ABSTRACT
OBJETIVO: Valorar si los síntomas neuropsiquiátricos interfieren en la detección de deterioro cognitivo por los médicos de familia en atención primaria, así como describir cuáles generan más confusión. DISEÑO: Estudio observacional y descriptivo. Emplazamiento: Equipo de psiquiatría de intervención en domicilio en colaboración con la red de atención primaria de Barcelona. PARTICIPANTES: Un total de 104 pacientes mayores de 65 años derivados desde atención primaria por sus médicos de familia solicitando valoración psiquiátrica en el domicilio por sospecha de enfermedad mental. Mediciones principales: Todos los casos recibieron un diagnóstico según criterios DSM-IV-TR. Se incluyeron en el estudio el Mini Mental State Examination (MMSE), el Inventario Neuropsiquiátrico de Cummings, la escala de Gravedad de Enfermedad Psiquiátrica, la escala de Evaluación de la Actividad Global, la escala de Impresión Clínica Global y el Cuestionario de Evaluación de la Discapacidad de la Organización Mundial de la Salud. RESULTADOS: El 55,8% de los pacientes derivados desde atención primaria tenían el MMSE alterado. Los síntomas neuropsiquiátricos más frecuentemente asociados a la sospecha de deterioro cognitivo fueron los delirios, las alucinaciones, la agitación, la desinhibición, la irritabilidad y la conducta motora sin finalidad. CONCLUSIONES: Cuando se detecten síntomas psiquiátricos propios de trastorno mental severo (TMS) en individuos de edad avanzada sin antecedentes de TMS hay que sospechar un deterioro cognitivo y se debería administrar una prueba de cribado
OBJECTIVE: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN: Descriptive and observational study. LOCATION: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS: A total of 104 patients over 65 years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. MAIN MEASUREMENTS: All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. RESULTS: 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. CONCLUSIONS: When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Cognition Disorders/diagnosis , Dementia/diagnosis , Brief Psychiatric Rating Scale , Home Care Services , Socioeconomic Factors , Diagnosis, Differential , Observational Study , SpainABSTRACT
OBJECTIVE: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN: Descriptive and observational study. LOCATION: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS: A total of 104 patients over 65years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. MAIN MEASUREMENTS: All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. RESULTS: 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. CONCLUSIONS: When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done.
