Prevalence and clinical correlates of pathological affective display in Alzheimer's disease.

Abstract

This study examined the prevalence and correlates of pathological affect in Alzheimer's disease. A consecutive series of 103 patients with Alzheimer's disease were examined with a comprehensive psychiatric assessment that included the pathological laughing and crying scale (PLACS). Forty patients (39%) showed pathological affect: 25% showed crying episodes, and 14% showed laughing or mixed (laughing and crying) episodes. Patients with pathological affect crying showed significantly higher depression scores and a significantly higher frequency of major depression and dysthymia than patients with no pathological affect. Patients with mixed pathological affect showed significantly more subcortical atrophy on CT than patients with pathological affect crying. Forty seven per cent of the patients with pathological affect had no congruent mood disorder, and they showed a significantly longer duration of illness and more severe anosognosia than patients with pathological affect that was congruent with an underlying mood disorder. The study validates the PLACS, and shows the high prevalence of pathological affect in Alzheimer's disease. (i Neurol Neurosurg Psychiatry 1995;59:55-60)

Pseudobulbar affect: an under-recognized and under-treated neurological disorder

“…1,6 Clinical case and study data have shown that PBA may cause severe distress, embarrassment, and social disability among patients. 3,[7][8][9][10] In addition, studies have shown that patients with PBA or similar syndromes experience an increased incidence of depression, 11 impairments in executive function 12 and sexual function, 13 and ability to perform activities of daily living 14 10,11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] ). This variability is probably due to differences in the populations studied and in the criteria and methods used for identifying PBA.…”

“…Ranges of estimated prevalence for PBA and similar syndromes, such as emotional lability as variously defined and identified in published reports are indicated by the vertical gray arrows. 5,10,11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Prevalence rates determined in the present study with PLACS≥13 and CNS-LS≥13 are indicated by the transverse plot points. The prevalence rates determined with CNS-LS≥21 in the present study were very similar to those for PLACS≥13, and are not shown here to enhance visual clarity.…”

Involuntary Emotional Expressive Disorder: A Case for a Deeper Neuroethics

“…PBA is fairly common in conditions such as MS 16 and ALS, 17 but relatively rare in patients with AD, 18 whereas the less specific state of emotional incontinence or lability is fairly common. 19 In our opinion, the best management approach is to inform families that the display of emotions is not associated with a strong underlying affect.…”

A Study of Potential Pharmacokinetic and Pharmacodynamic Interactions between Dextromethorphan/Quinidine and Memantine in Healthy Volunteers

“…[20] Although there are limited data available on the prevalence of PBA in this population, it has been estimated that up to 39% of patients with Alzheimer’s disease also experience PBA. [2,21] Therefore, physicians may consider treating patients with Alzheimer’s disease with memantine and DMQ concomitantly. Since both agents are NMDA receptor antagonists, however, their coadministration could, theoretically, lead to an additive effect at NMDA receptors and increased rates or severity of adverse events (AEs).…”