptoms. The aim of this study was to investigate psychiatric drug use by geriatric patients in an ED for whom a psychiatric consultation was needed, according to their psychopathology and severity of outcome. Methods During 2014 to 2023, 342 aged patients (35.96% men and 64.04% women; median age = 73 years, range 68–79 years) sought help at the ED of our hospital and required psychiatric consultation. Results Male sex, nonsuicidal self‐harm, and access through emergency medical services were predictors of >48‐h ED stay/hospital admission (the main severity outcome). Patients with bipolar disorder (BD) and psychotic disorders were more socially disadvantaged and with significantly longer length of stay at the ED than the other groups. Additionally, BD patients had more psychiatric drug prescriptions at discharge than patients in the other diagnostic groups. Current nonsuicidal self‐harm emerged as a predictor of >48‐h ED stay/hospital admission. Conclusions Future studies should focus on investigating suicide risk in ED contexts, on correct diagnosing and on prescription appropriateness of medications in older adults with psychiatric disorders referring to the ED so to tailor‐cut treatment on individual patients' needs. Relevant to Clinical Practice This study highlights the significant impact of psychiatric conditions on healthcare utilization among elderly patients presenting to the ED. The findings emphasize the need for improved diagnosis and management of psychiatric disorders, medication optimization, and tailored treatment approaches.
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spelling doaj-art-9bd1bd16a3274435a56a29bcf6d3bf0f2025-08-20T03:21:43ZengWileyPsychiatric Research and Clinical Practice2575-56092025-06-017211712710.1176/appi.prcp.20250002Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment OutcomesMarianna Mazza0Marcello Covino1Francesco Maria Lisci2Caterina Brisi3Georgios D. Kotzalidis4Giuseppe Marano5Francesca Abate6Maria Benedetta Anesini7Gianluca Boggio8Michele Ciliberto9Valeria De Masi10Cecilia Falsini11Ester Maria Marzo12Sara Rossi13Maria Chiara Spera14Alberto Torresi15Benedetta Simeoni16Francesco Franceschi17Gabriele Sani18Unit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyEmergency Medicine Department Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyEmergency Medicine Department Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore Rome ItalyEmergency Medicine Department Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore Rome ItalyUnit of Psychiatry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome ItalyObjective A high proportion of patients presenting to Emergency Departments (EDs) consists of vulnerable elderly people. Mental illnesses are frequently related to advancing age, with difficult to detect symptoms. The aim of this study was to investigate psychiatric drug use by geriatric patients in an ED for whom a psychiatric consultation was needed, according to their psychopathology and severity of outcome. Methods During 2014 to 2023, 342 aged patients (35.96% men and 64.04% women; median age = 73 years, range 68–79 years) sought help at the ED of our hospital and required psychiatric consultation. Results Male sex, nonsuicidal self‐harm, and access through emergency medical services were predictors of >48‐h ED stay/hospital admission (the main severity outcome). Patients with bipolar disorder (BD) and psychotic disorders were more socially disadvantaged and with significantly longer length of stay at the ED than the other groups. Additionally, BD patients had more psychiatric drug prescriptions at discharge than patients in the other diagnostic groups. Current nonsuicidal self‐harm emerged as a predictor of >48‐h ED stay/hospital admission. Conclusions Future studies should focus on investigating suicide risk in ED contexts, on correct diagnosing and on prescription appropriateness of medications in older adults with psychiatric disorders referring to the ED so to tailor‐cut treatment on individual patients' needs. Relevant to Clinical Practice This study highlights the significant impact of psychiatric conditions on healthcare utilization among elderly patients presenting to the ED. The findings emphasize the need for improved diagnosis and management of psychiatric disorders, medication optimization, and tailored treatment approaches.https://doi.org/10.1176/appi.prcp.20250002
spellingShingle Marianna Mazza
Marcello Covino
Francesco Maria Lisci
Caterina Brisi
Georgios D. Kotzalidis
Giuseppe Marano
Francesca Abate
Maria Benedetta Anesini
Gianluca Boggio
Michele Ciliberto
Valeria De Masi
Cecilia Falsini
Ester Maria Marzo
Sara Rossi
Maria Chiara Spera
Alberto Torresi
Benedetta Simeoni
Francesco Franceschi
Gabriele Sani
Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
Psychiatric Research and Clinical Practice
title Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
title_full Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
title_fullStr Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
title_full_unstemmed Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
title_short Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes
title_sort psychotropic drugs for older adults with psychiatric disorders presenting to the emergency department prescription patterns and treatment outcomes
url https://doi.org/10.1176/appi.prcp.20250002
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