Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T13:03:00.529Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour

Published online by Cambridge University Press:  02 January 2018

Alastair Burns ,
Robin Jacoby  and
Raymond Levy
Raymond Levy
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Out of a sample of 178 patients with AD, aggression was present in 20%, wandering in 19%, binge-eating in 10%, hyperorality in 6%, urinary incontinence in 48%, and sexual disinhibition in 7%. Behavioural abnormalities were greater in those with more severe dementia. Temporal-lobe atrophy correlated with aggression, and widening of the third ventricle with hyperorality. Features of the Kluver–Bucy syndrome were commonly seen, but the full syndrome occurred in only one subject. Patients with at least one feature of the Kluver–Bucy syndrome had greater temporal-lobe atropy than those without any of the features.

Type
Papers
Information
The British Journal of Psychiatry , Volume 157 , Issue 1 , July 1990 , pp. 86 - 94
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abas, M., Sahakian, B. & Levy, R. (1990) Neuropsychological deficits and CT scan changes in elderly depressives. Psychological Medicine (in press).CrossRefGoogle Scholar
Adolfsson, R., Gottfries, C., Roos, B., et al (1979) Changes in the brain catecholamines in patients with dementia of Alzheimer type. British Journal of Psychiatry, 135, 216–223.CrossRefGoogle ScholarPubMed
Alzheimer, A. (1907) Über eine Eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift für Psychiatrie und Psychisch–Gerichtlich Median, 64, 146–148.Google Scholar
American Psychiatric Association (1967) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Berrios, G. & Brook, P. (1984) Visual hallucinations and sensory delusions in the elderly. British Journal of Psychiatry, 144, 662–664.CrossRefGoogle ScholarPubMed
Berrios, G. & Brook, P. (1985) Delusions and the psychopathology of the elderly with dementia. Acta Psychiatrica Scandinavica, 72, 296–301.CrossRefGoogle ScholarPubMed
Birkett, D. (1972) The psychiatric differentiation of senility and arteriosclerosis. British Journal of Psychiatry; 120, 321–325.CrossRefGoogle ScholarPubMed
Branchey, L., Branchey, M., Shaw, S., et al (1984) Depression, suicide and aggression in alcoholics and their relationship to plasma amino acids. Psychiatric Research, 12, 219–226.CrossRefGoogle ScholarPubMed
Bucht, G. & Adolfsson, R. (1983) The comprehensive psychopathological rating scale in patients with dementia of the Alzheimer type and multi-infarct dementia. Acta Psychiatric Scandinavica, 68, 263–270.Google Scholar
Burke, W., Rubin, E., Morris, J., et al (1988) Symptoms of ‘depression’ in dementia of the Alzheimer type. Alzheimer's Disease and Associated Disorders, 2, 4356–4362.Google Scholar
Burns, A. & Philpot, M. (1987) Capgras' syndrome in a patient with dementia. British Journal of Psychiatry, 150, 876–877.CrossRefGoogle Scholar
Burns, A., Carrick, J., Ames, D., et al (1989) The cerebral cortical appearance in late paraphrenia. International Journal of Geriatric Psychiatry, 4, 31–34.Google Scholar
Copeland, J., Kelleher, M., Kellett, J., et al (1976) The Geriatric Mental State Schedule: 1 Development and reliability. Psychological Medicine, 6, 439–449.CrossRefGoogle Scholar
Cummings, J. (1985) Organic delusions: phenomenology, anatomical correlations and review. British Journal of Psychiatry, 146, 184–197.CrossRefGoogle ScholarPubMed
Cummings, J. & Duchen, L. (1981) Kluver–Bucy syndrome in Pick disease: clinical and pathologic conditions. Neurology, 31, 1415–1422.CrossRefGoogle Scholar
Cummings, J. & Benson, D. (1983) Dementia: A Clinical Approach. Boston: Butterworths.Google Scholar
Cummings, J., Miller, B., Hill, M. A., et al (1987) Neuropsychiatric Aspects of multi-infarct dementia and dementia of the Alzheimer type. Archives of Neurology, 44, 389–393.Google Scholar
Cummings, J., Gosenfeld, L., Houlihan, J., et al (1983) Neuropsychiatric disturbances associated with idiopathic calcification of the basal ganglia. Biological Psychiatry, 18, 591–601.Google ScholarPubMed
Cutting, J. (1987) The phenomenology of acute organic psychosis: comparison with acute schizophrenia. British Journal of Psychiatry, 151, 324–332.CrossRefGoogle ScholarPubMed
Dewhurst, K., Oliver, J., Trick, K., et al (1969) Neuropsychiatric aspects of Huntington's disease. Confinia Neurologica, 31, 258–268.CrossRefGoogle ScholarPubMed
Dolan, R., Calloway, S., Thacker, P., et al (1986) Cerebral cortical appearance in depressed subjects. Psychological Medicine, 16, 775–779.CrossRefGoogle ScholarPubMed
Drevets, W. & Rubin, E. (1989) Psychotic symptoms in the longitudinal course of senile dementia of the Alzheimer type. Biological Psychiatry, 25, 39–48.Google Scholar
Fairburn, C. & Hope, R. (1988a) Changes in behaviour in dementia: a neglected research area. British Journal of Psychiatry, 152, 406–407.CrossRefGoogle ScholarPubMed
Fairburn, C. & Hope, R. (1988b) Changes in eating in dementia. Neurobiology of Ageing, 9, 28–29.Google Scholar
Fair weather, D. (1947) Psychiatric aspects of the post-encephalitic syndrome. Journal of Mental Science, 93, 201–254.CrossRefGoogle Scholar
Fish, F. (1985) Fish's Clinical Psychopathology (2nd edn) (ed. M. Hamilton). Bristol: Wright.Google Scholar
Folstein, M., Folstein, S. & McHugh, P. (1975) Mini-Mental State. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Frances, A. (1979) Familial basal ganglia calcification and schizophreniform psychosis. British Journal of Psychiatry, 135, 360–362.Google Scholar
Goodman, L. (1953) Alzheimer's disease: a clinical and pathologic analysis of 23 cases with a theory on pathogenesis. Journal of Nervous and Mental Disease, 117, 97–130.Google Scholar
Green, J., Clement, C. & De Groot, J. (1957) Rhinencephalic lesions and behaviour in cats. Journal of Comparative Neurology, 108, 505–536.Google Scholar
Gustafson, L. & Risberg, J. (1974) Regional cerebral blood flow related to psychiatric symptoms in dementia with onset in the pre-senile period. Acta Psychiatrica Scandinavica, 50, 516–538.CrossRefGoogle Scholar
Heath, R. & Mickle, W. (1960) Evaluation of seven years' experience with depth electrode studies in human patients. In Electrical studies of the Unanaesthetised Brain (eds E. Ramey & D. O'Docherty), pp. 214–247. New York: Hober.Google Scholar
Hendrickson, E., Levy, R. & Post, F. (1979) Averaged evoked responses in relation to cognitive and affective state of elderly psychiatric patients. British Journal of Psychiatry, 134, 494–501.CrossRefGoogle ScholarPubMed
Hitchcock, E. & Cairns, V. (1973) Amygdalotomy. Postgraduate Medical Journal, 49, 894–904.Google Scholar
Hope, R., Fairburn, C. & Goodwin, G. (1989) Increased eating in dementia. International Journal of Eating Disorders, 8, 111–115.Google Scholar
Hughes, C., Berg, L., Danziger, W., et al (1982) A new clinical skill for the staging of dementia. British Journal of Psychiatry, 140, 566–572 (updated by Berg, L. (1984)). British Journal of Psychiatry, 145, 339.Google Scholar
Jacoby, R. & Levy, R. (1980) Computed tomography in the elderly: 2. Senile dementia: diagnosis and functional impairment. British Journal of Psychiatry, 136, 256–269.CrossRefGoogle ScholarPubMed
Kay, D. W. K. (1962) Outcome and cause of death in mental disorders of old age: a long term follow up of functional and organic psychoses. Acta Psychiatrica Scandinavica, 38, 249–276.CrossRefGoogle Scholar
Kiloh, L. (1961) Pseudo-dementia. Acta Psychiatrica Scandinavica, 37, 336–351.Google Scholar
Kluver, H. & Bucy, P. (1937) “Psychic blindness” and other symptoms following bilateral temporal lobectomy in rhesus monkeys. American Journal of Physiology, 119, 352.Google Scholar
Knesevich, J., Martin, R., Berg, L., et al (1983) Preliminary report on affective symptoms in the early stages of senile dementia of the Alzheimer type. American Journal of Psychiatry, 140, 233–235.Google Scholar
Kral, V. (1983) The relationship between senile dementia (Alzheimer type) and depression. Canadian Journal of Psychiatry, 28, 304–306.CrossRefGoogle ScholarPubMed
Kumar, A., Koss, E., Metzler, D., et al (1988) Behavioural symptomatology in dementia of the Alzheimer type. Alzheimer's Disease and Associated Disorders, 2, 363–365.CrossRefGoogle ScholarPubMed
Lazarus, L., Newton, N., Cohler, B., et al (1987) Frequency in presentation of depressive symptoms in patients with primary degenerate dementia. American Journal of Psychiatry, 144, 41–45.Google Scholar
Lemoine, P., Flachaire, E., Beney, C., et al (1984) Study of the platelet serotonin concentrations in the whole population of a psychiatric unit. New Research Strategies in Biological Psychiatry (ed. Kamali). London: Libby.Google Scholar
Leuchter, A. & Spar, J. (1985) The late onset psychoses: clinical and diagnostic features. Journal of Nervous and Mental Disease, 173, 488–494.Google Scholar
Lishman, W. A. (1987) Organic Psychiatry (2nd edn). Oxford: Blackwell Scientific.Google Scholar
Martin, E., Wilson, R., Penn, R., et al (1987) Cortical biopsy results in Alzheimer's disease: correlation with cognitive deficits. Neurology, 37, 1201–1204.Google Scholar
Mayer-Gross, W., Slater, E. & Roth, M. (1960) Clinical Psychiatry. London: Cassell.Google Scholar
Mayeux, R., Stern, Y. & Sano, N. (1985) Psychosis in patients with dementia of the Alzheimer type. Annals of Neurology, 18, 144.Google Scholar
McDonald, C. (1969) Clinical heterogeneity in senile dementia. British Journal of Psychiatry, 115, 267–271.Google Scholar
McKhann, G., Drachman, D., Folstein, M., et al (1984) Clinical diagnosis of Alzheimer's disease: report on the NINCDS-ADRDA work group under the auspices of the Dept. of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.Google Scholar
Meer, B. & Baker, J. (1966) Stockton Geriatric Rating Scale. Journal of Gerontology, 21, 392–403.Google Scholar
Merriam, A., Aronson, N., Gaston, P., et al (1988) The psychiatric symptoms of Alzheimer's disease. Journal of the American Geriatric Society, 36, 7–12.Google Scholar
Morris, C., Hope, R. & Fairburn, C. (1989) Eating habits in dementia: a descriptive study. British Journal of Psychiatry, 154, 801–806.Google Scholar
Mover, K. (1971) The Physiology of Hostility. Chicago: Markham.Google Scholar
Murphy, M. (1979) Clinical correlations of CT scan – detected calcifications of the basal ganglia. Annals of Neurology, 6, 507–511.Google Scholar
Naguib, M. & Levy, R. (1982) Prediction of outcome in senile dementia – a computed tomography study. British Journal of Psychiatry, 140, 263–267.CrossRefGoogle ScholarPubMed
Pearlson, G., Rabins, P., Kim, W., et al (1989) Structural brain CT and cognitive deficits in elderly depressives with and without reversible dementia. Psychological Medicine, 19, 573–584.Google Scholar
Pilleri, G. (1966) The Kluver–Bucy syndrome in man. Psychiatric Neurology (Basel), 152, 65–103.Google Scholar
Post, F. (1962) The Significance of Affective Symptoms in Old Age. London: Oxford University Press.Google Scholar
Rabins, P., Mace, M. & Lucas, M. (1982) The impact of dementia on the family. Journal of the American Medical Association, 248, 333–335.Google Scholar
Rabins, P., Merchant, A. & Nestadt, G. (1984) Criteria for diagnosing reversible dementia caused by depression. British Journal of Psychiatry, 144, 488–492.CrossRefGoogle ScholarPubMed
Reding, M., Haycox, J. & Blass, J. (1985) Depression in patients referred to a dementia clinic. Archives of Neurology, 42, 894–896.Google Scholar
Reifler, B., Larson, E. & Harley, R. (1982) Co-existence of cognitive impairment and depression in geriatric outpatients. American Journal of Psychiatry, 139, 623–626.Google Scholar
Reisberg, B., Borenstein, J., Salob, S., et al (1987) Behavioural symptoms in Alzheimer's disease: phenomenology and treatment. Journal of Clinical Psychiatry, 48, (suppl. 5), 9–15.Google Scholar
Rennick, P., Nolan, D., Baver, R., et al (1973) Neuropsychological and neurological follow up after herpes hominis encephalitis. Neurology, 23, 42–47.Google Scholar
Rossor, M., Iverson, L., Reynolds, G., et al (1984) Neurochemical characteristics of early and late onset types of Alzheimer's disease. British Medical Journal, 288, 961–964.Google Scholar
Roth, M., Tym, E., Mountjoy, C., et al (1986) CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698–709.Google Scholar
Rothschild, A. (1941) The clinical differentiation of senile and arteriosclerotic psychoses. American Journal of Psychiatry, 98, 324–333.CrossRefGoogle Scholar
Rubin, E., Drevets, W. & Burke, A. (1988) The nature of psychotic symptoms in senile dementia of the Alzheimer type. Journal of Geriatric Psychiatry and Neurology, 1, 16–20.Google Scholar
Ryden, M. (1988) Aggressive behaviour in persons with dementia who live in the community. Alzheimer Disease and Associated Disorders, 2, 342–355.Google Scholar
Sanford, J. (1975) Tolerance of disability in elderly dependents by supporters at home: its significance for hospital practice. British Medical Journal, iii, 471–473.Google Scholar
Seltzer, B. & Sherwin, I. (1983) A comparison of clinical features in early and late onset primary degenerative dementia. Archives of Neurology, 40, 143–146.Google Scholar
Shulman, K. & Post, F. (1980) Bipolar affective disorder in old age. British Journal of Psychiatry, 136, 26–32.Google Scholar
Sim, M. & Sussman, I. (1962) Alzheimer's disease: its natural history and differential diagnosis. Journal of Nervous and Mental Disease, 135, 489–499.CrossRefGoogle ScholarPubMed
Sjogren, P., Sjogren, H. & Lindgren, A. G. H. (1952) Morbus Alzheimer and morbus Pick. Acta Psychiatrica and Neurologica Scandinavica (suppl. 82).Google Scholar
Smith, D., King, M. & Hoebelb, G. (1970) Lateral hypothalamic controls of killing: evidence for a cholinergic mechanism. Science, 167, 900–901.Google Scholar
Sourander, P. & Sjogren, H. (1970) The concept of Alzheimer's disease and its clinical implications. In Alzheimer's Disease and Related Conditions (eds G. Wolstenholme & M. O'Connor), pp. 11–32. London: Churchill.Google Scholar
Stern, Y., Mayeux, R., Sano, M., et al (1987) Predictors of disease course in patients with Alzheimer's disease. Neurology, 37, 1649–1653.CrossRefGoogle Scholar
Swearer, J., Drachman, D., O'Donnell, B., et al (1988) Troublesome and destructive behaviours in dementia. Journal of the American Geriatric Society, 36, 784–790.Google Scholar
Swigar, M., Benes, F., Rothman, S., et al (1985) Behavioural correlates of CT scan changes in older psychiatric patients. Journal of the American Geriatric Society, 33, 96–103.Google Scholar
Teri, L., Larson, E. B. & Reifler, B. (1988) Behavioural disturbance in dementia of the Alzheimer type. Journal of the American Geriatric Society, 37, 109–116.Google Scholar
Teri, L., Borson, S., Kiyak, A., et al (1989) Behavioural disturbance, cognitive dysfunction and functional skill: prevalence and relationship in Alzheimer's disease. Journal of the American Geriatrics Society, 37, 109–116.Google ScholarPubMed
Terzain, H. & Ore, G. (1955) Syndrome of Kluver and Bucy. Neurology, 5, 373–380.Google Scholar
Thompson, P. & Blessed, G. (1967) Correlation between the 37-item mental test score and abbreviated ten-item mental test score by psychogeriatric day patients. British Journal of Psychiatry, 151, 206–209.Google Scholar
Tierney, M., Fisher, R., Lewis, A., et al (1988) The NINCDS–ADRDA work group criteria for the clinical diagnosis of probable Alzheimer's disease: a clinicopathologic study of 57 cases. Neurology, 38, 359–364.Google Scholar
Toone, B. (1981) Psychoses in epilepsy. In Epilepsy in Psychiatry (eds E. Reynolds & M. Trimble). New York: Churchill Livingstone.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Wraog, R. & Jeste, D. (1989) Overview of depression and psychosis in Alzheimer's disease. American Journal of Psychiatry, 146, 577–587.Google Scholar
World Health Organization (1989) International Classification of Diseases (draft of 10th edn) (ICD–10). Geneva: WHO.Google Scholar
Ziegler, D. (1954) Cerebral atrophy in psychiatric patients. American Journal of Psychiatry, 111, 54–58.Google Scholar
Zubenko, G. & Moossy, J. (1988) Major depression in primary dementia – clinical and neuropathologic correlates. Archives of Neurology, 45, 1182–1186.Google Scholar
Zweig, R., Ross, C., Hedreen, J., et al (1988) The neuropathology of aminergic nuclei in Alzheimer's disease. Annals of Neurology, 24, 233–242.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.