Vocally disruptive behavior (VDB) in the institutionalized elderly: a naturalistic multiple case report

Area of Science:

• Geriatric Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Investigating current clinical practices for Vascular Dementia (VDB) treatment in specialized old age psychiatric clinics and nursing homes.
• Focusing on a convenience sample of 85 patients in French and German-speaking Switzerland.
• Aiming to characterize VDB patients and identify common treatment approaches.

Observation:

• Most VDB patients in the study had co-occurring dementia.
• 75% had current or premorbid psychiatric disorders; 25% had premorbid personality disorders.
• Multiple psychosocial interventions were frequently employed and deemed effective by carers.

Findings:

• Psychosocial interventions for VDB are underutilized despite perceived effectiveness.
• Many VDB patients did not receive targeted psychotropic medication, though ~70% of prescribed medications showed positive effects.
• Premorbid psychiatric and personality disorders are significant factors in VDB's etiopathogenesis.

Implications:

• Highlights the underuse of potentially effective psychosocial interventions in VDB care.
• Suggests a need to integrate the management of premorbid psychiatric and personality disorders into VDB treatment strategies.
• Calls for a revised framework for VDB treatment considering underlying psychiatric conditions.