ISSN:0885-6230    

DOI:10.1002/gps.930091202

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThis article explores the conceptual construction of Cotard's syndrome and includes an analysis of 100 cases of which 20 were over 65. Jules Cotard took the view thatdélire des négationswas only a subtype of depressive illness characterized by sadness, guilt, marked anxiety, suicidal behaviour, insensitivity to pain, and delusions of negation, damnation and enormity. Soon after his death, however, a debate ensued as to whether what he had described was specific to melancholia or could be found associated with other psychoses. This view predominated for more than 80 years. Currently, and despite the fact that the French termdéAliremeans more than ‘delusion’, some authors use ‘Cotard's delusion’ to refer to the isolated of ‘being dead’. From clinical and evolutionary perspectives, it is unclear why an isolated delusion should merit (as some have suggested) a special brain location. Analysis of the cases so far reported suggests that it is only in the elderly that Cotard's syndrome tends to acquire its clinical completeness. There is no evidence, however, that its presence is a function of dise

ISSN:0885-6230    

DOI:10.1002/gps.930091203

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe Psychogeriatric Dependency Rating Scale (PGDRS) behavior subscale was completed for 431 residents of eight nursing homes at three time points: the weeks preceding nursing home admission, 2 weeks and 2 months after nursing home admission. The mean PGDRS behaviour subscale score significantly decreased from before admission to 2 weeks after admission but returned to preadmission levels at 2 months after admission (p<0.01). There were significant temporary decreases after admission in the prevalence of interfering behaviour, difficulty understanding, self‐destructive behaviour, persecutory ideas and hallucinations. A decrease in behaviour problems after admission was associated with admission because of disruptive behaviour, possible Alzheimer's disease and expecting to live permanently in the nursing home. An increase in behaviour problems was associated with admission because of disruptive behaviour, dementia with stroke, delirium, being uneasy with other residents, unoccupied by activities, incontinence and physical dependenc

ISSN:0885-6230    

DOI:10.1002/gps.930091204

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractFalls in 44 matched control patients (average age 87.1) were statistically compared to 38 patients (average age 85.3) who received scheduled or as needed (prn) single‐agent psychotropics over a 6‐month period. Prospective assessments of psychotropic drug therapy were made on a monthly basis, and data on falls and fractures were retrospectively gathered. Both scheduled and prn single‐agent usage of benzodiazepine (BZ) hypnotics, and scheduled usage of BZ anxiolytics and thioridazine increased the incidence and episodes of falls over the frequency of falls found in the control group. Fractures were more prevalent in the treatment group over the 6‐month period, but half the falls in the control group resulted in fractures. Longer‐acting BZs, both prn and scheduled, resulted in a greater rate of falls than the shorter‐acting BZs, but even the shorter‐acting (SA) BZs given on a scheduled basis more often than three times a week had a greater rate of falls than the control group. When not more than 3 SABZ doses per week were given, no falls were noted for the follow‐up 6‐month period. It appears that most single psychotropics, except the SABZs given no more often than three times a week, haloperidol and desipramine, increase the risk of falls and fractures in a very old frail nursin

ISSN:0885-6230    

DOI:10.1002/gps.930091205

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe effects of relocating 19 patients with dementia and their nursing staff from an old long‐stay hospital ward to a community nursing home were evaluated. Compared with patients who were remaining in hospital, those relocated patients who were still alive at the time of follow‐up showed no evidence of changes in behavioural dependency or the number of problem behaviours. Nursing staff who were being moved, compared to their colleagues, showed more dissatisfaction with their work in the period before the move. Moving patients and staff together may have helped to minimize the impact of the move on the patients, but this study draws attention to the importance of providing support for staff undergoing such chan

ISSN:0885-6230    

DOI:10.1002/gps.930091206

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractInterpreting data on the balance and capacity of long‐term care facilities within districts and their relationship to population ‘need’ has been difficult because of unmonitored cross‐boundary flow, particularly within the independent sector. A simple banding technique is described which distinguishes likely importer and exporter districts. Modest provision of long‐stay hospital care is shown to be associated with less use of rest/nursing

ISSN:0885-6230    

DOI:10.1002/gps.930091207

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe long‐term outcome of a civilian disaster is examined in an elderly population assessed originally for medicolegal purposes. Thirty‐one elderly inhabitants of the village of Lockerbie, who had survived the Lockerbie air disaster, were assessed 1 year after the event. Nineteen of the sample were available for reexamination 2 years later. Although there was a significant reduction in the incidence of PTSD and significant improvement across a range of anxiety‐based symptoms, 15.7% of the subjects continued to fulfil diagnostic criteria (DSM‐III‐R) for PTSD. In these subjects, there was a persistence of other anxiety‐related symptoms and of major depression (DSM‐III‐R). This is the only longitudinal assessment of PTSD in elderly subjects and it shows that, as with younger subjects, PTSD tends to persist for at least 2 years after the traumatic event and, for a substantial minority, has still not remitted within 3 years of the

ISSN:0885-6230    

DOI:10.1002/gps.930091208

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractLithium augmentation of antidepressant therapy in elderly outpatients has not been systematically assessed. A prospective, practice‐based observational study of 44 patients comparing an antidepressant monotherapy group (N= 23) with a lithium augmentation group (N= 21) was conducted in a geriatric psychiatry, outpatient clinic. The severity of depression was evaluated with the Montgomery–Asberg Depression Rating Scale (MADRS), the DSM‐III‐R Global Assessment of Functioning (GAF), a treatment effectiveness rating (ER) and the Geriatric Depression Scale (GDS). Patient‐reported adverse events were systematically collected. The mean age for the group was 76.5 ± 6.0 years, 81.8% were female and the most common principal diagnosis was major depression (88.6%). Doxepin was the most commonly prescribed antidepressant (29.5%), followed by nortriptyline (27.2%) and phenelzine (15.9%). Patients receiving lithium augmentation were less depressed and functioning better than those in the antidepressant alone treatment group—MADRS: 8.5 ± 8.8 vs 13.9 ± 9.0 (p<0.05); GAF: 77.9 ± 8.3 vs 68.5 ± 10.5 (p<0.01); ER: X2= 4.5 (p<0.05); GDS: 4.0 ± 2.7 vs 5.9 ± 4.3 (NS). Patients in the lithium group tended to report fewer adverse events (3.7 ± 2.1 vs 5.0 ± 3.0 (NS)). Results suggest that lithium augmented patients are less depressed and report fewer adverse events than those on antidepressants alone. Lithium appears to be a safe and effective addition to antidepressant pharmacoth

ISSN:0885-6230    

DOI:10.1002/gps.930091209

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930091210

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930091211

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY