Factors Influencing Comorbid Physical Diseases in Elderly Inpatients With Mental Disorders: A Cross-Sectional Study

Study Design Overview

This cross-sectional study examined the influencing factors of physical diseases in elderly patients with mental illnesses. The research team utilized self-developed questionnaires and rating scales to gather detailed clinical and general information about the participants.

Subject Selection

The study included 332 elderly patients hospitalized with mental illness from February 2021 to March 2022. Participants met the following criteria: age of 60 years or older, a diagnosis of schizophrenia, affective disorders, or other mental health conditions according to the CCMD-3 guidelines, the ability to respond naturally and complete the scales, and permission to sign informed consent.

Data Collection Methods

General Information

Researchers gathered personal data through a customized questionnaire, including gender, age, lifestyle habits, disease duration, hospital stay length, and somatic conditions such as circulatory, digestive, respiratory, and urinary system diseases.

Various scales were used to evaluate psychiatric symptoms, depression, anxiety, delirium, functional abilities, social support, daily living activities, and swallowing functions. Assessments included the Brief Psychiatric Rating Scale, Geriatric Depression Scale, Generalized Anxiety Disorder-7, Confusion Assessment Method, Functional Activities Questionnaire, Social Support Rating Scale, Activity Daily of Living (Barthel Index), and Water Swallowing Test.

Brief Psychiatric Rating Scale (BPRS)

The BPRS, created by Overall and Gorham in 1962, assesses the severity of psychiatric symptoms. Scores range from 18 to 126, with higher scores indicating more severe conditions.

Geriatric Depression Scale (GDS)

Developed by Yesavage in 1982, the GDS consists of 30 questions. Scores of 0-9 are considered normal, 10-19 indicate mild depression, and 20-30 suggest severe depression.

Generalized Anxiety Disorder-7 (GAD-7)

The GAD-7 is a seven-item self-report scale for anxious symptoms, rated on a 4-point Likert scale. Higher scores (0-21) denote more severe anxiety.

Confusion Assessment Method (CAM)

The CAM, first introduced by Inouye et al. in 1990, is a diagnostic tool for delirium with high sensitivity. Scores below 19 indicate no delirium, 20-22 suggest suspicion of delirium, and over 22 signify delirium.

Functional Activities Questionnaire (FAQ)

The FAQ, designed by Pfeffer et al. in 1982, assesses Instrumental Activities of Daily Living, measured on a 4-point Likert scale. Higher scores indicate greater difficulty.

Social Support Rating Scale (SSRS)

The SSRS evaluates social support levels using a 10-item scale in three dimensions: objective, subjective, and utilization of support. Higher scores indicate greater social support.

Activity Daily of Living (ADL)

The Barthel Index, developed by Lawton and Brody in 1969, assesses daily living abilities. Scores are categorized into four levels: complete independence (100 points), moderate independence (60-99 points), needing assistance (40-59 points), and complete dependence (≤40 points).

Water Swallowing Test (WST)

The WST, a five-level test measuring swallowing function, evaluates reactions to 30 ml of water. Categories include complete recovery, improved swallowing, or unchanged/worse function.

Procedure for Data Collection

Questionnaires were distributed in a brain hospital inpatient ward by four nurses trained as investigators. Collection and validation of responses were conducted on-site to ensure accuracy and data integrity. The study achieved a 100% return rate with 332 valid questionnaires collected.

Statistical Analysis

Data from the study will be analyzed to determine the correlations between mental health conditions and comorbid physical diseases in elderly patients, providing insights into the complexities of healthcare management for this population.