Psychotic symptoms in patients with dementia

Abstract

SUMMARYThe current article reviews the current state of knowledge pertaining to psychotic symptoms in patients with dementia, drawing on over 70 studies in this area. The majority of studies utilizing a purpose-designed structured instrument have found a prevalence of psychotic symptoms in excess of 60%. The annual incidence and resolution rates are, however, considerably lower, in the region of 2%. There is little consensus about which factors are of aetiological importance, although it does seem that those with a dementia of moderate severity have the highest prevalence. Perhaps the lack of clarity in this aetiological research partly relates to the limited attention paid to phenomenology. Some suggestions about future research directions which might improve our phenomenological understanding of these conditions are made. Psychotic symptoms are associated with considerable secondary morbidity including increased aggression, irritability and distress.

Delusions of Japanese patients with Alzheimer's disease

“…These findings are well within the range reported in previous studies (Wragg and Jeste, 1989;Rubin, 1992;Rockwell et al, 1994;Ballard and Oyebode, 1995;Migliorelli et al, 1995;Mega et al, 1996;Ozawa, 1997;Hirono et al, 1998;Rao and Lyketsos, 1998;Wilson et al, 2000). However, estimates of the prevalence of delusions vary widely, delusions of japanese patients with alzheimer's diseasefrom 10% (Birkett, 1972) to 73% (Leuchter and Spar, 1985) of AD patients among studies.…”

“…However, they have received much less attention than cognitive impairment. Risk factors for development of delusions in AD, such as sociodemographic characteristics and cognitive impairment, are still controversial (Ballard and Oyebode, 1995;Rao and Lyketsos, 1998). In this study, we address the prevalence, associated factors and type of delusions in Japanese patients with AD and compare these results with those of Western countries.…”

Reducing the burden of caring for Alzheimer's disease through the amelioration of ‘delusions of theft’ by drug therapy

“…Delusions of theft' (`Someone is stealing my valuables') are the most frequently observed neuropsychiatric manifestation of the illness delusion in dementia patients (Burns et al, 1990;Ballard and Oyebode, 1995). In addition, the delusions and ensuing aggression and anxiety are major factors that increase the burden of caregivers.…”

“…The content of the delusions can be classi®ed into persecutory delusions (`People are stealing things from the patient',`The patient is being conspired against or harassed', or`The patient has been abandoned'), misidenti®cation delusions (`Someone is in the house' or`A spouse and others are not who they claim to be'), and delusional jealousy (`in®delity in a spouse').`Delusions of theft' (delusions involving the theft of possessions), a type of persecutory delusion, are the most frequently noted delusion in AD (Greene et al, 1982;Burns et al, 1990;Ballard and Oyebode, 1995;Ozawa, 1997). The subject of these delusions (the thief) is often the nearby caregiver, the repercussions of which cause an increase in the accused caregiver's mental burden.…”

Antipsychotics and risk of cerebrovascular events in treatment of behavioural and psychological symptoms of dementia in Hong Kong: a hospital‐based, retrospective, cohort study

“…The global dementia prevalence in people aged 60 or above was estimated to be 3.9%. Behavioural and Psychological Symptoms of Dementia (BPSD) occur in the majority of people with dementia (Ballard and Oyebode, 1995). BPSD can be defined as a constellation of psychological reactions, psychiatric symptoms and behaviours occurring in people with dementia of any aetiology (International Psychogeriatric Association, 1999).…”