Psychosis in geropsychiatric inpatients with and without dementia

✍ Scribed by Laura L. Champagne; Claudia A. Orengo; Mark E. Kunik; Victor Molinari; Richard H. Workman Jr; Sandhya Trivedi

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 478 KB
• Volume: 11
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(199606)11:6<523::aid-gps352>3.0.co;2-g

✦ Synopsis

Psychotic symptoms are commonly encountered in elderly patients both with and without dementia. The authors compared presentation and treatment response between these two groups. Of 206 consecutive admissions to an inpatient geropsychiatry unit, 52 (26%) had psychotic symptoms. Thirteen of these had dementia and 22 had a primary Axis I psychotic disorder without dementia. Both groups presented similarly, improved significantly from admission to discharge and demonstrated equivalent medication side-effect profiles. Elderly psychotic patients with and without dementia improve significantly on antipsychotics and tolerate their side-effects; however, those with dementia receive lower dosages of medication to treat their symptoms. KEYWORDS-PSYChOSi S; geriatric psychiatry; dementia; dosage; side-effect profile Psychosis occurs frequently in elderly persons both with and without dementia. Psychotic symptoms are evident in 4% of community-dwelling elders (Christenson and Blazer, 1984), 10-73% of patients with Alzheimer's disease (Wragg and Jeste, 1989) and 40% of patients referred to an inpatient geropsychiatry unit . Psychosis in the elderly has many etiologies (Holden, 1987), with symptoms varying by diagnosis. Patients with schizophrenia typically have bizarre, culturally incongruent, systematized delusions and auditory hallucinations. Patients with mood disorders have delusions and hallucinations which are generally mood congruent, transient and not elaborate (American Psychiatric Association, 1994). Patients with dementia commonly display delusions of persecution, somatic delusions and visual hallucinations .

Besides accounting for symptom variation, the etiology of psychotic symptoms has important