The authors retrospectively reviewed the charts of all patients seen by the Psychiatric Consultation Service at their institution between January 1, 1989 to December 31, 1992. A total of 94 patients were evaluated for competency (study group). These were compared with 88 diagnostically matched patients (control group) who were assessed for reasons other than competency during the same time period. Patients in the study group were more likely to be black, less likely to be prescribed psychotropics, and more likely to be consulted upon later on during the course of their hospitalization. Among patients assessed for competency (study group) those patients judged to be incompetent were more likely to be older, have organic mental disorders (OMD), be prescribed psychotropics, and have longer hospital stays. Amongst patients in the study group, geriatric patients (> 60) when compared with nongeriatric patients were more likely to be female, Caucasian, and have OMD and multiple medical illnesses.