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Behavioural Disturbances (behavioural + disturbance)

Distribution by Scientific Domains

Medical Sciences	90%
2 Other Domains	10%

Distribution within Medical Sciences

Psychiatry	75%
Anesthesia & Pain Management	10%
3 Other Subdomains	15%

Selected Abstracts

Role of behavioural disturbance in the loss of autonomy for activities of daily living in Alzheimer patients

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2003
L. Lechowski
Abstract Background Cognitive impairment is associated with functional impairment in patients with Alzheimer's disease (AD). Behavioural disturbance is very common in these patients. Nevertheless, there has been very little research into the relations between behavioural disturbance and functional status in AD. The purpose of this study is to investigate the relationship between behavioural disturbance and functional status after taking account of cognitive impairment. Material and methods 579 patients were prospectively evaluated at 16 French hospitals, all referents for AD, and were diagnosed with possible or probable AD. These patients were assessed with NeuroPsychiatric Inventory (NPI), cognitive subscales of the Alzheimer's Disease Assessment Scale (ADAS-cog), Clinical Dementia Rating scale (CDR) and Instrumental Activities of Daily Living scale (IADL). Results The number of men with available data for IADL total score was too small to make any analysis. ,Group A' gathered 256 women for whom the relation between autonomy for Activities of Daily Living (ADL) and the other variables were determined. ,Group B', pooled 85 women for whom relations found were verified. Linear regression was used for the analysis. With age, cognitive impairment allows us to explain best (38%) the loss of autonomy for ADL. Conclusion The role of behavioural disturbances in the loss of autonomy for ADL was not determinant in our study, whereas cognitive impairment and age were better able to determine the loss of autonomy for ADL. Further study is needed to explain the decline of functional status in AD patients. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Improvement in behavioural symptoms in patients with moderate to severe Alzheimer's disease by memantine: a pooled data analysis

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2008
S. Gauthier
Abstract Introduction Behavioural disturbances are a common and distressing aspect of Alzheimer's disease (AD). This pooled analysis evaluated the specific benefits of memantine on behavioural disturbances in patients with moderate to severe AD. Methods Data were pooled from six 24/28-week, randomised, placebo-controlled, double-blind studies. Of the 2,311 patients included in these studies, 1,826 patients with moderate to severe AD (MMSE <20) were included in this analysis, corresponding to the extended indication for memantine in Europe. In this subgroup, 959 patients received memantine 20,mg/day and 867 received placebo. Behavioural symptoms were rated using the Neuropsychiatric Inventory (NPI) total and single-item scores at weeks 12 and 24/28. Results At weeks 12 and 24/28, ITT analysis demonstrated that memantine treatment produced statistically significant benefits over placebo treatment in NPI total score (p,=,0.001 and p,=,0.008), and in NPI single items: delusions (p,=,0.007,week 12, p,=,0.001,week 24/28), hallucinations (p,=,0.037,week 12), agitation/aggression (p,=,0.001,week 12, p,=,0.001,week 24/28), and irritability/lability (p,=,0.005,week 24/28), LOCF population. Analysis of the patients without symptoms at baseline indicated reduced emergence of agitation/aggression (p,=,0.002), delusions (p,=,0.047), and disinhibition (p,=,0.011), at week 12, and of agitation/aggression (p,=,0.002), irritability/lability (p,=,0.004), and night-time behaviour (p,=,0.050) at week 24/28 in those receiving memantine. OC analyses yielded similar results. Conclusions The data suggest that memantine is effective in treating and preventing the behavioural symptoms of moderate to severe AD. Specific persistent benefits were observed on the symptoms of delusions and agitation/aggression, which are known to be associated with rapid disease progression, increased caregiver burden, early institutionalisation, and increased costs of care. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Do premorbid impairments predict emergent ,prodromal' symptoms in young relatives at risk for schizophrenia?

EARLY INTERVENTION IN PSYCHIATRY, Issue 3 2009
Matcheri S. Keshavan
Abstract Aims: Individuals at risk for developing schizophrenia (SZ) in the future frequently exhibit subtle behavioural and neurobiological abnormalities in their childhood. A better understanding of the role of these abnormalities in predicting later onset of ,prodromal' symptoms or psychosis may help in early identification of SZ. Methods: In an ongoing prospective follow-up study of young genetically at-risk relatives of patients with SZ, we studied the prevalence of problems in premorbid social adjustment and childhood psychopathology and examined their relationship with the presence and progression of ,prodromal' symptoms of SZ. Results: Growth curve analyses showed that ,prodromal' symptoms, as measured by the Scale of ,Prodromal' Symptoms, increased during follow-up. Premorbid maladjustment and childhood behavioural disturbances were cross-sectionally correlated broadly with ,prodromal' symptomatology scores. Longitudinal analyses revealed that behavioural disturbances, but not childhood maladjustment at baseline, significantly predicted increases in ,prodromal' symptomatology during the 2-year study period. Conclusion: Premorbid behavioural disturbance and maladjustment may predict the later emergence of ,prodromal' symptoms. ,Prodromal' symptoms in young at-risk relatives may define a subgroup worthy of follow-up into the age of risk for psychosis in order to cost-effectively characterize the predictors of psychotic symptoms and SZ. [source]

Role of behavioural disturbance in the loss of autonomy for activities of daily living in Alzheimer patients

Sunlight levels and behavioural disturbance in dementia

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2002
Bart Sheehan
No abstract is available for this article. [source]

Aged pesticide residues are detrimental to agrobiont spiders (Araneae)

JOURNAL OF APPLIED ENTOMOLOGY, Issue 8 2008
S. Pekár
Abstract Spiders are among the most abundant arthropods in agroecosystems, playing an important role as natural enemies of various pests. In this study we evaluated residual activity of selected pesticides on the mortality and behaviour of four spider species (Dictyna uncinata, Pardosa palustris, Philodromus cespitum and Theridion impressum). We used three pesticides: a herbicide Command (clomazone), and insecticides Decis (deltamethrin) and Nurelle (chlorpyrifos and cypermethrin). Mortality was recorded after exposure of spiders to fresh (2-h), 5, 10, 15 and 20-day-old residues. For each residue mortality was evaluated after 24,72 h. Residual effect differed between preparations and, in some cases, between spiders. All of the Nurelle residues (fresh to 20-day-old) caused 100% mortality in all spider species. Residues of Command were rather harmless (causing <20% mortality) to all spider species as the herbicide activity declined with age. Residues of Decis had species-specific effects as the mortality varied between 0 and 90%. In Dictyna the mortality gradually declined with the age of residues, while in Pardosa the mortality increased. In Philodromus and Theridion the mortality declined up to 10-day-old residues and then increased so that 20-day-old residues caused almost as high mortality as the new ones. Exposure to pesticide residues immediately affected the movement of Pardosa spiders. Residues of Decis and Nurelle decreased spider locomotion, while those of Command increased locomotion in comparison with the control. In another experiment, we studied repellence of fresh pesticide residues to Pardosa spiders. In comparison with the control, spiders stayed a similar time on the surface treated with Command, but four times less on Decis and nine times less on Nurelle-treated surfaces, respectively. In conclusion, aged insecticide residues possess a high activity and can cause long-term decline in the abundance and prolonged behavioural disturbance of spiders in agroecosystems. [source]

Adult-onset tic disorder, motor stereotypies, and behavioural disturbance associated with antibasal ganglia antibodies

MOVEMENT DISORDERS, Issue 10 2004
Mark J. Edwards MBBS
Abstract The onset of tics in adulthood is rare and, unlike the childhood variety, there is commonly a secondary environmental cause. We present four cases (1 man, 3 women) with an adult onset tic disorder (mean age of onset, 36 years; range, 27,42 years) associated with the presence of serum antibasal ganglia antibodies (ABGA). One patient had motor tics and unusual motor stereotypies, 2 had multiple motor and vocal tics, and the remaining patient had motor tics only. Concomitant psychiatric disturbance was noted in 3 cases. In 2 cases, there was a close temporal relationship between upper respiratory tract infection and the subsequent onset of tics. Imaging was possible in three cases and was normal in two but revealed a lesion involving the right caudate and lentiform nuclei in the other. We suggest that there might be a causal relationship between ABGA and the clinical syndrome in these cases and that ABGA should be considered as a possible etiology for adult-onset tics. © 2004 Movement Disorder Society [source]

Individual differences in the experience of burden in caring for relatives with dementia: role of personality and mastery

AUSTRALASIAN JOURNAL ON AGEING, Issue 4 2005
Edward Helmes
Objective:,We explored individual differences in caregiver outcome according to the personality and behavioural style of the carer. Current models of caregiver burden fail to consider such factors. Methods:,This cross-sectional, exploratory study used carer variables of personality traits and mastery and patient variables of cognitive, functional and neurobehavioural status to predict scores on an established measure of burden in a sample of 51 people with dementia and their carers. Results:,Hierarchical multiple regression showed a significant association between behavioural disturbance and neuroticism and burden, but not with mastery. Conclusions:,The primary findings in this study are that models of caregiver outcome need to take an individual differences perspective in accounting for caregiver mental health risk factors: personality characteristics do play a part in the way caregivers manage this difficult role. [source]

Do premorbid impairments predict emergent ,prodromal' symptoms in young relatives at risk for schizophrenia?

Improvement in behavioural symptoms in patients with moderate to severe Alzheimer's disease by memantine: a pooled data analysis

Subjective cognitive complaints, neuropsychological performance, affective and behavioural symptoms in non-demented patients

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2008
Roberto Gallassi
Abstract Objective Subjective cognitive complaints (SCC) have been previously investigated to establish whether they are risk factors for dementia, but no clear-cut conclusions have emerged. In this study non-demented patients with SCC were studied and the neuropsychological findings, affective and behavioural aspects and parameters with the highest correct classifications in discriminating patients who had only SCC but no objective clinical and neuropsychological impairment, i.e. no cognitive impairment (NCI) patients and those with objective neuropsychological deficits, namely patients with mild cognitive (MCI) were analyzed. Methods Consecutive non-demented outpatients with SCC were enrolled of over 9 months and examined using neuropsychological tests and scales for depression, anxiety and behaviour. Clinical criteria and neuropsychological test results were used to classify patients into groups of NCI, MCI and subtypes of MCI. Results Ninety-two patients with SCC were included; 49 of them had objective deficits (MCI patients), whereas 43 were without any clinical and cognitive impairment (NCI patients). These patients had lower age, higher education and better general cognitive indices than MCI patients who had higher caregiver distress, depression and irritability. The combination of a battery for mental deterioration and for behavioural memory assessment were the most discriminative in differentiating the two groups. Conclusions An objective cognitive impairment, reaching the criteria for a MCI diagnosis, was present in almost half of patients having SCC. MCI patients have more behavioural disturbances than NCI subjects. SCC should not be underestimated and appropriate neuropsychological assessment is required to reassure subjects with normal results and to identify patients with MCI. Copyright © 2007 John Wiley & Sons, Ltd. [source]

The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes,

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2007
Geir Selbæk
Abstract Background Psychiatric and behavioural symptoms in dementia are associated with a range of negative outcomes, including institutional placement and the widespread use of psychotropic drugs in spite of limited evidence for their efficacy. Aims To determine the prevalence of psychiatric and behavioural symptoms and the pattern of psychotropic drug prescription in patients with various degrees of dementia. Methods A sample of 1,163 non-selected nursing home patients were assessed by means of the Neuropsychiatric Inventory, the Clinical Dementia Rating scale and Lawton's activities of daily living scale. In addition, information was collected from the patients' records. Results Dementia was found in 81% of the patients and 72% of them had clinically significant psychiatric and behavioural symptoms. The frequencies of symptoms increased with the severity of the dementia. Psychotropic medication was being prescribed to 75% of patients with dementia. There was a significant relationship between the type of drug and the symptom for which it had been dispensed. Conclusion Psychiatric and behavioural symptoms are frequent in nursing homes and the rate increases with the progression of the dementia. Systematic programmes are needed for disseminating skills and providing guidance regarding the evaluation and treatment of these symptoms in nursing homes. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Role of behavioural disturbance in the loss of autonomy for activities of daily living in Alzheimer patients

Frontotemporal dementia: patient characteristics, cognition, and behaviour

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2002
J. Diehl
Abstract Objectives To describe sociodemographic data of patients with frontotemporal dementia (FTD), to compare the cognitive profile of patients with FTD with that of severity-matched patients with Alzheimer's disease using the CERAD neuropsychological battery (CERAD-NP), to investigate the frequency of behavioural disturbances, and to examine the relation between FTD-specific non-cognitive behavioural symptoms of patients with FTD with age and sex. Methods Fifty outpatients were diagnosed with FTD according to the Lund-Manchester consensus criteria. Cognitive impairment was assessed in 30 patients using the CERAD-NP. Severity of dementia was rated on the Clinical Dementia Rating (CDR). Eleven non-cognitive symptoms were rated by severity. To compare CERAD-NP results between patients with FTD and AD, 30 patients with AD were matched for age, sex, and global severity of cognitive performance. Results The average age at onset of first symptoms was 57.8 years. Eighteen patients (36%) had a positive family history of dementia. On the CERAD-NP patients with FTD performed significantly better than patients with AD on word list learning, delayed verbal recall and visuoconstruction (p<0.05). There were no significant differences between FTD and AD on naming and verbal fluency tasks. The most frequent non-cognitive behavioural symptoms in FTD were loss of insight, speech abnormality, and apathy. Non-cognitive behavioural symptoms were more frequent in younger and in male than in older patients and in female patients. Conclusions The CERAD-NP is a valuable clinical instrument for the cognitive evaluation of patients with suspected FTD. Complementary short tests of attention and executive function may be recommended. To enhance diagnostic sensitivity informant interviews should focus on non-cognitive behavioural changes, taking advantage of standardised questionnaires. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Challenging behaviours in nursing home residents with dementia: a randomized controlled trial of multidisciplinary interventions

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2002
Janet Opie
Abstract Objectives To test the premise that individually tailored psychosocial, nursing and medical interventions to nursing home residents with dementia will reduce the frequency and severity of behavioural symptoms. Methods A four-member team comprising a psychiatrist, psychologist and nurses conducted detailed assessments of 99 nursing home residents with advanced dementia who were rated by staff as having frequent, severe behavioural disturbances. Residents were then randomly assigned to an ,early' or ,late' intervention group and observed for four weeks. Interventions encompassed psychosocial strategies, nursing approaches, psychotropic medications and management of pain. Outcome measures included the frequency and severity of disruptive behaviours and assessments of change by senior nursing home staff. Results While improvements in behaviour were noted in both groups from the outset of observations, pointing to a powerful Hawthorne effect, consultancies were associated with a modest but statistically significant decrease in challenging behaviours. Staff assessments of the interventions were highly favourable. Conclusions The consultancies were effective and well received by staff. The change-inducing nature of any new endeavour is an integral part of research in a long-term setting. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Fall risk factors in older people with dementia or cognitive impairment: a systematic review

JOURNAL OF ADVANCED NURSING, Issue 5 2009
Jürgen Härlein
Abstract Title.,Fall risk factors in older people with dementia or cognitive impairment: a systematic review. Aim., This paper is a report of a review conducted to identify and summarize specific risk factors for falls in older people with dementia or cognitive impairments as documented by prospective or case,control studies. Background., People with dementia have a doubled to threefold risk for falls, but the reasons for this have not yet been fully explained. Several integrative literature reviews discuss possible specific fall risk factors. However, there is lack of a systematic evaluation of studies. Data sources., The CINAHL, PubMed, EMBASE and PsychInfo databases were searched for the period between 1980 and May 2007. Review methods., A systematic review was conducted. Cohort or case,control studies published in English or German were included if they investigated risk factors for falls or fall-related injuries in a sample consisting of participants with dementia or cognitive impairment. Two reviewers independently assessed study quality. Results., Six prospective studies were included in the review. These differed concerning samples, settings, follow-up periods and examined variables. Therefore, meta-analysis was not possible. Eight categories of risk factors emerged: disease-specific motor impairments, impaired vision, type and severity of dementia, behavioural disturbances, functional impairments, fall history, neuroleptics and low bone mineral density. Conclusion., There is lack of sound studies examining fall risk factors in cognitively impaired elders. Well-known risk factors such as motor impairment show particular characteristics in people with dementia. In addition, behavioural disturbances contribute to their high risk for falls. Further prospective studies are needed. [source]

Clonidine in paediatric anaesthesia: review of the literature and comparison with benzodiazepines for premedication

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2006
H. Bergendahl
Background:, Children undergoing anaesthesia and surgery can experience significant anxiety and distress during the peri-operative period, but whether routine premedication is necessary is currently debated. Benzodiazepines are the most frequently used drugs as premedication in paediatric anaesthesia. In the US, 50% of young children undergoing surgery receive premedication and midazolam is the most frequently used drug in this context (1). Nishina and coworkers (2) concluded in a review article in 1999 that clonidine, administered via an oral, rectal, or caudal route, is a promising adjunct to anaesthetics and analgesics to enhance quality of peri-operative management in infants and children. Later publications also support the use of clonidine for premedication (3,6). The aim of this communication is to review the use of clonidine in paediatric anaesthesia and to propose clonidine as a promising alternative to midazolam. Clonidine is associated with a number of beneficial effects in the context ofanaesthesia both in adults and children. Why clonidine is not routinely use in clinical practice despite the massive publication list is to a large extent due to the lack of marketing efforts from the pharmaceutical industry since multiplegeneric preparations are now readily available on most markets. Midazolam is also associated with a number of beneficial effects, but is far from an ideal premedicant in children, especially with regards to the amnesia, confusion and long term behavioural disturbances. Clonidine has contrary to midazolam no effect on respiration. We believe that clonidine is a good alternative to midazolam as premedication in infants and children. [source]

An interim analysis of a cohort study on the preoperative anxiety and postoperative behavioural changes in children having repeat anaesthetics

PEDIATRIC ANESTHESIA, Issue 9 2002
A. Watson
Introduction Anxiety in the preoperative period and at induction of anaesthesia in children is associated with disturbances in postoperative behaviour (1,4). There is little work looking at the effects of repeat anaesthetic procedures on anxiety and subsequent postoperative behaviour disturbances. The aim of this study was to see if the effect of repeat anaesthetics was cumulative on postoperative behavioural problems and whether repeated anaesthetics provoke increasing anxiety. We investigated factors that may identify children who are susceptible to behavioural changes following repeat anaesthetics. We present an interim analysis of data on 8 patients as part of a long-term cohort study on 40 children with retinoblastoma who have required repeat anaesthetics for assessment and treatment of their condition. Method Approval for this study was granted by the East London and City Health Authority ethics committee. 40 patients are being recruited and being followed over a two year period. All children have retinoblastoma and are between the ages of 18 months to 4 years. The anaesthetic technique was not standardised but details of it were collected. Data collected were demographic details of child (age, sex, weight, ASA grade, siblings, stressful events in the last 3 months, recent immunisations, number of previous anaesthetics, problems with previous general anaesthetics, medical history of children, temperament of child using the EASI scoring system (4); demographic data of parents (age, parental education, family members affected, baseline measure of parental anxiety using State trait anxiety inventory (STAI). Anxiety on entry into the anaesthetic room and at induction was measured by the modified Yale preoperative anxiety scale (mYPAS), cooperation of the child at induction was measured by the Induction compliance checklist (ICC). Anxiety of the parent after induction was measured by the STAI score. Behaviour was measured at 1 day, 1 week, 1 month and 4 months after each procedure by means of the post hospital behaviour score (PHBQ) (5). A comparison with preoperative behaviour was made and data is presented of the percentage of children with new negative behavioural problems. A detailed analysis of the types of behaviour change was noted. anova for repeat measures with multiple dependent measures was used to analyse data on child anxiety and postoperative behavioural problems. Results Eight patients have had 3 separate anaesthetics over one and a half years. These have been at 4 monthly intervals. There was no significant increase in anxiety levels with repeat anaesthetics. The median mYPAS score at induction were 100 for all 3 anaesthetics. (P = 0.41). The type of behavioural change was variable and demonstrated no trend. No patient was identified as being prone to behavioural changes after every anaesthetic. Patients who displayed new negative behavioural problems would have them after any anaesthetic with no obvious cumulative effect with each repeat anaesthetic. Conclusions Our patients had maximum anxiety scores at induction, so the mYPAS scoring system is not sensitive enough to show that repeat anaesthetics provoke increasing anxiety. There is a very random pattern to behavioural disturbances after repeat anaesthetics with no evidence that negative behavioural changes are compounded with repeated anaesthetics. Collection of complete data from the remaining 32 patients may yield some trends regarding behavioural disturbances but our use of the mYPAS to measure anxiety in this very anxious population is unlikely to be helpful. [source]

Strategies for the capture and transport of bonefish, Albula vulpes, from tidal creeks to a marine research laboratory for long-term holding

AQUACULTURE RESEARCH, Issue 13 2009
Karen J Murchie
Abstract Throughout their circumtropical distribution, bonefish (Albula spp.) play a vital role in local economies as a highly prized sport fish. Recent interest in stock enhancement to sustain bonefish fisheries has led to the recognition that there currently are no data on how to live capture large numbers of adults (potential broodstock), transport them to captive facilities and how to handle them to ensure high survival. The objective of this study was to develop strategies for the capture and relocation of wild bonefish to a marine research holding facility to enable basic research and explore the potential for culturing bonefish for stock enhancement. Bonefish Albula vulpes (Linnaeus, 1758) were captured as they entered or left tidal creeks on Eleuthera, The Bahamas using seine nets and then transported by boat or truck to the laboratory. The relocation process evoked secondary stress responses at the metabolic, osmoregulatory and haematological levels as indicated by changes in blood glucose, lactate, haematocrit and ion values, relative to control fish. Physical and behavioural disturbances were also observed in bonefish that were unable to acclimate to laboratory conditions. Successful laboratory acclimation and long-term holding of wild bonefish was achieved through an adaptive learning process, whereby we identified a series of strategies and handling techniques to facilitate the acclimation of wild adult bonefish to captivity. This knowledge will enable future laboratory research on bonefish and is a prerequisite to the culture of this highly prized sport fish, and other sub-tropical and tropical marine species. [source]

Nutrition, mood and behaviour: a review

ACTA NEUROPSYCHIATRICA, Issue 5 2009
Nerissa L Soh
Objective: To conduct a critical review of recent empirical research regarding mood, behaviour and nutrition factors including essential fatty acids, macronutrients, micronutrients and food additives. Method: A literature search of databases Medline, PsycInfo, CINAHL and Embase up to October 2008. The search emphasised empirical research published in the last 10 years and also included older literature. Studies in both adults and children were addressed. Results: Research into omega-3 fatty acids has been substantial but evidence for their potential in treating mood and behaviour is modest. In comparison, there has been much less research into carbohydrate and protein intakes and little evidence for their ability to influence mood and behaviour. Recent trials with food additives suggest their removal from the diet may benefit susceptible children with hyperactivity disorders. Micronutrient supplementation appears to improve mood only in those who were initially deficient in micronutrients. Conclusions: More stringent research designs such as longitudinal studies and the use of biologically inert placebos within randomised controlled trials are needed before supplemental use of omega-3 fatty acids to treat disorders of mood and behaviour can be recommended. Caution is advised regarding the indiscriminate use of diets free of artificial food additives in managing hyperactivity disorders, as they may place an undue burden on individuals and their families. Should omega-3 fatty acid supplementation or the elimination of certain food additives be established as effective, they may provide cost-effective, accessible and well-tolerated adjuncts to standard psychiatric treatments for mood and behavioural disturbances. [source]