The Link Between Psychosis and Aggression in Persons with Dementia: a Systematic Review

Overview

Journal Psychiatr Q

Specialty Psychiatry

Date 2010 Jan 9

PMID 20058077

Citations 3

Authors

Denis Shub

Valdesha Ball

Asghar-Ali Ali Abbas

Aruna Gottumukkala

Mark E Kunik

Affiliations

Soon will be listed here.

Abstract

The purpose of this study was to systematically review the literature to determine whether aggression is linked to psychosis in persons with dementia. An electronic search using PubMed for articles in English focusing on psychosis and aggression or agitation in adults aged 65+ with dementia. Cross-sectional, longitudinal, and randomized controlled treatment studies examining the outcomes of aggression and psychosis were eligible for inclusion. Eighteen articles were selected for final analysis. Of the seven cross-sectional and two longitudinal studies directly examining the correlation of aggression and psychosis, most showed a positive association. Outcome data from the nine treatment studies was more mixed. Limited data link psychosis with aggression in persons with dementia. Prospectively designed studies looking at the temporal relationship of these variables are needed to make a stronger causal argument.

Citing Articles

Antipsychotic use in dementia: the relationship between neuropsychiatric symptom profiles and adverse outcomes.

Mueller C, John C, Perera G, Aarsland D, Ballard C, Stewart R Eur J Epidemiol. 2020; 36(1):89-101.

PMID: 32415541 PMC: 7847435. DOI: 10.1007/s10654-020-00643-2.

Systematic reviews on behavioural and psychological symptoms in the older or demented population.

van der Linde R, Stephan B, Savva G, Dening T, Brayne C Alzheimers Res Ther. 2012; 4(4):28.

PMID: 22784860 PMC: 3506942. DOI: 10.1186/alzrt131.

Understanding aggressive behaviour across the lifespan.

Liu J, Lewis G, Evans L J Psychiatr Ment Health Nurs. 2012; 20(2):156-68.

PMID: 22471771 PMC: 3411865. DOI: 10.1111/j.1365-2850.2012.01902.x.

References

Lyketsos C, Steele C, Galik E, Rosenblatt A, Steinberg M, Warren A . Physical aggression in dementia patients and its relationship to depression. Am J Psychiatry. 1999; 156(1):66-71. DOI: 10.1176/ajp.156.1.66. View

Mizrahi R, Starkstein S, Jorge R, Robinson R . Phenomenology and clinical correlates of delusions in Alzheimer disease. Am J Geriatr Psychiatry. 2006; 14(7):573-81. DOI: 10.1097/01.JGP.0000214559.61700.1c. View

Tariot P, Schneider L, Katz I, Mintzer J, Street J, Copenhaver M . Quetiapine treatment of psychosis associated with dementia: a double-blind, randomized, placebo-controlled clinical trial. Am J Geriatr Psychiatry. 2006; 14(9):767-76. DOI: 10.1097/01.JGP.0000196628.12010.35. View

Talerico K, Evans L, Strumpf N . Mental health correlates of aggression in nursing home residents with dementia. Gerontologist. 2002; 42(2):169-77. DOI: 10.1093/geront/42.2.169. View

Devanand D, Jacobs D, Tang M, Sano M, Marder K, Bell K . The course of psychopathologic features in mild to moderate Alzheimer disease. Arch Gen Psychiatry. 1997; 54(3):257-63. DOI: 10.1001/archpsyc.1997.01830150083012. View

Freund-Levi Y, Basun H, Cederholm T, Faxen-Irving G, Garlind A, Grut M . Omega-3 supplementation in mild to moderate Alzheimer's disease: effects on neuropsychiatric symptoms. Int J Geriatr Psychiatry. 2007; 23(2):161-9. DOI: 10.1002/gps.1857. View

Donaldson C, Tarrier N, Burns A . The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997; 170:62-8. DOI: 10.1192/bjp.170.1.62. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147(8):573-7. DOI: 10.7326/0003-4819-147-8-200710160-00010. View

Rabins P, Blacker D, Rovner B, Rummans T, Schneider L, Tariot P . American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. Am J Psychiatry. 2008; 164(12 Suppl):5-56. View

10.

Mintzer J, Tune L, Breder C, Swanink R, Marcus R, McQuade R . Aripiprazole for the treatment of psychoses in institutionalized patients with Alzheimer dementia: a multicenter, randomized, double-blind, placebo-controlled assessment of three fixed doses. Am J Geriatr Psychiatry. 2007; 15(11):918-31. DOI: 10.1097/JGP.0b013e3181557b47. View

11.

Sultzer D, Davis S, Tariot P, Dagerman K, Lebowitz B, Lyketsos C . Clinical symptom responses to atypical antipsychotic medications in Alzheimer's disease: phase 1 outcomes from the CATIE-AD effectiveness trial. Am J Psychiatry. 2008; 165(7):844-54. PMC: 2714365. DOI: 10.1176/appi.ajp.2008.07111779. View

12.

Zubenko G, Moossy J, Martinez A, Rao G, Claassen D, Rosen J . Neuropathologic and neurochemical correlates of psychosis in primary dementia. Arch Neurol. 1991; 48(6):619-24. DOI: 10.1001/archneur.1991.00530180075020. View

13.

Wooltorton E . Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials. CMAJ. 2002; 167(11):1269-70. PMC: 134141. View

14.

Devanand D, Marder K, Michaels K, Sackeim H, Bell K, Sullivan M . A randomized, placebo-controlled dose-comparison trial of haloperidol for psychosis and disruptive behaviors in Alzheimer's disease. Am J Psychiatry. 1998; 155(11):1512-20. DOI: 10.1176/ajp.155.11.1512. View

15.

Brodaty H, Draper B, Saab D, Low L, Richards V, Paton H . Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. Int J Geriatr Psychiatry. 2001; 16(5):504-12. DOI: 10.1002/gps.382. View

16.

De Deyn P, Carrasco M, Deberdt W, Jeandel C, Hay D, Feldman P . Olanzapine versus placebo in the treatment of psychosis with or without associated behavioral disturbances in patients with Alzheimer's disease. Int J Geriatr Psychiatry. 2004; 19(2):115-26. DOI: 10.1002/gps.1032. View

17.

Street J, Clark W, Gannon K, Cummings J, Bymaster F, Tamura R . Olanzapine treatment of psychotic and behavioral symptoms in patients with Alzheimer disease in nursing care facilities: a double-blind, randomized, placebo-controlled trial. The HGEU Study Group. Arch Gen Psychiatry. 2000; 57(10):968-76. DOI: 10.1001/archpsyc.57.10.968. View

18.

Sink K, Holden K, Yaffe K . Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA. 2005; 293(5):596-608. DOI: 10.1001/jama.293.5.596. View

19.

Petrovic M, Hurt C, Collins D, Burns A, Camus V, Liperoti R . Clustering of behavioural and psychological symptoms in dementia (BPSD): a European Alzheimer's disease consortium (EADC) study. Acta Clin Belg. 2008; 62(6):426-32. DOI: 10.1179/acb.2007.062. View

20.

Tractenberg R, Weiner M, Patterson M, Teri L, Thal L . Comorbidity of psychopathological domains in community-dwelling persons with Alzheimer's disease. J Geriatr Psychiatry Neurol. 2003; 16(2):94-9. PMC: 4418652. DOI: 10.1177/0891988703016002006. View