摘要:

AbstractThe elderly are at high risk to develop neurotoxicity in the course of lithium therapy. This is especially true for patients with neurologic or cognitive impairments. This may occur even when lithium treatment is modified to include lower doses and lower target blood levels. The literature is reviewed concerning current uses of lithium in older patients. The rationale for expecting that red blood cell (RBC) lithium levels could have predictive value in the early detection of impending serious neurotoxicity is discussed. There appears to be a critical value for RBC lithium in the region of 0.6 mEq/ 1 that is ominous as a harbinger of impending toxicity. This critical concentration may be considerably lower for patients with dementia.

ISSN:0885-6230    

DOI:10.1002/gps.930050102

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe lithium literature indicates that geriatric psychiatric patients are particularly at risk for developing serious neurotoxic side‐effects. There is currently no reliable method for predicting which patients are at heightened risk for this adverse development. There is evidence that the adjunctive monitoring of intra‐erythrocyte (RBC) lithium levels may offer early indications that such toxicity is impending. Applications of such measurements are shown in two case reports which offer preliminary support for the value of RBC lev

ISSN:0885-6230    

DOI:10.1002/gps.930050103

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe Multiphasic Environmental Assessment Procedure (MEAP; Moos and Lemke, 1984) was used to assess a British sample of specialized envionments for the dementing and elderly. Results supported the utility of the MEAP as a measurement tool. Shortcomings in the planning for such environments were identified, for example in the provision of adequate safety, prosthetic and orientational aids, and some assumptions about care priorities were challenged, such as the cruciality of ‘integration’ and the necessity for proximity to community facilities of units for the dementing. Comparisons with American normative data were made, with the most consistent finding being a more satisfactory provision of physical environment features in the American sam

ISSN:0885-6230    

DOI:10.1002/gps.930050104

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractIn a study linked to the examination of the ‘MEAP’ as a measure of environments for the dementing, a procedure for measuring stress in the carers of the dementing was designed and administered to staff caring for the dementing in three different facilities. Stress was attributed primarily to staff, resident, or environmental characteristics. Events were identified to which care staff of the dementing attributed their stress, and variables including types of staff training and experience, levels of dementia in residents and staff levels were discussed as possible contributors to the perception of events as stress

ISSN:0885-6230    

DOI:10.1002/gps.930050105

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractA two‐year review of a psychiatric clinic within a geriatric medical day hospital was undertaken to obtain: (a) the prevalence of major depression in that clinic and (b) outcome at 6–12 months postintervention. The clinic provided only consultative service to primary caregivers. Thirty‐seven per cent of the 78 referrals to this clinic, ie 15% of all day hospital attenders, had a DSM‐III diagnosis of major depression; the depressed group had more widows. Outcome of depression at six months and 12 months was better than or comparable to recent reports despite the low‐contact psychiatric involvement. Cognitive scores and severity of depression had no effect on outcome in this group. More setting‐specific prevalence and outcome studies are recommended for a better understanding of depression in

ISSN:0885-6230    

DOI:10.1002/gps.930050106

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractAlthough gradual global progression is one of the cardinal features of primary degenerative dementia of the Alzheimer type, clinical observation of patients suggested that there is some variability in the degree and rapidity of decline of different symptoms of this illness. In particular, it appeared that language fluency and self‐awareness of memory problems did not decline simultaneously. This study was designed to test the hypothesis that an inverse relationship exists between self‐awareness and fluency in patients with Alzheimer's disease. Thirty‐two patients suffering from Alzheimer's disease were divided into two groups on the grounds of presence or absence of self‐awareness of memory handicaps. These patients were also assessed in regard to fluency using a three‐point scale devised for this purpose. A significant inverse association was found between self‐awareness and fluency. This appeared to be a specific relationship, unrelated to global indicators of function including Mini‐Mental Status Evaluation, Aphasia Screening Test scores or demographic features. Possible implications of this with reference to intracerebral localization issues in mild‐moderate Alzheimer's diseas

ISSN:0885-6230    

DOI:10.1002/gps.930050107

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe computer diagnosis AGECAT applied to data from the Geriatric Mental State is shown to agree closely with cases of dementia and depression selected by the ‘pervasive illness’ (Gurlandet al., 1983) and DSM III methods (American Psychiatric Association, 1980). AGECAT selects more borderline cases of depression than either of the other two methods, but also designates two levels of mild or subcases for both depression and demen

ISSN:0885-6230    

DOI:10.1002/gps.930050108

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractThis study aimed at identifying patterns or clusters of functional impairment and behavioural disturbances in vocally disruptive patients compared with controls. Identified vocally disruptive patients (37) from psychogeriatric wards (264 patients) were included and compared with controls (37) matched for sex and wards. Assessment of the degree of orientation and functional performance (physical and psychosocial) was made using a newly developed rating scale, Organic Brain Syndrome Scale, consisting of two subscales, a 16‐item scale measuring orientation and a 39‐item scale measuring functional performance. Principal component analysis was applied reducing the first subscale into three factors (orientation to time, person, past and present events) and the other subscale into seven factors (functional performance and orientation in the ward, fluctuations in mental state and emotional disturbances, speech performance and psychomotor slowing, mobility, hostility, presence of delusions and hallucinations, sensitivity and euphoric state). Discriminant analysis revealed that vocally disruptive behaviour related significantly to physical dependence and disorientation in the ward, confusional reactions, delusions, hallucinations and a more preserved speech performance compared with controls. Suggestions have been made that vocally disruptive behaviour develops when environmental factors such as sensory deprivation interact with the effects of the brain dam

ISSN:0885-6230    

DOI:10.1002/gps.930050109

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930050101

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY