Journal of Geriatric Mental Health最新文献

{"title":"Aripiprazole worsening visual hallucination in a patient with lewy body dementia","authors":"Sujita Kumar Kar, Suyash Dwivedi","doi":"10.4103/jgmh.jgmh_31_18","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_31_18","url":null,"abstract":"33 Sir, Lewy body dementia is the most common degenerative form of dementia, next to Alzheimer’s disease.[1] Patients with Lewy body dementia often experience psychotic symptoms such as delusions and hallucinations. In Lewy body dementia, hallucinations are the most common psychotic symptoms.[2] Evidence suggest the association of visual hallucinations, misidentifications, and delusions with dysfunctions of parieto‐occipital cortex, limbic–paralimbic cortex, and frontal lobe, respectively.[3] A recent systematic review and meta‐analysis on pharmacological treatments of Lewy body dementia highlights about the inadequacy of high‐level evidence‐based pharmacological interventions.[4] Donepezil and rivastigmine can improve cognitive and psychiatric symptoms in Lewy body dementia. Antipsychotic agents that may be of some use for the management of psychotic symptoms in Lewy body dementia are – quetiapine, clozapine, olanzapine, and risperidone.[4] High neuroleptic sensitivity is a challenge which limits the use of antipsychotic agents to treat psychotic symptoms associated with Lewy body dementia. We present here a case (after obtaining informed consent) of Lewy body dementia, who reported worsening of visual hallucinations with aripiprazole.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"33 - 34"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health policy for elderly","authors":"","doi":"10.4103/jgmh.jgmh_26_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_26_19","url":null,"abstract":"The population of elderly has been increasing globally with a more rapid increase in the developing countries like India. The increase in life expectancy has contributed to the increase in elderly population, particularly the older old (above 80 years’ age). Unlike some of the developed countries, the change in demography in developing countries has started even before the adequate improvement in the health‐care system to manage the challenges in health care of elderly. The burden due to noncommunicable diseases (NCD) is high in elderly as they have a high prevalence of comorbid general medical and mental health problems. The health system in India is less prepared for the management of NCD in elderly that requires an approach of chronic care. The facilities for the treatment of mental health problems even in young adults in India are not adequate, and Mental Health Care Act, 2017 highlights this issue, and there is a need for prompt action to improve this situation. Elderly being a vulnerable population have more risk factors and also have more barriers in access to treatment. The National Programme For Health Care of the Elderly launched few years back to promote active and healthy aging in elderly has not yet been implemented actively. Therefore, there is an urgent need for policies and geriatric mental health services to focus toward this neglected population.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"193 1","pages":"4 - 6"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implications of late-onset primary tic disorder in an elderly male: A case report","authors":"Suyash Dwivedi, Sujita Kumar Kar","doi":"10.4103/JGMH.JGMH_19_19","DOIUrl":"https://doi.org/10.4103/JGMH.JGMH_19_19","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"31 - 32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risperidone-induced skin rash in an elderly female","authors":"M. Shah, S. Karia, Heena Merchant, N. Shah, A. Sousa","doi":"10.4103/JGMH.JGMH_7_19","DOIUrl":"https://doi.org/10.4103/JGMH.JGMH_7_19","url":null,"abstract":"Skin reactions have been reported with various antipsychotic drugs in scientific literature. It is important that clinicians be watchful of skin reactions in the elderly with antipsychotic medication, which can be an uncommon occurrence. It has been documented that the elderly are more prone to skin reactions with various forms of medication. We herewith report a case of skin reaction with risperidone in an elderly female patient.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"28 - 30"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying multiple domain memory impairment in high-risk group for Alzheimer's disorder","authors":"Susmita Halder, A. Mahato","doi":"10.4103/jgmh.jgmh_4_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_4_19","url":null,"abstract":"Introduction: Occasional lapses in memory in elderly people are often considered as normal aging process and not a warning sign of serious mental deterioration or Alzheimer's disease (AD). When memory loss becomes so pervasive and severe that it disrupts daily activities, it becomes a signal for early AD. As the disease is irreversible and progressive in nature, identification of persons with high risk of developing AD is becoming a priority. The objective of this study was to identify and characterize the deficits in the memory performance of patients who presented with memory difficulties, without any other significant cognitive decline, and identified with high risk. Subject and Methods: Consecutive patients of both sexes in the age range of 55–70 years, who presented with problem in memory, were screened on the Mini–Mental State Examination and further assessed on the Dementia Rating Scale. Patients identified with high risk for AD were assessed for their memory profile using the PGI Memory Scale and further compared with healthy controls. Results: The high-risk group performed significantly lower than controls in domains of recent memory, delayed recall, verbal retention for dissimilar pairs, visual retention, and recognition. Conclusion: Multiple memory domains are affected in high-risk group for AD. Although they did not qualify to be diagnosed with AD, their memory profile is distinct with healthy controls and may be indicative of proneness for the disease.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"53 1","pages":"14 - 18"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild cognitive impairment – A hospital-based prospective study","authors":"Shiva Shanker Reddy Mukku, M. Varghese, S. Bharath, Keshav J. Kumar","doi":"10.4103/jgmh.jgmh_30_18","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_30_18","url":null,"abstract":"Background: Mild cognitive impairment (MCI) is regarded as a transitional state between normal aging and dementia. It may progress to dementia, remain same, or revert to normalcy. Most western studies report an annual conversion of 10%–15% of MCI to dementia. There is a paucity of literature on prospective studies on MCI in India. Objective: The objective is to prospectively study the cognitive status of MCI patients at least 1 year after their diagnosis. The other objective was to find the conversion among the MCI patients to Alzheimer's dementia. Methodology: We followed up persons with MCI above 50 years evaluated in the Geriatric Clinic of National Institute of Mental Health and Neurosciences (NIMHANS) between 2012 and 2014, reassessed their cognitive abilities (neuropsychological measures) 1 year later, and compared them with earlier assessment and the conversion rate among this sample. Hindi Mental Status Examination (HMSE), Everyday Abilities Scale for India (EASI), NIMHANS neuropsychological battery for Indian elderly, and Clinical Dementia Rating (CDR) scale instruments were used for assessment. Results: Twenty-seven persons with a diagnosis of MCI were contacted. Twenty-one participated and underwent repeat clinical and neuropsychological evaluations. The mean duration of follow-up was 1.43 (standard deviation: ± 0.46) years. Six participants (28.6%) had progressed to mild Alzheimer's disease (AD) based on EASI, CDR, and neuropsychological scores, 15 (71.4%) retained their MCI status, and none had reverted back to normal status. The mean age of converters (progressed to mild AD) was 72 ± 5.69 years and nonconverters (remained as MCI) was 72.6 ± 7.16 years. Multiple medical comorbidities were found in both the groups with hypertension being the higher in converters (P = 0.04). Among the converters compared to nonconverters, there was a significant decline in total word list learning (P = 0.006), design construction copy (P = 0.042), total figures canceled in figure cancellation test (P = 0.009), and total omissions on figure cancellation test (P = 0.02). Discussion and Conclusion: Scores on episodic memory, attention, and visuospatial skills were low in the MCI compared to normal controls to start with – there was a further significant decline in few of these parameters over the follow-up. The conversion rate in our study was 28.6% for 1.43 years, which is higher compared to the western studies. Executive function learning and memory were the domains predominantly affected in the converters compared to nonconverters. The study based on tertiary hospital and help seeking with a specialist by those who perceived/were perceived to worsen could be probable reason for this higher rate. Higher medical comorbidities, lower HMSE scores, and executive function and memory at baseline are found to increase the risk of progression to AD.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"19 - 25"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregabalin misuse in a 75-year-old woman","authors":"A. Sousa","doi":"10.4103/jgmh.jgmh_35_18","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_35_18","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient treatment outcomes of aged substance-using patients admitted to a tertiary care center","authors":"P. Kathiresan, S. Sarkar, Y. S. Singh Balhara","doi":"10.4103/JGMH.JGMH_9_18","DOIUrl":"https://doi.org/10.4103/JGMH.JGMH_9_18","url":null,"abstract":"Background and Aims: Studies on aged substance users are few from the Indian subcontinent, though they are likely to represent a subgroup of patients with distinct clinical needs. This study aimed to present the inpatient treatment outcomes of such aged substance-using patients admitted to a tertiary care treatment facility in India. Methodology: This descriptive, retrospective chart-based study presents data of aged patients (age 50 years and above) admitted between January and December 2014 at the National Drug Dependence Treatment Centre, Ghaziabad. Results: A total of 72 aged patients were admitted during this period out of total 953 admissions (7.6% of the sample). All of them were male. Forty patients (55.6%) had a diagnosis of alcohol dependence and 32 (44.4%) had a diagnosis of opioid dependence. The mean duration of stay was 12.9 (±9.6) days. Of these 72 patients, treatment could be completed for 57 patients (79.2%), while seven patients left against medical advice, four were discharged on disciplinary grounds, three were shifted to another facility (two due to medical reasons), and one absconded. Treatment completion rate was least among aged patients with only opioid dependence (25.65%). Conclusion: Medical issues may be a consideration of premature discharge among aged patients admitted for the treatment of substance use disorders. Furthermore, treatment noncompletion is more among aged patients with opioid use disorder than among alcohol use disorder. Further studies are needed with prospective methodology for the assessment of various factors associated with treatment completion, which can help to address the treatment needs of aged patients with substance use disorders, which in turn can lead to better treatment outcomes for them.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"5 1","pages":"139 - 142"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46375256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insomnia in elderly: A neglected epidemic","authors":"Shiva Shanker Reddy Mukku, V. Harbishettar, P. Sivakumar","doi":"10.4103/JGMH.JGMH_15_18","DOIUrl":"https://doi.org/10.4103/JGMH.JGMH_15_18","url":null,"abstract":"Sleep is an important vital function. Sleep promotes many functions such as restoration of body, repair of tissues, immune regulation, and consolidation of memory. Insomnia is one of the most common complaints in patients with mental health problems. The prevalence of insomnia is higher in elderly than in general population. The reasons could be due to physiological changes in sleep architecture with aging, high medical morbidity, multiple medication, loneliness, and environmental factors causing sleep disturbances. Although insomnia is a common troubling problem in the elderly, only minority seek professional help. Some elderly self-medicate with over-the-counter medications for their sleep problems. These practices lead to serious adverse effects over the long term. There are many myths related to insomnia in elderly. Thus, insomnia in elderly is often under-recognized and under-treated problem. In this article, we review the literature on sleep problems in the elderly and discuss the systematic evaluation of insomnia in the elderly.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"5 1","pages":"84 - 93"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41900605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An old man who spit pearls-A case discussion","authors":"S. Agarwal, Apoorva Yadav, A. Tyagi, Arpit Koolwal, S. Choudhary","doi":"10.4103/jgmh.jgmh_19_18","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_19_18","url":null,"abstract":"In the history of psychiatry, the contents of delusions have always interested the community of mental health professionals. We came across a 65-year-old patient with a peculiar delusion of spitting pearls. This study purports to discuss, first, the late age of onset of the delusions in the absence of any cognitive deficits along with unique delusional content and, second, the possible role of environment in the formulation of delusional content.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"5 1","pages":"167 - 169"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45745886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}