Co-occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly
Co-occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly
复制标题
DOI：
10.1002/gps.2052
复制
发表时间：
2008-11-01
影响因子：
4
通讯作者：
Bourdel-Marchasson, Isabelle
中科院分区：
文献类型：
--
作者：
Dechamps, Arnaud;Jutand, Marthe Aline;Bourdel-Marchasson, Isabelle
目的 从神经精神科问卷 - 养老院版（NPI - NH）的因子结构中探索并确定痴呆和精神病患者行为综合征的临床特征。
场所 两家养老院和两家长期护理院。
设计 观察性横断面研究。
参与者 163名患有痴呆或精神病的住院老年人（66.9%为女性），平均年龄80.9 ± 9.1岁。
测量 NPI - NH包括12种神经精神症状和一个痛苦量表。频率（F）和严重程度（S）评分的乘积得分提供了12个项目中每个项目的总分。根据患者的诊断，对F×S得分进行了带有最大方差旋转的探索性主成分分析。
结果 发现NPI - NH具有较高的内部一致性（α = 0.8）。在痴呆患者中发现了一个4因子解，解释了63.9%的方差，综合征包括：（a）“多动”；（b）“情感”；（c）“精神病”；（d）“幻觉”。在精神病患者中也发现了一个4因子解，解释了61.3%的方差，综合征包括：（a）“情感”；（b）“额叶症状”；（c）“日落综合征”；（d）“精神运动性激越”。一种综合征不太可能单独出现，而最有可能与其他综合征一起出现。在痴呆患者（30.5%的病例中为a + b + c）和精神病患者（35.2%的病例中为a + b + c + d）中发现了综合征共现的特定模式。
结论 综合征分类与诊断标准一致。综合征共现的临床应用有助于进一步理解和评估药物及非药物治疗中的行为变化。版权所有（C）2008约翰威立父子有限公司
Objectives To explore and determine the clinical figures of behavioral syndromes from the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in demented and psychotic patients.Setting Two nursing homes and two long-term care homes.Design Observational, cross-sectional.Participants One hundred and sixty-three institutionalized elderly with dementia or psychosis (66.9% female), mean age 80.9 +/- 9.1 years.Measurements The NPI-NH includes 12 neuropsychiatric symptoms and a distress scale. The product score of frequency (F) and severity (S) ratings provides an overall score for each of the 12 items. An exploratory principal component analysis with Varimax, rotation was performed on the F x S scores according to patients' diagnosis.Results High internal consistency of the NPI-NH was found (alpha = 0.8). In demented patients a 4-factor solution was found that explained 63.9% of the variance, with the syndromes: (a) 'hyperactivity'; (b) 'affective'; (c) 'psychosis'; and (d) 'Hallucinations'. A four-factor solution was also found in psychotic patients, explaining 61.3% of variance, with syndromes: (a) 'affective'; (b) 'frontal lobe symptoms'; (c) 'sundowning'; and (d) 'psychomotor agitation'. A syndrome was unlikely to appear alone but was most likely to occur with other syndromes. A specific pattern of syndrome co-occurrence were found in demented (a + b + c in 30.5% of cases) and psychotic patients (a + b + c + d in 35.2% of cases).Conclusion The syndrome taxonomies are consistent with the diagnostic criteria. The clinical use of syndrome co-occurrence could help to further understand and evaluate behavioral changes in pharmacological and non-pharmacological treatments. Copyright (C) 2008 John Wiley & Sons, Ltd.