IntroductionInsomnia is the most frequent sleep disorder in late life. Forty-two percent of elderly people in the United States often complain about difficulties to get or maintain sleep, or awakening too early. Insomnia is frequent in old people greatly due to frequency of concomitant medical illnesses and polypharmacy, rather than because of age.ObjectivesThe objective of our research was to revise the current state of knowledge about management of insomnia in people above 65 years of age.MethodologyFor that, a bibliographical search through PubMed.gov has been made. From the obtained results, the 14 which best suited for our goals were selected, 10 of them dealing with people above 65 years and the rest with people above 75 or 80 years of age.ResultsBased on the literature reviewed, the current options of management of late-life insomnia are based on behavioral or pharmacological therapy. The combination of behavioral therapies shows results and is currently considered as an option, especially given the possibility of medicine interaction and the secondary effects hypnotic and sedative medicines might produce. There is a paucity of long-term safety and efficacy data for the use of non-benzodiazepine sedative-hypnotics. There are no criteria for the use of antidepressant sedatives in elderly people without diagnosed depression, although they are still used in practice.ConclusionPossibility of using behavioral therapy as first option. In case of polymedicated or multi-pathological patients, pay special attention when starting a pharmacological treatment, choose the most suitable one and supervise it closely.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The lack of adherence in antipsychotic treatment is related to the increased number of relapses and, therefore, with a higher incidence of hospitalization and visits to the emergency department; as well as an increase in the family burden and the use of assistance resources. The introduction of a second generation antipsychotic in a long acting formulation would allow better control for psychotic patients and thus a reduction in the need for extra care Objective: To assess the effectiveness of long lasting risperidone (LLR) in the drug compliance and its impact on health assistance resources. Method: A retrospective revision was carried out with patients admitted to the acute unit of our hospital between 1st September 2004 and 31st August 2005, with one of the following diagnosis: schizophrenia, schizoaffective disorder, bipolar disorder and delusional disorder; Choosing from those under treatment with LLR, we obtained a sample of 44 patients. Clinical and demographical relevant variables were taken into consideration. The study has a ''mirror image'' design where we compared data before and after the introduction of LLR using Student t test for dependant samples. Results: We observed a statistically significant decrease in the incidence and length of hospitalization following treatment with LLR. An increase in the number of psychiatric casualties was observed, although it had no statistical significance and the data were subject to bias. Conclusions: LLR may increase the drug compliance and therefore reduce number and length of hospitalizations.
IntroductionCapgras syndrome is the most frequent delusional misidentification syndrome (DMS) which was first described in 1923 by Capgras and Reboul-Lachaux as ‘L’illusion des sosies’. Consists of believe that close relatives have been replaced by nearly identical impostors. It can occur in the context of psychiatric disorders (schizophrenia, major depression) such organic, in which onset of delirium is usually later coinciding with neurological damage or neurodegenerative disease.Case reportWoman 73-year-old diagnosed of schizophrenia since more than thirty years ago. Her family talk about general impairment of the patient in the last two years. She needed a couple of psychiatric hospitalizations because of her psychiatric disease, and probably onset of cognitive impairment. In this context, we objectified the presence of a Capgras syndrome.ObjectivesTo review the literature available about Capgras syndrome in elderly and illustrate it with a clinical case.MethodsReview of literature about Capgras syndrome in elderly by searching of articles in the PubMed database of the last five years to illustrate the exposure of a single case report.ResultsThe etiology of this syndrome is not yet well understood. Advanced age is frequently found Capgras syndrome with or without the concomitant presence of an obvious cognitive impairment.ConclusionsSince it is a complex process an etiological model that combines cognitive and perceptual deficits, organic impairment and psychodynamic factors should be proposed. And it is important to make a correct differential diagnosis that allows us to carry out the best possible treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The resources for deaf persons’ mental health and the studies in the field of the psychopharmacology are nowadays inadequate to meet the specific needs of this population. The indications or the way of using the medication do not differ between deaf and hearing persons, but it is not well-known among professionals that during the psychopharmacologic treatment of deaf patients it is possible to observe the presence of intense and unexpected side effects of the medication, so that it does turn out to be indispensable to give special attention to the prescription of psychoactive drugs in deaf persons. This ignorance is partly due to the fact that the research in this area is deficient. The above mentioned side effects are more prevailing and intense in deaf persons than in hearings and often interfere with basic aspects of a person's daily life as it is his system of communication, the language of signs that becomes affected, for example, due to alterations in the vision or the movement, which means in practice (at the same time) a decrease in the quality of life. Therefore, our aim is to emphasize that the indications for pharmacological treatment in deaf persons are the same than in hearings and at the same time to emphasize the importance of knowing the specific needs.
IntroductionDelusional of parasitosis or Ekbom's syndrome (ES) is a psychiatric disorder in which the patient has a fixed and false belief that small organisms infest the body. The belief is often accompanied by hallucinations. It is an uncommon condition that was initially studied by dermatologists, more prevalent in the elderly and typically observed in women older than 50 years although isolated cases among men have been reported.ObjectiveTo review current knowledge about delusional of parasitosis in elderly patients through literature systematic review and the analysis of a case report.MethodologyWe performed a literature search using electronic manuscripts available in PubMed database published during the last five years, following the description and discussion of a clinical case. We report a case of an 85-year-old man who presented a delusional parasitosis as a primary disorder.ResultsThe literature on ES consists mostly of case reports and limited series. In this paper, we analyze the etiology, demographic characteristics, clinical features and treatment in geriatric patients with delusional parasitosis.ConclusionInternational classifications have included this syndrome in non-schizophrenic delusions. However, it has also been reported in schizophrenia, affective disorders, and organic or induced psychosis. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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