Distinction of dementia and depression in various stages of the disease processes

2016 ◽  
Vol 33 (S1) ◽  
pp. S39-S39 ◽  
Author(s):  
W. Maier
Keyword(s):  
The Elderly ◽  
Psychotic Symptoms ◽  
Alzheimer Type ◽  
Metabolic Factors ◽  
Incident Dementia ◽  
Clinical Syndromes ◽  
Activity Of Daily Life ◽  
Clinical Tools ◽  
Competing Interest ◽  
Old Age Depression

Old age depression is often difficult to discriminate from dementia (particularly of Alzheimer type) – particularly cross-sectionally. Incident dementia is frequently associated with depressed mood and agitation; depression in the elderly goes together with executive and memory dysfunctions; associated psychotic symptoms and activity-of-daily-life dysfunctions are shared by both conditions as well as major risk factors as vascular and metabolic factors. Frequently both syndromes are “masking” each other; depression may furthermore present as the first clinical sign of Alzheimers disease.Yet, both clinical syndromes/disorders emerging from quite different are pathogenic neurobiological mechanisms with differentiating neuropsychological, – imaging and – chemical features. Clinical tools can be derived and enable accurate differential diagnosis. Thus, the distinction between both syndromes is a first instance for biomarker supported differential diagnoses in psychiatry.Disclosure of interestThe author has not supplied his declaration of competing interest.

Differential Diagnosis Based on Age. Diagnostic Difficulties

2016 ◽  
Vol 33 (S1) ◽  
pp. S473-S473
Author(s):  
S. Rodrígue Vargas
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Diagnostic Difficulties ◽  
Diagnostic Hypothesis ◽  
Competing Interest

IntroductionFollowing a case presented in our inpatient unit as well as various interdepartmental from internal medicine and other emergencies, we decided to conduct a literature review on the different organic causes that can trigger the onset of psychotic symptoms in elderly.ObjectivesA correct differential diagnosis of psychiatric symptoms in elderly.AimsLiterature review of the literature on the presentation of psychotic symptoms in the elderly.MethodsDescription of a clinical case and development of diagnostic hypotheses.Results and conclusionsFor several decades are experiencing a gradual aging of the population, which means that we are at the onset of clinical symptoms not described by classical authors. Furthermore, scientific advances make infectious causes (such as neurosyphilis was our first diagnostic hypothesis) are increasingly rare. The elderly usually has multiple comorbidities, which are receiving various treatments that must be ruled out possible adverse effects.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

Psychosis in adolescence: A prognosis or a diagnosis? Integrated treatment with psychodynamic peer support

2017 ◽  
Vol 41 (S1) ◽  
pp. S126-S127
Author(s):  
L. Ciampa ◽  
F. Gucci
Keyword(s):  
Peer Support ◽  
Social Relations ◽  
Intervention Strategy ◽  
Real Life ◽  
Integrated Treatment ◽  
Psychotic Symptoms ◽  
Psychodynamically Oriented ◽  
Rehabilitative Intervention ◽  
Competing Interest ◽  
One Year

IntroductionOur work comprises an integrated intervention strategy for the treatment of psychotic manifestations and functioning in adolescents which, following the theories of Laufer and Chan, questions the usefulness of the diagnosis ‘psychotic’ during adolescence. We apply an “open light treatment” (IPOLT), which includes psychodynamically oriented peer-support.ObjectivesTo build a new form of therapeutic alliance with peer-support based on shared real life experiences enabling adolescents to reintegrate within their environment and re-establish cognitive functioning which has become disorganised, aiding a gradual return of the cohesion of ego and self and in some cases, cessation of psychotic symptoms.MethodologyAn observational study of one year on a group of ten adolescents aged 17 to 20 in institutional and private settings with psychotic manifestations and functioning. The group were tested at the start and end of the study using WAIS-IV and MMPI-A.ResultsThe adolescents recruited showed a faster recovery of the cohesive processes of their fragmented ego as well as a quicker resumption of social relations. Our model provided an organising function and a flexible yet secure ‘container’ (Bion, 1988) for the young people's psychic structure. The tests showed a demonstrable improvement in their verbal comprehension, visual-spazial reasoning, fluid reasoning, working memory and processing speed.ConclusionsPsychotic manifestations occurring in adolescence may decrease with an immediate integrated and rehabilitative intervention, without need of an institutional psychiatric setting. In conclusion, we find that “psychosis” in adolescence is a prognosis and not a diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Serum selenium concentration is associated with metabolic factors in the elderly: a cross-sectional study

2010 ◽  
Vol 7 (1) ◽  
pp. 38 ◽  
Author(s):  
Kuen-Cheh Yang ◽  
Long-Teng Lee ◽  
Yow-Shan Lee ◽  
Hui-Ying Huang ◽  
Ching-Yu Chen ◽  
...  
Keyword(s):  
Selenium Concentration ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Serum Selenium ◽  
Sectional Study ◽  
Metabolic Factors ◽  
Cross Sectional ◽  
Serum Selenium Concentration

Early psychosis in young women

2016 ◽  
Vol 33 (S1) ◽  
pp. S7-S7
Author(s):  
A. Riecher-Rössler
Keyword(s):  
Young Women ◽  
Help Seeking ◽  
Negative Symptoms ◽  
Stress Reactivity ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Seeking Behavior ◽  
Drug Naïve ◽  
Competing Interest ◽  
The University

IntroductionIt is well known that young women are at lower risk for schizophrenic psychoses than young men. However, little is known about the peculiarities of emerging psychosis in young women.ObjectivesTo describe characteristics of emerging psychosis in women.MethodsWithin the FePsy (Früherkennung von Psychosen = early detection of psychosis) study at the University of Basel Psychiatric Clinics we have examined consecutively all patients with a first episode of psychosis (FEP) or an at-risk mental state (ARMS) referred to us between 2000 and 2015.ResultsWomen did not significantly differ from men regarding psychopathology, neither in the ARMS nor in the FEP group. This was true for positive as well as negative symptoms and basic symptoms. Interestingly, women had a higher correlation of self-rating with observer-rating regarding psychotic symptoms. Duration of untreated psychosis was significantly lower in women than in men. Women seek help more quickly than men and their first contact is more often their partner.Regarding neurocognition women showed a slightly better performance in verbal tasks. They also had higher prolactin levels and larger pituitary volumes, even when drug-naive.Transition to psychosis occurred as often and as quickly in women as in men.ConclusionsThere are only few gender differences in patients with emerging psychosis, which resemble mainly those found in the general population, with women showing a better help-seeking behavior, being more partner-oriented, having a better verbal performance and potentially also a higher stress reactivity [1].Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Psychotic Symptoms in the Elderly

2005 ◽  
Vol 07 (05) ◽  
pp. 238-241 ◽  
Author(s):  
Rebecca W. Brendal ◽  
Theodore A. Stern
Keyword(s):  
The Elderly ◽  
Psychotic Symptoms

Psychological and Physical Problems in Elderly People with Problems of Falls

2017 ◽  
Vol 41 (S1) ◽  
pp. S659-S660
Author(s):  
M. Mentis ◽  
M. Gouva ◽  
E. Antoniadou ◽  
K. Mpourdoulis ◽  
I. Kesoudidou ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Elderly People ◽  
The Elderly ◽  
Poor Mental Health ◽  
University Hospital ◽  
Psychological State ◽  
Physical Damage ◽  
The Difference ◽  
Competing Interest

IntroductionFalls of the elderly to a degree been associated with poor mental health, poor social support and poor physical health.ObjectivesTo investigate the falls of elderly people in relation to their mental and physical healthy.AimsTo compare the effects of falls in the elderly in the areas of mental and physical health.MethodsThe current study used purposive sampling compromised from 48 people that visited the emergency department at the Patras University Hospital in 2016. The inclusion criterion for participation was age (> 65 years). Data was collected using WHO's questionnaire, the WHOQUOL-BREF. Finally, data was analyzed using the test t test for independent samples.ResultsThe sample constituted by 39.6% of male and 61.4% of female. The average age of the sample was M = 75.89 years. In relation to mental health, the average of the elderly with a history of falls found M = 57.26 (SD = ± 22.87), while the other was found M = 74.45 (SD = ± 15.81). The difference between the two groups was statistically significant (P < 0.05), while physical health although again the first group found to have a smaller average (M = 56.65, SD = ± 22.13) relative to the second group (M = 63.78, SD = ± 12.59) no statistical difference was observed.DiscussionsThese results demonstrates that falls beyond the physical damage that are immediately visible can as well create significant issues in the psychological state of the elderly exacerbating anxiety, fear and social isolation, which has been associated with depression event.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Frontotemporal dementia and psychosis: Literature review

2016 ◽  
Vol 33 (S1) ◽  
pp. S367-S367
Author(s):  
D. Brandão ◽  
J. Massano
Keyword(s):  
Literature Review ◽  
Frontotemporal Dementia ◽  
Positive Family History ◽  
Genetic Mutation ◽  
Conclusive Evidence ◽  
Psychotic Symptoms ◽  
Initial Symptom ◽  
Clinical Criteria ◽  
Competing Interest ◽  
The Right

IntroductionFrontotemporal dementia (FTD) is a progressive neurodegenerative disease especially sporadic. About 30–40% have positive family history, with an identifiable genetic mutation in a percentage of cases increasing. Although the FTD psychosis has been recognized for many years, it is not included in the clinical criteria.ObjectivesTo assess the prevalence and characteristics of psychotic symptoms in FTD, compare the presence of psychosis in FTD C9+ versus C9− and analyze the occurrence of wrong diagnoses in FTD with psychosis.MethodsLiterature review, using computerized databases (Pubmed®). Articles were selected based on the content of their abstract and their relevance.ResultsIt is frequently the presence of psychotic symptoms in FTD associated with C9+ versus C9−. These may arise as initial symptom often leading to a psychiatric diagnosis years before obtaining diagnosis of FTD. There is no conclusive evidence about the anatomical correlation of psychotic features in the FTD, although there is the possible association with the right brain degeneration.ConclusionsThe existence of psychotic symptoms do not argues against the diagnosis of FTD verifying a high frequency of psychosis in FTD – C9+. As can be the first symptom in FTD is critical to differentiate psychiatric disorders. Further studies are needed in order to obtain a better characterization of psychotic symptoms in FTD – C9+.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Electroconvulsive therapy in schizophrenia – where do we stand?

2016 ◽  
Vol 33 (S1) ◽  
pp. s262-s263
Author(s):  
J. Silva ◽  
J. Mota ◽  
P. Azevedo
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Drug Intolerance ◽  
Rapid Control ◽  
Practice Of Medicine ◽  
Nice Guidance ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionElectroconvulsive therapy is currently used in the management of severe depression, long-term mania and catatonia. Regarding schizophrenia-related psychosis ECT is also an option, but the indication is restrictive to severe cases, drug intolerance or resistant ones. Lack of evidence of cost-effectiveness compared to clozapine, and side effects of ECT techniques before 2003, influenced NICE guidance to not recommend ECT in schizophrenia, but modern ECT machines and procedures are subsequent to 2003. ECT is often performed when clozapine fails to respond in monotherapy or if there is intolerance to antipsychotic side effects. ECT in combination with clozapine seems to have significant results allowing the patients to achieve rapid control of psychotic symptoms with fewer side effects, comparing with antipsychotics-association strategies.ObjectivesTo summarized the latest literature about this field and to present recent data from the Electrovulsivetherapy Unit, in Hospital de Magalhães Lemos, Portugal.AimTo explore and critically review the controversies of electroconvulsive therapy in the management of drug-resistant schizophrenia.MethodsRetrospective data of an Electroconvulsive Therapy Unit during 2006–2015 was review.Results198 ECT treatments in schizophrenic patients were performed in our unit, during 2006–2007, in a total of 647 ECT (30,6%). In 2014–2015, 945 schizophrenic patients received ECT treatment, in a total of 2149 performed ECT (43,9%).ConclusionsAlthough guidelines are crucial for the uniform practice of medicine, sometimes is important to be critical about them. The use of ECT in schizophrenia is safe and effective and further research is needed to continue to support this treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Culture and mental disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S517-S517
Author(s):  
A. Adrián ◽  
C. Noval Canga ◽  
H. Rebeca ◽  
S. Isabel ◽  
G. Sofía ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Mental Disorders ◽  
Psychiatric Diagnosis ◽  
Emergency Service ◽  
Psychotic Symptoms ◽  
Sociocultural Factors ◽  
Psychiatric History ◽  
Sexual Content ◽  
Competing Interest

ObjectivesShow with a case report how psychiatric pathology may face differential diagnosis problems when sociocultural aspects are involved.Methods and materialsSeventy-three year old man, born in Colombia. During the last two months, he had come many times to the emergency service due to behavioural changes. He does not have previous psychiatric history. His daughter refers that one of the patient's sisters has been diagnosed of “mystical madness”. The previous days he abandoned his medical treatment saying that he “gets in touch with his wife and that he wants to meet her”. Since his wife's dead, he had presented an excessively adapted behaviour, without grief symptoms. The first hospitalization day he said we wanted to get married with one of his daughters, with a sexual content speech, being able to get emotional when he spoke about his dead wife. Now the patient is under frequent reviews, and it is thought the differential diagnosis of depression with psychotic symptoms, due to the lack of symptoms remission.ConclusionWhenever we face different psychiatric diagnosis we don’t keep in mind some sociocultural factors, which could be masked and raise different doubts. It is important to keep in mind that each country or ethnical have their own cultural habits which are going to deeply influence patient's personality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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