ABSTRACT
Symptomatic behavioral disturbances including agitation, motor restlessness, outbursts and hostility remain a major problem in clinical management of gerontopsychiatric patients. Termination of home care and subsequent hospitalisation is caused largely by behavior disturbances and not cognitive deficits. Clinical efficacy of neuroleptic treatment seems to be modest and is limited by unwanted side effects. Carbamazepine shows psychotropic effects and seems to improve limbic pathology including aggression and poor impulse control in various psychiatric disorders. Treatment with carbamazepine was evaluated in an open study design in 29 gerontopsychiatric inpatients. Carbamazepine was efficient in treating agitated behavior disturbances in dementia and other disorders. Adverse effects of the drug showed up only in a small percentage of the patients and were reversible after discontinuation of the drug. The results suggest that carbamazepine may be effective in treating agitated behavior in gerontopsychiatric patients with different disorders. It may represent a sensible alternative or complementation to other therapeutic interventions.
Subject(s)
Carbamazepine/therapeutic use , Dementia/drug therapy , Mood Disorders/drug therapy , Psychomotor Agitation/drug therapy , Aged , Carbamazepine/adverse effects , Dementia/diagnosis , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Mood Disorders/diagnosis , Neuropsychological Tests , Psychomotor Agitation/diagnosisABSTRACT
A 82-year old woman had, since the age of 50, a history of 9 phases of monopolar endogenous depression with abnormal intestinal sensations and hypochondriac delusions that appeared as delusional parasitosis in 5 of these phases. Differential diagnosis and therapeutic aspects are discussed.
Subject(s)
Delusions/psychology , Depressive Disorder/psychology , Giardiasis/psychology , Intestinal Diseases, Parasitic/psychology , Aged , Aged, 80 and over , Delusions/diagnosis , Depressive Disorder/diagnosis , Diagnosis, Differential , Female , Giardiasis/diagnosis , Humans , Hypochondriasis/diagnosis , Hypochondriasis/psychology , Intestinal Diseases, Parasitic/diagnosis , Physician-Patient Relations , Sick Role , Suicide, Attempted/psychologyABSTRACT
The concept of social competence covers emotional, cognitive and behavioral abilities in the field of interpersonal communication and behavior patterns to cope with practical problems of life. Under the specific conditions of age, aging, and diseases in one part of the elderly, a loss of psycho-social competence may reduce the ability and quality of independent living. To improve social competence in old patients, an age-adapted assertiveness-training, based on the Assertiveness Training Program was proved in a group of psychogeriatric inpatients in a controlled study. In the self-rated activities of daily living and state-anxiety as well as in observer-rated self-confidence and assertiveness, the training group showed significant improvement compared to the controls.
Subject(s)
Anxiety/therapy , Assertiveness , Behavior Therapy/methods , Hospitalization , Self Concept , Aged , Anxiety/psychology , Depressive Disorder/psychology , Depressive Disorder/therapy , Female , Humans , Male , Middle Aged , Neurotic Disorders/psychology , Neurotic Disorders/therapy , Paranoid Disorders/psychology , Paranoid Disorders/therapy , Personality InventoryABSTRACT
Two demented patients, one with primary degenerative dementia and one with multi-infarct dementia, each showed attachment to a soft toy animal, which fulfilled the criteria of a transitional object as described by Winnicott. This could be regarded as a regression phenomenon, according to the basic pathogenetic concept that cerebral disease causes a dissolution of the highest central nervous functions.
Subject(s)
Dementia, Multi-Infarct/psychology , Dementia/psychology , Object Attachment , Regression, Psychology , Aged , Aged, 80 and over , Delusions/diagnosis , Delusions/psychology , Dementia/diagnosis , Dementia, Multi-Infarct/diagnosis , Female , Hallucinations/diagnosis , Hallucinations/psychology , Humans , Personality Development , Reality Testing , Social EnvironmentABSTRACT
It is an overall knowledge, that dementia and depression are the most common diagnosis in old age psychiatry. This fact has long since been known, in fact first descriptions of cognitive disorders during the course of endogenous depression can already be found at the beginning of the century in works of Gaupp and Kraepelin. On the other hand there are depressive symptoms in people with later evident dementia that can be found years before cognitive disorders are evident. These short introductory remarks show the need of early diagnosis to enable us to more efficient therapy. The following paper gives a survey of the recent and efficient diagnostic possibilities for practible clinical work as well as it shows new research aspects in this field.
Subject(s)
Dementia/diagnosis , Depression/diagnosis , Aged , Diagnosis, Differential , Humans , Intelligence Tests , Neuropsychological TestsABSTRACT
Autogenic training (a.t.) as an additional therapeutic method was applied to 20 psychogeriatric inpatients in daily exercises. The patients were suffering from major depression, dementia, psychoneurotic disorders and Parkinson's disease. By using only the basic exercises, supported by some learning helps, 14 out of the 20 patients were able to learn and practice a.t. with quite good success, especially in the treatment of sleep disorders and restless states. Involving the nursal staff proved to be of great importance. Finally special aspects of the application of a.t. in psychogeriatric inpatients are discussed.
Subject(s)
Autogenic Training , Dementia/therapy , Depressive Disorder/therapy , Parkinson Disease/therapy , Aged , Aged, 80 and over , Attitude to Death , Dementia/psychology , Depressive Disorder/psychology , Female , Humans , Hypochondriasis/therapy , Male , Parkinson Disease/psychology , Professional-Patient RelationsABSTRACT
Following consideration of the nosological role of hyperglycemic states in psychiatry the case report of a fifty-five year-old patient is presented suffering from fatty cell degeneration of the liver and a relapsing pancreatitis due to chronic alcoholism. After a long period of abstinence without previously known diabetes mellitus a sudden ketoacidotic coma developed with maximum serum glucose level of 2020 mg%. Having emerged during coma treatment Wernicke's encephalopathy passed into Korsakoff's syndrome the main features of which remained unchanged for more than one year. In this case thiamine deficiency of different pathogenetical origin is discussed: defective exogeneous availability due to malabsorption; depletion of endogeneous thiamine stores due to enlarged requirements for glucose oxidation during coma therapy; antimetabolic effects to thiamine by nitroimidazole-derivatives administered parenterally.
