ISSN:0885-6230    

DOI:10.1002/gps.930030202

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe authors review the history of neuroleptic treatment in dementia. The initial review of 34 studies published since 1954 was limited to the 20 double‐blind and / or placebo‐controlled studies. Sixty per cent of the studies revealed generally positive clinical results in demented patients following neuroleptic treatment. Acute side‐effects were not reported to be more prevalent or severe than in other psychiatric populations and included sedation, orthostatic hypotension, extrapyramidal reactions, and various anticholinergic symptoms. Careful assessment of the cognitive effects following neuroleptics, particularly those with known anticholinergic properties, was not performed in most of these studies and should be a focus of future prospective studies in this population. Nonetheless, it does appear that neuroleptics have a role in the treatment of patients with dementia. When used at low doses for specific purposes (i.e. treatment of agitation, hyperactivity, hallucinations, or hostility), they can both safe and effective in this popul

ISSN:0885-6230    

DOI:10.1002/gps.930030203

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractAfter partial success of traditional methods (closed formulary, use of generic drugs, retrospective drug usage review and continuing education) to reduce drug costs, a new‐approach ‘team approach’ was tried. This involved a clinical pharmacist and psychiatrists jointly reviewing patient drug therapies in view of a previously agreed set of guidelines. These guidelines were formulated to optimize patient therapy after a thorough review of clinical pharmacology and pharmacokinetics of drugs and pathophysiology of different psychiatric disorders. Drug cost savings of 49% and 16% were achieved in two different wards. The clinical pharmacist's active involvement accounted for a difference of 33% between the two

ISSN:0885-6230    

DOI:10.1002/gps.930030204

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn 1982/83 a random community sample of 1070 people aged 65 years and over resident in Liverpool was identified. GMS data from this sample were analysed using the AGECAT computer diagnostic program and reliable and valid rates for the different mental illnesses were determined. One hundred and seventy‐nine subjects have died during the first three years of follow‐up in the longitudinal study and form the basis of the mortality data presented here. The results demonstrate a significant relationship between mortality rates and mental disorder and we discuss these findings for different diagnostic categories as well as using the ability of the AGECAT system to look at case lev

ISSN:0885-6230    

DOI:10.1002/gps.930030205

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA double‐blind placebo‐controlled trial of the calcium antagonist Nimodipine in 10 patients with multi‐infarct dementia (MID) shows that there is no improvement when compared with 10 patients on placebo assessed by clinical ratings and sequential NMR imaging. The value of repeated NMR imaging in measuring changes in MID is desc

ISSN:0885-6230    

DOI:10.1002/gps.930030206

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractOne hundred and seventeen inpatients and outpatients with primary degenerative dementia participated in a multicentre, placebo‐controlled, parallel‐group, therapeutic study with CBM 36‐733 (2‐methyl‐alpha‐ergokryptine) lasting eight weeks. The daily dose of CBM 36‐733 was 2.0 mg, after a slow increase over 10 days. The assessment of effects relied on factors derived from the SCAG (Sandoz Clinical Assessment Geriatric) scale and the NOSIE (Nurses' Observation Scale for Inpatient Evaluation), a battery of pscyhometric tests, and overall evaluation of efficacy and tolerability (plus laboratory analyses). CBM 36‐733 was well tolerated and positive changes were seen with regard to the ‘Apathy’ factor of the SCAG scale and in psychometric tests measuring psychomotor speed, attention, and some aspects of memory. Longer‐term studies are now required to determine the clinical relevance and duration of improvements that can be achieved with CBM 36‐733 in patients suffering from primar

ISSN:0885-6230    

DOI:10.1002/gps.930030207

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractClonidine loading tests (100μg i.v.) for growth hormone (GH) release were performed in eight patients with dementia of the Alzheimer type and four with multi‐infarct dementia. clonidine did not stimulate GH but depressed blood pressure levels. Basal GH levels correlated to clinical variables of affective symptomatology but not with monoamine levels in the cerebrospinal fluid. Treatment with a 5‐HT uptake inhibitor (citalopram) did not affect the outcome of the loading t

ISSN:0885-6230    

DOI:10.1002/gps.930030208

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractOne hundred elderly patients investigated for a cross‐sectional relationship between dementia and limited mobility were reviewed a year later. Forty patients had died during this time. While there was a strong relationship between poor mobility and mortality, there was little between psychiatric function or symptoms and mortality. There was also a considerable decline in physical function over the year, but little association between original mental function and this. Finally, there was a decline in cognitive function. There was no increase in the frequency of other psychiatric symptoms, but different patients were affected by particular symptoms initially and one year late

ISSN:0885-6230    

DOI:10.1002/gps.930030209

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThis study reviews referrals of elderly medically ill patients to a psychogeriatric team in a district general hospital. Sociodemographic variables, medical diagnosis, source and reasons for referral, and primary DSM III diagnosis were determined. The impact on referral patterns of the introduction of a pscychogeriatric liaison attachment to complement the existing consultation service was also assessed.In three years, 217 patients were referred, the majority from the general medical specialities. The median age of the sample was 79.5 years, more than half were female and over 60% demonstrated multiple physical pathology, particularly cerebrovascular and cardiovascular disorders. The most prevalent psychiatric diagnoses were dementia, delirium and depression. The pattern of referrals changed significantly with the introduction of the consultation–liaison service. The number of referrals increased by over 100% and there was a significant increase in the recognition and referral of functional psychiatric disorders, especially depression. The role of the geriatricians and the liaison psychiatry attachment in promoting these changes and the clinical, teaching and research advantages of this type of collaboration are discusse

ISSN:0885-6230    

DOI:10.1002/gps.930030210

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractTwo studies were carried out to validate the St Thomas' Questionnaire (SQSD) for use by health professionals to distinguish between cases of depression in the elderly without underlying organic involvement, and thus potentially reversible, from those of a progressive and irreversible senile dementing state. In the first study 50 patients with a diagnosis of senile dementia, 50 with functional disorders known to include an affective component and a control group of 50 coping elderly people within the district were psychologically tested. Independent assessments by a psychiatrist were also provided for the two experimental groups. After taking age and IQ differences into account using multiple regression, performance scores on the SQSD were compared between groups. Significant differences were found (p<0.01) between controls and dementing patients and between depressed patients and dementing patients, but not between depressed patients and controls. When individual subtests of the SQSD were examined, certain items were found to be of greater discriminatory value than others, and in the second study the less discriminatory items were eliminated and a shorter version of the test was administered to a further sample of 50 patients diagnosed as depressed and / or dementing. Again significant differences were found (p<0.01) between the groups, demonstrating the SQSD to be of diagnostic value in discriminating a primarily depressed state from a dementing process.

ISSN:0885-6230    

DOI:10.1002/gps.930030211

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY