Prevalence and Pharmacotherapy of Behavioral and Psychological Symptoms of Dementia in a Geriatric Psychiatry Unit: A Retrospective Analysis.

Abstract

To observe (1) the proportion and nature of behavioral and psychological symptoms of dementia (BPSD) in patients treated at a geriatric psychiatry ward in Germany over a time span of 1 year and (2) the use and effect of various pharmacologic interventions in managing BPSD in a real-world scenario. This study was a naturalistic, retrospective analysis. Between May 2015 and May 2016, 437 patients aged 65 to 100 years with various psychiatric diseases (including dementia, schizophrenia, and depression) were admitted to a geriatric psychiatry unit in Germany. Their medical charts were reviewed to identify patients with dementia who presented with BPSD according to DSM-5 criteria. Since a decline in behavioral organization is a typical clinical manifestation of delirium, delirious patients with behavioral symptoms at admission were also included. Of 437 patients, 74 (16.9%) showed severe behavioral symptoms that were categorized into 6 groups: aggression, screaming, wandering, food refusal, self-harm, and a combination of both behavioral and psychological symptoms. Overall, 65 patients (87.5%) showed improvement in their behavior regardless of the pharmacotherapy they were receiving. BPSD is one of the main reasons for admission to a geriatric psychiatry unit. Most of the patients with BPSD showed an improvement of behavioral symptoms with pharmacotherapy. Nonetheless, a clear correlation between a specific pharmacologic agent and behavioral improvement could not be established. A multimodal concept that involves both pharmacologic and nonpharmacologic approaches in managing BPSD should be the focus of future research.