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Objective: To evaluate the feasibility and effectiveness of the CORDIAL program, a psychosocial intervention consisting of cognitive behavioral therapy (CBT), cognitive rehabilitation, and reminiscence to manage depressive symptoms for people with mild cognitive impairment (MCI) or dementia.Design: We conducted a randomized controlled trial, based on a two-group (intervention and control), pre-/post-intervention design.Setting: Participants were recruited from five different old age psychiatry and memory clinics at outpatients' hospitals.Participants: Hundred and ninety-eight people with MCI or early-stage dementia were included.Intervention: The intervention group (n = 100) received 11 individual weekly sessions of the CORDIAL program. This intervention includes elements from CBT, cognitive rehabilitation, and reminiscence therapy. The control group (n = 98) received treatment-as-usual.Measurements: We assessed Montgomery-Åsberg Depression Rating Scale (MADRS) (main outcome), Neuropsychiatric Inventory Questionnaire, and Quality of Life in Alzheimer's disease (secondary outcomes) over the course of 4 months and at a 10-month follow-up visit.Results: A linear mixed model demonstrated that the depressive symptoms assessed by MADRS were significantly more reduced in the intervention groups as compared to the control group (p < 0.001). The effect persisted for 6 months after the intervention. No significant differences between groups were found in neuropsychiatric symptoms or quality of life.Conclusion: Our multicomponent intervention, which comprised 11 individual sessions of CBT, cognitive rehabilitation, and reminiscence therapy, reduced depressive symptoms in people with MCI and dementia. [ABSTRACT FROM AUTHOR]

There is a growing attention worldwide to young-onset dementia (YOD) and this group's special challenges and needs. The literature on psychosocial interventions for this population is scarce, and little is known about the specific challenges and benefits of working therapeutically with this group of patients. The aim of this study was to explore if a manual-based structured cognitive behavioral/cognitive rehabilitation program would be beneficial for these patients. One case, a 63-year-old woman with YOD, is presented to illustrate how this intervention can be applied to individual patients to manage depressive symptoms in YOD. [ABSTRACT FROM AUTHOR]

Background: Neuropsychiatric symptoms (NPS) affect the majority of patients who have dementia. Neuropsychiatric sub-syndromes with symptoms that occur together and have common neurobiological correlates have been identified. There are scarce data regarding the comparison of the pattern of the neuropsychiatric sub-syndromes in distinct ethnical and cultural populations. We aim at comparing the pattern of the NPS, and the factor analysis of the Neuropsychiatric Inventory (NPI-10) in two samples of outpatients with dementia living in Brazil and Norway.Methods: This is a cross-sectional study. The sample consists of 168 Brazilian and 155 Norwegian demented patients from psychogeriatric facilities and community-based educational programs. Brazilian patients were diagnosed with Alzheimer's disease (63.7%), vascular dementia (15.5%), or mixed dementia (20.8%), whereas the diagnoses of Norwegian patients were Alzheimer's disease (97.4%) and mixed dementia (2.6%). Principal component analysis with the Varimax rotation was used for factor analysis of the NPI-10.Results: Apathy (80.4 %), agitation/aggression (45.8%), and aberrant motor behavior (45.8%) were the most common symptoms in the Brazilian sample. Apathy (72.3%), dysphoria (61.9%), and anxiety (52.3%) were the most frequent symptoms in the Norwegian sample. Factor analysis of the NPI-10 revealed three syndromes for the Brazilian (Psychosis, Mood, Psychomotor) and Norwegian (Psychosis, Mood, Frontal) groups.Conclusions: The frequency of individual NPS may differ among distinct populations. However, Psychosis and Depression are common sub-syndromes in diverse ethnical and cultural patients with dementia. Our findings support the syndromic approach for the clinical assessment of the patients with dementia. [ABSTRACT FROM PUBLISHER]

Background: Parental emotional overinvolvement (EOI) may entail a worse outcome in schizophrenia. In the present study we examined demographic and clinical predictors of EOI.Method: The predictors were examined in a Norwegian sample of 41 recently admitted patients (schizophrenia or schizophreniform disorder) and 66 parents. Parents' expressed emotion was assessed by the Camberwell Family Interview.Results: Regression analyses showed that higher EOI was significantly related, on the part of the parent, to being a mother, single, spending more time with the patient; and, on the part of the patient, to no substance misuse, more anxiety-depression, and less uncritical and aggressive behaviour. EOI was not linked to previous hospital admissions.Conclusion: Our analyses indicate that characteristics of the parent and of the parent-patient dyad seem to be the most important determinants of EOI. EOI is probably not linked to psychotic relapse, but rather to affective disturbances in the patient. [ABSTRACT FROM AUTHOR]

Background and aim: People with dementia depend on a relative to be able to stay at home longer However, being a caregiver has shown to influence on their quality of life (QoL). Depression is the most common factor associated with low caregiver QoL, while relational factors have shown to be a protective factor. Less is known about how female and male caregivers approve to the caregiving demands, and thus how these demands influence their QoL. In this study, we aimed at investigating what factors influenced on QoL related to gender and how these fluctuated with time. Method: In this longitudinal design, a total of 208 caregivers, 158 female mean age 62.5 and 50 male caregivers, mean age 67.9 were assessed for Quality of Life-Alzheimer Disease (QoL). In addition, depression, family relationship and caregivers' burden of care were assessed. Linear regression analyses were applied to explore the bivariate and multivariate associations between the dependent variable QoL and potential explanatory variables. The same questionnaires were completed at one-year follow-up, and the results from the remaining 176 caregivers were compared with their baseline scorings. Results: Caregivers' depressive feelings were the strongest predictors of caregivers' QoL. What differed in the explained perceived QoL was feeling of social isolation in female caregivers, and male caregivers' perception of their care receivers' emotionally overinvolved attitude towards them. Additionally, female caregivers expressed a higher burden and cared for a relative more affected by their dementia. After one year, their QoL declined, more for male than female, while their level of depressive feelings, distress and level of EOI remained unchanged. Conclusion: The study revealed that except for depressive feelings, female and male caregivers faced their caring experience, differently. The implication of these findings is that gender must be considered when planning for interventions. While female caregivers might need more time for leisure activities, male caregivers need ways to deal with their emotional relationship with their care receivers. Treatment of their depressive feelings seems to be crucial. They would also need approaches specifically targeting the different stages as dementia develop. [ABSTRACT FROM AUTHOR]