More severe CFs in patients with dementia were significantly associated with impaired ability to engage in ADLs and poorer QOL.

We have recently proposed a model for subtyping schizophrenia based on antipsychotic (AP) treatment response. Evidence suggests that APs, both old and new, are comparable in terms of efficacy; however, one AP, clozapine, is uniquely effective in one subgroup of patients (that is, those with treatment-resistant schizophrenia [TRS]). This permits us to subdivide schizophrenia into 3 specific groups: AP responsive, clozapine responsive, and clozapine resistant. Here, we integrate this model with current criteria related to TRS and ultraresistant schizophrenia, the latter referred to in our model as clozapine resistant. We suggest several modifications to existing criteria, in line with current evidence and practice patterns, particularly emphasizing the need to focus on positive symptoms. While APs can favourably impact numerous dimensions related to schizophrenia, it is their effect on positive symptoms that distinguishes them from other psychotropics. Further, it is positive symptoms that are central to AP and clozapine resistance, and it is these people that place the greatest demands on acute and long-term inpatient resources. In moving AP development forward, we advocate specifically focusing on positive symptoms and capitalizing on the evidence we have of 3 subtypes of psychosis (that is, positive symptoms) based on treatment response, implicating 3 distinguishable forms of underlying pathophysiology. Conversely, pooling these groups risks obfuscating potentially identifiable differences. Such a position does not challenge the importance of dopamine D 2 receptor blockade, but rather highlights the need to better isolate those other subgroups that require something more or entirely different. W W W Sous-typage de la schizophrénie par la réponse au traitement : développement des antipsychotiques et rôle central des symptômes positifsNous avons récemment proposé un modèle de sous-typage de la schizophrénie basé sur la réponse au traitement antipsychotique (AP). Les données probantes suggèrent que les AP, anciens comme nouveaux, sont d'efficacité comparable; cependant, un AP, la clozapine, a une efficacité unique dans un sous-groupe de patients (c'est-à-dire, ceux qui souffrent de schizophrénie résistante au traitement [SRT]). Ceci nous permet de subdiviser la schizophrénie en 3 groupes spécifiques : réceptive aux AP, réceptive à la clozapine, et résistante à la clozapine. Ici, nous intégrons ce modèle à des critères actuels liés à la SRT et à la schizophrénie ultrarésistante, cette dernière étant identifiée dans notre modèle comme étant résistante à la clozapine. Nous suggérons plusieurs modifications open access

We have recently proposed a model for subtyping schizophrenia based on antipsychotic (AP) treatment response. Evidence suggests that APs, both old and new, are comparable in terms of efficacy; however, one AP, clozapine, is uniquely effective in one subgroup of patients (that is, those with treatment-resistant schizophrenia [TRS]). This permits us to subdivide schizophrenia into 3 specific groups: AP responsive, clozapine responsive, and clozapine resistant. Here, we integrate this model with current criteria related to TRS and ultraresistant schizophrenia, the latter referred to in our model as clozapine resistant. We suggest several modifications to existing criteria, in line with current evidence and practice patterns, particularly emphasizing the need to focus on positive symptoms. While APs can favourably impact numerous dimensions related to schizophrenia, it is their effect on positive symptoms that distinguishes them from other psychotropics. Further, it is positive symptoms that are central to AP and clozapine resistance, and it is these people that place the greatest demands on acute and long-term inpatient resources. In moving AP development forward, we advocate specifically focusing on positive symptoms and capitalizing on the evidence we have of 3 subtypes of psychosis (that is, positive symptoms) based on treatment response, implicating 3 distinguishable forms of underlying pathophysiology. Conversely, pooling these groups risks obfuscating potentially identifiable differences. Such a position does not challenge the importance of dopamine D2 receptor blockade, but rather highlights the need to better isolate those other subgroups that require something more or entirely different.

In the long-term care setting, aggressive behavior plays an important role in both subjective and objective nursing burden, while impaired ADLs increase the objective burden for nursing staff.

RESULTSA total of 71 staff members from various eldercare centres participated in the study, of which 51 (71.8%) were women. At three-month follow-up, there was a significant change in most measures on Ryden's Perception Scale (p < 0.05). There were significant improvements in knowledge scores for dementia and depression (p < 0.001). Knowledge gains after the workshop were maintained at three-month follow-up. CONCLUSIONTraining of eldercare workers in mental healthcare is helpful for knowledge improvement and altering perceptions of caring for older persons. With continued support from mental health professionals, such training could contribute to better care for this vulnerable population.