Improving the Management of Disruptive Behavior and Reducing Antipsychotic Medications in Nursing Facility Residents

Stefanacci, Richard G.; Arnicar, Robin; Clark, Thomas R.; Gerber, Joseph; Haimowitz, Daniel; Kuhlor, Aysha; Scanland, Susan

doi:10.4140/tcp.n.2014.797

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This included the patients with schizophrenia when analyzed alone, the mood disordered patients when analyzed without the patients with schizophrenia, and the combined sample when analyzed together. Long-term results for patients who are prescribed antipsychotics are important to assess, since they are prescribed (at times by non-psychiatrists) to many different types of people, including children and older people to prevent disruptive behavior (Olfson et al, 2012; Stefanacci et al, 2014). While administered widely, we still do not have clear knowledge of all of the effects.…”

Section: Discussionmentioning

confidence: 99%

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Harrow

Jobe

Faull

et al. 2017

Psychiatry Research

View full text Add to dashboard Cite

To assess the long-term effectiveness of antipsychotic medications in facilitating work functioning in patients with schizophrenia we conducted longitudinal multi followup research on 139 initially psychotic patients. The 70 patients with schizophrenia and 69 initially psychotic mood disordered control patients were followed up 6 times over 20 years. We compared the influence on work functioning of patients with schizophrenia continuously prescribed antipsychotics with patients with schizophrenia not prescribed antipsychotics, using statistical controls for inter-subject differences. While antipsychotics reduce or eliminate flagrant psychosis for most patients with schizophrenia at acute hospitalizations, four years later and continually until the 20 year followups, patients with schizophrenia not prescribed antipsychotics had significantly better work functioning. The work performance of the patients who were continuously prescribed antipsychotics was at a low rate and did not improve over time. Multiple other factors also interfere with work functioning. The data suggest that some patients with schizophrenia not prescribed antipsychotics for prolonged periods can function relatively well. Multiple other factors are associated with poor post-hospital work performance. The longitudinal data raise questions about prolonged treatment of schizophrenia with antipsychotic medications.

show abstract

Section: Discussionmentioning

confidence: 99%

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Harrow

Jobe

Faull

et al. 2017

Psychiatry Research

View full text Add to dashboard Cite

show abstract

“…However, overlap with comorbid psychiatric disorders and confusion regarding differential diagnosis, especially with depression (PBA versus mood disorder, or both), pose challenges for adequately identifying and managing PBA (Arciniegas and Lauterbach, 2005;Work et al, 2011). As a result, antipsychotics, antidepressants, and anxiolytics are often used to manage PBA symptoms, despite the lack of substantial clinical evidence supporting their use for this indication (Lövheim et al, 2006;Brooks et al, 2013;Stefanacci et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pseudobulbar affect symptoms and clinical correlates in nursing home residents

Foley

Konetzka

Bunin³

2015

Int J Geriat Psychiatry

View full text Add to dashboard Cite

ObjectivePseudobulbar affect (PBA) is a neurological disorder of emotional expression, characterized by uncontrollable episodes of crying or laughing in patients with certain neurological disorders affecting the brain. The purposes of this study were to estimate the prevalence of PBA in US nursing home residents and examine the relationship between PBA symptoms and other clinical correlates, including the use of psychopharmacological medications.MethodsA retrospective study was conducted between 2013 and 2014 with a convenience sample of residents from nine Michigan nursing homes. Chronic‐care residents were included in the “predisposed population” if they had a neurological disorder affecting the brain and no evidence of psychosis, delirium, or disruptive behavior (per chart review). Residents were screened for PBA symptoms by a geropsychologist using the Center for Neurologic Study‐Lability Scale (CNS‐LS). Additional clinical information was collected using a diagnostic evaluation checklist and the most recent Minimum Data Set 3.0 assessment.ResultsOf 811 residents screened, complete data were available for 804, and 412 (51%) met the criteria for the “predisposed population.” PBA symptom prevalence, based on having a CNS‐LS score ≥13, was 17.5% in the predisposed population and 9.0% among all nursing home residents. Those with PBA symptoms were more likely to have a documented mood disorder and be using a psychopharmacological medication, including antipsychotics, than those without PBA symptoms.ConclusionsPseudobulbar affect symptoms were present in 17.5% of nursing home residents with neurological conditions, and 9.0% of residents overall. Increasing awareness and improving diagnostic accuracy of PBA may help optimize treatment. © 2015 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

show abstract

Improving the Management of Disruptive Behavior and Reducing Antipsychotic Medications in Nursing Facility Residents

Cited by 2 publications

References 0 publications

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Prevalence of pseudobulbar affect symptoms and clinical correlates in nursing home residents

Contact Info

Product

Resources

About