To the best of our knowledge, this was the first study to investigate the demographic and clinical characteristics of patients with dementia in a psychiatric hospital in China. Our results demonstrated a higher ratio (61.87%) of female dementia than male dementia patients (38.13%), and the mean age of females was significantly higher than that of males, which is consistent with previous studies [20, 21]. The probable reason for this result is women’s longer lifespans , as the prevalence of dementia increases with age.
In addition, our data revealed that the cost per case in psychiatric outpatients is low compared to the findings in other studies in China . One possible reason for the difference is that patients with dementia were from a psychiatric hospital rather than a general hospital. Another explanatory factor is that the cost of informal care for patients with dementia was not taken into account.
The current study also showed that 39.52% of patients with dementia had only one visit, indicating poor outpatient adherence. In addition, gender differences were found in visit frequency. The discrepancies between genders were probably attributed to the higher number of female patients, owing to the greater caution of men in seeking medical attention.
A further finding of our present study, similar to previous studies [23, 24], was that BPSD was common: generalized anxiety disorder (48.17%), nonorganic insomnia (40.03%), delusional disorder (29.08%) and depressive disorder (25.46%). Meanwhile, our finding that female patients had a significantly higher risk of depression symptoms than male patients was in line with previous studies that have shown that women are more prone to depressive symptoms [15, 25]. Evidently, BPSD are an integral part of dementia. However, apathy and agitation were not included in this study because the outpatient department did not record them, which may have influenced the results. These symptoms could affect the patient's mental behaviour and place a serious burden on the caregiver, which is also the major reason that the patients visit the psychiatric department.
More interestingly, a previous study revealed that the prevalence of prescribed medication classifications was as follows: antidepressant (37.4%), benzodiazepines (39.0%), antipsychotic (22.2%) and antidementia (18.3%) . In contrast, we found the following prevalence of drug use among patients with dementia: antidementia (68.30%), benzodiazepines (48.83%), antipsychotic (45.43%) and antidepressants (22.24%). One possible reason for the difference is the smaller sample size in the previous study and the exclusion of some patients with severe dementia. Despite the limited evidence, this high utilization rate of psychotropic drugs is most likely an attempt to treat neuropsychiatric symptoms of dementia .
The limitations of this study should be noted. First, this was a retrospective study over 6 years (2013–2019), and data were collected by medical records. Some important factors, such as course of illness and degree, were not available for assessment. Second, since the participants were recruited from a single regional hospital, the findings cannot be generalized to all hospitals. Third, no further detailed analysis was carried out on the symptoms and medication in psychiatric departments.