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ABSTRACT Behavioral disturbances are clinically relevant in patients with dementia, and pharmacological regimens to mitigate these symptoms have provided limited results. Proven to be effective in several psychiatric conditions, electroconvulsive therapy is a potentially beneficial strategy for treating severe agitation due to dementia. Objective: This review aimed to examine the publications on the efficacy, safety and tolerability of electroconvulsive therapy in treating patients with agitation due to dementia. Methods: We performed a systematic analysis on the electroconvulsive therapy to treat patients with dementia and coexisting severe agitation. Articles were classified according to the level of evidence based on methodological design. Patients received an acute course of electroconvulsive therapy, often followed by maintenance intervention. Results: We selected 19 studies (156 patients; 64.1% women; 51-98 years old), which met the inclusion criteria: one case-control study by chart analysis (level of evidence 2); one open-label study (level of evidence 3); three historical/retrospective chart analyses (level of evidence 4); and 14 case series/reports (level of evidence 5). No randomized, sham-controlled clinical trials (level of evidence 1) were identified, which represents the main methodological weakness. Some patients had postictal delirium, cardiovascular decompensation and cognitive changes, lasting for a short time. Conclusions: Overall, patients achieved significant improvement in agitation. However, the main finding of the present review was the absence of methodological design based on randomized and sham-controlled clinical trials. Despite methodological limitations and side effects requiring attention, electroconvulsive therapy was considered a safe and effective treatment of patients with severe agitation and related behavioral disorders due to dementia.
RESUMO Distúrbios comportamentais são clinicamente relevantes em pacientes com demência, e regimes farmacológicos para mitigar esses sintomas têm proporcionado resultados limitados. Comprovadamente eficaz em diversas condições psiquiátricas, a eletroconvulsoterapia é uma estratégia potencialmente benéfica para o tratamento de pacientes com agitação grave na demência. Objetivos: Esta revisão examina as publicações sobre eficácia, segurança e tolerabilidade da eletroconvulsoterapia no tratamento de pacientes com agitação na demência. Métodos: Realizamos uma análise sistemática da eletroconvulsoterapia no tratamento de pacientes com demência e agitação grave. Os artigos foram classificados quanto ao nível de evidência com base no delineamento metodológico. Os pacientes receberam um curso agudo de eletroconvulsoterapia, frequentemente seguido de manutenção. Resultados: Foram selecionados 19 estudos (156 pacientes; 64,1% mulheres; 51-98 anos): um estudo caso-controle desenvolvido com base na análise de prontuários (nível de evidência 2); um estudo aberto (nível de evidência 3); três estudos de análise retrospectiva de prontuários (nível de evidência 4); e 14 séries/relatos de casos (nível de evidência 5). Não foram identificados ensaios clínicos randomizados e controlados com placebo (nível de evidência 1), fator que representa a principal fragilidade metodológica. No entanto, o principal achado da presente revisão consistiu na ausência de desenho metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Em geral, os efeitos colaterais foram transitórios e bem tolerados. Alguns pacientes apresentaram delirium pós-ictal, descompensação cardiovascular e alterações cognitivas por períodos breves. Conclusões: No geral, os pacientes obtiveram melhora significativa na agitação. No entanto, o principal achado da presente revisão foi a ausência de delineamento metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Apesar das limitações metodológicas e dos efeitos adversos, a eletroconvulsoterapia foi considerada um tratamento seguro e eficaz em pacientes com agitação grave e com outros distúrbios comportamentais clinicamente relevantes na demência.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Violence , Mental DisordersABSTRACT
Behavioral and psychological symptoms of dementia (BPSD) are common in the patients with dementia.Creative arts therapies (CAT) are one of the safe and effective non-pharmacological interventions for BPSD.This paper elaborates on the therapeutic effects of four common CAT,including art therapy,music therapy,dance therapy,and drama therapy,on BPSD.Despite the shortcomings,CAT offer a new gateway for the safe and noninvasive treatment of BPSD.
Subject(s)
Humans , Art Therapy , Music Therapy , Dementia/psychologyABSTRACT
Objective:To explore the factors on malnutrition or risk of malnutrition in patients with Alzheimer′s disease (AD)-related cognitive impairment,and to further analyze the association between the severity of behavioral and psychological symptoms in dementia (BPSD) and nutritional status.Methods:The clinical data of 247 patients with AD-related cognitive impairment were collected continuously from the Chinese Imaging, Biomarkers and Lifestyle Study of Alzheimer′s Disease (CIBL) cohort between June 1, 2021 and August 31, 2022. The patients were divided into well-nourished group ( n=128) and malnourished group ( n=119) according to the scores of Mini-Nutritional Assessment scale (MNA). The sociodemographic data (sex, age, body mass index, waist-to-hip ratio, education level), the medical history of olfactory dysfunction, combination with more than two chronic diseases, and gastrointestinal diseases, presenting BPSD, and the scores of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), Activity of Daily Living (ADL), Caregiver Burden Inventory (CBI) and Dietary Diversity Score (DDS) were compared between the two groups. The factors with statistically significant differences in hypothesis test and univariate Logistic regression analysis were enrolled in multivariate Logistic regression analysis to further identify independent factors associated with malnutrition in patients with AD-related cognitive impairment. Furthermore, the association between NPI scores and MNA scores was analyzed by Spearman′s rank correlation test. Results:Compared with those in the well-nourished group, patients in the malnourished group had higher age [(66.70±7.01) years vs (69.14±8.87) years, t=-2.39, P=0.018], lower body mass index [(24.68±2.84) kg/m 2vs (22.69±3.63) kg/m 2, t=4.78, P<0.001], and higher proportion of presenting BPSD [22.66% (29/128) vs 76.47% (91/119), χ 2=71.49, P<0.001]; lower scores of MMSE, MoCA, and DDS [24.27±4.69 vs 18.95±8.40, t=6.09; 20.29±5.18 vs 14.55±8.12, t=6.56; 8.00 (8.00, 9.00) vs 8.00 (7.00, 8.00), Z=-4.66; all P<0.001], and higher scores of NPI, ADL and CBI [1.00 (0, 6.00) vs 10.00 (2.00, 25.00), Z=-6.50; 20.00 (20.00, 22.00) vs 27.00 (20.00, 40.00), Z=-7.08; 1.00 (0, 14.75) vs 12.00 (2.00, 35.00), Z=-5.13; all P<0.001]. There were no statistically significant differences in the sex, waist-to-hip ratio, education level, and the medical history of olfactory dysfunction, combination with more than two chronic diseases, and gastrointestinal diseases between the two groups. The multiple Logistic regression analysis demonstrated that the decreased body mass index ( OR=0.79, 95% CI 0.70-0.89, P<0.001), presenting BPSD ( OR=7.84, 95% CI 3.67-16.73, P<0.001), elevated ADL scores ( OR=1.15, 95% CI 1.06-1.24, P<0.001) and CBI scores ( OR=0.98, 95% CI 0.97-1.00, P=0.026), and decreased scores of DDS ( OR=0.66, 95% CI 0.51-0.84, P=0.001) were independently associated with malnutrition in patients with AD-related cognitive impairment. The MNA scores were significantly negatively associated with NPI scores ( r=-0.483,95% CI -0.58--0.38, P<0.001). Conclusions:The decreased body mass index, dietary diversity, and ability of daily living, and presenting BPSD and heavy burden of caregivers can independently contribute to the malnutrition in patients with AD-related cognitive impairment. The more serious the BPSD, the worse the nutritional status.
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Objectives:To analyze the potential biomarkers of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer′s disease (AD) continuum.Methods:A prospective cohort study was consecutively conducted on 179 patients with AD continuum (135 presented with BPSD, 44 patients without BPSD as control) from Capital Medical University, Beijing Tiantan Hospital, the Chinese imaging biomarkers and lifestyle cohort between January 1, 2021 and December 31, 2022. Gender, age, body max index, education level, diagnosis, the apolipoprotein E epsilon4 allele (APOE ε4) carrier status, the scores of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), cerebrospinal fluid (CSF) AD-related pathological biomarkers (Aβ 42, Aβ 40, Aβ 42/40, tTau, pTau181), and blood biomarkers (white blood cell count, red blood cell count, hemoglobin, platelet, total bilirubin, albumin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting glucose, erythrocyte sedimentation rate, homocysteine, vitamin B 12, folate) were compared between the two groups by using hypothesis testing and univariate logistic regression analysis. Multivariate logistic regression analysis was used to analyze the potential biomarkers associated with BPSD in patients with AD. Results:Among the 179 patients with AD continuum in the final analysis, 77 patients were men, 102 cases were women; 35 patients were identified with mild cognitive impairment (MCI) due to AD and 144 patients with AD dementia stage, the mean age was (66.54±9.75) years. Compared with those in control group, patients with BPSD had lower cerebrospinal fluid (CSF) Aβ 40 and blood hemoglobin levels [7.08 (4.42, 15.42) vs 9.62 (6.45, 12.12) pg/L, (132.70±13.37) vs (138.80±14.38) g/L] ( U=-1.856, t=2.579, P<0.05). The levels of CSF Aβ 40 ( OR=0.030, 95% CI: 0.001-0.760) and blood hemoglobin ( OR=0.051, 95% CI: 0.004-0.670) were independently negatively associated with BPSD in patients with AD continuum (both P<0.05). Conclusion:The decreased levels of CSF Aβ 40 and blood hemoglobin could be considered as potential biomarkers in detecting BPSD in patients with AD continuum.
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Objective:To investigate the grouping characteristics of psychological state symptom clusters in patients with non-small cell lung cancer during programmed death 1 (PD-1) monoclonal antibody combined with chemotherapy, and to analyze the predictors of different symptom cluster characteristics.Methods:This study was a cross-sectional study. In the form of a questionnaire, 171 patients with non-small cell lung cancer who received PD-1 monoclonal antibody combined with chemotherapy in Gansu Wuwei Tumor Hospital from March 2019 to March 2021 were selected as the research object by convenient sampling method. The general data questionnaire, Pittsburgh Sleep Quality Index, Cancer-Related Fatigue Survey Scale, Hospital Anxiety and Depression Scale, Physical Activity Measurement Scale for Cancer Patients, Distress Thermometer, and Quality of Life Measurement Scale for Lung Cancer Patients were used for investigation. The latent class model was fitted based on the evaluation results of physical fatigue, anxiety, depression, sleep quality and psychological distress in patients with non-small cell lung cancer during treatment. Latent class model analysis was performed on the scale results to establish a category group model. Logistic regression analysis was used to compare the demographic characteristics, disease stage, classification, and personality characteristics of patients in each group, and to explore the predictive indicators between different categories.Results:According to the symptoms of fatigue, anxiety, depression, sleep disorder and psychological distress in patients with non-small cell lung cancer during PD-1 monoclonal antibody therapy combined with chemotherapy, they were divided into two different categories. The group with high psychological symptoms accounted for 44.44% (76/171) and the group with low psychological symptoms accounted for 55.56% (95/171). The scores of physiological status, social/family status, emotional status, functional status, additional attention and physical activity in the quality of life scale of lung cancer patients with low psychological symptoms were 11.28 ± 5.62, 17.57 ± 4.31, 11.14 ± 3.27, 14.83 ± 5.24, 14.76 ± 4.03 and 88.61 ± 17.38, respectively. The scores were higher than those in the high psychological symptom group 17.82 ± 4.43, 10.76 ± 3.63, 18.62 ± 6.06, 9.34 ± 3.13, 26.26 ± 3.23, 58.04 ± 15.41, the differences were statistically significant ( t values were 10.36-15.84, all P<0.05); logistic regression analysis showed that personality traits [extroverted ( OR=0.08, 95 % CI 0.03-0.23, P<0.05), intermediate ( OR=0.16, 95 % CI 0.08-0.33, P<0.05)] and physical activity in cancer patients ( OR=0.91, 95 % CI 0.88-0.93, P<0.05) were predictors for distinguishing high psychological symptom group. Conclusions:There are obvious classification characteristics of psychological symptom clusters in patients with non-small cell lung cancer during PD-1 monoclonal antibody combined with chemotherapy. Different psychological interventions and nursing care are given according to different psychological symptom characteristics during treatment to improve the quality of life of patients.
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Objective:To explore the impact factors of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer′s disease (AD).Methods:The clinical data of 116 patients with AD admitted to the Outpatient Department of Cognitive Neurology of Beijing Tiantan Hospital, Capital Medical University from June 1, 2021 to March 1, 2022 were collected continuously. The patients were divided into BPSD group ( n=85) and control group ( n=31) according to the presence or absence of BPSD. The sociodemographic data (gender, age, body mass index, years of education), the medical history of hypertension, diabetes mellitus, hyperlipidemia, and the scores of the Mini-Mental State Examination (MMSE), the Activity of Daily Living (ADL), Mini-Nutritional Assessment scale (MNA) and Caregiver Burden Inventory (CBI) were compared between the two groups with hypothesis test and univariate logistic regression analysis. The statistically significant factors in hypothesis test and univariate logistic regression analysis were enrolled in multivariate logistic regression analysis to further identify the factors associated with BPSD in patients with AD. Results:There was no significant statistics differences in the gender, age, body max index, years of education and the medical history of hypertension, diabetes mellitus, hyperlipidemia between the two groups (all P>0.05). Compared with control group, patients with BPSD had lower scores of MMSE and MNA scales [(16.24±7.52) vs (20.81±5.09) points, (21.62±3.75) vs (24.87±2.89) points] (both P<0.001) and higher scores of ADL and CBI scales [29.00 (22.00, 38.50) vs 22.00 (20.00, 25.00) points, 25.00 (12.50, 41.00) vs 3.00 (0.00, 11.00) points](both P<0.001). The multiple logistic regression analysis demonstrated that the decreased MNA scores ( OR=0.762, 95% CI: 0.631-0.922; P=0.005) and elevated CBI scores ( OR=1.077, 95% CI: 1.029-1.128; P=0.002) were associated with BPSD in patients with AD. Conclusion:The malnutrition or the risk of malnutrition and greater caregiver burden can independently contribute to the onset of BPSD in patients with AD.
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El objetivo del presente trabajo fue estudiar la salud mental y lo síntomas psicológicos en adultos argentinos en contexto de pandemia por Covid-19. El diseño metodológico aplicado fue no experimental de corte transversal, bajo la modalidad de estudio descriptivo, correlacional y de diferencia de grupos. Se trabajó con una muestra de 931 participantes residentes en diferentes provincias de Argentina de edades comprendidas entre 18 y 84 años (MEDAD = 33.08, DE= 15.28, 52% mujeres, 48% varones). Los resultados informaron diferencias significativas entre la salud mental, los síntomas de depresión, ansiedad e intolerancia a la incertidumbre según las variables sociodemográficas analizadas. Se pudo comprobar que a mayor tiempo en confinamiento, mayores son los síntomas que se presentan relacionados a las variables estudiadas y menor es el estado completo de salud mental. Se corrobora que las variables relacionadas a los síntomas de ansiedad, depresión e intolerancia a la incertidumbre predicen de forma negativa el bienestar psicológico, social y emocional en la población Argentina en contexto de pandemia por COVID-19(AU)
This investigation aimed to study mental health and psychological symptoms in Argentinian adults at Covid-19 pandemic context. The methodological design applied was non-experimental, cross-sectional, under descriptive, correlational and group differencing study modality. The sample was 931 participants residing in different provinces of Argentina, aged between 18 and 84 years old (MEDAD = 33.08, SD = 15.28, 52% female, 48% male).Results reported significant differences between mental health, depression, anxiety and intolerance of uncertainty symptoms, according to the sociodemographic variables analyzed. It was found that the longer the time in confinement, the greater the symptoms appeared related to the variables studied and the lower the complete state of mental health. It is confirmed that the variables related to anxiety, depression and intolerance to uncertainty symptoms, negatively predict the psychological, social and emotional well-being in the Argentinian population under COVID-19 pandemic context(AU)
Subject(s)
Humans , Adult , Middle Aged , Mental Health , COVID-19 , Uncertainty , PandemicsABSTRACT
El aislamiento preventivo a causa de la pandemia por COVID-19 ha provocado un aumento en la prevalencia de síntomas psicológicos y emocionales en población adulta de diferentes países. Los objetivos de esta investigación consistieron en: a) realizar la validación de la versión abreviada del Inventario de Síntoma- v45 para su uso en adultos de la Ciudad de Buenos Aires y Conurbano Bonaerense; y b) describir los factores estresantes y la sintomatología psicológica ante la situación de aislamiento obligatorio. Se administró un cuestionario sociodemográfico y la versión abreviada del Inventario de Síntomas Psicológicos a 430 participantes adultos de Buenos Aires (82% mujeres y 18% varones) con un rango de edad fue de 18 a 63 años, una media de 30 años y un desvío estándar de 10. Las diferentes evidencias obtenidas sugieren que el Inventario de Síntomas abreviado es un instrumento válido y confiable. A través de este Inventario se registró una elevada prevalencia de síntomas asociados especialmente a ansiedad fóbica, ansiedad y depresión. Esta evidencia señala la importancia de programas de evaluación e intervención psicológica para disminuir el impacto psicológico del aislamiento a causa de la COVID-19(AU)
Subject(s)
Humans , Adult , Middle Aged , Stress, Psychological , COVID-19 , Social IsolationABSTRACT
@#Introduction: Healthcare workers serve as the frontliners against the coronavirus 2019 disease (COVID-19) and this puts them most at risk of infection as they attend to numerous patients with unknown status. This study aimed to examine stress, anxiety, and depression among healthcare workers caring for COVID-19 patients in Sarawak General Hospital (SGH), Malaysia. Materials and Methods: This cross-sectional observational study conducted in SGH during the pandemic with an online self-administered questionnaire composed of two parts, the socio-demographic characteristics, and the Depression Anxiety Stress Scale (DASS). Results: A total of 105 healthcare workers responded to this study. A questionnaire in both Bahasa Melayu and English was used. The findings showed that all healthcare workers had mild anxiety, with the majority experiencing mild stress (57.1%), and almost half of the respondents experiencing mild depression (41%). Female subjects had a significant higher mean score in anxiety level and stress level compared to male subjects (10.0±3.20 vs. 8.6±2.93, p<0.05; 14.1±4.76 vs. 10.7±3.70, p<0.05, respectively). Staff who were transferred from other units to handle COVID-19 cases experienced more psychological symptoms. There were significant correlations between the depression, anxiety and stress levels among the healthcare workers and the number of children they had (r=0.739, p=0.001; r=0.642, p=0.001; r=1, p =0.001 respectively). However, the stress level among the healthcare workers was reversely correlated with their years of working experience (r=-0.199, p=0.042). Conclusion: This study identified some socio-demographic factors associated with increased levels of stress, anxiety and depression among the healthcare workers during pandemic, which may lay ground for future interventions.
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O presente estudo buscou analisar a relação entre variáveis sociodemográficas (idade, sexo, número de pessoas que moram juntas, tipo de residência, renda e diagnóstico psiquiátrico prévio), comportamentos relacionados à pandemia (tempo diário de aprendizado sobre o Covid-19 e concordância com medidas de distância social) e aspectos psicológicos relacionados à saúde mental geral (bem-estar psicológico, saúde mental, solidão, ansiedade, estresse e depressão). Este estudo transversal quantitativo foi composto por 543 adultos, com idade entre 18 e 76 anos (M = 37,01; DP = 12,85), em sua maioria mulheres. Foram aplicados questionários sobre comportamentos de isolamento durante a pandemia Covid-19, questionário WHO-5, GHQ-12, UCLA, GAD-7, PSS-10 e CES-D. Os dados foram coletados online em todas as regiões brasileiras. Realizamos análise de regressão linear para cada variável dependente (bem-estar, saúde mental, solidão, ansiedade, estresse e depressão). Os resultados indicam que maior renda, morar em casa e não ter diagnóstico psiquiátrico estão associados a maiores escores de bem-estar. Além disso, essas mesmas variáveis sociodemográficas estão negativamente associadas a maiores escores de solidão, estresse, ansiedade e depressão. Concordar com procedimentos de distanciamento social está associado a melhores indicadores de bem-estar e menores escores de ansiedade e estresse. Nós podemos considerar com base nos resultados que fatores sociais, como o tipo de residência e renda, influenciam na qualidade de vida e refletem diretamente na saúde mental. Quanto ao comportamento durante a pandemia, seguir as medidas de distanciamento social pode reduzir a ansiedade e o estresse, melhorando a sensação de bem-estar. Essas descobertas podem ajudar a formular políticas públicas de saúde preventivas.(AU)
The present study sought to analyze the relationship between sociodemographic variables (age, sex, number of people living together, type of residence, income, and previous psychiatric diagnosis), behaviors related to the pandemic (daily learning time about Covid-19 and agreement with measures of social distance) and psychological aspects related to general mental health (psychological well-being, mental health, loneliness, anxiety, stress, and depression). This quantitative cross-sectional study consisted of 543 adults aged 18 and 76 years (M = 37.01; SD = 12.85), mostly women. Questionnaires on isolation behaviors during the Covid-19 pandemic, WHO-5, GHQ-12, UCLA, GAD-7, PSS-10, and CES-D questionnaires were applied. Data were collected online in all Brazilian regions. We performed linear regression analysis for each dependent variable (well-being, mental health, loneliness, anxiety, stress, and depression). The results indicate that higher income, living at home, and not having a psychiatric diagnosis are associated with higher well-being scores. Furthermore, these same sociodemographic variables are negatively associated with higher loneliness, stress, anxiety, and depression scores. Agreeing with social distancing procedures is associated with better indicators of well-being and lower anxiety and stress scores. Based on the results, we can consider that social factors, such as type of residence and income, influence quality of life and directly reflect mental health. As for behavior during the pandemic, following social distancing measures can reduce anxiety and stress, improving feelings of well-being. These findings can help formulate public preventive health policies.(AU)
El presente estudio buscó analizar la relación entre variables sociodemográficas (edad, sexo, número de personas que conviven, tipo de residencia, ingresos y diagnóstico psiquiátrico previo), conductas relacionadas con la pandemia (tiempo de aprendizaje diario sobre Covid-19 y concordancia con medidas de distancia social) y aspectos psicológicos relacionados con la salud mental en general (bienestar psicológico, salud mental, soledad, ansiedad, estrés y depresión). Este estudio transversal cuantitativo consistió en 543 adultos, con edades entre 18 y 76 años (M = 37.01; DT = 12.85), en su mayoría mujeres. Se aplicaron cuestionarios sobre comportamientos de aislamiento durante la pandemia Covid-19, WHO-5, GHQ-12, UCLA, GAD-7, PSS-10 y CES-D. Los datos se recopilaron en línea en todas las regiones brasileñas. Realizamos análisis de regresión lineal para cada variable dependiente (bienestar, salud mental, soledad, ansiedad, estrés y depresión). Los resultados indican que los ingresos más altos, vivir en casa y no tener un diagnóstico psiquiátrico se asocian con puntajes de bienestar más altos. Además, estas mismas variables sociodemográficas se asocian negativamente con puntuaciones más altas de soledad, estrés, ansiedad y depresión. Estar de acuerdo con los procedimientos de distanciamiento social se asocia con mejores indicadores de bienestar y menores puntuaciones de ansiedad y estrés. Con base en los resultados, podemos considerar que factores sociales, como el tipo de residencia y los ingresos, influyen en la calidad de vida y repercuten directamente en la salud mental. En cuanto al comportamiento durante la pandemia, seguir las medidas de distanciamiento social puede reducir la ansiedad y el estrés, mejorando la sensación de bienestar. Estos hallazgos pueden ayudar a formular políticas públicas de salud preventiva.(AU)
Subject(s)
Mental Health , Pandemics , COVID-19ABSTRACT
ABSTRACT The study aimed to investigate the prevalence and effects of premenstrual syndrome (PMS) on the psychological factors of university students who do and do not participate in resistance training. The initial sample consisted of 81 participants, and the prevalence of PMS was 64.2%. Forty women diagnosed with PMS were divided into two groups: women who participated in (GP) and did not participate in (GNP) resistance training. The intergroup comparison showed significant differences (with higher scores in the GNP) in the items: difficulty concentrating, lack of energy, and feeling under pressure, and they reported a greater influence of the symptoms on their family relationships. It is concluded that women who participate in resistance training have reduced indicators of some psychological symptoms of PMS.
RESUMO O estudo objetivou investigar a prevalência e os efeitos da Síndrome Pré-Menstrual (SPM) nos fatores psicológicos de universitárias praticantes e não praticantes de treinamento resistido. A amostra inicial consistiu em 81 participantes, e a prevalência da SPM foi de 64,2%. Quarenta mulheres diagnosticadas com SPM foram divididas em dois grupos: praticantes (GP) e não-praticantes (GNP) de treinamento resistido. A comparação intergrupos apresentou diferenças significativas (com maiores escores do GNP) referentes aos itens: dificuldade de concentração, falta de energia, e sentindo-se sob pressão, tendo maior interferência dos sintomas em seus relacionamentos familiares. Conclui-se que mulheres praticantes de treinamento resistido apresentam indicadores reduzidos de alguns sintomas psicológicos da SPM.
RESUMEN El objetivo fue investigar la prevalencia y los efectos del síndrome premenstrual (SPM) sobre los factores psicológicos de las universitarias que practican y no practican el entrenamiento de resistencia. La muestra inicial consistió en 81 mujeres, y la prevalencia del SPM fue del 64,2%. Cuarenta mujeres diagnosticadas con SPM se dividieron en dos grupos: practicantes (GP) y no practicantes (GNP) de entrenamiento de resistencia. La comparación intergrupal mostró diferencias significativas (con puntajes de GNP más altos) con respecto a: dificultad para concentrarse, falta de energía y sentirse bajo presión, con una mayor interferencia de síntomas en sus relaciones familiares. Las mujeres que practican el entrenamiento de resistencia han reducido los indicadores de algunos síntomas psicológicos del SPM.
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OBJECTIVE: Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD. METHODS: A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020).
Subject(s)
Activities of Daily Living , Anxiety , Cognition , Dementia , Depression , Dihydroergotamine , Methods , Music Therapy , Quality of LifeABSTRACT
OBJECTIVE： To systematically evaluate the efficacy and safety of risperidone versus haloperidol in the treatment of behavioral and psychological symptoms of dementia （BPSD）， and to provide evidence-based reference for clinical drug use. METHODS： Cochrane library， PubMed， EMbase， CNKI， CBM， Wanfang and VIP database were searched for the randomized controlled trials （RCT） on risperidone （trial group） versus haloperidol （control group） in the treatment of BPSD. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 26 studies were included， involving 2 219 patients. The results of Meta-analysis showed that the total response rate [RR＝1.11， 95％CI（1.05， 1.18）， P＝0.000 3] and CMAI score [SMD＝0.19， 95％CI（0.04， 0.34）， P＝0.01] in trial group were significantly higher than control group. MMSE score [SMD＝－0.32， 95％CI（－0.63， －0.01）， P＝0.04]， and the incidence of extrapyramidal reaction [RR＝0.39， 95％CI（0.31， 0.49）， P＜0.000 1]， gastrointestinal reaction [RR＝0.51， 95％CI（0.38， 0.68）， P＜0.000 1]， somnolence [RR＝0.47， 95％CI （0.25， 0.88）， P＝0.02]， thirst [RR＝0.50， 95％CI（0.33， 0.74）， P＝0.000 5] and constipation [RR＝0.33， 95％CI（0.20， 0.54）， P＜0.000 1] in trial group were significantly lower than control group. There were no statistical significance in BEHAVE-AD score [SMD＝0.03， 95％CI（－0.09，0.16）， P＝0.62] and the incidence of insomnia [RR＝1.26， 95％CI（0.76， 2.11）， P＝0.37]， headache/dizziness [RR＝0.65， 95％CI（0.38， 1.12）， P＝0.12] and tachycardia[RR＝0.40， 95％CI（0.12， 1.31）， P＝0.13] between two groups. CONCLUSIONS： The efficacy and safety of risperidone in the treatment of BPSD are signi- ficantly better than haloperidol， and risperidone can improve agitation behavior and general cognitive state of patients.
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BACKGROUND: The aims of this study were to determine the extent of workplace bullying perceptions among the employees of a Faculty of Medicine, evaluating the variables considered to be associated, and determining the effect of workplace bullying perceptions on their psychological symptoms evaluated by the Brief Symptom Inventory (BSI). METHODS: This cross-sectional study was performed involving 355 (88.75%) employees. RESULTS: Levels of perceived workplace bullying were found to increase with the increasing scores for BSI and BSI sub-dimensions of anxiety, depression, negative self, somatization, and hostility (all p < 0.001). One point increase in the workplace bullying perception score was associated with a 0.47 point increase in psychological symptoms evaluated by BSI. Moreover, the workplace bullying perception scores were most strongly affected by the scores of anxiety, negative self, depression, hostility, and somatization (all p < 0.05). CONCLUSION: The present results revealed that young individuals, divorced individuals, faculty members, and individuals with a chronic disease had the greatest workplace bullying perceptions with our study population. Additionally, the BSI, anxiety, depression, negative self, somatization, and hostility scores of the individuals with high levels of workplace bullying perceptions were also high.
Subject(s)
Anxiety , Bullying , Chronic Disease , Cross-Sectional Studies , Depression , Divorce , HostilityABSTRACT
Dementia is a neuropsychiatric disorder characterized by cognitive impairment,and behavioral and psychological symptoms.Behavioral and psychological symptoms of dementia (BPSD) are common in patients with dementia and can have a major impact on the quality of life for patients and caregivers,and accelerate their cognitive decline.Atypical antipsychotics (AAP) possess excellent efficacy and tolerability in BPSD treatment;however,compared with conventional drugs,the use of antipsychotics has been widely debated for concerns over safety in elderly patients with dementia.The US FDA has issued several specific recommendations and emphasized that treatment of BPSD with AAP is"off-label".We have searched and reviewed the literature on the treatment of BPSD with AAP published in the last 10 years,and evaluated the efficacy and safety of AAP for clinicians' reference.
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OBJECTIVES: The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS: Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. RESULTS: Especially, the group with high severity of WMH showed significantly lower language fluency (p < 0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. CONCLUSIONS: There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.
Subject(s)
Aged , Humans , Alzheimer Disease , Brain , Cognition , Dementia , Executive Function , Magnetic Resonance Imaging , Cognitive Dysfunction , Retrospective Studies , Weights and Measures , White MatterABSTRACT
This is a case of a patient with Behavioural andPsychological Symptoms of Dementia (BPSD) causingcaregiver burden in her husband. The family physician wasable to lead a multidisciplinary team to manage andoptimise her care in the community.
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Objective To observe the efficacy and safety of citalopram in the treatment of behav-ioural and psychological symptoms of dementia(BPSD)and cognitive function of Alzheimer's disease(AD) patients.Methods From April 2015 to February 2016,80 cases of moderate Alzheimer's disease(according to the clinical dementia rating scale,CDR)with symptoms of BPSD in Qingdao Mental Health Center were collected and randomly divided into treatment group and control group.Treatment group was given citalopram (10 to 30 mg/d),the control group was given the same dose of placebo,and the patients in both group were given memantine(10 mg/bid)for 12 weeks.Simple mental state examination(MMSE)was used to measure cognitive function.Neural psychiatric questionnaire(NPI)measurement was used to evaluate BPSD and the TESS was used to assess adverse effects.Results Decreased scores of MMSE between the treatment group and the control group were respectively(0.67±0.77)and(0.26±0.68)after 12 weeks of treatment.There was significant difference in decreased scores of MMSE between the two groups(t=2.49,P=0.02).The scores of NPI in agitation/attack(t=2.986,P=0.04),apathy(t=3.144,P=0.002),indifference/dysthymia (t=6.094,P=0.000)and anxiety(t=6.496,P=0.000)showed statistically significant differences between the two groups.There were no significant difference in TESS scores(P>0.05).The most frequently adverse e-vents in the study included dizziness,headache,fatigue and nausea.QTc interval prolongation were found in participants treated with 30 mg citalopram per day in the study group.Conclusion Citalopram is an effec-tive and safe drug in the treatment of BPSD and cognitive function associated with moderate AD.
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Objective To compare the cognitive functions and behavioral and psychological symptoms between Parkinson disease with dementia(PDD)and Alzheimer disease(AD). Methods Seventy-five cases with AD and 63 cases with PDD were recruited in this study. The mini mental state examination (MMSE), Montreal cognitive assessment (MoCA)and activities of daily living scale (ADL)were used to evaluate the cognitive impairment.The Chinese version of neuropsychiatric questionnaire(CNPI)was used to measure behavioral and psychological symptoms. Results ①Cognitive assessments:there were no statistically significant differences in total MMSE scores,total MoCA scores,total CNPI scores and ADL scores between AD patients and PDD patients (P>0.05).The sub-items of MoCA showed that memory loss was more severe in AD patients(2.17±0.65)than in PDD patients(2.44±0.50)(P<0.01).Visuospatial/executive dysfunction was more severe in PDD patients(3.73±0.70)than in AD patients(4.01±0.76)(P<0.05).②The items of CNPI showed that ADD patients had lower scores in the items of CNPI compared with the PDD patients (15.31±3.16 vs 19.41±3.52). The sub-items of CNPI showed that the most common mental symptoms in PDD patients were hallucination, depression, and agitation, which were 55.6%, 54%, and 52.4%, respectively Compared with the AD patients (P<0.05). On the contrary, compared with PDD patients, the most common mental symptoms were anxiety, apathy and irritability in AD patients, which were 53.3%, 52% and 49.3%, respectively (P<0.05). Conclusion Patients with AD and PDD exhibit different characteristics in cognitive functions and behavioral and psychological symptoms.Neuropsychological tests combined with clinical history can be helpful for differentiation between AD and PDD in dementia patients.
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The study is designed as a systematic review on nonpharmacological interventions for patients with moderate to severe dementia. This review will be conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The following databases will be searched: Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, KoreaMED, KMbase, and KISS. The primary outcome will include the effect of the interventions on activities of daily living and behavioral and psychological symptoms of dementia. The literature search will be conducted based on search strategies designed for each database. The reviewers will independently assess the identified studies and extract the data. The risk of bias will be assessed and a meta-analysis will be conducted in accordance with the methodology for meta-analysis described in the Cochrane handbook. This systematic review will provide clinicians and policy makers with reliable evidence for developing and implementing nonpharmacological interventions for moderate to severe patients with dementia.