Awareness and its relationships with neuropsychiatric symptoms in people with Korsakoff syndrome or other alcohol‐related cognitive disorders living in specialized nursing homes

Abstract

Objectives Impaired awareness of functional deficits is often observed in people with Korsakoff syndrome (KS) and may result in refusal of care, although this area has been understudied. This study aimed to investigate levels of impaired awareness and their relationships with neuropsychiatric symptoms (NPS) in people with KS residing in specialized nursing homes. Methods A cross‐sectional, observational study was conducted among 215 residents with KS or other alcohol‐related cognitive disorders. Awareness was measured with the Patient Competency Rating Scale (PCRS). NPS and subsyndromes were measured with the Neuropsychiatric Inventory–Questionnaire (NPI‐Q). Adjusted multilevel regression analyses were performed to examine the relationships between the level of awareness and NPS. Results The mean level of impaired awareness was 39.3 (SD = 19.9) indicating moderate impairment. Twenty‐nine percent of the residents had no or mildly impaired awareness; 37% were moderately impaired, and 34% were severely impaired. Residents with moderately impaired awareness showed more severe apathy than residents with no or mildly impaired awareness (difference 1.23; 95% CI 1.02‐1.48; p = 0.03). No associations were found between the level of awareness and other NPI outcomes. Cognitive functioning seems to have the strongest impact on the association between level of awareness and NPS in KS residents. Conclusions Impaired awareness of functional deficits is highly common in KS residents; however, apart from apathy, is not significantly related with NPS. Additional research should further examine, which interventions are effective in dealing with impaired awareness in these people, particularly when apathy is present.

The relationship between executive dysfunction and neuropsychiatric symptoms in patients with Korsakoff’s syndrome

“…The NPI-Q is widely used and has acceptable psychometric properties (Kaufer et al, 2000;Tate, 2010). Although informant reports have a potential bias, for instance ratings being affected by the quality of the relationship to the patient, the informant's perspective is likely to be more valid than the ratings from the patients with KS, as they typically lack insight into their own disorder, thus providing a less valid estimate of their neuropsychiatric symptoms (Arts et al, 2017;Gerridzen et al, 2019;Walvoort et al, 2016).…”

“…Neuropsychiatric symptoms are associated with higher caregiver burden (Chen et al, 2017) and more frequent use of psychotropic drugs (Maust et al, 2017). In addition, patients with KS tend to overestimate their cognitive and functional capacities, typically having limited insight into their own disorder (Egger et al, 2002;Gerridzen et al, 2019), whilst also being institutionalized and dependent on daily care. This may explain the high prevalence of agitation/ aggression or disinhibition, as patients assume they do not need the provided care and may show frustration or aggression as a result.…”

Beriberi disease – a picture of thiamine deficiency in underdeveloped and highly developed countries

“…However, the symptoms are different from beriberi. It consists of two teams: Wernicke-Korsakoff syndrome is thought to have a classic triad of symptoms including ataxia, nystagmus and an altered mental state (confusion / dementia), but this can be seen only in about ⅓ of patients [7]. The aim of the study is to review the data on the history and etiology of beriberi as well as to compare the image and causes of the disease in poor and well-developed countries.…”

The Sociopsychological Profile of Persons with Alcohol Anosognosia in the Context of Social Customer Support

“…The sick with alcohol anosognosia because of mental problem, caused by strong alcohol dependence, cannot perceive their condition accurately. The psychological causes of the problem of anosognosia, more or less attention to its relation with dipsomania and its treatment, are considered in the works of modern scientists such as Vannini et al [14], Yakovlev et al [15], Steinmetz et al [16], Tarkhan et al [17], Walvoort et al [18], Skrypnikov et al [19], Sullivan and Pfefferbaum [20], Fama [21], and Gerridzen et al [22].…”

“…It is assumed that the patient, with regard to his/her education, upbringing, constantly flowing information about the consequences of alcohol abuse, as well as personal experience, should know that he/she has alcohol addiction. This circumstance is especially important since otherwise the insufficient knowledge or inadequate perceptions of this disease could be decisive in denying it [22]. Alcohol anosognosia can be considered as a psychological defense mechanism, as a blockade or distortion of experiences associated with the disease to eliminate the conflict between the "self-concept" and direct experience, as a result of a widespread positive attitude toward alcohol consumption with a negative attitude toward its consequences.…”