Nursing Home Residents' Positive Behavioral Responses to Individualized Music Predict Improvements in Sundowning Symptoms After Music Listening.

The goal of this exploratory study was to predict which long-term care residents with dementia would experience improvements in their sundowning symptoms after listening to personalized music playlists. We studied 101 residents with moderate to severe dementia from 15 long-term care facilities across 8 months. We observed residents' behavioral responses to individualized music while they listened and recorded sundowning symptoms both before and after each listening session.

The Effects of Individualized Music Listening on Affective, Behavioral, Cognitive, and Sundowning Symptoms of Dementia in Long-Term Care Residents.

Objectives: This study aimed to replicate music's positive effects on dementia-related symptoms, determine whether a 6-month intervention would lead to greater positive outcomes than typical 3- to 4-month interventions, and examine changes in sundowning symptoms after music listening.

Methods: 282 nursing home residents with dementia listened to personalized music playlists 1-3 times weekly for 30 minutes across 6 months. Standardized assessments of affect, behavior, and cognition and direct observations of sundowning symptoms comprised the outcomes.

Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses.

Objectives: Patients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients.

Design: Comparative study.

An examination of factors affecting persistence with initial antipsychotic treatment in patients with schizophrenia.

Objectives: During a schizophrenia treatment episode, persistence with the initial antipsychotic may indicate optimal pharmacotherapy and be a precursor to longer-term effectiveness and other positive outcomes. The objective of this study was to examine the ability of selected variables to predict antipsychotic persistence among patients receiving olanzapine or risperidone as initial treatment.

Research Design And Methods: Data for this analysis, which was not defined in the original study protocol, came from a naturalistic, randomized, open-label trial comparing costs and effectiveness of first-line antipsychotic treatment options in schizophrenia.

Comparison of olanzapine and risperidone in the treatment of psychosis and associated behavioral disturbances in patients with dementia.

Objective: The authors compared efficacy of olanzapine versus placebo and risperidone as measured by the Neuropsychiatric Inventory and Clinical Global Impression-Severity of Psychosis scale in patients with dementia-related psychosis.

Methods: Patients with moderate-to-severe psychotic symptoms associated with dementia were recruited from outpatient or residential settings and randomly assigned to 10-week, double-blind, flexible-dose treatment with olanzapine (N=204; 2.5 mg-10 mg/day; mean: 5.

Duloxetine for the long-term treatment of major depressive disorder in patients aged 65 and older: an open-label study.

Background: Late-life depression is a common, chronic and recurring disorder for which guidelines recommend long-term therapy. The safety and efficacy of duloxetine for the treatment of major depressive disorder (MDD) were evaluated using data from elderly patients (age > or = 65 years; n = 101) who participated in a large, multinational, open-label study.

Methods: Patients meeting DSM-IV criteria for MDD received duloxetine 80 mg/d (40 mg twice daily (BID)) to 120 mg/d (60 mg BID) for up to 52 weeks.

Metabolic Issues With Atypical Antipsychotics in Primary Care: Dispelling the Myths.

BACKGROUND: Recently, much attention has been focused on the increased rate of metabolic syndrome componen ts among psychiatric patients, including glucose intolerance, hyperglycemia, diabetes mellitus, hyperlipidemia, hypertension, and weight gain. Various reports have identified cases of newly diagnosed diabetes during treatment with atypical antipsychotic agents. However, the question remains whether there is a relationship between atypical antipsychotic use and the metabolic syndrome or whether there is a higher risk in this population irrespective of medication use.

Mood Disorders in Family Practice: Beyond Unipolarity to Bipolarity.

Primary care physicians increasingly have treated depressive disorders over the last decade. Unrecognized bipolar disorder, sometimes misdiagnosed as unipolar depression, may lead to treatment resistance or nonresponse. We describe differences between unipolar and bipolar disorders, focusing on recognition, diagnosis, and treatment of bipolar spectrum disorders such as bipolar I, bipolar II, antidepressant-induced mania, and cyclothymia.

A Perspective on the Primary Care of Patients With Behavior, Mood, and Thought Disturbances: Clinical Applications of Olanzapine.

Primary care practitioners are in an ideal position to initiate treatment for patients with behavior, mood, and thought disturbances. It is believed that early identification and treatment of these symptomatic features of primary or secondary central nervous system disorders may significantly reduce morbidity and benefit the patient, his/her family, and involved caregivers, including the primary care physician. A broad list of central nervous system-active medications are utilized by family physicians to treat patients who exhibit symptoms of agitation, altered mood, and disordered thought.

Olanzapine versus placebo in the treatment of psychosis with or without associated behavioral disturbances in patients with Alzheimer's disease.

Objectives: Psychotic symptoms and behavioral disturbances are a concern in the care of elderly patients with Alzheimer's dementia (AD). This study was conducted to compare the efficacy of olanzapine versus placebo in patients with psychotic symptoms associated with AD in long-term or continuing-care settings.

Methods: Patients (n = 652) with AD and delusions or hallucinations were randomly assigned to 10 weeks of double-blind treatment with placebo or fixed-dose olanzapine (1.

Retrospective cohort study of diabetes mellitus and antipsychotic treatment in a geriatric population in the United States.

Objectives: The objective of this study was to investigate risk of diabetes among elderly patients during treatment with antipsychotic medications.

Design: We conducted a longitudinal, retrospective study assessing the incidence of new prescription claims for antihyperglycemic agents during antipsychotic therapy.

Setting: Prescription claims from the AdvancePCS claim database were followed for 6 to 9 months.

Treating patients in primary care: the impact of mood, behavior, and thought disturbances.

Patients with symptoms of mood, behavior, and thought disturbances are regularly treated in the primary care setting. More often than not, the disorders associated with these symptoms are overlooked or misdiagnosed by physicians, in part because these patients present symptomatic complaints that are seemingly unrelated to the underlying disorder. Recognition of comorbid psychiatric symptoms allows physicians to treat the whole person more effectively.

Electroconvulsive Therapy in the Medically Ill Elderly.

Treatment with electroconvulsive therapy (ECT) of medically ill geriatric patients with affective disorders is described. Of 135 patients to whom ECT was administered in 6 years, 55% were over 60 years of age. One-third (45) exhibited cardiovascular (62%), central nervous system (15%), or other medical conditions (22%) increasing the risks of the treatment.