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The effect of errorless learning on psychotic and affective symptoms, as well as aggression and apathy in patients with Korsakoff's syndrome in long-term care facilities

Published online by Cambridge University Press:  20 June 2018

Yvonne C. M. Rensen ,
Jos I. M. Egger ,
Josette Westhoff ,
Serge J. W. Walvoort  and
Roy P.C. Kessels
Yvonne C. M. Rensen*
Affiliation:
Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
Jos I. M. Egger
Affiliation:
Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
Josette Westhoff
Affiliation:
Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
Serge J. W. Walvoort
Affiliation:
Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
Roy P.C. Kessels
Affiliation:
Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
*
Correspondence should be addressed to: Y. C. M. Rensen, PhD, Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and alcohol related cognitive disorders, PO Box 5 5800 AA, Venray, the Netherlands. Email: yrensen@vvgi.nl.
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Abstract

Objectives:

Errorless learning is a promising rehabilitation principle for learning tasks in patients with amnesia, including patients with Korsakoff's syndrome. Errorless learning might possibly also contribute to decreases in behavioral and psychiatric problems, as patients in long-term care facilities become more independent after training. The aim of this study was to examine the effects of errorless learning on potential changes in psychotic and affective symptoms, aggression and apathy, in contrast with a control group who received care as usual.

Methods:

The current study is a quasi-experimental study on errorless learning and psychotic and affective symptoms, aggression, and apathy in patients with Korsakoff's syndrome, living in long-term care facilities for patients with Korsakoff's syndrome (KS) in the Netherlands. The GIP-28, HoNOS−ABI, and NVCL−20 were administered to a group of patients with KS who received errorless learning training (n = 51) and a patient control group who received care as usual (n = 31). Wilcoxon Signed-Rank Tests were performed to examine psychotic and affective symptoms, aggression, and apathy at baseline and at follow-up in the errorless learning group and the control group.

Results:

Errorless learning training effectively reduced psychotic symptoms (including provoked confabulations), affective symptoms, and agitation/aggression. There were no significant changes (increases nor decreases) in the control group. Levels of apathy were stable over time in both groups.

Conclusions:

Results with respect to psychotic and affective symptoms, aggression, and apathy are discussed in depth. Patients with KS can become more autonomous in a cared for setting using errorless learning principles. This might also result in decreases in behavioral and psychiatric problems in patients.

Keywords

Korsakoff's syndromeerrorless learningaffectdepressionapathypsychoticaggression
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 1: Issue Theme: Parkinson's Disease , January 2019 , pp. 39 - 47
Copyright
Copyright © International Psychogeriatric Association 2018 

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association.Google Scholar
Arts, N. J. M., Walvoort, S. J. W. and Kessels, R. P. C. (2017). Korsakoff's syndrome: a critical review. Neuropsychiatric Disease and Treatment, 13, 2875–2890. doi:10.2147/NDT.S130078.Google Scholar
Blansjaar, B. A., Takens, H. and Zwinderman, A. H. (1992). The course of alcohol amnestic disorder: a three-year follow-up study of clinical signs and social disabilities. Acta Psychiatrica Scandinavica, 86, 240–246. doi:10.1111/j.1600-0447.1992.tb03260.x.Google Scholar
Brodaty, H. and Burns, K. (2012). Nonpharmacological management of apathy in dementia: a systematic review. American Journal of Geriatric Psychiatry, 20, 549–564. doi:10.1097/JGP.0b013e31822be242.Google Scholar
Clare, L., Wilson, B. A., Carter, G., Roth, I. and Hodges, J. R. (2002). Relearning face–name associations in early Alzheimer's disease. Neuropsychology, 16, 538–547. doi:10.1037//0894-4105.16.4.538.Google Scholar
Cohen-Mansfield, J. (1991). Instruction Manual for the Cohen-Mansfield Agitation Inventory (CMAI). Rockville: The Research Institute for the Hebrew Home of Greater Washington.Google Scholar
Cohen-Mansfield, J., Marx, M. S. and Rosenthal, A. S. (1989). A description of agitation in a nursing home. Journals of Gerontology, 44, M77–M84. doi:10.1093/geronj/44.3.m77.Google Scholar
Cooper, J. M., Shanks, M. F. and Venneri, A. (2006). Provoked confabulations in Alzheimer's disease. Neuropsychologia, 44, 1697–1707. doi:10.1016/j.neuropsychologia.2006.03.029.Google Scholar
Egger, J. I. M., Wester, A. J., De Mey, H. R. A. and Derksen, J. J. L. (2002). Korsakoff's syndrome on the MMPI-2. Acta Neuropsychiatrica, 14, 231–236. doi:10.1034/j.1601-5215.2002.140506.x.Google Scholar
Eisses, A. M. H. and Kluiter, H. (2002). De Gedragsobservatieschaal voor de Intramurale Psychogeriatrie (GIP-28) in het verzorgingshuis: een psychometrische evaluatie. [The Behavioral Rating Scale for Psychogeriatric Inpatients (GIP-28) in nursing homes: a psychometric evaluation]. Tijdschrift voor Gerontologie en Geriatrie, 33, 112–118.Google Scholar
Field, A. P. (2009). Discovering Statistics Using SPSS. London, UK: Sage.Google Scholar
Fleminger, S. (2005). Honos-ABI: a reliable outcome measure of neuropsychiatric sequelae to brain injury? Psychiatric Bulletin, 29, 53–55. doi:10.1192/pb.29.2.53.Google Scholar
Gerridzen, I. J. and Goossensen, M. A. (2014). Patients with Korsakoff syndrome in nursing homes: characteristics, comorbidity, and use of psychotropic drugs. International Psychogeriatrics, 26, 115–121. doi:10.1017/S1041610213001543.Google Scholar
Gerridzen, I. J. et al. (2017). Prevalence and severity of behavioural symptoms in patients with Korsakoff syndrome and other alcohol-related cognitive disorders: a systematic review. International Journal of Geriatric Psychiatry, 32, 256–273. doi:10.1002/gps.4636.Google Scholar
Haslam, C. and Kessels, R. P. C. (eds.) (2018). Errorless Learning in Neuropsychological Rehabilitation: Mechanisms, Efficacy and Application. London, UK: Routledge.Google Scholar
Jonghe de, J. F., Ooms, M. E. and Ribbe, M. W. (1997). Verkorte gedragsobservatieschaal voor intramurale psychogeriatrie (GIP-28) [short version of the dutch behavioral rating scale for psychogeriatric inpatients (GIP-28)]. Tijdschrift voor Gerontologie en Geriatrie, 28, 119–123.Google Scholar
Komatsu, S.-I., Mimura, M., Kato, M., Wakamatsu, N. and Kashima, H. (2000). Errorless and effortful processes involved in the learning of face-name associations by patients with alcoholic Korsakoff's syndrome. Neuropsychological Rehabilitation, 10, 113–132. doi:10.1080/096020100389200.Google Scholar
Kopelman, M. D., Thomson, A. D., Guerrini, I. and Marshall, E. J. (2009). The korsakoff syndrome: clinical aspects, psychology and treatment. Alcohol and Alcoholism, 44, 148–154. doi:10.1093/alcalc/agn118.Google Scholar
Lee, G. Y., Yip, C. C. K., Yu, E. C. S. and Man, D. W. K. (2013). Evaluation of a computer-assisted errorless learning-based memory training program for patients with early Alzheimer's disease in Hong Kong: a pilot study. Clinical Interventions in Aging, 8, 623–633. doi:10.2147/cia.s45726.Google Scholar
Nijman, H. L. I. et al. (1999). The staff observation aggression scale-revisited (SOAS-R). Aggressive Behavior, 25, 197–209. doi:10.1002/(sici)1098-2337(1999)25:3<197::aid-ab4>3.3.co;2-3.3.3.co;2-3.>Google Scholar
Oudman, E. and Wijnia, J. W. (2014). Evolution of quality of life in patients with Korsakoff's syndrome in a long-term care facility. International Psychogeriatrics, 26, 2073–2079. doi:10.1017/s1041610214001719.Google Scholar
Oudman, E. et al. (2013). Acquisition of an instrumental activity of daily living in patients with Korsakoff's syndrome: a comparison of trial and error and errorless learning. Neuropsychological Rehababilitation, 23, 888–913. doi:10.1080/09602011.2013.835738.Google Scholar
Oudman, E. and Zwart, E. (2012). Quality of life of patients with Korsakoff's syndrome and patients with dementia: a cross-sectional study. Journal of the American Medical Directors Asscoiation, 13, 778–781. doi:10.1016/j.jamda.2012.08.003.Google Scholar
Rensen, Y. C. M., Egger, J. I. M., Westhoff, J., Walvoort, S. J. W. and Kessels, R. P. C. (2017a). Errorless (re)learning of everyday activities in patients with Korsakoff's syndrome: a feasibility study. Neuropsychological Rehabilitation, 13, 2867–2873. doi:10.1080/09602011.Google Scholar
Rensen, Y. C. M., Egger, J. I. M., Westhoff, J., Walvoort, S. J. W. and Kessels, R. P. C. (2017b). The effect of errorless learning on quality of life in patients with Korsakoff's syndrome. Neuropsychiatric Disease and Treatment, 13, 2867–2873. doi:10.1080/09602011.2017.1379419.Google Scholar
Rensen, Y. C. M., Kessels, R. P. C., Migo, E. M., Wester, A. J., Eling, P. A. T. M. and Kopelman, M. D. (2016). Personal semantic and episodic autobiographical memories in Korsakoff syndrome: a comparison of interview methods. Journal of Clinical and Experimental Neuropsychology, 1–13, doi:10.1080/13803395.2016.1248811.Google Scholar
Rensen, Y. C. M. et al. (2015). Assessment of confabulation in patients with alcohol-related cognitive disorders: the Nijmegen–Venray Confabulation List (NVCL-20). The Clinical Neuropsychologist, 29, 804–823. doi:10.1080/13854046.2015.1084377.Google Scholar
Rosenthal, R. (1991). Meta-Analytic Procedures for Social Research (Revised). Newbury Park, CA: Sage.Google Scholar
Small, G. W. et al. (1997). Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American association for geriatric psychiatry, the Alzheimer's association, and the American geriatric society. The Journal of the American Medical Association, 278, 1363–1371.Google Scholar
Theleritis, C., Siarkos, K., Katirtzoglou, E. and Politis, A. (2017). Pharmacological and nonpharmacological treatment for apathy in Alzheimer disease: a systematic review across modalities. The Journal of Geriatric Psychiatry, 30, 26–49. doi:10.1177/0891988716678684.Google Scholar
Thomson, A. D., Guerrini, I. and Marshall, E. J. (2012). The evolution and treatment of Korsakoff's syndrome. Neuropsychology Review, 22, 81–92. doi:10.1007/s11065-012-9196-z.Google Scholar
Van Oort, R. and Kessels, R. P. C. (2009). Executive dysfunction in Korsakoff's syndrome: time to revise the DSM criteria for alcohol-induced persisting amnestic disorder?. International Journal of Psychiatry in Clinical Practice, 13, 78–81. doi:10.1080/13651500802308290.Google Scholar
Verhage, F. (1964). Intelligentie En Leeftijd [Intelligence and Age]. Assen, the Netherlands: Van Gorkum.Google Scholar
Walvoort, S. J. W., Van der Heijden, P., Kessels, R. P. C. and Egger, J. I. M. (2016a). Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study. Neuropsychiatric Disease and Treatment, 12, 1609–1615. doi:10.2147/ndt.s104442.Google Scholar
Walvoort, S. J. W., Wester, A. J., Doorakkers, M. C., Kessels, R. P. C. and Egger, J. I. M. (2016b). Alcohol gerelateerde cognitieve stoornissen in de DSM-5. [Alcohol related cognitive disorders in the DSM-5]. Tijdschrift voor Psychiatrie, 58, 397–401.Google Scholar
Wijnia, J. W., van de Wetering, B. J., Zwart, E., Nieuwenhuis, K. G. and Goossensen, M. A. (2012). Evolution of Wernicke-Korsakoff syndrome in self-neglecting alcoholics: preliminary results of relation with Wernicke-delirium and diabetes mellitus. American Journal on Addictions, 21, 104–110. doi:10.1111/j.1521-0391.2011.00199.x.Google Scholar
Wilson, K. et al. (2012). The psycho-social rehabilitation of patients with alcohol-related brain damage in the community. Alcohol and Alcoholism, 47, 304–311. doi:10.1093/alcalc/agr167.Google Scholar
Zigmund, A. S. and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. doi:10.1111/j.1600-0447.1983.tb09716.x.Google Scholar