A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review

Dongen, Dorien H.E.; Havermans, Demi C.D.; Deckers, Kay; Olff, Miranda; Verhey, Frans R.J.; Sobczak, Sjacko

doi:10.1111/psyg.12830

Cited by 12 publications

(21 citation statements)

References 57 publications

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“…The case reports show positive effects on the symptoms measured or described, such as fewer flashbacks, more acceptance of the past and less restlessness 24,27,28 . Positive effects of EMDR on neuropsychiatric symptoms often associated with challenging behaviour of dementia can reflect the alternative clinical presentation of PTSD in people with dementia, showing symptoms such as screaming 16 . These case reports indicate that EMDR might be also feasible and effective for reducing PTSD symptoms in people with dementia.…”

Section: Discussionmentioning

confidence: 72%

“…In addition, people with dementia and PTSD can show a variety of symptoms often associated with neuropsychiatric symptoms of dementia and not as symptoms of PTSD 14 . Examples are verbal agitation, physical aggression, flashbacks, fear and nightmares 15,16 . For neuropsychiatric symptoms seen in people with dementia the treatment options reported are broad with low grades of evidence 17 .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of post‐traumatic stress disorder in people with dementia: a structured literature review

Ruisch

Vorst²,

Boersma

et al. 2023

Psychogeriatrics

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Post-traumatic stress disorder (PTSD) is associated with cognitive dysfunctions and is an independent risk factor for dementia. A recent study has found the prevalence of PTSD in people with dementia is 4.7%-7.8%. However, little is known about the effectiveness of PTSD treatment for people with dementia. The primary aim of the current study is to review previous studies on the treatment of PTSD in people with dementia. A structured literature review was performed using a 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' analysis in PubMed, Embase, Psy-cINFO and CINAHL. Two independent researchers screened titles and abstracts. The inclusion criteria were: PTSD symptoms present, diagnosis of dementia, PTSD treatment form described and effects of the treatment mentioned. Articles that matched these criteria were included and content and quality were analyzed. We included nine articles, all case reports, with a total of 11 cases. The discussed treatment options are eye movement desensitisation and reprocessing (EMDR) (n = 3), prolonged exposure (n = 1), cognitive behavioural therapy (n = 1) and pharmacological treatment (n = 4). All articles reported a positive effect of the intervention on several monitored symptoms. Evidence for positive effects and feasibility of EMDR were most reliable, and it was applied in two articles of sufficient quality published in 2018 and 2019. EMDR 'on-the-spot' was described with positive effect in one article in which three cases were discussed. The quality of included papers ranged from insufficient to sufficient. This review shows that people with PTSD and dementia can benefit from PTSD treatment. EMDR, prolonged exposure, acceptance and commitment therapy and pharmacological treatment are applicable in this population. EMDR treatment is most described in this population (n = 5) and shows positive results, and the studies are of sufficient quality (n = 3). Further research in the form of a randomised controlled trial is required to study the effectivity of different treatment interventions in this population.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Treatment of post‐traumatic stress disorder in people with dementia: a structured literature review

Ruisch

Vorst²,

Boersma

et al. 2023

Psychogeriatrics

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show abstract

“…A shared limitation in diagnosing PTSD using the ICD-11 and DSM-5 is the required presence of one of the core elements 'avoidance symptoms', which a literature review show are not recognized in people with dementia. 23,49 The development of the TRADE-interview has added value for both clinical practice and research. The TRADEinterview offers opportunities to conduct methodologically solid and consistent research into this complex target group.…”

Section: Discussionmentioning

confidence: 99%

“…43 This can be explained by case reports in the literature that indicate that criterion C (avoidance symptoms) were rarely reported. 23 , 49 Notably, most sub-criteria of criterion D (negative cognition and mood symptoms) were excluded in the TRADE-interview because they are indistinguishable from BPSD. Most experts indicated that before such cut-offs should and could be considered, actual testing and observation in practice should take place.…”

Section: Discussionmentioning

confidence: 99%

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The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study

Havermans

Alphen

Olff

et al. 2022

J Geriatr Psychiatry Neurol

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Cognitive and behavioral aspects may mask posttraumatic stress disorder (PTSD) in people with dementia. PTSD severely lowers quality of life in people with dementia. Proper recognition of PTSD is essential to ensure adequate treatment. However, a valid diagnostic tool for PTSD in dementia is lacking. A Delphi study was conducted among 20 Dutch and 6 international experts in the field of PTSD and dementia care or research. The aim was to reach consensus in 3 rounds on the added value, form, content, and application for developing such an instrument. The first round confirmed the need for a new diagnostic tool for research and clinical practice. Consensus was reached on 23 statements regarding the support base and 19 related to content of the instrument. In the third round, opinions on several conceptual problems were gathered. Based on the experts' opinions, a draft version of an instrument, the TRAuma and DEmentia-interview (TRADE-interview), was developed. Clinical and research implications of this new measure are discussed.

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Neuropsychiatric symptoms of dementia in those with and without a recorded history of psychological trauma: A comparative study from an Australian dementia support service

Cations,

Atee,

Morris

et al. 2024

Int J Geriat Psychiatry

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ObjectiveTo compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service.MethodsThis was a 5‐year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex.ResultsAmong 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night‐time behaviours.ConclusionsTraumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia.

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A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review

Cited by 12 publications

References 57 publications

Treatment of post‐traumatic stress disorder in people with dementia: a structured literature review

Treatment of post‐traumatic stress disorder in people with dementia: a structured literature review

The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study

Neuropsychiatric symptoms of dementia in those with and without a recorded history of psychological trauma: A comparative study from an Australian dementia support service

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