PMID- 32239593
OWN - NLM
STAT- MEDLINE
DCOM- 20210204
LR  - 20221207
IS  - 1479-8301 (Electronic)
IS  - 1346-3500 (Linking)
VI  - 20
IP  - 5
DP  - 2020 Sep
TI  - Post-traumatic stress disorder mistaken for behavioural and psychological 
      symptoms of dementia: case series and recommendations of care.
PG  - 754-759
LID - 10.1111/psyg.12549 [doi]
AB  - In late life, traumas may act cumulatively to exacerbate vulnerability to 
      post-traumatic stress disorder (PTSD). PTSD is also a risk factor for cognitive 
      decline. Major neurocognitive disorder (MND) can be associated with worsening of 
      already controlled PTSD symptoms, late-life resurgence or de novo emergence. 
      Misidentifying PTSD symptoms in MND can have negative consequences for the 
      patient and families. We review the literature pertaining to PTSD and dementia 
      and describe five cases referred for consultation in geriatric psychiatry 
      initially for behavioural and psychological symptoms of dementia (BPSD), which 
      were eventually diagnosed and treated as PTSD in MND subjects. We propose that 
      certain PTSD symptoms in patients with MND are misinterpreted as BPSD and 
      therefore, not properly addressed. For example, flashbacks could be interpreted 
      as hallucinations, hypervigilance as paranoia, nightmares as sleep disturbances, 
      and hyperreactivity as agitation/aggression. We suggest that better 
      identification of PTSD symptoms in MND is needed. We propose specific 
      recommendations for care, namely: clarifying diagnosis by distinguishing PTSD 
      symptoms coexisting with different types of dementia from a specific dementia 
      symptom (BPSD), gathering a detailed history of the trauma in order to 
      personalise non-pharmacological interventions, adapting psychotherapeutic 
      strategies to patients with dementia, using selective serotonin reuptake 
      inhibitors as first-line treatment and avoiding antipsychotics and 
      benzodiazepines. Proper identification of PTSD symptoms in patients with MND is 
      essential and allows a more tailored and efficient treatment, with decrease in 
      inappropriate use of physical and chemical restraints.
CI  - (c) 2020 Japanese Psychogeriatric Society.
FAU - Bruneau, Marie-Andree
AU  - Bruneau MA
AUID- ORCID: 0000-0003-2909-0612
AD  - Centre de Recherche, Institut Universitaire de Geriatrie de Montreal, Montreal, 
      Quebec, Canada.
AD  - Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada.
FAU - Desmarais, Philippe
AU  - Desmarais P
AD  - Department of Medicine, Division of Geriatrics, Centre Hospitalier de 
      l'Universite de Montreal, Montreal, Quebec, Canada.
AD  - Department of Neurosciences, Centre de Recherche du Centre Hospitalier de 
      l'Universite de Montreal, Montreal, Quebec, Canada.
FAU - Pokrzywko, Klara
AU  - Pokrzywko K
AD  - Centre de Recherche, Institut Universitaire de Geriatrie de Montreal, Montreal, 
      Quebec, Canada.
AD  - Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20200401
PL  - England
TA  - Psychogeriatrics
JT  - Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
JID - 101230058
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Serotonin Uptake Inhibitors)
RN  - 12794-10-4 (Benzodiazepines)
SB  - IM
MH  - Aged
MH  - *Antipsychotic Agents/therapeutic use
MH  - Benzodiazepines/therapeutic use
MH  - *Dementia/diagnosis/drug therapy
MH  - Diagnostic Errors
MH  - Humans
MH  - Selective Serotonin Reuptake Inhibitors/therapeutic use
MH  - *Stress Disorders, Post-Traumatic/diagnosis
OTO - NOTNLM
OT  - behavioural and psychological symptoms of dementia
OT  - dementia
OT  - post-traumatic stress disorder
EDAT- 2020/04/03 06:00
MHDA- 2021/02/05 06:00
CRDT- 2020/04/03 06:00
PHST- 2020/02/05 00:00 [received]
PHST- 2020/03/16 00:00 [accepted]
PHST- 2020/04/03 06:00 [pubmed]
PHST- 2021/02/05 06:00 [medline]
PHST- 2020/04/03 06:00 [entrez]
AID - 10.1111/psyg.12549 [doi]
PST - ppublish
SO  - Psychogeriatrics. 2020 Sep;20(5):754-759. doi: 10.1111/psyg.12549. Epub 2020 Apr 
      1.