Psychotic Symptoms In Individuals Research Articles

Classification of psychotic symptoms in dementia sufferers

Little attention has been payed to the classification of psychotic symptoms in dementia sufferers. This article compares the etiology of delusions, visual hallucinations and delusional misidentification and examines the value of factors generated from principal components analysis as a possible classificatory system in a group of 125 patients with DSM-III-R dementia in contact with clinical services who were prospectively evaluated using standardized instruments to describe in detail individual psychotic symptoms. The assessment also included the Geriatric Mental State Schedule, the History and Aetiology Schedule and the CAMCOG. Delusions and visual hallucinations had a distinct cognitive profile as did delusions and delusional misidentification, although there was an overlap between visual hallucinations and delusional misidentification. Four factors were generated from principal components analysis. Three of these closely mirrored the 3 symptom groups delusions, visual hallucinations and delusional misidentification, although the phantom-boarder delusion was correlated with the visual hallucination factor and not delusional misidentification. The fourth factor included visual hallucinations of relatives and delusions that relatives were in the house. This factor was strongly inversely associated with emotional distress and could perhaps best be seen as a comfort phenomena. The pattern of cognitive deficits and etiological associations of each of the factors were independent of one another, supporting the notion that it is useful to consider them as separate entities.

The prevalence and phenomenology of psychotic symptoms in dementia sufferers

AbstractOne hundred patients referred to old age psychiatry services in the West Midlands and 25 patients referred to a memory clinic in Bristol with mild to moderate dementia were assessed using the GMS/HAS schedule together with a detailed inventory to assess their psychotic symptoms. On careful evaluation one patient did not have dementia. Eighty‐three of the other 124 patients (66.9%) had at least one psychotic symptom. The prevalence of psychotic symptoms in the patients from the West Midlands and from the memory clinic in Bristol were extremely similar. Thirty‐five per cent had at least one visual hallucination, 12.9% had at least one auditory hallucination, 48.4% had at least one delusional belief and 29.0% had at least one delusional misperception. Most individuals experienced their psychotic symptoms at a frequency between weekly and daily. Twenty‐four had no insight into their psychotic symptoms and acted upon them, while only one patient had full insight into their symptoms. Thirty‐seven subjects were mildly distressed and 14 were severely distressed by the psychotic symptoms they experienced. There was a trend for patients with cortical Lewy body dementia to be more likely to have psychotic symptoms than patients with Alzheimer's disease or vascular dementia. The symptom profile of psychotic symptoms in the different dementias was, however, very similar. The frequencies of individual psychotic symptoms are described in the text.