ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors treated 115 elderly patients (ambulatory and without dementia) with recurrent major depression, by means of combined nortriptyline and interpersonal psychotherapy. They contrasted Cumulative Illness Rating Scale-Geriatric (CIRS-G) scores (for medical burden) in recovered and nonrecovered patients and generated a Cox proportional-hazards model of time-to-remission. The authors found no association between pretreatment chronic medical burden and acute treatment outcome in recovered (83 of 115) and nonrecovered patients and no relation of pretreatment CIRS-G scores with time-to-recovery. Findings support recent recommendations that practitioners be optimistic in treating elderly depressed, ambulatory patients whether or not significant medical burden coexists.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors performed a chart review of 174 patients age 50 and over (mean age, 69 years) to test a model of social and clinical characteristics that predict engagement in outpatient treatment. “Engaged” patients were defined as those who had three or more clinic visits. Logistic regression analysis, using a 14-variable model, was highly significant (T= 0.0003) and able to correctly classify 70% of cases. There were four predictors of clinical engagement: being a Medicaid recipient (P< 0.01), shorter length of current symptoms (P< 0.05), younger age (P= 0.06), and having a diagnosis of schizophrenia (P= 0.06); and these variables accounted for all the explained variance. These findings indicated that predictors of engagement do not invariably follow the patterns reported for younger patients.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Labile affect is a common characteristic of elderly psychiatry patients, especially among patients in the early stages of primary progressive dementia. The authors sought to develop a method of assessing the full range of positive and negative moods in psychiatric patients with early dementia and healthy elderly subjects. They modified the Derogatis Affects Balance Scale (DABS) to ease its administration in cognitively compromised patients and presented it to 51 geropsychiatry inpatients with dementia of either Alzheimer's or vascular etiology. The modified DABS was found to discriminate depressed and nondepressed dementia patients and have acceptable test-retest reliability coefficients, despite extensive variation in scores. Analyses of construct and criterion-related validity were also consistent with previous DABS normative studies.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors prospectively examined elderly patients diagnosed with major depression with psychotic features (MD-P) and patients diagnosed with dementia of the Alzheimer Type (DAT) for neuroleptic-induced parkinsonism (NIP) during perphenazine treatment. Baseline parkinsonian symptoms did not differ between groups. With treatment, mean NIP score doubled in DAT patients but remained unchanged in the MD-P group. The difference between groups was highly significant and remained so after the effects of age, perphenazine dose, and duration of perphenazine treatment were controlled. Although the mechanisms underlying these differences in NIP development remain to be determined, clinical guidelines for neuroleptic dosages in elderly patients need to account for variability in neuroleptic tolerance between diagnostic groups.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors sought to determine whether subsyndromal delirium is a qualitatively distinct clinical entity or a spectrum of cognitive and behavioral abnormalities. They conducted a prospective, longitudinal study on 325 patients in an acute care hospital with 3− and 6-month follow-ups. Patients were classified into one of three groups: those meeting full DSM criteria for delirium, those with subsyndromal delirium, and those with no symptoms of delirium. There were no differences in risk factors between those developing DSM-defined delirium or subsyndromal delirium. Number of independent risk factors was a significant predictor of delirium. Patients with subsyndromal delirium fall on a continuum between those with DSM-defined delirium and those with no symptoms of delirium. These data suggest that delirium does represent a spectrum of neurobehavioral impairment. Patients with symptoms of subsyndromal delirium are at risk for considerable morbidity; therefore clinicians should attempt to reduce and treat the onset of occurrence of subsyndromal delirium.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A patient with vascular dementia had severe, unremitting agitation that was refractory to conventional therapies and put her life in jeopardy. She had a dramatic response to bilateral electro-convulsive therapy (ECT), with longitudinal follow-up demonstrating that her behavioral symptoms lapsed predictably when maintenance ECT was delayed.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID