The Capgras syndrome and other forms of delusional misidentification may be encountered frequently in neuropsychiatric settings. DMS can occur in the presence of idiopathic psychiatric illness, in diffuse brain illness such as dementia, and in focal neurologic disease. In patients who have focal lesions, there is evidence that right hemisphere damage is necessary for the production of DMS. Although DMS is associated with a pattern of neuropsychologic impairments in the domains of memory, perception, and executive function, these impairments alone do not account for the selectivity and delusional nature of DMS. Therefore, other factors such as premorbid psychopathology, motivation, and loss of ego functions may be important in determining which vulnerable patients develop DMS and which do not.
To clarify the relation between anosognosia for hemiplegia and confabulation, 11 patients with acute right cerebral infarctions and left upper limb hemiparesis were assessed for anosognosia for hemiplegia, illusory limb movements (ILMs), hemispatial neglect, asomatognosia, and cognitive impairment. Five of 11 patients had unequivocal confabulation as evidenced by ILMs. The presence of ILMs was associated with the degree of anosognosia (p=0.002), with hemispatial neglect (p<0.05), and with asomatognosia (p<0.01). The results confirm that a strong relation exists between anosognosia for hemiplegia and confabulations concerning the movement of the plegic limb. There is also a strong relation between ILMs and asomatognosia. (J Neurol Neurosurg Psychiatry 2000;68:511-513)
Residents' participation in research has been advanced through participation in PART. Ensuring research competency among all psychiatrists is crucial to providing the best science-based care; PART represents a cost-effective way to integrate research training with psychiatric residency. The authors also discuss opportunities and obstacles to developing research programs as part of psychiatric residency training.
Assessment is paramount in the process of selecting appropriate treatment media. This paper presents an overview of suitable assessment procedures that may be used with older people with dementia in order to formulate a multisensory environment therapy programme. Primarily, current literature is explored, in terms of both the assessment procedures used prior to using the multisensory environment and the research outcomes. Secondly, an overview is given of two successful assessment procedures used, which integrate applied behaviour analysis and developmental approaches. This will provide the therapist with an assessment framework to determine the sensory preferences of older people with dementia, who may benefit from the multisensory environment.
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