Background: Several reports have indicated that the Behavioral and Psychological Symptoms of Dementia (BPSD) are associated with increased burden of care, carer depression and increased rates of institutionalization of patients. The present study aims to review the association between these variables in cross-sectional as well as longitudinal studies.

BackgroundEvaluation of telepsychiatry (via videoconference) for older adults is mostly focussed on nursing homes or inpatients. We evaluated the role of a community based program for older adults in rural and remote regions of South Australia.MethodThe utilization pattern was studied using retrospective chart review of telepsychiatry assessments over 24 months (2010–2011). Satisfaction was evaluated through prospective post-consultation feedback (using a 5-point Likert scale), from patients, community based clinicians and psychiatrist participating in consecutive assessments from April–November 2012. Descriptive analysis was used for the utilization. Mean scores and proportions were calculated for the feedback. Mann Whitney U test was used to compare patient subgroups based on age, gender, prior exposure to telepsychiatry services and inpatient/ outpatient status. Feedback comments were analysed for emerging themes.ResultsOn retrospective review of 134 consults, mean age was 75.89 years (SD 7.55), 60.4% (81) were females, and 71.6% (96) lived independently. Patients had a broad range of psychiatric disorders, from mood disorders to delirium and dementia, with co-morbid medical illness in 83.5% (112). On feedback evaluation (N = 98), mean scores ranged from 3.88–4.41 for patients, 4.36–4.73 for clinicians and 3.67–4.45 for psychiatrists. Feedback from inpatients (14 out of 37) was significantly lower compared to outpatients (37 out of 61) (chi sq. = 0.808, p < 0.05), and they were significantly less satisfied with the wait time (U = 163.0, p < 0.05) and visual clarity (U = 160.5, p < 0.05). Audio clarity was the most common aspect of dissatisfaction (mean score less than 3) among patients (6, 11%). Psychiatrists reported a preference for telepsychiatry over face to face in 55.4% (46) assessments. However, they expressed discomfort in situations of cognitive or sensory disabilities in patients.ConclusionsIn rural and remote areas, community-based telepsychiatry program can be a useful adjunct for psychiatrist input in the care of older adults. Innovations to overcome sensory deficits and collaboration with community services should be explored to improve its acceptance among the most vulnerable population.

MMPI scores of 57 native and 218 non-native Canadian Prairie psychiatric offenders were compared. In uncontrolled comparisons, considerable cross-cultural profile similarity was observed. Nevertheless, natives displayed significantly higher scores on L, F, and Hs (p < .05), and tended towards significance on Sc (p < .08). Natives scored significantly lower on Mf. Next, separate native and non-native multiple regressions were performed, using the 13 MMPI scales as criterion variables with age, time served, education level, WAIS full scale IQ, and Verbal Comprehension as the predictors. Average /P's of .26 (ns) and .17 (p < .001) were observed for natives and non-natives, respectively. WAIS full scale IQ and education level were the strongest predictors of native and non-native MMPIs, respectively. When controlled MMPI comparisons were made using IQ and education as covariates, the previous differences were erased. Profile similarity was still evident. With covariates, significantly lower native scores were found on Mf, Pa, and Si, while K was significantly higher. The lowered native profile was due primarily to the IQ covariate. It was concluded that the MMPI was valid for use with native offenders where consideration is given to the secondary effects of IQ and the limited influence of culture.The Minnesota Multiphasic Personality Inventory (MMPI) is the most widely used psychological assessment tool in correctional jurisdictions (Gendreau, 1975;Gearing, 1979; National Institute of Corrections, 1985). Concerning the measure's validity, Gearing (1979) reviewed 71 studies of MMPI applications in forensics and concluded that the test provides a reasonable classification of psychopathology among offenders. Frequently, the MMPI is used with other information in selecting an inmate's prison placement, in making a treatment plan, in coming to a parole decision (Elion & Megargee, 1975), and in screening incomingThe views expressed herein are the sole responsibility of the authors and do not necessarily reflect the position of the Solicitor General of Canada or Correctional Service of Canada. The data were collected while the second author was at the Regional Psychiatric Centre (Prairies). Thanks to Tracy Pytlowany, Eric Smith, and Ingrid Draper for assisting with the data collection and to Rod Luciuk for computerizing records. Requests for reprints should be addressed to the second author at Rideau

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