title: Psychosis and physical aggression in probable Alzheimer's disease.
abstract: OBJECTIVE
  The purpose of this study was to determine the frequency and type of psychotic symptoms in patients with probable Alzheimer's disease and to test whether there is a relationship between specific psychotic symptoms and episodes of physical aggression.
  
  
  METHODS
  From 209 patients with possible or probable Alzheimer's disease who had been assessed in a research clinic every 6 months for up to 4.5 years, 181 subjects with probable Alzheimer's disease were selected for study. On the basis of the summary note for each visit in the patients' charts, the presence of delusions, hallucinations, misidentifications, and episodes of physical aggression was determined. Data regarding psychotic symptoms and aggression were available for 170 and 169 subjects, respectively.
  
  
  RESULTS
  Delusions had been reported for 74 (43.5%) of the patients and were the most frequent psychotic symptom; persecutory delusions were the most common type. Physical aggression had been noted for 50 (29.6%) of the patients. Delusions and misidentifications frequently preceded and were significantly associated with episodes of physical aggression. The presence of delusions was a significant predictor of physical aggression but accounted for only 3.5% of the variance.
  
  
  CONCLUSIONS
  This study suggests that delusions are a risk factor for physical aggression in patients with probable Alzheimer's disease who have moderate to severe cognitive impairment. As delusions accounted for only a small percentage of the variance, further research is needed to identify other variables that may be significant predictors of physical aggression in this population.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: L H
authors.initials: LH
authors.lastname: Deutsch
authors.forename: F W
authors.initials: FW
authors.lastname: Bylsma
authors.forename: B W
authors.initials: BW
authors.lastname: Rovner
authors.forename: C
authors.initials: C
authors.lastname: Steele
authors.forename: M F
authors.initials: MF
authors.lastname: Folstein
mesh_terms: D000368:Aged; D000374:Aggression / Q000523:psychology*; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D015995:Prevalence; D011336:Probability; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors