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10 - Management of behavioural and psychological symptoms of dementia and acquired brain injury

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Joel Sadavoy ,
Krista L. Lanctôt  and
Shoumitro Deb
Edited by
Peter Tyrer  and
Kenneth R. Silk
Joel Sadavoy
Affiliation:
University of Toronto Mount Sinai Hospital Toronto Canada
Krista L. Lanctôt
Affiliation:
Department of Psychiatry Sunnybrook Health Sciences Centre Toronto, ON Canada
Shoumitro Deb
Affiliation:
Department of Psychiatry University of Birmingham Queen Elizabeth Psychiatric Hospital Birmingham UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

The practical management of the behavioural symptoms of dementia is one of the most pressing subjects in psychiatry. It is this, more than any other form of treatment, that decides whether a sufferer from dementia stays at home, in supported accommodation, or in hospital. It is therefore a very important subject, and this chapter illustrates what tends to happen when many hard-working and well-meaning clinicians decide, more or less independently, to investigate the value of different treatments. We get a large number of rating scales for assessment that overlap considerably, many published studies and many controlled trials that are difficult to combine in meta-analyses. As a consequence we derive a relatively poor evidence base, particularly in acquired brain injury, that makes it very difficult for the practitioner to choose how to proceed. But we must not be too unfair. The diagnostic system has not helped clinicians in the management of these symptoms and the notion of BPSD (Behavioural and Psychological Symptoms of Dementia) is a relatively recent one. It appears to be a good foundation on which to build.

Introduction

Non-cognitive symptoms of dementia have been labelled in different ways depending on the focus of the observation: agitation (Cohen-Mansfield et al., 1989), behavioural disturbance (Baumgarten et al., 1990), and dysfunctional behaviour (Malloy et al., 1991), to name a few.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 187 - 216
Publisher: Cambridge University Press
Print publication year: 2008

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