Behavioral and psychological symptoms of dementia (BPSD) are frequently observed in Alzheimer's disease (AD) and affect more than 80% of patients over the course of AD. The goal of this study was to establish a model for grouping the symptoms of BPSD into clinical syndromes. Over a 24-month period, an observational study was conducted using a population of ambulatory patients with AD of mild to moderate severity. The Neuropsychiatric Inventory (NPI) was administered to the patients' caregivers every 6 months. BPSD were grouped using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the NPI scores of each assessment. The sample population consisted of 491 patients (70.9% women) with an average age of 75.2 years (SD=6.6). The five EFA suggested that there was a stable three-factor structure. According to the results of the EFA, three models of symptom grouping were adjusted using CFA methodology. The CFA model that satisfactorily grouped the NPI scores into three factors included a psychotic syndrome (hallucinations, delusions), an affective syndrome (depression, anxiety, irritability, agitation) and a behavior syndrome (euphoria, disinhibition, apathy, aberrant motor behavior). Based on our findings, we propose a model for grouping the BDSD in which there are core nuclear syndromes (psychotic and affective) as well as an unspecified behavior syndrome comprising satellite symptoms that may be related to the presence of the nuclear syndromes.

Joint hypermobility syndrome (JHS), also known as Ehlers-Danlos III, is an inherited disorder of connective tissue, characterised by an exceptional increase in the joint's mobility and the presence of musculoskeletal and other symptoms. It is a benign syndrome if compared with the other types of Ehlers-Danlos, but it can become disabling particularly because it is a significant source of pain and distress. The purpose of this work is to describe some common problems in JHS that render psychological intervention in their overall management relevant. Chronic pain, associated psychopathological factors such as anxiety, depression and somatosensory amplification, and problems arising from a lack of recognition and knowledge of the syndrome, are frequent among those affected, having a negative impact on their quality of life. We emphasise the relevance of addressing JHS from a biopsychosocial approach.

Behavioral and psychological symptoms of dementia (BPSD) are characterized by fluctuations in their frequency and severity as well as by differences in the concurrent presentation of different symptoms. The goal of the current study was to identify groups of patients with Alzheimer's disease (AD) that had similar trajectories in the expression of BPSD. Over a 24-month period, an observational study was conducted using a population of ambulatory patients with AD of mild or moderate severity. The Neuropsychiatric Inventory (NPI) was administered every 6 months to the patient's caregiver. To classify patients according to changes in the frequency and severity of BPSD, growth mixture models were fitted to the applied to the grouping of NPI subscales in the following three categories: psychotic syndrome (hallucinations and delusions), affective syndrome (depression, anxiety, irritability, and agitation), and behavioral syndrome (disinhibition, euphoria, apathy, and aberrant motor behavior). The sample population consisted of 491 patients (70.9% women) that had an average age of 75.2 years (SD=6.6). Different trajectory patterns were identified based on differences in changes over the time in the frequency (stable, increasing, decreasing, or fluctuating in course) and severity (low, moderate, or elevated severity) for psychotic syndrome, emotional syndrome, and behavior syndrome. Patients with AD display a high degree of variability in the evolutionary course of BPSD. It is possible to identify groups of patients with similar evolutionary trajectories in terms of changes in the frequency and severity of BPSD.

JHS is a frequent condition among young people evaluated. JHS is associated with psychological distress and higher levels of somatosensory amplification.

Neurobehavioral disorders are common consequences of traumatic brain injury (TBI) that should be objectively assessed in this population.The use of scales allows us to unify terms both in clinical practice and investigative work; it also constitutes a useful guide in clinical interviews and makes it possible to see outcome changes in patients with or without intervention. The aim of this study is to review the most frequently neurobehavioral scales used to measure the non-cognitive disorders of conduct in TBI patients. METHOD: A systematic and descriptive literature review was done in Medline, without time limit, which focused on scales applied to behavioral disorders in moderate and severe TBI patients. RESULTS: Ninety articles were selected for the final review and thirty-seven different scales were identified. Seven of these instruments represent sixty-five percent of all behavioral scales applied in the studies collected and were selected for the present review.There are scales that are more general and include a wide range of neurobehavioral symptoms, like the Neurobehavioral Rating Scale and the Neuropsychiatric Inventory. On the opposite, there are questionnaires that focus on specific symptoms like aggressiveness, agitation and apathy such as the Agitated Behavior Scale or the Apathy Evaluation Scale.The forms for caregiver or staff were the most prevalent in our review. The most representative behavioral scales applied to moderate and severe TBI patients were analyzed using clinical useful, covered domains, item descriptions, administration procedures and psychometric properties.