Umesh Shreekantiah, Goyal Nishant, Grover Sandeep, Bhattacharyya Ranjan, Menon Vikas, Mohapatra Debadatta, Mehra Aseem, Bakhla Ajay Kumar
Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Department of Psychiatry, Murshidabad Medical College and Hospital Murshidabad, West Bengal, India.
Indian J Psychiatry. 2022 Jul-Aug;64(4):370-376. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_117_21. Epub 2022 Jul 13.
Behavioral and psychological symptoms (BPS) are usually the expected consequences of dementia. BPS increases morbidity and burden, affects the quality of life, and impacts care costs. However, the symptom characteristics, clinical correlations, and symptom-specific clusters aiding the diagnosis are less well studied, especially in the Indian population.
The present study examined the BPS clusters based on various cognitive and neuropsychiatric profiles in patients with dementia under a multicentric study in India. We did a cross-sectional assessment using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and cognitive functions by Montreal Cognitive Assessment (MoCA), and the severity of dementia using the Clinical Dementia Rating (CDR) scale. In addition, all of the participants were evaluated on a structured Clinical Interview for DSM-5 Research Version for past or current psychiatric disorder(s).
We describe the various BPS clusters uniquely associated with the severity of dementia. Further, on linear regression analysis, we predicted three symptom clusters (anxiety, irritability, aberrant motor) in mild, two symptom clusters (disinhibition, agitation/aggression) in moderate and three symptom clusters (delusion, euphoria/elation, disinhibition) in severe dementia.
The study provides insights into the various symptom characteristics and inter-relationship of BPS, which may benefit the clinician while assessing patients with dementia.
行为和心理症状(BPS)通常是痴呆症的预期后果。BPS会增加发病率和负担,影响生活质量,并影响护理成本。然而,症状特征、临床相关性以及有助于诊断的症状特异性集群的研究较少,尤其是在印度人群中。
本研究在印度的一项多中心研究中,根据痴呆症患者的各种认知和神经精神特征检查了BPS集群。我们使用神经精神科问卷(NPI-Q)进行横断面评估,并通过蒙特利尔认知评估(MoCA)评估认知功能,使用临床痴呆评定量表(CDR)评估痴呆症的严重程度。此外,所有参与者都接受了针对DSM-5研究版过去或当前精神疾病的结构化临床访谈评估。
我们描述了与痴呆症严重程度独特相关的各种BPS集群。此外,在线性回归分析中,我们预测了轻度痴呆中的三个症状集群(焦虑、易怒、异常运动)、中度痴呆中的两个症状集群(脱抑制、激越/攻击)以及重度痴呆中的三个症状集群(妄想、欣快/狂喜、脱抑制)。
该研究提供了对BPS各种症状特征和相互关系的见解,这可能有助于临床医生在评估痴呆症患者时提供帮助。