• Mood disorders was the most frequent principal MHSA diagnosis across all age groups in 1997 and 2008.
• Mood disorders accounted for the majority (61 percent) of all MHSA hospitalizations among children 1-17 years in 2008 and about four in ten MHSA discharges in other age groups.
• The number of stays with a principal diagnosis of mood disorders increased among 18-44 year olds (24 percent) and 45-64 year olds (84 percent) from 1997 to 2008.
• The number of hospitalizations specifically for depression changed little for children 1-17 and adults 18-44, rose for adults 45-64 (by 56 percent), and decreased for older adults (by -39 percent for 65-84 year olds and -38 percent for those 85 years and older).
• In contrast, stays for bipolar disorders more than doubled over the same period for patient age groups of 64 years and younger. Growth in stays was especially high for children 1-17 years (increasing by 333 percent between 1997 and 2008). While the cause of this increase is unclear and should be interpreted cautiously, it may reflect an increased recognition of bipolar disorder, especially in children—a group that has been historically under-diagnosed.^3,4 It may also reflect the difficulty of assigning a diagnosis for a condition, especially in children, that may share presenting symptoms with schizophrenia/other psychotic disorders and attention deficit/conduct/disruptive behavior disorders.
• Schizophrenia/other psychotic disorders was the second most frequent MHSA condition for all adult age groups (18 years and older), and it was the third most frequent MHSA condition for children 1-17 years in 2008.
• While the number of stays for schizophrenia for most age groups changed little from 1997 to 2008, it increased 62 percent for 45-64 year olds and 33 percent for patients 85 years and older.
• Alcohol-related disorders accounted for 12 percent of MHSA hospital stays among 18-44 year olds, 21 percent of MHSA stays among 45-64 year olds, and 12 percent of MHSA stays for 65-84 year olds.
• Drug-related disorders appeared prominently among the top four principal MHSA conditions for all age groups except children (1-17 years):
• The number of hospital stays for drug-related conditions rose rapidly among 45-64 year olds (117 percent), 65-84 year olds (96 percent), and adults 85 and older (87 percent) while remaining relatively stable (11-percent decline) among adults 18-44.

• Rapid growth in drug-induced delirium and in poisonings by opiate-based pain medications was primarily responsible for the increase in drug-related hospitalizations for patients 85 years and older. Together in 2008, these conditions accounted for 78 percent of the drug-related stays and 89 percent of the increase in drug-related stays for these oldest patients. Drug-induced delirium can result from side-effects of medications and occurs often in elderly hospitalized patients.^5,6,7
• Drug-induced delirium and poisonings by opiate-based pain medications were also responsible for a large number of drug-related discharges in 45-64 year olds (19 percent) and 65-84 year olds (60 percent).

(text version)

• Adults 18-44 years accounted for the majority of stays for bipolar disorders, drug-related disorders, and adjustment disorders.
• For alcohol-related disorders, 18-44 year olds accounted for 42 percent of stays and 45-64 year olds accounted for 50 percent of stays.
• For schizophrenia/other psychotic disorders, 18-44 year olds accounted for 49 percent of stays and 45-64 year olds accounted for 38 percent of stays.
• Children 1-17 years accounted for a substantial proportion (9 to 13 percent) of stays for depression, bipolar disorders, anxiety disorders, and adjustment disorders.
• Patients 65 and older accounted for 17 percent of anxiety disorders and 12 percent of both depression and schizophrenia/other psychotic disorders.

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