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The persistence of neuropsychiatric symptoms in dementia: the Cache County Study
- Authors:
- STEINBERG Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(1), January 2004, pp.19-26.
- Publisher:
- Wiley
The aim was to estimate the 18-month persistence of neuropsychiatric symptoms in dementia in a population-based sample, and to compare the severity of neuropsychiatric symptoms at baseline to the severity at 18-month follow-up. A population-based sample of 329 residents of Cache County, Utah, diagnosed with dementia was rated on the Neuropsychiatric Inventory (NPI). Of the 204 participants with neuropsychiatric symptoms at baseline (defined as total NPI score >0), NPI data were obtained approximately 18 months later on 117 who were alive and available for follow-up. Eighty-one percent of those with neuropsychiatric symptoms at baseline (defined as total NPI score>0) continued to have at least one symptom at follow-up. Sixty-seven percent of participants with a clinically significant total NPI score (defined as ;4) at baseline continued to have a clinically significant total NPI score at follow-up. Among the ten neuropsychiatric domains assessed at baseline, delusions persisted in 65.5% of individuals, followed by depression (58.3%), and aberrant motor behavior (55.6%), while hallucinations and disinhibition persisted in only 25.0% and 11.1% respectively. In participants who were symptomatic at both baseline and follow-up, the mean severity scores at the two observation points were comparable in all ten neuropsychiatric domains. Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable.
Emotional support, negative interaction and DSM IV lifetime disorders among older African Americans: findings from the national survey of American life (NSAL)
- Authors:
- LINCOLN Karen D., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(6), June 2010, pp.612-621.
- Publisher:
- Wiley
While both emotional support and negative interaction (conflicts) with family members have been linked to mental health problems, few studies have examined the associations between emotional support and negative interaction and psychiatric disorders in late life. This study investigated the relationship between emotional support and negative interaction on lifetime incidence of mood and anxiety disorders among older African Americans. Data from the National Survey of American Life identified 786 African Americans aged 55 years and older to be included in the study. The DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to assess mental disorders, and three dependent variables were examined: the prevalence of lifetime mood disorders; the prevalence of lifetime anxiety; and the prevalence of lifetime mood and anxiety disorders. Findings showed that emotional support was not associated with any of the three dependent variables. Negative interaction was significantly and positively associated with the chances of having a lifetime mood disorder, a lifetime anxiety disorder and the number of lifetime mood and anxiety disorders, with 23% of respondents reporting at least one mental disorder over their lifetime. The authors conclude that this study’s finding can alert clinicians to the potential negative impacts of family involvement and their implications for psychiatric disorders.
Delirium among patients with and without dementia: does the diagnosis according to the DSM-IV differ from the previous classifications?
- Authors:
- LAURILA Jouko V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(3), March 2004, pp.271-277.
- Publisher:
- Wiley
Different diagnostic criteria differ in their capacity to identify subjects as delirious. It is not known how DSM-IV classification, compared with the DSM-III, DSM-III-R, and ICD-10, identifies delirium among individuals with and without dementia and whether the symptom profiles differ between these two subgroups. A cross-sectional study was performed on patients (age 70 years) in seven acute geriatric wards (n = 230) and in seven nursing-homes (n = 195) in Helsinki, Finland. Delirium was diagnosed according to the operationalized criteria according to the DSM-III, DSM-III-R, DSM-IV, and clinical criteria of ICD-10. Dementia was defined according to consensus judgment among three geriatricians with concise information including: prior dementia diagnoses, Clinical Dementia Rating Scale, operationalized criteria according to the DSM-IV, nurses and/or caregivers interviews, and the results of the brain CT/MRI and prior Mini-Mental State Examination scores, when available. According to the DSM-III, DSM-IIIR, DSM-IV and ICD-10 criteria of delirium 22.7, 23.5, 25.9 and 14.9% of the demented, and 12.9, 13.5, 23.5 and 2.9% of the non-demented, respectively, were diagnosed as delirious. In stepwise logistic regression analysis clouding of consciousness, perceptual disturbances, and disorganized thinking were the most significant contributors to delirium diagnosis according to the DSM-IV among individuals with dementia, whereas perceptual disturbances, motor disturbances, and disorientation were the most significant contributors among those without dementia. DSM-IV criteria of delirium identify new, often non-demented, subjects as being delirious, while ICD-10 is overly restrictive. The symptom profile of delirium was slightly different among individuals with and without dementia.
Prevalence of DSM—IV psychiatric disorder in the French elderly population
- Authors:
- RITCHIE K., et al
- Journal article citation:
- British Journal of Psychiatry, 184(2), February 2004, pp.147-152.
- Publisher:
- Cambridge University Press
France has high rates of psychotropic drug consumption and suicide in the elderly population, but it has not yet been possible to determine whether this is due to exceptionally high morbidity rates. The aim was to describe the first longitudinal population study of psychiatric disorder undertaken in France, and to estimate current and lifetime prevalences and age of onset of psychiatric disorder. A study group of 1873 non-institutionalised persons aged 65 years and over was randomly recruited from the Montpellier district electoral rolls. The Mini International Neuropsychiatric Interview was used to assess current and lifetime symptoms. Cases identified by the application of DSM — IV criteria were re-examined by a clinical panel. Forty-six per cent of the study population had experienced a mental disorder in their lifetime, and 3.7% had made a suicide attempt. Lifetime prevalence of major depression was 26.5% and 30% for anxiety disorders. Current prevalence rates were 14.2% for anxiety disorders, 10.7% for phobia, 3% for major depression and 1.7% for psychosis. Results show veryhigh rates of lifetime but not current major depression. Rates of currentphobia and suicidal ideation in the very elderly are also high compared with other studies. The rates reported are likely to be underestimates.
Schizophrenia into later life: treatment, research, and policy
- Editor:
- COHEN Carl
- Publisher:
- American Psychiatric Publishing
- Publication year:
- 2003
- Pagination:
- 322p.,bibliogs.
- Place of publication:
- Washington, DC
Provides an overview of the current state of knowledge about schizophrenia in later life and examine the implications for treatment, research, and policy. The focus is on those persons who develop schizophrenia later in life. Topics include, the differential diagnosis of psychotic disorders in the elderly, the effects of chronic medication exposure on the biological features of schizophrenia, and gender differences in the expression of the disease across the life span
Executive and memory function and its relationship to trait impulsivity and aggression in personality disordered offenders
- Authors:
- DOLAN Mairead, ANDERSON Ian M.
- Journal article citation:
- Journal of Forensic Psychiatry, 13(3), December 2002, pp.503-526.
- Publisher:
- Routledge
The authors examined the relationship between trait impulsivity and executive and memory function in aggressive personality disordered offenders and non-aggressive healthy controls. There were 60 personality disordered offenders and 27 healthy controls who were characterized using the Special Hospital Assessment of Personality and Socialisation (SHAPS) and psychometric measures of impulsivity and aggression. Executive and memory function was assessed using a battery of traditional neuropsychological tests. SHAPS 'psychopathic' offenders perform poorly on frontal tasks assessing concept formation in a verbal format. Impulsivity and aggression correlate negatively and significantly with executive but not with memory function, the effects of IQ having been controlled for. Impulsive/aggressive (psychopathic) offenders have executive deficits over and above that which can be accounted for by the observed IQ deficits in this population.
Communication and mental illness: theoretical and practical approaches
- Editors:
- FRANCE Jenny, KRAMER Sarah
- Publisher:
- Jessica Kingsley
- Publication year:
- 2001
- Pagination:
- 478p.,bibliogs.
- Place of publication:
- London
Aims to help professionals to understand the important role that communication plays in mental health and apply that knowledge in a variety of mental health settings. The first part of the book provides theoretical background to the methods of communication adopted by people with a range of diagnoses of mental illness. It also makes practical suggestions as to how this information can improve the professional's management of patients. Part Two looks at how information about communication in mental illness can influence service provision, with suggestions for future policy and practice. Concludes with a section describing the state of current research.