Repressive Coping Does Not Contribute to Anosognosia in First-Diagnosis Patients With Alzheimer Disease

Abstract

Anosognosia is common in patients with Alzheimer disease (AD) even in early stages. Although neural correlates and the impact of cognitive dysfunctions have been described, possible psychodynamic processes such as a repressive coping style as described in other illnesses, have not been examined. Our study aimed to examine possible psychological influence factors on illness perception embracing a repressive coping style and cognitive functions in AD patients in the diagnostic process. Fifty-four subjects with mild AD diagnosed in our memory clinic were enrolled. Anosognosia was evaluated using a patient-caregiver discrepancy rating. All patients underwent comprehensive neuropsychological testing. In addition, characteristics of a repressive coping style were assessed. In total, 79.6% of our patients showed a lack of awareness at least to some degree. 33.3% of the patients were classified as repressors. Repressors and nonrepressors did not differ in cognition, or the unawareness score. Multivariate regression analysis showed that repressive coping style did not significantly contribute to anosognosia, but that verbal memory and naming ability had a strong influence. Although our data indicate that a high proportion of patients with mild AD show characteristics of repressive coping, this possible defense mechanism had no influence on the awareness of illness-related deficits measured by caregiver patient discrepancy.

Quality of the caregiving relationship and quality of life in mild Alzheimer's dementia

“…Therefore, lack of awareness might also be due to affective dysfunction. In contrast, psychodynamic processes such as a repressive coping style were shown to contribute to lack of awareness …”

“…In contrast, psychodynamic processes such as a repressive coping style were shown to contribute to lack of awareness. 66 Bjørge et al 67 have also pointed to an inconsistency between the caregiver and the AD patient's perceptions of their relationship, and suggested that supporting distressed caregivers in changing their negative perspective might be helpful for them and their relationship quality.…”

Awareness of Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia Diagnoses Associated With Lower Self-Ratings of Quality of Life in Older Adults

“…It is possible that some unaware patients were experiencing anosognosia whereby they were unable or unwilling to recognize their impairments. The percentage of patients with anosognosia is highly variable in clinical populations, ranging from about 27% upwards to 80% (Turró-Garriga et al, 2016;Verhülsdonk et al, 2016). Understanding the degree to which anosognosia that can develop in neurodegenerative diseases is protective against declines in QOL for persons with AD dementia may be useful for understanding and addressing the burdens that may be placed on individuals who are cognitively typical yet diagnosed with AD dementia.…”

Anosognosia: How to Treat the Lack of Insight in Mental Health

“…The management of the condition presents a wide range of challenges regarding the effective alleviation of the state. The existence of a similar situation is influenced by a wide range of problems attributable to the mental condition of the patient [9]. The effective management of Ann W. condition would be faced by various challenges, which are primarily influenced by her history with mental problems.…”