Abstract：
:Geriatric patients with dementia frequently present with agitation, aggression, psychosis, and other behavioral and psychological symptoms of dementia (BPSD). We present an update of our previously published algorithms for the use of psychopharmacologic agents in these patients taking into account more recent studies and findings in meta-analyses, reviews, and other published algorithms. We propose three algorithms: BPSD in an emergent, urgent, and non-urgent setting. In the emergent setting when intramuscular (IM) administration is necessary, the first-line recommendation is for olanzapine (since IM aripiprazole, previously favored, is no longer available) and haloperidol injection is the second choice, followed by possible consideration of an IM benzodiazepine. In the urgent setting, the first line would be oral second-generation antipsychotics (SGAs) aripiprazole and risperidone. Perhaps next could be then prazosin, and lastly electroconvulsive therapy is a consideration. There are risks associated with these agents, and adverse effects can be severe. Dosing strategies, discontinuation considerations, and side effects are discussed. In the non-emergent setting, medications are proposed for use in the following order: trazodone, donepezil and memantine, antidepressants such as escitalopram and sertraline, SGAs, prazosin, and carbamazepine. Other options with less support but potential future promise are discussed.
journal_name
Psychiatry Resjournal_title
Psychiatry researchauthors
Chen A,Copeli F,Metzger E,Cloutier A,Osser DNdoi
10.1016/j.psychres.2020.113641subject
Has Abstractpub_date
2021-01-01 00:00:00pages
113641eissn
0165-1781issn
1872-7123pii
S0165-1781(20)33302-3journal_volume
295pub_type
杂志文章,评审abstract：:Despite mounting evidence for the distinctiveness of symptom dimensions in obsessive-compulsive disorder, neuropsychological studies have been few, focused on small samples, and relying on classification of participants based on mutually exclusive symptom categories, resulting in lack of concordance across neuropsycho...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2016.12.044
更新日期：2017-03-01 00:00:00
abstract：:Only little is known about pathological personality traits in patients with Gilles de la Tourette syndrome (GTS). The aim of this study was to further investigate the prevalence of personality traits in adults with GTS. We used a variety of rating scales to assess not only personality traits, but also severity of tics...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2015.04.043
更新日期：2015-08-30 00:00:00
abstract：:The significance of neurological signs in schizophrenia is poorly understood. In part, this may reflect the marked variability in the methods of ascertainment in previous studies. The Neurological Evaluation Scale (NES) is designed to standardize the assessment of neurological impairment in schizophrenia. The battery ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/0165-1781(89)90148-0
更新日期：1989-03-01 00:00:00
abstract：:Bipolar disorder (BD) is multifactorial mood disorder characterized by alternating episodes of hyperactive mania and severe depression. Lithium is one of the most preferred drug used as mood stabilizer in treating BD. In this study, we examined the changes in plasma metabolome in BD subjects in the context of lithium ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2019.01.031
更新日期：2019-03-01 00:00:00
abstract：:Transdiagnostic approach has a long history in neuroimaging, predating its recent ascendance as a paradigm for new psychiatric nosology. Various psychiatric disorders have been compared for commonalities and differences in neuroanatomical features and activation patterns, with different aims and rationales. This revie...
journal_title：Psychiatry research
pub_type： 杂志文章,评审
doi：10.1016/j.psychres.2019.01.026
更新日期：2019-07-01 00:00:00
abstract：:Psychopathy is a cluster of personality traits associated with high rates of aggression. While research on psychopathic traits largely focuses on neurobiological factors implicated in aggression, other research suggests that contextual factors, such as social exclusion, also contribute to promoting aggression. Yet, th...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2018.07.024
更新日期：2018-10-01 00:00:00
abstract：:Serotonergic abnormalities have been regularly reported in the brains of suicide victims. Because of evidence that pineal function is altered in depressed subjects and that serotonin-releasing axons may innervate the pineal, we assayed tritiated serotonin binding in a series of control and suicide pineals. High affini...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/0165-1781(90)90131-n
更新日期：1990-04-01 00:00:00
abstract：:Determining meaningful activation thresholds in functional magnetic resonance imaging (fMRI) paradigms is complicated by several factors. These include the time-series nature of the data, the influence of physiological rhythms (e.g. respiration) and vacillations introduced by the experimental design (e.g. cueing). We ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/s0925-4927(97)00024-3
更新日期：1997-08-08 00:00:00
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journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2012.07.006
更新日期：2012-12-30 00:00:00
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journal_title：Psychiatry research
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1997-06-16 00:00:00
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journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2004.03.010
更新日期：2004-06-30 00:00:00
abstract：:The experience of maternal distress in pregnancy is often linked with poorer obstetric outcomes for women as well as adverse outcomes for offspring. Alterations in placental glucocorticoid signalling and subsequent increased fetal exposure to cortisol have been suggested to underlie this relationship. In the current s...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2017.05.013
更新日期：2017-09-01 00:00:00
abstract：:Computed tomographic (CT) scans of brains of patients with borderline personality disorder and normal volunteers were analyzed for ventricle-brain ratios, third ventricular size, and evidence of frontal lobe atrophy. There were no significant differences between the two groups on any of these measures except for a nar...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/0165-1781(89)90126-1
更新日期：1989-02-01 00:00:00
abstract：:Foreign migrant domestic workers experience an increased burden of mental disorders. Discrimination contributes to this burden. Social resources may buffer migrants from the effects of this discrimination. The present study explored the relationship between discrimination and common mental disorder (CMD) symptoms, anx...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2018.11.050
更新日期：2019-01-01 00:00:00
abstract：:High rates of psychiatric impairment in adults with 22q11 deletion syndrome (22q11DS, also referred to as DiGeorge or velocardiofacial syndrome) suggest that behavioral trajectories of children with 22q11DS may provide critical etiologic insights. Past findings that report Diagnostic and Statistical Manual (DSM) diagn...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2008.03.023
更新日期：2009-03-31 00:00:00
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journal_title：Psychiatry research
pub_type： 临床试验,杂志文章
doi：10.1016/0165-1781(79)90016-7
更新日期：1979-12-01 00:00:00
abstract：:Seasonal trends in South African suicide incidence were investigated with a view to ascertaining whether they are consistent with those in the northern hemisphere regarding: (1) the existence of the expected pattern; (2) this pattern being more pronounced for less urbanized groups; and (3) the presence of a secondary ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/s0165-1781(96)02974-5
更新日期：1997-01-15 00:00:00
abstract：:There are now numerous reports of neuroanatomical abnormalities in people with bipolar disorder. However, it remains unclear whether those abnormalities predate the onset of the illness. In this cross-sectional magnetic resonance imaging study, we assessed 11 young people clinically at ultra-high risk of development o...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.pscychresns.2011.06.010
更新日期：2012-01-30 00:00:00
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journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2008.06.012
更新日期：2009-08-30 00:00:00
abstract：:There is growing concern over the potential for increased suicide risk in vulnerable populations as the COVID-19 pandemic unfolds. To contextualize this risk during the first weeks of the nationwide lockdown efforts, we had 1,013 U.S. adults complete questionnaires assessing worries over COVID-19, insomnia severity, a...
journal_title：Psychiatry research
pub_type： 信件
doi：10.1016/j.psychres.2020.113134
更新日期：2020-08-01 00:00:00
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journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/s0165-1781(98)00087-0
更新日期：1998-11-16 00:00:00
abstract：:Depressed patients with (a) mood reactivity alone (MR group), (b) mood reactivity plus one or more associated features (atypical depression, AD group), and (c) patients with neither mood reactivity nor atypical depression (non-MR/AD group) were compared on their cortisol response to 75 mg of desipramine (DMI), a relat...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/0165-1781(96)02781-3
更新日期：1996-03-29 00:00:00
abstract：:A set of face stimuli called the NimStim Set of Facial Expressions is described. The goal in creating this set was to provide facial expressions that untrained individuals, characteristic of research participants, would recognize. This set is large in number, multiracial, and available to the scientific community onli...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2008.05.006
更新日期：2009-08-15 00:00:00
abstract：:In the present study we set out to explore the long-term clinical course of schizophrenia in a holistic manner by adopting sequence analysis. Our aim was to identify course types of illness by means of cluster analysis. The study was based on course and outcome data for 107 patients followed up over 134 months after f...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2015.04.056
更新日期：2015-08-30 00:00:00
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journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2017.03.056
更新日期：2017-07-01 00:00:00
abstract：:Baseline 8 a.m. adrenocorticotropic hormone (ACTH) and cortisol levels and the postdexamethasone ACTH/cortisol values at 8 a.m. and 4 p.m. were determined in 86 depressed females diagnosed using DSM-III criteria. Postdexamethasone ACTH and cortisol values were significantly correlated with their baseline levels. We ha...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/0165-1781(90)90013-u
更新日期：1990-11-01 00:00:00
abstract：:There is increasing evidence that obsessive-compulsive disorder (OCD) is mediated by genetic factors. Although the precise mechanism of inheritance is unclear, recent evidence has pointed towards the involvement of the serotonergic and dopaminergic systems in the disorder's development. Furthermore, early-onset OCD ap...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2004.05.007
更新日期：2004-09-30 00:00:00
abstract：:The tryptophan catabolite (TRYCAT) pathway is induced by indoleamine 2,3-dioxygenase (IDO), which upon activation depletes plasma tryptophan (TRP) and increases the synthesis of TRYCATs. Both phenomena are associated with somatization and depression. The aims of this study are to examine whether disorders in the TRYCA...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2011.09.029
更新日期：2012-04-30 00:00:00
abstract：:Although several studies have detected differences in clinical features among specific phobias, there is a shortage of detailed national data on the on the DSM-IV SP subtypes, particularly in the Asian population. To examine the prevalence, demographic and other correlates, and co-morbidities of DSM-IV SP subtypes in ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/j.psychres.2012.12.025
更新日期：2013-10-30 00:00:00
abstract：:This study was designed to determine the effects of aging on the volume of the basal ganglia in individuals with Down syndrome (DS) and to examine the relationship between basal ganglia volumes, neuropsychological test performance, and dementia status in this population. Subjects were 32 adults with DS. Basal ganglia ...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/s0925-4927(97)00011-5
更新日期：1997-05-16 00:00:00
