Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy.
Residenza Sociosanitaria Assistenziale per Anziani "Aurelia e Silvestro Storelli", Bisceglie, Italy.
Int J Geriatr Psychiatry. 2019 Sep;34(9):1308-1315. doi: 10.1002/gps.4961. Epub 2018 Aug 23.
The prevalence of neuropsychiatric symptoms (NPS) diminishes the quality of life and increases the care burden in patients with dementia. Despite the clinical importance of dementia-associated NPS, no protocols for treating NPS are already well established. Attention has turned to the effectiveness of nonpharmacological treatments for NPS since their potential safe alternative to pharmacotherapy.
This study is aimed to compare the effects in older individuals with dementia living in a residential care, of two intervention programs, the gesture-verbal treatment (GVT), a treatment implemented by us on a previous method for word retrieval in individuals with aphasia, and the better-known doll therapy (DT). The GVT would act on both receptive and expressive language skills, the DT on attachment and emotional connections.
We evaluated NPS by the neuropsychiatric inventory in a total of 30 patients divided into 3 groups, the GVT, the DT, and control groups, using a pre-post design. The treatment groups completed 12-week nonpharmacological interventions in addition to standard rehabilitative therapies, while the control group participated only in standard rehabilitative therapies.
The DT group showed significant improvements in agitation, irritability, apathy, depression, and delusions relative to controls. The GVT group showed significant improvements in apathy and depression with respect to controls. The DT intervention ameliorated symptoms of agitation compared to the GVT intervention whereas the GVT intervention improved apathy compared to the DT intervention.
Improved understanding of the potential therapeutic benefits of different treatments for neuropsychiatric symptoms is crucial for establishing nonpharmacological interventions in dementia.
神经精神症状（NPS）的流行降低了痴呆患者的生活质量并增加了护理负担。尽管与痴呆相关的 NPS 具有临床重要性，但尚无针对 NPS 的既定治疗方案。由于非药物治疗对药物治疗具有潜在的安全替代作用，因此人们对其治疗 NPS 的有效性产生了兴趣。
本研究旨在比较两种干预措施（手势语言治疗（GVT）和众所周知的玩偶治疗（DT））对居住在养老院中的老年痴呆症患者的影响。GVT 可作用于接受和表达语言技能，而 DT 则作用于依恋和情感联系。
我们通过神经精神病学问卷评估了 30 名患者的 NPS，这些患者分为 GVT、DT 和对照组 3 组，采用预前后设计。治疗组在接受标准康复治疗的同时，还完成了为期 12 周的非药物干预，而对照组仅接受标准康复治疗。
与对照组相比，DT 组在激越、烦躁、淡漠、抑郁和妄想方面的症状有显著改善。GVT 组在淡漠和抑郁方面的症状与对照组相比有显著改善。与 GVT 干预相比，DT 干预可改善激越症状，而与 DT 干预相比，GVT 干预可改善淡漠症状。
更好地了解不同神经精神症状治疗方法的潜在治疗益处，对于在痴呆症中建立非药物干预措施至关重要。
