bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between general practitioners with high or low use of a psychogeriatric domiciliary visit service
Authors: Orrell Martin W. , Hardy‐Thompson Christine , Bergmann Klaus 
Published: December 2004

AbstractIn a catchment area survey of general practitioners regarding their use of the psychogeriatric domiciliary service, a comparison is made between those doctors with a high or low use of such visits in the care of their elderly patients. General practitioners with a high use of the service tended to be more satisfied with the service and more prepared to attend domiciliary visits. The high users were also more likely to consider the patient's physical disability as an important factor in their decision to request a visit in preference to another method of assessment. However, high users were less likely to have had previous psychiatric training and more likely to feel susceptible to pressure from relatives. Although in some ways high users seemed to be using the service more appropriately, psychiatric training may be important in helping the general practitioner to cope with elderly patients.
Oxiracetam in the treatment of primary dementia of the Alzheimer's type: A small case series
Authors: Dager Stephen R. , Loebel J. Pierre , Claypool Keith , Case Mary , Budech Christopher B. , Dunner David L. 
Published: December 2004

AbstractA 16‐week open‐label trial of high‐dose oxiracetam (up to 3200 mg per day), was not clinically effective overall in treating a small cohort of patients with mild‐moderate dementia of the Alzheimer's type (DAT). However, one of six patients did demonstrate evidence of progressive clinical improvement followed by relapse after discontinuation of medication. Resumption of treatment with oxiracetam after a 6‐month interval was associated with a similar pattern of improvement on neuropsychological testing and enhanced social functioning which was sustained during an additional 5 years of treatment. Following death due to unrelated causes, brain histopathologic findings were consistent with late‐stage DAT despite the patient's sustained clinical improvement while under treatment with oxiracetam.
A survey of geriatric psychiatrists in the US regarding research
Authors: Jeste Dilip V. , Fitten L. Jaime , Clemons Brenda , O'Neal Sheila , Harris M. Jackuelyn 
Published: December 2004

AbstractA questionnaire survey was conducted to elicit responses regarding research‐related experiences and attitudes among the members of the American Association of Geriatric Psychiatry. Nineteen per cent of the 1200 members to whom the questionnaire was sent responded. An analysis revealed that, while an overwhelming majority (85%) of the respondents felt that geriatric research was important, most encountered enormous barriers. These barriers ranged from funding and time constraints to a lack of training programs and institutional support, to the methodological issues in doing research on an elderly population. A majority of the respondents suggested that more funding be made available for research, and for research training (fellowship and residency programs), start‐up projects for private practice research, and improvement of methodology and protocols. Another frequent recommendation was for increasing collaboration among investigators, including setting up centers for cooperative studies and training.
Foundation funding sources in geriatric mental health
Authors: Harris M. Jackuelyn , Halpain Maureen 
Published: December 2004

AbstractAs federal and state funding sources become increasingly more competitive, other sources of funding for research, education and clinical programs need to be considered. In 1989, over $81 million was given by private sources in support of programs that directly benefited the elderly. This article examines methods for seeking private funding and provides a list of foundations with either specific or possible interest in geriatrics and mental health. We also offer specific suggestions for enhancing the chances of obtaining funding from these foundations.
The ethics of conducting research with older psychiatric patients
Authors: Fitten L. Jaime 
Published: December 2004

AbstractThe ethical context in which geropsychiatric research is carried out today in the United States has its origins in events of the 1960s and 1970s. Three main trends can be identified. The first is sociopolitical and involves the challenge to tradition and authority manifested in that period with its consequent moral pluralism and focus on new forms of individualism. Ethical thinkers redirected their attention to more normative questions and moral problems in medicine came under close scruitiny. Regulatory changes affecting research followed. The second trend greatly influenced the type of research that would predominate in psychiatry after the mid‐1970s. This trend involved the redirection of psychiatric thinking towards renewed interest in psychopathology, nosology and quantitation which was dormant during the preceding psychodynamically oriented decades. The final trend was the aging of the American population. Whereas before the 1960s there was little interest in aging the age‐related neuropsychiatric conditions, subsequent decades ushered in much interest and support for human aging research. New moral problems have naturally arisen. Most of them have involved vulnerable subpopulations of elderly. Nontheless, while small areas of disagreement remain and regulation is incomplete, research in geriatric psychiatry now proceeds within a well‐structured context of ethical guidelines and government regulations.
Psychiatric disorders in the nursing home: A selective review of studies related to clinical care
Authors: Rovner Barry W. , Katz Ira R. 
Published: December 2004

AbstractExisting research demonstrates that nursing homes are the modern mental institutions for the elderly in the United States, but that training of staff and physicians, processes of care, and the recognition and treatment of mental disorders lag behind the current state of scientific knowledge. The prevalence of diagnosable psychiatric disorders has been estimated to be 80% or higher. The most common of these disorders are the dementias, primarily Alzheimer's or vascular, that can be uncomplicated or complicated by the presence of hallucinations, delusions, depression or behavioral symptoms. Other common disorders include depression and delirium. Problems currently under investigation include the effectiveness of special care units for patients with dementia, the characterization and treatment of the non‐cognitive, psychiatric symptoms of dementia, including consideration of the appropriate use of psychotropic medications, and the recognition, diagnosis, and treatment of depression. Although there is a clear need for more research, the available data already demonstrate the need for augmented psychiatric input into nursing home care.
Alzheimer's disease, the phenomenon of parent fixation and bowlby's attachment theory
Authors: Miesen Bère M. L. 
Published: December 2004

AbstractSooner or later many Alzheimer's disease (AD) patients behave as if their deceased parents are still alive. This phenomenon is called parent fixation (PF) and is considered within the theoretical framework of Bowlby's Attachment theory. The hypothesis is that PF is an expression of their need to feel safe and secure. Explorative research indicates that PF is correlated with the level of cognitive functioning and attachment behaviour. The results show that (1) AD can be considered as a "strange situation" which activates attachment behaviour; and (2) the PF which occurs in AD patients has different meanings for the different stages of dementia. The conclusion is that in Alzheimer's disease patients there is more to be taken into account than cognitive disabilities and neurobiological deficits. A great deal of their behaviour can be better perceived and understood as the result (eg aggression) of attachment behaviour in a situation that is experienced as insecure.
Daytime vocal activity in institutionalized severely demented patients identified as vocally disruptive by nurses
Authors: Hallberg Ingalill R. , Edberg Anna‐Karin , Nordmark Åsa , Johnsson Kristina , Norberg Astrid 
Published: December 2004

AbstractThis study aimed at exploring vocal activity in severely demented patients with vocally disruptive behaviour as identified by nurses. Continuous tape‐recordings (07.00 am–07.00 pm) of the vocal activity of 33 residents in psychogeriatric wards were analysed regarding duration, level, number, type, content and direction. The activity lasted for a mean of 338.7 minutes/patient and the longest episode of each patient had a mean duration of 103.5 minutes and turned into shouting in 17 cases. The vocal activity consisted of (1) inarticulate sounds or syllables; (2)predominance of inarticulate vocal activity; (3) articulate words or sentences; (4) predominance of articulate vocal activity; and lastly (5) "dialogue vocal activity". No significant relationships emerged when a multiple regression analysis with type as dependent and demographic data as independent variables was applied. The vocal activity was: impossible to interpret, directed to others, responsive, or non‐directed utterances. The communicative function of the words used related to need for someone, incompetence, protest, need for help, in pain and despair/fear—hence, relating to an emotionally negative content, and less often to a positive emotional content. The vocal activity seemed possible to interpret as a "language" stemming from strong emotions mostly of a negative nature and a "language" used in monologues which could represent a self‐stimulating "language", thus meeting the need for activity. The results indicated that patients' emotional state must be attended to.
Evaluation of the hospital anxiety and depression scale as a screening instrument in geriatric medical inpatients
Authors: Davies Keren Nicola , Burn Wendy Katherine , McKenzie Fiona Ross , Brothwell Judith Ann , Wattis John Philip 
Published: December 2004

AbstractThe Hospital Anxiety and Depression Scale (HAD) was developed as a screening instrument for use in medical patients. The depression subscale has been validated as a measure of severity in elderly depressed psychiatric inpatients. This study assessed its usefulness as a screening instrument in inpatients in a geriatric medical unit. One hundred geriatric inpatients were evaluated using the Geriatric Mental State (Community Version) to identify cases. The HAD lacked sensitivity and specificity in this situation.
The prevalence of psychiatric illness in acute geriatric admissions
Authors: Katherine Burn Wendy , Nicola Davies Keren , Ross Mckenzie Fiona , Ann Brothwell Judith , Philip Wattis John 
Published: December 2004

AbstractThe prevalence of psychiatric illness among 100 elderly medical inpatients was determined using the Geriatric Mental State Schedule, in its Community Version. Due to the difficulties in assessing this group of patients, less than half of those admitted could be included in the study. The diagnostic cases identified were in three groups: organic brain disease (chronic brain failure), depression, and anxiety. Depression was found in 23%, anxiety in 7% and organic brain disease in 13%.
‘What becomes of demented patients referred to a psychogeriatric unit?’ An approach to audit
Authors: Reddy Subbalekshmi , Pitt Brice 
Published: December 2004

AbstractA 1‐year follow‐up study was undertaken of a random sample of 40 elderly patients living at home given a diagnosis of "dementia" after referral to the Psychogeriatric Department at St Charles' Hospital, London, W10. Eighteen (45%) patients were admitted to institutional care. There was an association between physical disability and institutionalization. A similar tendency was observed for social disturbance and hospital admission. The 1‐year survival rate for the sample was 82.5%. All the seven patients who died were moderately/severely demented. Twenty‐three patients (55%) had informal key carers. Half of these showed considerable stress according to the General Health Questionnaire and the Strain Scale scores. All the recommendations made by the psychogeriatric team were carried out without much delay.
Age‐related correlations in patient symptom management strategies in schizophrenia: An exploratory study
Authors: Cohen Carl I. 
Published: December 2004

AbstractThe role that symptom management strategies play in the remediation of schizophrenia with age has been largely neglected. The aim of this study is to examine whether there are age‐related alterations in symptom management strategies. A total of 86 schizophrenic outpatients (age range 19–69 years) were queried about management strategies for 29 symptoms. Of the nine strategies employed ‘social diversion’ was significantly associated with increased age and ‘acceptance’ and ‘fighting back’ showed positive and negative trends with increased age, respectively. These age‐associated differences in management strategies are hypothesized to represent an interaction of trial and error procedures unique to the disorder intertwined with life‐span changes.
A comparison between three psychogeriatric rating scales
Authors: Jensen Elmo , Dehlin Ove , Gustafson Lars 
Published: December 2004

AbstractThis study compares a new psychogeriatric rating scale, the Organic Brain Syndrome (OBS) scale, which is a combined observation and interview scale, with two other scales. Twenty‐eight elderly demented patients took part in the study. The OBS scale was compared to the Gottfries, Bråne and Steen (GBS) scale, the Mini Mental State Examination (MMSE) scale and a global rating. The correlations between OBS, GBS and MMSE were high, showing that the concurrent validity is good. The ratings of the OBS scale were independent of the patient's physical disabilities as measured by Katz's index, ie the discriminant validity was good. The analyses show similarities and differences between the clinical dimensions described in the rating scales. The OBS scale contributes unique clinical information and is a valid instrument for assessment of dementia symptoms.
Normalization of sexual behaviour in a female with dementia after treatment with cyproterone
Authors: Nadal Miguel , Allgulander Swante 
Published: December 2004

AbstractCompulsive behaviours can be a feature of different psychiatric diseases but overt hypersexuality is nevertheless a rare condition in females, especially in the absence of endocrinological alterations. We present here the case of a 49‐year‐old female who, after several confusional episodes, required hospitalization first at the Psychiatry Clinic and later on at the Psychogeriatric Unit when the diagnosis of dementia of Pick's type was suspected, and who developed an overt hypersexuality manifested in the form of open and frequent masturbations. Due to the failure of conventional therapy, the antiandrogen agent cyproterone acetate was used resulting in a normalization of her sexual behaviour. No main side‐effects could be observed and the drug was withdrawn after a few months of treatment. In our opinion, the antiandrogen cyproterone should be considered in similar cases when other therapies fail.
Prediction of first episode of clinical depression in patients newly admitted to a medical long‐term care facility: Findings from a prospective study
Authors: Foster Jeffrey R. , Cataldo Janine K. 
Published: December 2004

AbstractA cohort of 104 patients newly admitted to a medical long‐term care facility was studied over 1 year for evolution of depression. Seven variables that were associated with level of depression were used in discriminant function analyses. Results showed that the variables had about 90% accuracy in predicting depressed versus non‐depressed groups with good sensitivity and specificity. The variables measured: coping with admission; life satisfaction at admission; affective and non‐affective symptoms at admission; clinical health status after admission; friends in hospital after admission; and changes in affective symptoms after admission before the onset of depression.
Is caring for elderly relatives with depression as stressful as caring for those with dementia? a pilot study in melbourne
Authors: Yeatman Richard , Bennetts Kerryn , Allen Nicholas , Ames David , Flicker Leon , Waltrowicz Wendy 
Published: December 2004

AbstractThe 30‐item General Health questionnaire (GHQ‐30) scores of the primary carers of 31 elderly patients with depression were compared with the GHQ‐30 scores of 30 primary carers of dementia sufferers. Carers of dementia sufferers who lived with their demented relative had GHQ‐30 scores almost four times higher than those carers who lived apart from a dementia sufferer. There was no difference in the GHQ‐30 scores of carers of depressed subjects living with or apart from their affected relative. Carers of demented patients tended on average to have higher GHQ‐30 scores than carers of depressed patients, but this difference was almost entirely accounted for by the fact that more carers of demented patients lived with their ill relatives. Patient and carer age and sex and severity of patients' depression were not related to the GHQ‐30 scores of their carers.
Predictors of depressive symptoms and low self‐esteem in a follow‐up study of elderly people over 10 years
Authors: Coleman Peter , Aubin Anne , Robinson Maureen , Ivani‐Chalian Christine , Briggs Roger 
Published: December 2004

AbstractWe report a follow‐up study of measures of depression and self‐esteem in a sample of elderly people, 101 of whom were reinterviewed 10 years after initial assessment and 70 of these again 13 years later. The initial assessment included a wide range of social, psychological and medical measures. The results of logistic regression analysis showed the most significant predictors of the emergence of depressive symptoms and/or low self‐esteem over this period of time to be receipt of help with household tasks, a negative attitude to ageing, and percveived inactivity. High self‐esteem, was also associated with resilience against depression. Despite the close association between measures of depression and self‐esteem, further investigation into the sources of self‐esteem can provide evidence on the origins of depressive disorders.
Alzheimer's disease in the old and the young
Authors: Han Luke , Birkett D. Peter 
Published: December 2004

AbstractThis study concerns differences between Alzheimer's disease in the old and the young. Literature differentiating Alzheimer's disease from ‘senile dementia’ is reviewed. Two groups of mental hospital patients with Alzheimer brain changes at autopsy are compared. They comprised the 17 oldest and 17 youngest of the 56 ptients with definite Alzheimer changes in a series of 212 consecutive autopsies. The younger group had been first hospitalized at later ages than the older group, and were more likely to have been demented at admission. The older group had mostly been diagnosed as schizophrenic (mainly paranoid) on admission. Neuropathologically the younger group showed more severe Alzheimer changes of all kinds. The changes in the older group tended to be limited to the hippocampus, whereas in the younger group they showed extension into the frontal and occipital cortex and were also found in subcortical gray matter. Lipofuscin was more abundant in the older group, so that a discrepancy between very severe Alzheimer changes and less abundant lipofuscin characterizes the younger cases.
Clock‐drawing and dementia in the community: A longitudinal study
Authors: Shulman Kenneth I. , Pushkar Gold Dolores , Cohen Carole A. , Zucchero Carla A. 
Published: December 2004

AbstractThe clock ‐drawing test was used in a longitudinal study of 183 dementing individuals and their caregivers. Clock‐drawing performance was measured by a simple standardized score which correlated significantly with other measures of cognitive function. Clock performance showed high individual consistency of performance as well as a significant deterioration from the initial level of performance to that obtained at 1‐year follow‐up. Dementing individuals who had experienced a significantly greater decline in clock‐drawing performance at 1‐year follow‐up were more likely to have caregivers who had already decided to institutionalize them. This suggests that the caregiver's decision to institutionalize was based in part on the perception of a rapid decline in their dependant's cognitive function. Thus, rate of change in cognitive function may prove to be as important a variable as the level of deterioration. The clock‐drwing test appears to be a useful adjunct in the assessment and monitoring of the progressive dementias in the community.
Demographic and clinical features of patients attending a memory clinic
Authors: Almeida Osvaldo P. , Hill Katie , Howard Robert , O'brien John , Levy Raymond 
Published: December 2004

AbstractBasic demographic and clinical features of the first 418 patients assessed at the Maudsley Memory Clinic are reported. Alzheimer's disease was the most frequent diagnosis (57%), followed by a group of patients complaining of memory problems but with no obvious neuropsychiatric diagnosis (24%). The latter were more likely to be younger unmarried self‐referred women living alone and with a frequent family history of dementia. The routine use of extensive laboratory investigations in memory clinics is not recommended, considering the meagre number of subjects suffering from reversible conditions identified in our clinic. The Maudsley Memory Clinic has proved to be a popular centre for the assessment and diagnosis of patients with memory complaints and has provided a useful source of subjects for research into memory‐associated disorders. The role of memory clinics in the new financial climate in the National Health Service remains to be determined.
Sexual problems associated with dementia: Part 1. Problems and their consequences
Authors: Haddad Peter M. , Benbow Susan M. 
Published: December 2004

AbstractSexual problems associated with dementia fall into four groups: problems involving an established partner, problems involving a new partner, problems occurring independent of a sexual partner (sexual acting out, inappropriate sexual talk, false sexual allegations) and sexual abuse. The whole area has received little attention despite the major consequences for patients, partners and carers.
Cases of mild dementia in the community: Improving efficacy of case finding by concurrent use of pairs of screening tests
Authors: Hooijer C. , Jonker C. , Lindeboom J. 
Published: December 2004

AbstractIn a previous study, combinations of two short screening tests for dementia appeared to have clear advantages over the use of one test both for the efficacy of case detection and for the comparability of studies. In the present study these results were replicated using different sampling rules for the first and second phases of the screening procedure. Preferences for specific test combinations are discussed.
The prevalence of dementia in a sample of elderly norwegians
Authors: Engedal Knut , Haugen Per Kristian 
Published: December 2004

AbstractA total of 1029 elderly persons aged 75 years and above, selected at random from two different samples, were examined to estimate the prevalence rate of dementia in the elderly. Of these, 334 were living at home, 518 in nursing homes, and 177 in homes for the aged. Dementia was diagnosed according to DSM‐III. The estimated prevalence rate for the total population aged 75 years and over was 16.3%, slightly higher in women (16.5%) than in men (15.8%). Nearly half (7.8%) lived in institutions, mainly in nursing homes. In the sample living at home, the prevalence rate was 10.5%, in the nursing homes 71.6%, and in the homes for the aged 22.6%. In subjects living in nursing homes, the prevalence rate was significantly higher in women, 77.8%, then in men, 54.1%.