Longitudinal assessment of psychotherapeutic day hospital treatment for neuropsychiatric symptoms in dementia.
OBJECTIVE
Behavioral and psychological symptoms (BPSD) of dementia are associated with more rapid cognitive deterioration as well as increased caregiver stress. The effectiveness of psychiatric day hospital care for this condition remains disputed. We report here the assessment of a psychotherapeutic day hospital program in a series of elderly people with dementia and concomitant BPSD.


METHODS
Treatment setting: The day hospital program combined music, movement, psychodynamic group therapies, sociotherapy as well as individual interviews and family interventions.


METHODS
76 individuals with mild to moderate dementia.


METHODS
The Neuropsychiatric Inventory (NPI), Therapeutic Community Assessment scale including staff (SAS) and client assessments (CAS) and a Group Evaluation Scale (GES) were administrated at admission, 3, 6 and 12 months and discharge.


RESULTS
Linear regression analysis showed that SAS (but not CAS) and GES scores significantly increased while the NPI total scores decreased across the different time points. NPI item score modifications were significant for anxiety and apathy. These changes remained significant when demographic variables, drug treatment changes and occurrence of life events were also considered.


CONCLUSIONS
A psychotherapeutic day hospital program designed for older people with dementia and neuropsychiatric symptoms allows for a significant reduction of anxiety and apathy, better adhesion to therapeutic community treatment and clinical progress in group therapy. Controlled interventional studies are needed to further confirm these data.
Weber
Kerstin
K
University Hospitals of Geneva, Psychiatry, Carouge, Switzerland.
Meiler-Mititelu
Corina
C
Herrmann
Francois Robert
FR
Delaloye
Christophe
C
Giannakopoulos
Panteleimon
P
Canuto
Alessandra
A
D000368:Aged; D000369:Aged, 80 and over; D003631:Day Care, Medical / Q000379:methods* / Q000523:psychology*; D003704:Dementia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009484:Neuropsychology; D010043:Outcome and Process Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D011613:Psychotherapy / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D013315:Stress, Psychological; D013557:Switzerland
D011619:Psychotropic Drugs