Friday, 4 April 2003

This presentation is part of : Plenary Session 5

The Hidden Face of Dementia: Behavioral and Psychological Symptoms (Annual Raymond Levy Lecture)

Alistair Burns, University of Manchester, Manchester, United Kingdom

Of all the symptoms of dementia, psychiatric symptoms and behavioral disturbances are probably the most important in terms of the stress they cause to carers and distress to patients. There have been a number of different ways of describing and categorizing these features of dementia, which have implications in terms of diagnosis, aetiology, and management.

While the field has advanced in a number of significant ways since the features were first described, a number of key questions remain regarding their significance and relationship to dementia:

· Are our current classification systems adequate? What is special about the phenomenology of dementia which differentiates it from that of parallel functional psychiatric disorders such as depression or schizophrenia?

· Are our assessment scales adequate? There are some instruments which have been specifically designed to assess symptoms occurring in dementia, but others are borrowed from elsewhere.

· Is management of these symptoms optimal? Effective pharmacological and non-pharmacological treatments are available and have been shown to be effective in a number of clinical trials, but they have yet to be widely embraced in primary care.

· Are the presence of these symptoms diagnostic (either in terms of different types of dementia or differentiating between dementia and mild cognitive impairment)?

This presentation will review some of the evidence to date in these areas and suggest avenues for future research and clinical practice.

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