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Research shows that in most countries the number of elderly persons is increasing and that close relationships in late life are playing a more important role. Therefore, it is surprising that there have been so few publications about family therapy for the elderly.To formulate some guidelines for psychotherapy for family members in their later years and to make suggestions regarding further research.We summarise the existing literature and focus on important themes about working with the elderly, supplementing major issues with our own clinical experience.Family therapy with the elderly differs from therapy for younger adults in some respects; for instance, the emphasis in the case of the elderly is more on strengthening the viability of a long/standing relationship. The reversal of roles that often accompanies the ageing process and leads to increasing dependency is another factor that affects the elderly more than the younger adults. If the last stage of life is to finish calmly and amicably, therapists need to tackle any tensions or injustices that patients have experienced in the course of their relationships.Psychotherapy for the elderly needs to provide clients with constant opportunities for reflection and should initiate discussions about partners' experiences of tensions and injustices in their earlier relationship. However, the increasing number of elderly persons means that more empirical research needs to be done into systematic psychotherapy.

The APA published the DSM-5 in May, 2013. When compared to dsm-iv, the latest edition incorporates many changes, some relating to neurocognitive disorders.To review critically the new DSM-5 alterations and adjustments relating to neurocognitive disorders.We compared the relevant chapters in DSM-IV-TR and DSM-5 and we searched the literature for articles involving discussions about cognitive disorders in DSM-5.With regard to differential diagnosis of neurocognitive disorders, DSM-5 has more in common with current clinical practice than does the DSM-IV. DSM-5 names ten etiological subtypes for which the diagnostic criteria are based on recent scientific research. However, some researchers and clinicians have reservations about using the term 'major neurocognitive disorder' instead of 'dementia', and are reluctant to make a distinction between 'mild' and 'major' cognitive disorders.The alterations and adjustments that appear in DSM-5 in relation to neurocognitive disorders may well mean progress for clinicians and researchers but they will inevitably require greater investment.

In natural viewing conditions, different stimulus categories such as people, objects, and natural scenes carry relevant affective information that is usually processed simultaneously. But these different signals may not always have the same affective meaning. Using body-scene compound stimuli, we investigated how the brain processes fearful signals conveyed by either a body in the foreground or scenes in the background and the interaction between foreground body and background scene. The results showed that left and right extrastriate body areas (EBA) responded more to fearful than to neutral bodies. More interestingly, a threatening background scene compared to a neutral one showed increased activity in bilateral EBA and right-posterior parahippocampal place area (PPA) and decreased activity in right retrosplenial cortex (RSC) and left-anterior PPA. The emotional scene effect in EBA was only present when the foreground body was neutral and not when the body posture expressed fear (significant emotion-by-category interaction effect), consistent with behavioral ratings. The results provide evidence for emotional influence of the background scene on the processing of body expressions. Hum Brain Mapp 35:492-502, 2014. (c) 2012 Wiley Periodicals, Inc.

Background and aims: Recently, we have developed a new PET reconstruction algorithm (AMAP) based on a maximum a-posteriori algorithm and using anatomical a-priori information obtained from MRI (Baete et al. 2004a,b). This algorithm corrects for partial volume effects during the reconstruction. The aim of this study was to study the effect on the modelling parameters when using data reconstructed with this new algorithm. Methods: In 10 healthy subjects (6 male, mean age: 67 yr), data were acquired dynamically for one hour (4 x 15s, 4 x 60s, 2 x 150s, 10 x 300s) on a HR+ after the injection of 300 MBq [11C]-PMP. Arterial blood samples were drawn to measure the plasma input function and to determine the metabolite fraction. A T1-weighted volumetric MRI was acquired and segmented according to an optimized VBM approach using a template of elderly normals. Dynamic PET images were reconstructed using AMAP or 3D-FBP (filtered backprojection). Both reconstruction Methods: included corrections for randoms, scatter and attenuation. A correction for small movements during the PET study was applied and the resulting images were then smoothed with a Gaussian kernel of 6 mm FWHM. An irreversible two-tissue compartment model was applied in each voxel with non-linear fitting of the parameters. A constrained value of K1/k2 was determined for each subject on the basis of a whole brain analysis using an unconstrained model. K1 and k3 parametric images were calculated using the data reconstructed with either one of the two Methods and the parametric maps were compared using SPM2 after warping to the MNI space and smoothing with a Gaussian kernel of 12 mm. Results: A high correlation (see table) between the K1 values obtained with the two reconstruction Methods: was found. The correlation for the k3 values was high in cerebellum, striatum and thalamus but was lower in the neocortex. Furthermore, k3 values calculated with the AMAP data were significantly (pFWEcor < 0.05) higher throughout the whole brain compared to the ones determined from the 3D-FBP data. However, no significant difference was found for the K1-maps. Median values (1/min) for K1 and k3 are given in the table. Conclusion: Kinetic modelling of [11C]-PMP reconstructed using AMAP is feasible and the k3 (but not the K1) values are higher compared to 3D-FBP.

Non-rapid eye movement (NREM) arousal sleep disorders (confusional arousal, somnambulism and sleep terror) are self-limiting and temporary phenomena which cannot be attributed to medical or psychiatric factors. However, very occasionally they can be the cause of unintentional injury to self or others. We describe the case of an 18-year-old who engaged in self-injurious behaviour while asleep. This behaviour could be attributed to confusional arousal.

Visual hallucinations (VH) are sometimes difficult to treat in patients with Lewy body dementia (LBD). We describe the concurrent use of clozapine and levodopa for the treatment of persistent VH and parkinsonism in a patient with LBD and severely increased sensitivity to antipsychotics.

status: published