bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elderly survivors of the Lockerbie air disaster
Authors: Livingston Hilary M. , Livingston Martin G. , Brooks D. Neil , McKinlay William W. 
Published: December 2004

AbstractThirty‐one elderly people were examined in Lockerbie and compared with 24 younger survivors of the disaster which took place in December 1988. Examination took place within one year of the disaster, but was timed to avoid the anniversary period. All subjects were in Lockerbie at the time the aeroplane exploded in mid‐air. Examinations were conducted for purposes of medico‐legal assessment. The elderly had similar responses to the younger disaster victims, the majority of whom met DSM‐III‐R criteria for PTSD. The elderly, however, had a very high incidence of coexisting major depression, unlike the younger population. Loss or injury to friends and the witnessing of human remains was positively correlated with a diagnosis of post‐traumatic stress disorder in the elderly but not in the younger subjects. Neither material nor personal loss, nor the witnessing of human remains, was associated with a diagnosis of depression in the elderly, although significant material loss was associated with depression in the younger patients.
Antipsychotic drugs in continuing care: A 2‐year follow‐up audit
Authors: Connelly Peter J. 
Published: December 2004

AbstractThe use of antipsychotic drugs was examined in a geriatric psychiatry continuing care unit using the same procedures as in 1990 in the same unit. The main change in practice between the 2 years was the increased use of high‐potency preparations in 1992, though in low dosage. The group on regular antipsychotics (RA) were less dependent and more disturbed than the group on no psychotropic medication (NM) but the severity of behaviour problems had fallen considerably in the RA group. Although those on high‐potency (HP) preparations were most disturbed than those on low‐potency (LP) drugs, this was partly a result of the policy of giving HP drugs to those who had responded inadequately to LP preparations. 31.5% of the population studied were on RA (37.5% in 1990) and 53% on NM (46% in 1990). Factors influencing the prescription and withdrawal of antipsychotic drugs in demented patients are discussed, and the need to develop clearer guidelines for the drug treatment of behaviour disturbance associated with dementia is identified.
The course of mild dementia in a birth cohort
Authors: Magnússon Hallgrímur , Helgason Tómas 
Published: December 2004

AbstractThe mental health of a birth cohort has been followed until the age of 87 years. The cohort consists of all Icelanders born during a period of three years. Only three probands were lost in the follow up period from 61 to 87 years.The diagnoses were made by two methods: an indirect method based mainly on information provided by general practitioners, and the computerized diagnosis AGECAT.Many cases diagnosed as mild dementia by the indirect method had no or very few cognitive symptoms when the AGECAT was applied.The diagnosis of mild dementia is associated with high mortality. Almost 30% of cases of mild dementia diagnosed by the indirect method before the age of 75 years have no symptoms of dementia at the age of 81 years and more than 10% continue to have mild symptoms. Similar results are found at the age of 87 years.Atherosclerotic disorders are present in 48.6% of cases of mild dementia and 58.6% of severe dementia in contrast to only 25–30% of probands with a effective disorder or without psychiatric diagnosis.
Syphilis, neither dead nor buried—A survey of psychogeriatric inpatients
Authors: Cleare Anthony James , Jacoby Robin , Tovey Stuart John , Bergmann Klaus 
Published: December 2004

AbstractOver a 5‐year period, 3.8% of 423 psychogeriatric inpatients who were tested for syphilis had positive serology. Eight out of 14 received treatment, in contrast to previous suggestions that treatment was rarely instigated. Screening and adequate investigation of this population remain important, and we believe that serology should be carried out routinely in organic cases.
Family therapy and dementia: Review and clinical experience
Authors: Benbow S. M. , Marriott A. , Morley M. , Walsh S. 
Published: December 2004

AbstractFamily therapy techniques have, until recently, had little impact on the development of old age psychiatry and the services provided. The literature on family therapy in relation to people with dementia and their families is reviewed and illustrated with results from a study of families coping with dementia who attended the York House Family Clinic. Similar therapeutic techniques were used with families coping with dementia as with those coping with other mental illnesses in later life, but some differences were found in the areas of discussion during sessions. Families coping with dementia were seen for fewer sessions, but more family members were present per session and sons and daughters‐in‐law were more likely to attend. The literature and various hypotheses which might explain these differences are presented and discussed. Further work in this area is needed, but our findings suggest that family therapy can be useful in work with dementia sufferes and their families, and can be offered within an old age psychiatry service.
Using direct observation to record the behaviour of long‐stay patients with dementia
Authors: Bowie Peter , Mountain Gail 
Published: December 2004

AbstractThis article describes the development of a direct observation system for the assessment of the behaviour of elderly demented long‐stay patients. The technique of recording behaviour in real time has high face validity, and in conjunction with portable computers was found to be very reliable. The technique was used to assess the behaviour of patients during their waking day on seven wards. The findings suggest that almost two‐thirds of the day is spent doing nothing, with aimless or disruptive behaviours also accounting for a significant period of the day. Only a small proportion of the day was spent in self‐care or social behaviours.
One‐year follow‐up of continuation convulsive therapy prescribed for depressed elderly patients
Authors: Mirchandani Indu C. , Abrams Robert C. , Young Robert C. , Alexopoulos George S. 
Published: December 2004

AbstractNine elderly patients with major depression were followed for outcome of continuation ECT. All nine patients had poor response to pharmacotherapy of the index episode, favorable response to acute treatment with ECT and, to varying degrees, previous failure of prophylactic pharmacotherapy. Four of the nine patients complied with continuation ECT as recommended for periods of 9 months to 1 year; these patients remained essentially well during the follow‐up period, while the five who stopped the treatment prematurely fared poorly (one died, one required chronic hospitalization and three where rehospitalized acutely). These findings suggest the need for controlled studies of continuation ECT in geriatric depression.
Does education protect against cognitive impairment? A comparison of the elderly in two australian cities
Authors: Jorm A. F. , Henderson A. S. , Scott R. , Korten A. E. , Christen H. , Mackinnon A. J. , Kay D. W. K. 
Published: December 2004

AbstractCognitive impairment was assessed using the Mini‐Mental State Examination in commuity surveys of the elderly in Canberra and Hobart. Mean scores on the Mini‐Mental were higher in Canberra than in Hobart and the prevalence of cognitive impairment was lower. This difference was found to be attributable to the higher level of education in the Canberra elderly. When education was statistically controlled, the difference between the cities disappeared. These findings may have implications for future cohorts of the elderly, which will have a higher level of education than the present‐day elderly. It is argued that the prevalence of congnitive impairment could drop in the future.
Cognitive assessment in alzheimer's disease: What does the camcog assess?
Authors: Greifenhagen A. , Kurz A. , Wiseman M. , Haupt M. , Zimmer R. 
Published: December 2004

AbstractThe CAMDEX (Cambridge Mental Disorders of the Elderly Examination) is a widely used instrument for the diagnosis of dementia. It contains a cognitive section (CAMCOG) which consists of 60 items grouped into eight a priori subscales (orientation, language, memory, praxis, attention, abstract thinking, perception and calculation). A principal component analysis was performed on CAMCOG data from 191 patients with probable Alzheimer's disease (mild to moderate dementia). The analysis identified four factors which were interpreted clinically as representing language/praxis, visuoconstructive abilities, remote memory and short‐term memory. These factors differed in number and in composition from the a priori subscales postulated by the developers of the instrument. The results of the principal component analysis of empirical CAMCOG data demonstrate an overlap and potentiation of different cognitive deficits in AD.
The Lockerbie disaster: A 3‐Year follow‐up of elderly victims
Authors: Livingston Hilary M. , Livingston Martin G. , Fell Sheila 
Published: December 2004

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 traumatic event.
Lithium augmentation in geriatric depressed outpatients: A clinical report
Authors: Parker Karen L. , Mitmann Nicole , Shear Neil H. , Herrmann Nathan , Shulman Kenneth I. , Silver Ivan L. , Gardner David M. , Busto Usoa E. 
Published: December 2004

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 pharmacotherapy in the elderly.
Depression and dementia in geriatric inpatients: Diagnostic comparisons between psychiatrists, geriatricians and test scores
Authors: Ryan D. H. , Blackburn P. , Lawley D. , Ellis A. , Musil J. , Kendrick D. C. 
Published: December 2004

AbstractA clinical and psychometric survey of depression and dementia in acute geriatric admissions (n = 50) found clinical evidence of depression and dementia in 25% and 35% of patients respectively, consistent with the results of prevalence surveys of geriatric hospital inpatients. There was a significant correlation between clinical assessment of dementia by geriatricians, and psychiatrists, and cognitive impairment using the Middlesex Elderly Assessment Memory Schedule (p < 0.01). Although an intercorrelation between clinical diagnosis of depression by geriatricians, psychiatrists and scores on the Geriatric Depression Scale (GDS) just reached significance (p < 0.05), there was no association between diagnosis of depression by geriatricians and GDS at a cutoff score of 11/30. The relationship was significant at a cutoff score of 16/30 (p < 0.02). In contrast, the associations between diagnosis of depression by psychiatrists and GDS were highly significant at both cutoff points (p < 0.002 and p < 0.001 respectively). No significant differences were found between geriatricians and psychiatrists on indications for (1) antidepressant medication, (2) referral to liaison psychiatry, or (3) referral to a community mental health team. None of the inpatients assessed were receiving antidepressant medication at the time of their discharge from hospital although depression was diagnosed in a quarter of all inpatients and geriatricians supported the use of antidepressant treatment in 40% of those cases identified. Factor analysis suggested that geriatricians were identifying a subgroup of patients as depressed who were not recognized either by psychiatrists or by psychometric testing. Patients with abnormal scores on psychometric testing were followed up after discharge and retested. There was evidence of a significant fall in GDS scores and a non‐significant trend to increased fail scores on the MEAMS test suggesting an improvement in depressive symptoms with physical recovery and further cognitive decline following discharge. The results of the present study underline the need for active liaison between geriatricians and psychiatrists to improve the recognition and treatment of concurrent psychological problems during inpatient episodes.
Depression in Alzheimer's disease: Phenomenological features and association with severity and progression of cognitive and functional impairment
Authors: Haupt Martin , Kurz Alexander , Greifenhagen Annette 
Published: December 2004

AbstractSeventy‐eight outpatients with a clinical diagnosis of dementia in Alzheimer's disease according to the ICD‐10 draft research criteria were investigated with annual evaluations over a period of 2 years to study the phenomenology and association with severity and progression of cognitive and functional impairment of depression in Alzheimer's disease. As measured by the Dementia Mood Assesment Scale (DMAS), depressive symptoms occurred frequently, such as decrease in motor activity, lack of responsiveness, agitation and depressed appearance. Multiple stepwise regression demonstrated that decrease in motor activity and lack of responsiveness were the strongest contributors to an association of depressive symptoms with severity of cognitive and functional impairment. The global score of the DMAS mood subscale was not related to dementia severity. There was no relation between depressive symptoms in Alzheimer's disease and the rate of cognitive and functional decline within a 12‐month and 24‐month observational period. Our results suggest that depressive symptoms are frequent concomitants of dementia in Alzheimer's disease. Depressive symptoms are in part associated with a greater severity of cognitive and functional impairment in Alzheimer's disease. However, depressive symptoms, unlike other non‐cognitive psychopathological symptoms, for example psychotic phenomena, are not prognostically relevant with respect to a lower or higher rate of symptom progression.
The prevalence and phenomenology of psychotic symptoms in dementia sufferers
Authors: Ballard C. G. , Saad K. , Patel A. , Gahir M. , Solis M. , Coope B. , Wilcock G. 
Published: December 2004

AbstractOne hundred patients referred to old age psychiatry services in the West Midlands and 25 patients referred to a memory clinic in Bristol with mild to moderate dementia were assessed using the GMS/HAS schedule together with a detailed inventory to assess their psychotic symptoms. On careful evaluation one patient did not have dementia. Eighty‐three of the other 124 patients (66.9%) had at least one psychotic symptom. The prevalence of psychotic symptoms in the patients from the West Midlands and from the memory clinic in Bristol were extremely similar. Thirty‐five per cent had at least one visual hallucination, 12.9% had at least one auditory hallucination, 48.4% had at least one delusional belief and 29.0% had at least one delusional misperception. Most individuals experienced their psychotic symptoms at a frequency between weekly and daily. Twenty‐four had no insight into their psychotic symptoms and acted upon them, while only one patient had full insight into their symptoms. Thirty‐seven subjects were mildly distressed and 14 were severely distressed by the psychotic symptoms they experienced. There was a trend for patients with cortical Lewy body dementia to be more likely to have psychotic symptoms than patients with Alzheimer's disease or vascular dementia. The symptom profile of psychotic symptoms in the different dementias was, however, very similar. The frequencies of individual psychotic symptoms are described in the text.
Nurses' experiences of strain and their reactions in the care of severely demented patients
Authors: Hallberg Ingalill R. , Norberg Astrid 
Published: December 2004

AbstractAll nurses (N = 132) on the wards specializing in the care of the demented within a municipality were given two scales to assess their view of common patient actions and how easy they thought those actions were to deal with in the care situation, and to assess their emotional reactions during the provision of care. Also the Maslach burnout Inventory (MBI) and the Work Related Strain Inventory (WRSI) were used to test concurrent validity. Based on principal component analysis, the nurses' view of patient actions resulted in being agitated, unruly, living empty lives, being peaceful, dependent, non‐responsive and cooperative, and the nurses' view of difficulties in dealing with patient actions revealed ability to manage deprivation, agitation, desertedness, wilfulness, peacefulness and cooperation. A three‐factor solution was chosen for the emotional reactions: feelings of devotion—rejection, association—dissociation and usefulness—uselessness. Agitated and dependent patient actions were found to be most common while agitation and desertedness were regarded as most difficult. Patient seen as agitated and living empty lives related to the provision of care being difficult while dependence related to care as being easy to provide. Thus the findings gave further support to the belief that viewing the patient's life as meaningful as well as being able to develop a cooperative nurse‐patient relationship is crucial for nurses' experience of strain. Thus support should be directed towards achieving this kind of relationship.
Citation patterns in the International Journal of Geriatric Psychiatry: Cultural ethnocentrism revisited?
Authors: Barak Yoram , Philpot Michael , Levy Raymond 
Published: December 2004

AbstractThe country/region of origin of all original papers appearing in the International Journal of Psychiatry (IJGP) during the first 9 years of its publication was recorded. A more detailed analysis of citation patterns was carried out on the 105 original articles published during 1992. The results indicated that 50–60% of the articles emanated from the United Kingdom but that in general authors cited a broad range of specialities from journals published around the world. North American authors tended to cite North American sources more frequently than did their counterparts from other countries. There was evidence that the impact of the IJGP is increasing despite its omission from some scientific reference databases.
Clinical characteristics of resistant depression in the elderly
Authors: Bonner D. , Howard R. 
Published: December 2004

AbstractThe case notes of 30 patients who had responded to treatment for a depressive episode and 29 patients who were considered to be resistant to treatment were examined retrospectively. ‘Treatment resistance’ was associated with an onset of depression before the age of 50, the presence of hypochondrical features and the presence of cognitive impairment. Those patients considered to be resistant to treatment were also significantly less likely to be given ECT, more likely to be taking benzodiazepines and to spend significantly more time in hospital. These findings are discussed.
Remote depressions of cerebral metabolism in hemiparetic stroke: Topography and relation to motor and somatosensory functions
Authors: Seitz Rüdiger J. , Schlaug Gottfried , Kleinschmidt Andreas , Knorr Uwe , Nebeling Bruno , Wirrwar Andreas , Steinmetz Helmuth , Benecke Reiner , Freund Hans‐Joachim 
Published: December 2004

AbstractDepressions of regional cerebral glucose metabolism (rCMRGlu) as measured with positron emission tomography in 28 patients with first hemiparetic stroke were mapped anatomically and related to the involvement of the cortico‐spinal tract and the somatosensory pathway. Cortico‐spinal tract and somatosensory pathway status were examined by magnetic evoked motor potentials (MEP) and somatosensory evoked potentials (SSEP), respectively. Patients were grouped with respect to the stroke lesions as assessed by magnetic resonance images into striatocapsular, thalamocapsular, and corticosubcortical groups. In spite of identical clinical presentation, the topography of significant remote rCMRGlu depressions varied in the affected cerebral hemisphere among the three groups, involving also the contralateral hemisphere in the thalamocapsular and cortico‐subcortical group. The thalamus was the only area with a significant mean rCMRGlu depression in all groups, although it was structurally spared in striatocapsular and cortico‐subcortical strokes. The remote rCMRGlu depressions in the primary sensorimotor cortex were associated with significantly abnormal MEPs in striatocapsular stroke, while both the MEPs and SSEPs were significantly abnormal in the cortico‐subcortical group. Further, depressed rCMRGlu in the putamen of the lesion side and in the cerebellar hemisphere ipsilateral to the hemiparesis correlated with motor impairment. Our data suggest that, in addition to damage of the efferent cortico‐spinal or afferent somatosensory tract, impairment of other circuits may contribute to the severe hemiparesis initially observed after stroke. We hypothesize that the chronic remote rCMRGlu depressions described in the present study result from axonal damage interfering with connectivity patterns. © 1994 Wiley‐Liss, Inc.