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Vocally disruptive behavior: A case report and literature review

Published online by Cambridge University Press:  17 May 2019

Barry McCarthy Open the ORCID record for Barry McCarthy [Opens in a new window] ,
Anna Boland ,
Sinead Murphy  and
Colm Cooney
Barry McCarthy*
Affiliation:
West Blanchardstown Mental Health Service, Blanchardstown Primary Care Centre, Grove Rd, Blanchardstown, Dublin 15, Ireland
Anna Boland
Affiliation:
Department of Old Age Psychiatry, Carew House, St Vincent’s University Hospital, Dublin 4, Ireland
Sinead Murphy
Affiliation:
Department of Old Age Psychiatry, Carew House, St Vincent’s University Hospital, Dublin 4, Ireland
Colm Cooney
Affiliation:
Department of Old Age Psychiatry, Carew House, St Vincent’s University Hospital, Dublin 4, Ireland
*
*Address for correspondence: Dr Barry McCarthy, MRCPsych, Senior Registrar, West Blanchardstown Mental Health Service, Blanchardstown Primary Care Centre, Grove Rd, Blanchardstown, Dublin 15, Ireland (Email: bmccarthy14@gmail.com)
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Abstract

Vocally disruptive behavior (VDB) is a common and particularly difficult symptom to manage in dementia. VDB is usually considered collectively with agitation and aggression as a component of behavioral and psychological symptoms in dementia and is therefore poorly understood as an individual symptom. A review of the literature is described where VDB as a challenging behavior has been individually examined as a symptom. A case of VDB occurring in patient with dementia is described where the patient’s repetitive vocalizations responded to treatment with pregabalin. This has not been previously reported in the literature. The prevalence of VDB, the factors associated with it and the current management guidelines for clinicians are outlined with a review of the drug treatment strategies for VDB. Pregabalin with its unique pharmacological profile and excellent tolerability should be considered as a possible treatment for VDB where drug treatment is indicated.

Keywords

Vocally disruptive behaviorsbehavioral and psychological symptoms of dementiadementiaanticonvulsantsneuropsychiatric symptoms
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 1 , March 2022 , pp. 97 - 102
Copyright
© The Author(s), 2019. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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References

Adams, J, Cheng, P, Deonarain, L, Frank, C, Mayers, A, Smith, BJ, et al. (2012). Extinction of care-induced vocalizations by a desentitization routine on a palliative care unit. American Journal of Hospice Palliative Medicine 29(4), 318–320.10.1177/1049909111420701CrossRefGoogle ScholarPubMed
Baldwin, DS, Ajel, K (2007). Role of pregabalin in the treatment of generalized anxiety disorder. Neuropsychiatric Disease and Treatment 3(2), 185–191.10.2147/nedt.2007.3.2.185CrossRefGoogle ScholarPubMed
Bang, J, Price, D, Prentice, G, Campbell, J (2008). ECT treatment for two cases of dementia-related pathological yelling. The Journal of Neuropsychiatry and Clinical Neurosciences 20(3), 379–380.10.1176/jnp.2008.20.3.379CrossRefGoogle ScholarPubMed
Barton, S, Findlay, D, Blake, RA (2005). The management of inappropriate vocalisation in dementia: a hierarchical approach. International Journal of Geriatric Psychiatry 20, 1180–1186.10.1002/gps.1416CrossRefGoogle ScholarPubMed
Beck, C, Richards, K, Lambert, C, Doan, R, Landes, RD, Whall, A, et al. (2001). Factors associated with problematic vocalizations in nursing home residents with dementia. The Gerentologist 51(3), 389–405.10.1093/geront/gnq129CrossRefGoogle Scholar
Bédard, A, Landreville, P, Voyer, P, Verreault, R, Vézina, J (2011). Reducing verbal agitation in people with dementia: evaluation of an intervention based on the satisfaction of basic needs. Aging and Mental Health 15(7), 855–865.10.1080/13607863.2011.569480CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J, Werner, P (1997). Management of verbally disruptive behaviors in nursing home residents. The Journals of Gerontology Series A Biological Sciences and Medical Sciences 52A(6), M369–M377.10.1093/gerona/52A.6.M369CrossRefGoogle Scholar
Cohen-Mansfield, J, Werner, P, Marx, MS (1990). Screaming in nursing home residents. Journal of the American Geriatrics Society 38(7), 785–792.10.1111/j.1532-5415.1990.tb01470.xCrossRefGoogle ScholarPubMed
Cooney, C, Mortimer, A, Smith, A, Newton, K, Wrigley, M (1996). Carbamazepine use in aggressive behaviour associated with senile dementia. International Journal of Geriatric Psychiatry 11(10), 901–905.10.1002/(SICI)1099-1166(199610)11:10<901::AID-GPS409>3.0.CO;2-73.0.CO;2-7>CrossRefGoogle Scholar
Crowther, G (2013). Pregabalin: a future treatment in the management of behavioural and psychological symptoms of dementia? Old Age Psychiatr [Internet] 56. Available from: https://catalogues.rcpsych.ac.uk/FILES/Spring%202013%20Number%2056.pdf accessed 25 April 2019.Google Scholar
Dwyer, M, Byrne, GJA (2000). Disruptive vocalization and depression in older nursing home residents. International Psychogeriatrics 12(4), 463–471.10.1017/S104161020000658XCrossRefGoogle ScholarPubMed
Enatsu, R, Hantus, S, Gonzalez-Martinez, J, So, N (2011). Ictal singing due to left frontal lobe epilepsy: A case report and review of the literature. Epilepsy Behavior 22(2), 404–406.10.1016/j.yebeh.2011.07.019CrossRefGoogle ScholarPubMed
Flo, E, Gulla, C, Husebo, BS (2014). Effective pain management in patients with dementia: benefits beyond pain? Drugs Aging [Internet] 31(12), 863–871. doi: 10.1007/s40266-014-0222-0 CrossRefGoogle ScholarPubMed
Gauthier, S, Cummings, J, Ballard, C, Brodaty, H, Grossberg, G, Robert, P, et al. (2010). Management of behavioral problems in Alzheimer’s disease. International Psychogeriatrics 22(3), 346–372.10.1017/S1041610209991505CrossRefGoogle ScholarPubMed
Hulstaert, A (2014). The Management of anxiety symptoms in patients with vascular dementia: A case report about treatment with pregabalin. Acta Psychiatrica Belgica 114(2), 5–8.Google Scholar
Lanctôt, KL, Herrmann, N, Mazzotta, P, Khan, LR, Ingber, N (2004). GABAergic function in Alzheimer’s disease: Evidence for the treatment of behavioural and psychological symptoms of dementia. Canadian Journal of Psychiatry 49(7), 439–453.10.1177/070674370404900705CrossRefGoogle ScholarPubMed
Lanovaz, MJ, Sladeczek, IE, Rapp, JT (2011). Effects of music on vocal stereotypy in children with autism. Journal of Applied Behavior Analysis 44(3), 647–651.10.1901/jaba.2011.44-647CrossRefGoogle ScholarPubMed
Locke, JM, Mudford, OC (2010). Using music to decrease disruptive vocalizations in a man with dementia. Behavioral Interventions 25, 253–260.Google Scholar
Magri, CJ, Ferry, P, Abela, S (2007). A review of the aetiology and management of vocal behaviour in dementia. Malta Medical Journal 19(3), 30–35.Google Scholar
Matson, J, Sipes, M, Horovitz, M, Worley, J, Shoemaker, M, Kozlowski, A (2011). Behaviors and corresponding functions addressed via functional assessment. Research in Developmental Disabilities 32(2), 625–629.10.1016/j.ridd.2010.12.011CrossRefGoogle ScholarPubMed
Montgomery, S, Chatamra, K, Pauer, L, Whalen, E, Baldinetti, F (2008). Efficacy and safety of pregabalin in elderly people with generalised anxiety disorder. The British Journal of Psychiatry 193(5), 389–394.10.1192/bjp.bp.107.037788CrossRefGoogle ScholarPubMed
Nagaratnam, N, Patel, I, Whelan, C (2003). Screaming, shrieking and muttering: the noise-makers amongst dementia patients. Archives of Gerontology and Geriatrics 36, 247–258.10.1016/S0167-4943(02)00169-3CrossRefGoogle ScholarPubMed
Semel, D, Murphy, K, Zlateva, G, Cheung, R, Emir, B (2010). Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies. BMC Family Practice 11, 85.10.1186/1471-2296-11-85CrossRefGoogle ScholarPubMed
Sloane, PD, Davidson, S, Buckwalter, K, Lindsey, BA, Ayers, S, Lenker, V, et al. (1997). Management of the patient with disruptive vocalization. The Gerentologist 37(5), 675–682.Google ScholarPubMed
Stahl, SM (2004). Anticonvulsants as anxiolytics, Part 2 Pregabalin and Gabapentin as α2δ ligands as voltage-gated calcium channels. The Journal of Clinical Psychiatry 65(4), 460–461.10.4088/JCP.v65n0401CrossRefGoogle Scholar
Stahl, SM (2004). Mechanism of action of α2δ ligands: Voltage Sensitive Calcium Channels (VSCC) modulators. The Journal of Clinical Psychiatry 65(8), 1033–1034.10.4088/JCP.v65n0801CrossRefGoogle ScholarPubMed
Tassone, DM, Boyce, E, Guyer, J, Nuzum, D (2007). Pregabalin: A novel gamma-aminobutyric acid analogue in the treatment of neuropathic pain, partial-onset seizures, and anxiety disorders. Clinical Therapeutics 29(1), 26–48.10.1016/j.clinthera.2007.01.013CrossRefGoogle ScholarPubMed
Tible, O, Mendez, M, von Gunten, A (2018). Phenomenological contribution to understanding of vocally disruptive behaviour: A clinical case study in a patient with dementia. International Journal of Geriatric Psychiatry Advance online publication. doi: 10.1002/gps.4947 Google Scholar
Tible, OP, Riese, F, Savaskan, E, von Gunten, A (2017). Best practice in the management of behavioural and psychological symptoms of dementia. Therapeutic Advances in Neurological Disorders 10(8), 297–309 10.1177/1756285617712979CrossRefGoogle ScholarPubMed
Ukai, K, Fujishiro, H, Ozaki, N (2017). Effectiveness of low-dose pregabalin in three patients with Lewy body disease and central neuropathic pain. Psychogeriatrics 17(2), 115–119.10.1111/psyg.12192CrossRefGoogle ScholarPubMed
von Gunten, A, Alnawagil, A, Abderhalden, C, Needham, I, Schupbach, B (2008). Vocally disruptive behavior in the elderly: A systematic review. International Psychogeriatrics 20(4), 653–672.10.1017/S1041610208006728CrossRefGoogle ScholarPubMed
von Gunten, A, Favre, M, Gurtner, C, Abderhalden, C (2011). Vocally disruptive behavior (VDB) in the institutionalized elderly: A naturalistic multiple case report. Archives of Gerontology and Geriatrics 52(3), e110–e116.10.1016/j.archger.2010.08.008CrossRefGoogle ScholarPubMed
Yusupov, A, Galvin, JE (2014). Vocalization in dementia: A case report and review of the literature. Case Reports in Neurology 6(1), 126–133.10.1159/000362159CrossRefGoogle ScholarPubMed