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The Association of Behavioral and Psychological Symptoms of Patients with Dementia and Comorbid Depression

Si-Sheng Huang, Yi-Cheng Liao

Objective: The objective of this study was to study behavioral and psychological symptoms of dementia (BPSD) associated with depressive symptoms in patients with dementia. Methods: We did a cross-sectional survey involving 276 patients with dementia from July 2001 to October 2008. Depression was assessed with the depression domain of the Neuropsychiatric Inventory (NPI). We compared differences in the prevalence of individual BPSDs between patients with dementia and depression and those with dementia alone. Results: The NPI total score was signifi cantly higher in the patients with at least one depressive symptom (p < 0.001). Considering each NPI domain separately, we found that delusion (p < 0.001), hallucination (p < 0.01), agitation (p = 0.001), anxiety (p < 0.001), irritability (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p < 0.05) signifi cantly occurred more frequently in patients with dementia and depression. Grouped by severity, those with mild dementia with depressive symptoms (CDR = 0.5 or 1) signifi cantly occurred more frequently with delusion (p < 0.001), hallucination (p < 0.05), agitation (p < 0.01), anxiety (p < 0.01), irritability/ lability (p < 0.001), and nighttime behavior disturbances (p < 0.001) than the group without depression. In the group with moderate-to-severe dementia with depression (CDR = 2, 3, or 4), only delusion (p < 0.05) and irritability/lability (p < 0.01) were signifi cantly occurred more frequently than that in those patients without depression. Conclusion: Certain BPSDs occur more frequently in patients with both dementia and depressive symptoms. Depression and other associated BPSDs may manifest simultaneously in the early stage of dementia. For preventing early institutionalization and disease progression, early recognition and treatment of those symptoms are important.
Key Word behavioral and psychological symptoms of dementia, depression, dementia, Neuropsychiatric Inventory
Editorial Committe, Taiwanese Journal of Psychiatry
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