Race and inpatient psychiatric diagnoses among elderly veterans.
Race and inpatient psychiatric diagnoses among elderly veterans.
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老年退伍军人的种族和住院精神病诊断。
DOI：
10.1176/appi.ps.51.6.795
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发表时间：
2000
影响因子：
3.8
通讯作者：
A. Mellow
中科院分区：
文献类型：
--
作者：
H. Kales;F. Blow;C. Bingham;L. Copeland;A. Mellow
目的
关于老年人口中不同种族文化群体之间精神病诊断的差异率的数据有限。本研究的目的是更密切地研究老年住院患者的种族和精神病诊断率的问题。
方法
全国样本包括23,758名60岁或以上的退伍军人，他们于1994年在退伍军人事务部（VA）医院的急性住院部住院。精神病诊断确定纳入六个诊断组之一：认知，情绪，精神病，物质使用，焦虑和其他疾病。该研究还评估了仅在精神科住院的患者中的精神病诊断率，并按年龄组和治疗环境进行了评估，例如医院的规模以及是否有学术联系。
结果
与老年西班牙裔和白人患者相比，老年非洲裔美国患者被诊断为认知障碍和物质使用障碍的比例显着较高，被诊断为情绪和焦虑障碍的比例显着较低。西班牙裔和非洲裔美国人患者的精神病诊断率显著高于白人患者。对于除认知障碍外的所有诊断，这些差异率也仅见于精神科住院患者。年龄和治疗环境似乎缓和了一些诊断率的差异，除了情绪障碍。在每一项分析中，非裔美国老年患者的心境障碍诊断率不到白人老年患者的一半。
结论
研究结果表明，老年非裔美国退伍军人承认退伍军人管理局住院单位有显着较低的比率情绪障碍的诊断。未来的研究应该检查患者和提供者因素对这些差异的贡献。
OBJECTIVE
Limited data exist on differential rates of psychiatric diagnoses between ethnocultural groups in the elderly population. The purpose of this study was to examine more closely the issue of race and rates of psychiatric diagnoses among elderly inpatients.
METHODS
The national sample included 23,758 veterans age 60 or over admitted in 1994 to acute inpatient units in Department of Veterans Affairs (VA) hospitals. Psychiatric diagnosis determined inclusion in one of six diagnostic groups: cognitive, mood, psychotic, substance use, anxiety, and other disorders. The study also assessed rates of psychiatric diagnoses among patients admitted to psychiatric units only and by age group and treatment setting, such as the size of the hospital and whether it had an academic affiliation.
RESULTS
Compared with elderly Hispanic and Caucasian patients, a significantly higher proportion of elderly African-American patients were diagnosed as having cognitive disorders and substance use disorders, and a significantly lower proportion were diagnosed as having mood and anxiety disorders. Hispanic and African-American patients had significantly higher rates of psychotic diagnoses than Caucasian patients. For all diagnoses except cognitive disorders, these differential rates were also found among patients admitted to psychiatric units only. Age and treatment setting appeared to moderate some of the differences in diagnostic rates, except for mood disorders. In every analysis performed, the rate of mood disorder diagnoses among elderly African-American patients was less than half the rate among elderly Caucasian patients.
CONCLUSIONS
The findings suggest that elderly African-American veterans admitted to VA inpatient units have strikingly lower rates of mood disorder diagnoses. Future studies should examine the contribution of both patient and provider factors to these differences.
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