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J. L. Cummings - One of the best experts on this subject based on the ideXlab platform.

  • Assessing the impact of Neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale.
    Journal of the American Geriatrics Society, 1998
    Co-Authors: Daniel I. Kaufer, J. L. Cummings, Patrick Ketchel, Audrey Macmillan, Dianne Christine, Tim Bray, Steve Castellon, Donna Masterman, Steven T. Dekosky
    Abstract:

    OBJECTIVES: To develop an adjunct scale to the Neuropsychiatric Inventory (NPI) for assessing the impact of Neuropsychiatric symptoms in Alzheimer's disease (AD) patients on caregiver distress. DESIGN: Cross-sectional descriptive and correlational study. SETTING: University out-patient memory disorders clinics. PARTICIPANTS: Eighty-five AD subjects and their caregivers (54 spouses, 31 children). MEASUREMENTS: The NPI and NPI Caregiver Distress Scale (NPI-D) were used to assess Neuropsychiatric symptoms in AD patients and related caregiver distress, respectively. Criterion validity of the NPI-D was examined (N = 69) by comparison with an abridged version of the Relatives' Stress Scale (RSS'), a general measure of caregiver stress, using item clusters that had previously been correlated to behavioral disturbances in demented patients. Test-retest (n = 20) and inter-rater reliability (n = 16) of the NPI-D were also assessed. RESULTS: Test-retest and interrater reliability of the NPI-D were both adequate. Overall, caregiver NPI-D distress ratings were correlated significantly with the RSS' (r = .60, P < .001). RSS' ratings correlated strongly with NPI scores (r = .64, P < .001), even after controlling for degree of cognitive impairment based on the Mini-Mental State Exam (MMSE) score (r = .61). MMSE scores showed a moderate correlation to RSS' ratings (-.30, P = .02), but this association was markedly attenuated when controlling for the degree of Neuropsychiatric disturbance based on the NPI score (r = −.14). NPI-D ratings for 9 of 10 NPI symptom domains correlated most strongly with either NPI symptom severity or total (frequency × severity) scores. Agitation, dysphoria, irritability, delusions, and apathy were the symptoms most often reported to be severely distressing to caregivers. CONCLUSIONS: The NPI-D provides a reliable and valid measure of subjective caregiver distress in relation to Neuropsychiatric symptoms measured by the NPI. Neuropsychiatric alterations are more strongly associated than cognitive symptoms to caregiver distress. The NPI-D may be useful in both clinical and research settings for assessing the contribution to caregiver distress of Neuropsychiatric symptoms in AD patients.

  • the Neuropsychiatric Inventory assessing psychopathology in dementia patients
    Neurology, 1997
    Co-Authors: J. L. Cummings
    Abstract:

    Article abstract-The Neuropsychiatric Inventory (NPI) was developed to assess psychopathology in dementia patients. It evaluates 12 Neuropsychiatric disturbances common in dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. The severity and frequency of each Neuropsychiatric symptom are rated on the basis of scripted questions administered to the patient9s caregiver. The NPI also assesses the amount of caregiver distress engendered by each of the Neuropsychiatric disorders. A total NPI score and a total caregiver distress score are calculated, in addition to the scores for the individual symptom domains. Content validity, concurrent validity, inter-rater reliability, and test-retest reliability of the NPI are established. Different neurologic disorders have characteristic Neuropsychiatric manifestations and distinctive NPI profiles. The NPI is sensitive to treatment effects and has demonstrated the amelioration of behavioral symptoms in Alzheimer9s disease by cholinergic agents. The NPI is a useful instrument for characterizing the psychopathology of dementia syndromes, investigating the neurobiology of brain disorders with Neuropsychiatric manifestations, distinguishing among different dementia syndromes, and assessing the efficacy of treatment. NEUROLOGY 1997;48(Suppl 6): S10-S16

  • The Neuropsychiatric Inventory: assessing psychopathology in dementia patients.
    Neurology, 1997
    Co-Authors: J. L. Cummings
    Abstract:

    The Neuropsychiatric Inventory (NPI) was developed to assess psychopathology in dementia patients. It evaluates 12 Neuropsychiatric disturbances common in dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. The severity and frequency of each Neuropsychiatric symptom are rated on the basis of scripted questions administered to the patient's caregiver. The NPI also assesses the amount of caregiver distress engendered by each of the Neuropsychiatric disorders. A total NPI score and a total caregiver distress score are calculated, in addition to the scores for the individual symptom domains. Content validity, concurrent validity, inter-rater reliability, and test-retest reliability of the NPI are established. Different neurologic disorders have characteristic Neuropsychiatric manifestations and distinctive NPI profiles. The NPI is sensitive to treatment effects and has demonstrated the amelioration of behavioral symptoms in Alzheimer's disease by cholinergic agents. The NPI is a useful instrument for characterizing the psychopathology of dementia syndromes, investigating the neurobiology of brain disorders with Neuropsychiatric manifestations, distinguishing among different dementia syndromes, and assessing the efficacy of treatment.

  • The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
    Neurology, 1994
    Co-Authors: J. L. Cummings, K. Gray, D. A. Carusi, Masahiko Mega, Susan Rosenberg-thompson, Jeffrey Gornbein
    Abstract:

    We developed a new instrument, the Neuropsychiatric Inventory (NPI), to assess 10 behavioral disturbances occurring in dementia patients: delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability/lability, apathy, and aberrant motor activity. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. Studies reported here demonstrate the content and concurrent validity as well as between-rater, test-retest, and internal consistency reliability; the instrument is both valid and reliable. The NPI has the advantages of evaluating a wider range of psychopathology than existing instruments, soliciting information that may distinguish among different etiologies of dementia, differentiating between severity and frequency of behavioral changes, and minimizing administration time.

Claire A. Surr - One of the best experts on this subject based on the ideXlab platform.

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory – Nursing Home assessment: reconceptualising psychiatric symptom attributions
    BJPsych Open, 2020
    Co-Authors: Sarah J. Smith, Alys W. Griffiths, Byron Creese, Cara Sass, Claire A. Surr
    Abstract:

    Background The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding. Aims This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews. Method The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions) Results Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication). Conclusions The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.

  • a biopsychosocial interpretation of the Neuropsychiatric Inventory nursing home assessment reconceptualising psychiatric symptom attributions
    BJPsych open, 2020
    Co-Authors: Sarah J. Smith, Alys W. Griffiths, Byron Creese, Cara Sass, Claire A. Surr
    Abstract:

    BACKGROUND The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding. AIMS This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews. METHOD The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions). RESULTS Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication). CONCLUSIONS The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory-Nursing Home (NH): reconceptualising psychiatric symptom attributions
    Royal College of Psychiatrists Cambridge University Press (CUP), 2020
    Co-Authors: Sj Smith, Aw Griffiths, Creese B, Sass C, Claire A. Surr
    Abstract:

    This is the author accepted manuscript.Data Sharing Statement: The data collected for this study can be made available by contacting the corresponding author.Background: The Neuropsychiatric Inventory is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric is important since the treatment and management of psychiatric symptoms relies on this understanding. Aims: This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in NPI-NH interviews. Method: The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n=651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n=3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with Orientation & Memory, Expressions of Need, Poor Care and Communication or Understandable Reactions) Results: Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (e.g. poor care and communication). Conclusions: The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.National Institute for Health Research (NIHR

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory – Nursing Home assessment: reconceptualising psychiatric symptom attributions
    'Royal College of Psychiatrists', 2020
    Co-Authors: Sj Smith, Aw Griffiths, Creese B, Sass C, Claire A. Surr
    Abstract:

    This is the final version. Available on open access from Cambridge University Press via the DOI in this recordData Sharing Statement: The data collected for this study can be made available by contacting the corresponding author.Background The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding. Aims This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews. Method The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions) Results Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication). Conclusions The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.National Institute for Health Research (NIHR

Daniel I. Kaufer - One of the best experts on this subject based on the ideXlab platform.

  • the Neuropsychiatric Inventory questionnaire npi q2 comparative data in alzheimer disease lewy body dementia and frontotemporal degeneration p6 195
    Neurology, 2016
    Co-Authors: Lydia Hatfield, Jennifer R. A. Taylor, James R. Bateman, Matthew Harris, Daniel I. Kaufer
    Abstract:

    Objective: Report on an extended form of the Neuropsychiatric Inventory Questionnaire (NPI-Q) that adds qualitative information about symptom domain ratings. Background: The NPI-Q is a questionnaire derived from the NPI that is intended for clinical practice and may be particularly useful for evaluating patients with Frontotemporal degeneration (FTD) and Lewy body dementia (LBD). Both the NPI and NPI-Q report general domain scores that lack specific symptom details, which may limit its utility as a clinical assessment. Methods: The NPI-Q2 adds representative items from each NPI domain to the corresponding domain-screening question. As part of an ongoing validation study, we report preliminary data on 73 AD, 47 LBD, and 89 FTD subjects. Results: Total NPI-Q2 severity scores were significantly lower in AD subjects than LBD or FTD subjects (p<0.005); distress scores showed a similar trend (p <.06). Apathy and anxiety were the most common symptoms across groups (LBD: 83[percnt] and 74[percnt]; FTD: 73[percnt] and 60[percnt], AD: 67[percnt] and 59[percnt]). Other prevalent symptoms showed group differences. Most LBD subjects had nighttime behaviors (71[percnt]) and hallucinations (70[percnt]), whereas FTD subjects commonly exhibited depression (60[percnt]) and motor behaviors (58[percnt]), and AD subjects had frequent nighttime behaviors (51[percnt]) and depression (49[percnt]). Hallucinations were significantly more prevalent in LBD subjects (70[percnt] vs. 16[percnt] and 12[percnt]). “Visual” (hallucinations), “uncooperativeness” (Agitation), and “worrying about planned events” (Anxiety) were consistently the most common symptom manifestations across all groups. Similarly, “sleepiness” was the most common nighttime behavior across all three diagnostic groups; whereas, the most common appetitive/eating behavior symptoms were different (LBD - weight loss, FTD - change in food preference, AD - weight gain). Conclusions: Qualitative information about specific symptom manifestations may enhance attempts to characterize neurocognitive disorders with greater precision and discriminability in clinical practice. These qualitative data may be particularly important for identifying specific vegetative symptom manifestations. Disclosure: Dr. Hatfield has nothing to disclose. Dr. Taylor has nothing to disclose. Dr. Bateman has nothing to disclose. Dr. Harris has nothing to disclose. Dr. Kaufer has received personal compensation for activities with Janssen Research and Development. Dr. Kaufer has received research support from Janssen Research and Development.

  • Assessing the impact of Neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale.
    Journal of the American Geriatrics Society, 1998
    Co-Authors: Daniel I. Kaufer, J. L. Cummings, Patrick Ketchel, Audrey Macmillan, Dianne Christine, Tim Bray, Steve Castellon, Donna Masterman, Steven T. Dekosky
    Abstract:

    OBJECTIVES: To develop an adjunct scale to the Neuropsychiatric Inventory (NPI) for assessing the impact of Neuropsychiatric symptoms in Alzheimer's disease (AD) patients on caregiver distress. DESIGN: Cross-sectional descriptive and correlational study. SETTING: University out-patient memory disorders clinics. PARTICIPANTS: Eighty-five AD subjects and their caregivers (54 spouses, 31 children). MEASUREMENTS: The NPI and NPI Caregiver Distress Scale (NPI-D) were used to assess Neuropsychiatric symptoms in AD patients and related caregiver distress, respectively. Criterion validity of the NPI-D was examined (N = 69) by comparison with an abridged version of the Relatives' Stress Scale (RSS'), a general measure of caregiver stress, using item clusters that had previously been correlated to behavioral disturbances in demented patients. Test-retest (n = 20) and inter-rater reliability (n = 16) of the NPI-D were also assessed. RESULTS: Test-retest and interrater reliability of the NPI-D were both adequate. Overall, caregiver NPI-D distress ratings were correlated significantly with the RSS' (r = .60, P < .001). RSS' ratings correlated strongly with NPI scores (r = .64, P < .001), even after controlling for degree of cognitive impairment based on the Mini-Mental State Exam (MMSE) score (r = .61). MMSE scores showed a moderate correlation to RSS' ratings (-.30, P = .02), but this association was markedly attenuated when controlling for the degree of Neuropsychiatric disturbance based on the NPI score (r = −.14). NPI-D ratings for 9 of 10 NPI symptom domains correlated most strongly with either NPI symptom severity or total (frequency × severity) scores. Agitation, dysphoria, irritability, delusions, and apathy were the symptoms most often reported to be severely distressing to caregivers. CONCLUSIONS: The NPI-D provides a reliable and valid measure of subjective caregiver distress in relation to Neuropsychiatric symptoms measured by the NPI. Neuropsychiatric alterations are more strongly associated than cognitive symptoms to caregiver distress. The NPI-D may be useful in both clinical and research settings for assessing the contribution to caregiver distress of Neuropsychiatric symptoms in AD patients.

  • effect of tacrine on behavioral symptoms in alzheimer s disease an open label study
    Journal of Geriatric Psychiatry and Neurology, 1996
    Co-Authors: Daniel I. Kaufer, Jeffrey L Cummings, Dianne Christine
    Abstract:

    We conducted an open-label study designed to assess the effects of tacrine on behavioral changes in patients with Alzheimer's disease (AD). Twenty-eight subjects completed a baseline evaluation and at least one assessment during treatment. Behavioral symptoms and cognitive function were assessed with the Neuropsychiatric Inventory (NPI) and Mini-Mental State Examination (MMSE), respectively. The mean NPI score at the maximum individual dose of tacrine attained was markedly decreased (behavior improved, compared to baseline). Symptoms of anxiety, apathy, hallucinations, aberrant motor behaviors, and disinhibition were most responsive. Subject stratification by dementia severity revealed a substantially reduced mean NPI score only in the group with moderate dementia, independent of cognitive response. Over half of the subjects with cognitive improvement had a marked reduction in behavioral symptoms, particularly apathetic behaviors. These data suggest that tacrine may be beneficial for selected behavioral symptoms in AD patients, particularly at higher doses and in those with moderate cognitive deficits.

Knut Engedal - One of the best experts on this subject based on the ideXlab platform.

  • Revista Brasileira de Psiquiatria Burnout in familial caregivers of patients with dementia
    2020
    Co-Authors: Annibal Truzzi, Knut Engedal, Ingun Ulstein, Letice Valente, Eliasz Engelhardt, Jerson Laks, Descriptors : Caregiver
    Abstract:

    Abstract Objectives: Familial caregivers of demented patients suffer from high levels of burden of care, but the literature is sparse regarding the prevalence and predictors of burnout in this group. Burnout is composed of three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (RPA). We aimed to investigate the associations between burnout dimensions and the caregivers' and patients' sociodemographic and clinical characteristics. Methods: This study is cross-sectional in design. Caregivers (N = 145) answered the Maslach Burnout Inventory, Beck Depression Inventory, Beck Anxiety Inventory and a Sociodemographic Questionnaire. Patients (N = 145) were assessed with the Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory, and Clinical Dementia Rating Scale. Results: High levels of EE were present in 42.1% of our sample, and DP was found in 22.8%. RPA was present in 38.6% of the caregivers. The caregivers' depression and the patients' delusions remained the significant predictors of EE. Conclusions: The presence of caregiver depression and patient delusions should always be part of the multidisciplinary evaluation of dementia cases. Burnout in familial caregivers of patients with dementi

  • the effect of coping on the burden in family carers of persons with dementia
    Aging & Mental Health, 2013
    Co-Authors: Froydis Kristine Bruvik, Ingun Ulstein, Anette Hylen Ranhoff, Knut Engedal
    Abstract:

    Objectives: This study explores the association between coping, measured by the extent of locus of control, and the burden of care on family carers of persons with dementia (PWD).Method: Two hundred thirty PWD living at home and their family carers were recruited from 20 Norwegian municipalities. The carers’ burden was assessed by the Relatives’ Stress Scale (RSS) and coping by the Locus of Control Behaviour Scale. The PWD were assessed by the Neuropsychiatric Inventory (NPI-Q), the Physical Self-Maintenance Scale (PSMS), the Instrumental Activities of Daily Living (IADL) scale, and the Mini Mental Status Examination (MMSE).Results: Locus of control (LoC) was found to be the most important factor associated with the burden on carers of PWD, even when we had controlled for the PWD variables, such as the NPI-Q score. The LoC and the carer's use of hours per day to assist the PWD were the only two variables the carers found that affected the extent of the burden. The NPI-Q was the most important variable in ...

  • discontinuation of antidepressants in people with dementia and Neuropsychiatric symptoms desep study double blind randomised parallel group placebo controlled trial
    BMJ, 2012
    Co-Authors: Sverre Bergh, Geir Selbæk, Knut Engedal
    Abstract:

    Objective To determine the effect of discontinuing antidepressant treatment in people with dementia and Neuropsychiatric symptoms. Design Double blind, randomised, parallel group, placebo controlled trial. Setting Norwegian nursing homes; residents recruited by 16 study centres in Norway from August 2008 to June 2010. Participants 128 patients with Alzheimer’s disease, dementia or vascular dementia, and Neuropsychiatric symptoms (but no depressive disorder), who had been prescribed escitalopram, citalopram, sertraline, or paroxetine for three months or more. We excluded patients with severe somatic disease or terminal illness, or who were unable to take tablets or capsules as prescribed. Interventions Antidepressant treatment was discontinued over one week in 63 patients, and continued in 68 patients. We assessed patients at baseline, four, seven, 13, and 25 weeks. Main outcome measures Primary outcomes were score differences between study groups in the Cornell scale of depression in dementia and the Neuropsychiatric Inventory (10 item version) after 25 weeks. Secondary outcomes were score differences in the clinical dementia rating scale, unified Parkinson’s disease rating scale, quality of life-Alzheimer’s disease scale, Lawton and Brody’s physical self maintenance scale, and severe impairment battery. Results Using a linear multilevel model analysis, we found that the discontinued group had significantly higher scores on the Cornell scale after 25 weeks than the continuation group (difference −2.89 (95% confidence interval −4.76 to −1.02); P=0.003). We saw a similar result in the mean total score for the Neuropsychiatric Inventory after 25 weeks, but this difference was non-significant (−5.96 (−12.35 to 0.44); P=0.068). We confirmed these results by non-response analysis (>30% worsening on the Cornell scale)—significantly more patients worsened in the discontinuation group than in the continuation group (32 (54%) v 17 (29%); P=0.006). We found no significant differences between the groups for secondary outcomes. Forty seven (37%) patients withdrew from the study early. Conclusions Discontinuation of antidepressant treatment in patients with dementia and Neuropsychiatric symptoms leads to an increase in depressive symptoms, compared with those patients who continue with treatment. Trial registration ClinicalTrial.gov NCT00594269, EudraCT 2006-002790-43.

  • Stability of the factor structure of the Neuropsychiatric Inventory in a 31-month follow-up study of a large sample of nursing-home patients with dementia
    International Psychogeriatrics, 2011
    Co-Authors: Geir Selbæk, Knut Engedal
    Abstract:

    Background: Neuropsychiatric symptoms (NPS) are highly prevalent among nursing home patients with dementia. Several studies have investigated subsyndromes of NPS but the stability of these subsyndromes over time has rarely been examined. We have examined the stability over time of the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in a large sample of nursing-home patients with dementia. Methods: Nursing-home patients with dementia were assessed with the NPI-NH at baseline (n = 895), and at 12-month (n = 592) and 31-month (n = 278) follow-up assessments, giving three partly overlapping samples. Exploratory factor analysis was done to investigate Neuropsychiatric subsyndromes of the NPI-NH at each assessment in these samples. Results: Three- or four-factor solutions were found, termed agitation, psychosis, apathy, and affective symptoms. Depression and anxiety (affective), delusion and hallucination (psychosis), and agitation and irritability (agitation) were the symptoms that most often co-occurred in the same factor. Apathy did not load together with affective symptoms at any of the assessments. Conclusions: Subsyndromes of the NPI-NH are relatively stable over 31-month follow-up assessments in nursing-home patients with dementia, indicating that these subsyndromes may be useful for following the natural course of symptoms as well as observing the effect of interventions. Our findings lend support to the distinction between apathy and affective symptoms, which may have important clinical implications.

Sj Smith - One of the best experts on this subject based on the ideXlab platform.

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory-Nursing Home (NH): reconceptualising psychiatric symptom attributions
    Royal College of Psychiatrists Cambridge University Press (CUP), 2020
    Co-Authors: Sj Smith, Aw Griffiths, Creese B, Sass C, Claire A. Surr
    Abstract:

    This is the author accepted manuscript.Data Sharing Statement: The data collected for this study can be made available by contacting the corresponding author.Background: The Neuropsychiatric Inventory is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric is important since the treatment and management of psychiatric symptoms relies on this understanding. Aims: This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in NPI-NH interviews. Method: The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n=651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n=3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with Orientation & Memory, Expressions of Need, Poor Care and Communication or Understandable Reactions) Results: Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (e.g. poor care and communication). Conclusions: The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.National Institute for Health Research (NIHR

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory – Nursing Home assessment: reconceptualising psychiatric symptom attributions
    'Royal College of Psychiatrists', 2020
    Co-Authors: Sj Smith, Aw Griffiths, Creese B, Sass C, Claire A. Surr
    Abstract:

    This is the final version. Available on open access from Cambridge University Press via the DOI in this recordData Sharing Statement: The data collected for this study can be made available by contacting the corresponding author.Background The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding. Aims This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews. Method The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions) Results Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication). Conclusions The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.National Institute for Health Research (NIHR

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory-Nursing Home (NH): reconceptualising psychiatric symptom attributions
    'Royal College of Psychiatrists', 2020
    Co-Authors: Sj Smith, Creese B, Sass C, Griffiths A, Surr C
    Abstract:

    Background: The Neuropsychiatric Inventory is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric is important since the treatment and management of psychiatric symptoms relies on this understanding. Aims: This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in NPI-NH interviews. Method: The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n=651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n=3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with Orientation & Memory, Expressions of Need, Poor Care and Communication or Understandable Reactions) Results: Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (e.g. poor care and communication). Conclusions: The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively

  • A biopsychosocial interpretation of the Neuropsychiatric Inventory – Nursing Home assessment: reconceptualising psychiatric symptom attributions
    'Royal College of Psychiatrists', 2020
    Co-Authors: Sj Smith, Creese B, Sass C, Griffiths A, Surr C
    Abstract:

    Background: The Neuropsychiatric Inventory is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric is important since the treatment and management of psychiatric symptoms relies on this understanding. Aims: This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in NPI-NH interviews. Method: The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n=651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n=3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with Orientation & Memory, Expressions of Need, Poor Care and Communication or Understandable Reactions) Results: Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (e.g. poor care and communication). Conclusions: The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively