Service Universitaire de Psychiatrie de l'Age Avancé (SUPAA), Département de Psychiatrie-CHUV, Rte du Mont, 1008 Prilly VD, Switzerland.
Arch Gerontol Geriatr. 2011 May-Jun;52(3):e110-6. doi: 10.1016/j.archger.2010.08.008. Epub 2010 Sep 17.
Employing a naturalistic multiple case study approach, we investigated the current clinical practice in the treatment and care of VDB among a convenience sample of 85 patients cared for in specialized old age psychiatric clinics and nursing homes in French and German-speaking Switzerland. We wished to clinically characterize VDB patients, to identify common approaches used to treat VDB in everyday practice, and to explore how the efficiency of the interventions employed was judged by the responsible carers. Data were collected by means of a questionnaire. Most patients with VDB in this study had dementia, of whom 75% had at least one current or premorbid psychiatric disorder and 25% had premorbid personality disorder. A majority of patients received multiple psychosocial care interventions that were often judged to be effective, but the potential of psychosocial interventions is underused. Many patients did not receive psychotropic medication specifically targeted at VDB, but about 70% of all prescriptions were judged to have positive effects. Premorbid psychiatric and personality disorders or traits are likely candidates to be entered into the etiopathogenic equation of VDB and set a new frame for approaches used to treat these underlying disorders.
采用自然主义多案例研究方法，我们调查了瑞士法语区和德语区的专门老年精神病诊所和疗养院对 85 名 VDB 患者的治疗和护理的临床实践。我们希望从临床角度描述 VDB 患者，确定在日常实践中治疗 VDB 的常见方法，并探讨负责护理者如何判断所采用干预措施的效果。数据通过问卷调查收集。本研究中大多数 VDB 患者患有痴呆症，其中 75%至少有当前或既往精神障碍，25%有既往人格障碍。大多数患者接受了多种心理社会护理干预，这些干预措施往往被认为是有效的，但心理社会干预的潜力尚未得到充分利用。许多患者没有接受专门针对 VDB 的精神药物治疗，但约 70%的处方被认为有积极效果。既往的精神和人格障碍或特征可能成为 VDB 的病因，并为治疗这些潜在障碍的方法设定新的框架。
