Criteria for Psychosis in Major and Mild Neurocognitive Disorders: International Psychogeriatric Association (IPA) Consensus Clinical and Research Definition

Cummings, Jeffrey L.; Pinto, Luiz Cortez; Cruz, Manuel; Fischer, Corinne E.; Gerritsen, Debby L.; Grossberg, George T.; Hwang, Tzung‐Jeng; Ismail, Zahinoor; Jeste, Dilip V.; Koopmans, Raymond T.C.M.; Lanctôt, Krista L.; Mateos, Raimundo; Peschin, Susan; Sampaio, Cristina; Tsuang, Debby W.; Wang, Huali; Zhong, Kate; Bain, Lisa J.; Sano, Mary

doi:10.1016/j.jagp.2020.09.002

Cited by 57 publications

(76 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the IPA employed its broad survey methodology to reach clinicians and researchers across the world, it became apparent that the respondents wanted additional clarity to identify and define the symptoms of psychosis. For example, nearly 79% of survey respondents agreed that it would be helpful to provide examples of dementia-related delusions and hallucinations; 76% endorsed the separation of criteria for duration and severity; and 80% endorsed adding to the definition, the impact of psychosis on "patient or others' functioning" (Cummings et al, 2020). The symptoms of hallucinations and delusions in the presence of the cognitive and functional impairment of dementia that occurs primarily in an aging population raise a number of questions.…”

Section: Why Do We Need a New Definition?mentioning

confidence: 99%

“…The separation of duration and severity and the expansion of each provided additional descriptive information addressed some uncertainty from the initial survey about symptom duration. The follow-up survey found 72% endorsement of the 1-month interval for duration and 88% endorsement of definitions of severity (Cummings et al, 2020). In the initial survey, there was mixed enthusiasm with fewer than 50% endorsing the continued use of the term "negative symptoms" as an associated feature and 59% endorsing its replacement with "apathy," which has recently been recognized as a separate syndrome (Robert et al, 2018).…”

Section: The Ipa Process For Revising Definitional Criteriamentioning

confidence: 99%

“…The effort continued with its work on defining agitation in cognitive disorders (Cummings et al, 2015), and the IPA has demonstrated an enduring commitment to identifying and treating the clinical problems that pose some of the greatest challenges to the quality of life of patients and their families. Most recently, such contributions have led to the publication of Consensus Criteria for Psychosis in Major and Mild Neurocognitive Disorders (NCDs) (Cummings et al, 2020). This IPA effort synthesizes contemporary global perspectives on the nature of behavioral and psychiatric symptoms accompanying cognitive disorders.…”

mentioning

confidence: 99%

See 2 more Smart Citations

International Psychogeriatric Association (IPA) consensus for defining psychosis in major and mild neurocognitive disorders

Sano

Cummings

Jeste

et al. 2021

Int. Psychogeriatr.

Self Cite

View full text Add to dashboard Cite

Section: Why Do We Need a New Definition?mentioning

confidence: 99%

Section: The Ipa Process For Revising Definitional Criteriamentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

International Psychogeriatric Association (IPA) consensus for defining psychosis in major and mild neurocognitive disorders

Sano

Cummings

Jeste

et al. 2021

Int. Psychogeriatr.

Self Cite

View full text Add to dashboard Cite

Section: Psychotic Syndromementioning

confidence: 99%

“…Previous diagnostic criteria were modified to be applicable to all types of dementia and to allow diagnosis after less duration of symptoms (48), also in consonance with criteria recently proposed by an expert panel of the International Psychogeriatric Association (49). Randomized trials (24,27,(29)(30)(31) and clinical experience support the use of neuroleptic treatment in patients with dementia who develop psychosis.…”

Section: Psychotic Syndromementioning

confidence: 99%

Syndrome-Based Prescription to Optimize Psychotropics: Are CHROME Criteria a Game Changer?

Múñiz¹,

López-Álvarez

Agüera-Ortíz

et al. 2021

Front. Psychiatry

View full text Add to dashboard Cite

A variety of medical and social factors have contributed over the last decades to the overuse of psychotropic drugs in people with dementia. One social factor is probably the frequent failure to provide adequate person-centered care, be it in the community or in institutional settings. This unfortunate reality has been reacted upon with numerous guidelines to reduce prescriptions of the most dangerous drugs (e.g., neuroleptics). Each psychotropic drug prescription can in principle be assessed around three dimensions: (a) adequate, (b) inadequate, and (c) chemical restraint. The CHemical Restraints avOidance MEthodology (CHROME) defined chemical restraint as any prescription based on organizational convenience, rather than justified with medical diagnosis. Two validation studies revealed that one of the main medical reasons of over- and miss-prescriptions was symptom-based prescription. By switching to syndrome-based prescription, a large proportion of drugs could be de-prescribed and some re-adjusted or kept. Paucity of research and weakness of data are not conclusive about the adequacy of specific drugs for the myriad of cases presented by patients with dementia and comorbid conditions. Clinical practice, however, leads us to believe that even under optimal care conditions, psychotropics might still contribute to quality of life if based on an adequate diagnosis. This article explains the rationale that underlies a syndromic approach aimed at optimizing psychotropic treatment in people with dementia whose significant suffering derives from their thought, affective, or behavioral problems. The results of previous validation studies of this new methodology will be discussed and conclusions for future results will be drawn.

show abstract

Progress in Pharmacologic Management of Neuropsychiatric Syndromes in Neurodegenerative Disorders

Cummings,

Lanctot,

Grossberg

et al. 2024

JAMA Neurol

Self Cite

View full text Add to dashboard Cite

ImportanceNeuropsychiatric syndromes (NPSs) are common in neurodegenerative disorders (NDDs); compromise the quality of life of patients and their care partners; and are associated with faster disease progression, earlier need for nursing home care, and poorer quality of life. Advances in translational pharmacology, clinical trial design and conduct, and understanding of the pathobiology of NDDs are bringing new therapies to clinical care.ObservationsConsensus definitions have evolved for psychosis, agitation, apathy, depression, and disinhibition in NDDs. Psychosocial interventions may reduce mild behavioral symptoms in patients with NDD, and pharmacotherapy is available for NPSs in NDDs. Brexpiprazole is approved for treatment of agitation associated with Alzheimer disease dementia, and pimavanserin is approved for treatment of delusions and hallucinations associated with psychosis of Parkinson disease. Trials are being conducted across several of the NDDs, and a variety of mechanisms of action are being assessed for their effect on NPSs.Conclusions and RelevanceDetection and characterization of NPSs in patients with NDDs is the foundation for excellent care. New definitions for NPSs in NDDs may inform choices regarding clinical trial populations and translate into clinical practice. Psychosocial and pharmacologic therapies may reduce behavioral symptoms and improve quality of life for patients and caregivers. Approved agents may establish regulatory precedents, demonstrate successful trial strategies, and provide the foundation for further advances in treatment development.

show abstract

Criteria for Psychosis in Major and Mild Neurocognitive Disorders: International Psychogeriatric Association (IPA) Consensus Clinical and Research Definition

Cited by 57 publications

References 32 publications

International Psychogeriatric Association (IPA) consensus for defining psychosis in major and mild neurocognitive disorders

International Psychogeriatric Association (IPA) consensus for defining psychosis in major and mild neurocognitive disorders

Syndrome-Based Prescription to Optimize Psychotropics: Are CHROME Criteria a Game Changer?

Progress in Pharmacologic Management of Neuropsychiatric Syndromes in Neurodegenerative Disorders

Contact Info

Product

Resources

About