Silent cerebral infarction (SCI) is often detected by magnetic resonance imaging (MRI) in patients with depression in late life. The late-life depression combined with SCI is known as MRI-defined vascular depression. Many studies have shown that this type of depression is likely to develop both psychiatric and neurological disorders in the course of time. Based on the previous findings, we made a 3-year follow-up study of patients with MRI-defined vascular depression in order to clarify risk factors that help develop complications such as delirium, dementia and parkinsonism. In this study, vascular risk factors (i.e., hypertension, diabetes mellitus etc.) were investigated retrospectively using clinical charts. Because of the small sample size, we could not find anything new about risk factors critical for either psychiatric or neurological disorders in patients with MRI-defined vascular depression. To demonstrate that preventing lifestyle-related diseases could reduce chances of having both psychiatric and neurological disorders, prospective studies are needed.

JA Hiroshima General Hospital has 578 beds, and the Psychiatric Department, founded in 1994, is staffed with two doctors without beds. On June 1, 1999, the Intensive Care Unit (ICU) was newly established in the hospital. Forty-two inpatients in the ICU were referred to us during the one-year period following the establishment of the ICU in our hospital. We investigated the reasons for consultation, somatic and psychiatric diagnoses, and outcome, and compared our findings with the results of the surveys conducted by other hospitals with psychiatric units. Our investigation revealed that “suicide attempt or suicidal ideation” was highest on the list of reasons for consultation, “acute drug intoxication” was highest on the list of medical diagnoses, “adjustment disorder” was highest on the list of psychiatric diagnoses, and that “discharged from ICU” was highest of outcomes. Compared with other reports, we had small percentages of “treatment for combined medical and psychiatric illness” among the reasons for consultation, and “schizophrenia” among psychiatric diagnoses, while we had higher percentages of “adjustment disorder” among psychiatric diagnoses, and “being transferred from the ICU to a medical ward” among outcomes, In view of the riskmanagement program at the hospital, we often felt there is difficulty treating physical diseases in psychiatric patients, especially patients who have made suicide attempts in medical wards. Therefore, we consider triage may be one of the most important functions of a psychiatic department without beds. To coordinate our roles successfully, it is necessary to build an effective network with other psychiatric institutions.