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Persecutory delusions in dementia.

J P Hwang1, S J Tsai, C H Yang

  • 1Department of Psychiatry, Veterans General Hospital-Taipei, Taiwan, Republic of China.

The Journal of Clinical Psychiatry
|September 15, 1999
PubMed
Summary
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Persecutory delusions affect nearly 27% of dementia patients, often involving caregivers and leading to aggressive behaviors. Careful assessment for violence and suicide risk is crucial for managing these challenging symptoms in dementia care.

Area of Science:

  • Geriatric Psychiatry
  • Neuroscience
  • Clinical Psychology

Background:

  • Persecutory delusions are a frequent symptom observed in patients with dementia.
  • Understanding their prevalence and associated factors is critical for effective patient management.

Purpose of the Study:

  • To determine the prevalence of persecutory delusions in dementia patients.
  • To identify factors associated with these delusions.
  • To characterize the nature and patient responses to persecutory delusions.

Main Methods:

  • A cohort of 167 patients diagnosed with dementia (using DSM-III-R criteria) was studied.
  • Assessment included the presence of persecutory delusions, their content, patient responses, and co-occurring psychiatric symptoms.

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Main Results:

  • Persecutory delusions were identified in 45 (26.9%) of the 167 patients.
  • Patients with these delusions showed higher rates of other delusions, hallucinations, and physical aggression.
  • Common themes involved caregivers as persecutors, with varied patient responses, including aggression towards medical staff post-hospitalization.

Conclusions:

  • Persecutory delusions are common across various dementia types and can manifest with significant behavioral issues.
  • Vigorous responses, including aggression and suicidal ideation, necessitate careful evaluation for patient safety.
  • Healthcare providers require awareness of clinical strategies for managing violent or uncooperative patients with dementia and delusions.