The aim of this study was to detect behavioral subsyndromes of the 12-item Neuropsychiatric Inventory (NPI). Cross-sectional data of 199 patients with dementia living in the community were collected. Principal component analysis (with Varimax rotation) was used for factor analysis. Results showed the presence of three behavioral subsyndromes: mood/apathy, psychosis, and hyperactivity. Anxiety was regarded as a separate symptom. The subsyndrome mood/apathy was the most common, occurring in almost 80% of the patients, versus psychosis and hyperactivity, which occurred in 37 and 60% of the patients, respectively.
The combined outcome measure and VAS showed no difference between radiofrequency and sham, though in both groups, significant VAS improvement occurred. The global perceived effect was in favor of radiofrequency. In selected patients, radiofrequency facet joint denervation appears to be more effective than sham treatment.
Although case histories of depression preceding Parkinson's disease (PD) point to a possible pathophysiological relationship between these two disorders, there is as yet no epidemiological evidence to support this view. We compared the incidence of depression in patients later diagnosed with PD with that of a matched control population. Using data from an ongoing general practice-based register study, the lifetime incidence of depressive disorder was calculated for patients until their diagnosis of PD and compared with that of a matched control population from the same register. At the time of analysis, the register held information on 105416 people. At the time of their diagnosis of PD, 9.2% of the patients had a history of depression, compared with 4.0% of the control population (chi(2) = 22.388, df = 1, P < 0.001). The odds ratio for a history of depression for these patients was 2.4 (95% CI: 2.1-2.7). We concluded that the higher incidence of depression in patients who were later diagnosed with PD supports the hypothesis of there being a biological risk factor for depression in these patients.
ESM enhances clinical practice and research. It is empowering, providing co-ownership of the process of diagnosis, treatment evaluation, and routine outcome measurement. Blended care, based on a mix of face-to-face and ESM-based outside-the-office treatment, may reduce costs and improve outcomes.
Our findings indicate that the caregiver's emotional reaction to patient behavior is more important than problem behaviors per se in the decision to institutionalize patients. Interventions aimed at teaching caregivers strategies to better manage difficult patient behaviors may provide caregivers with the necessary resources to continue care at home. Future interventions need to account for the specific needs and problems of different caregiver groups.
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