These results provide support for the clinical use of the NPI-NH as a screen for neuropsychiatric symptoms in an elderly neuropsychiatric population. However, additional research is encouraged to further evaluate the clinical utility of the NPI-NH in nursing home and inpatient geriatric settings.
Widespread negative attitudes toward electroconvulsive therapy (ECT) are present in the general public and among heath care professionals. However, there is evidence to suggest that clinical experience and knowledge of ECT positively improve attitudes toward this treatment. The purpose of this study was to evaluate the effects of an ECT education training program on attitudes toward ECT. Participants were 73 student nurses (91.8% women) and 21 care aid students (81.0% women) undertaking a 6-week rotation in psychiatry at a large provincial psychiatric hospital in British Columbia, Canada. The ECT education training program consisted of a brief lecture, viewing of an educational videotape, familiarization with the ECT equipment, and observation of an ECT treatment. Participants completed a short questionnaire pretraining and posttraining program. Attitudes toward ECT did not substantially differ between the 2 groups. For the entire sample, only 8.5% reported that they were well informed about ECT before the training session. More favorable attitudes were reported upon completion of the ECT education program compared with attitudes reported before training. These findings suggest that attitudes toward ECT increase favorably when individuals are provided with training and experience.
We describe here a case of olanzapine associated weight gain, hyperglycemia and neuroleptic malignant syndrome in a 64 year-old woman with a significant medical history. Eighteen weeks after initiating olanzapine, Mrs X lost glycemic control, exhibited signs and symptoms consistent with neuroleptic malignant syndrome and gained 8.9 kg. We suggest that utilization of olanzapine in the less medically stable geriatric patient be implemented with vigilant monitoring for such complications mentioned above.
There are no cases in the literature describing the use of electroconvulsive therapy (ECT) in a patient with an intraorbital vascular mass. We report the clinical course of a 69-year-old female with a cavernous hemangioma of the left orbit who was successfully treated with ECT for major depressive disorder. There were no apparent effects on the orbital hemangioma as a result of ECT-related blood pressure elevations measured up to 195/90 mm Hg despite pretreatment with intravenous esmolol. Modulation of ECT-related cardiovascular changes in the presence of intracranial or intraorbital vascular masses remains advisable to reduce the risk of an adverse vascular event during ECT. The use of propofol anesthesia appears to be preferable in such cases.
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