title: Specific psychological and behavioral symptoms of depression in patients with dementia.
abstract: Behavioral and psychological symptoms in dementia (BPSD) are very common, with 90% of patients experiencing at least one during the course of the disease. One-third of persons with dementia have depressive symptoms, and concomitant BPSD are very likely.
  
  
  OBJECTIVE
  This study aimed to characterize the psychological and behavioral manifestations of depression in patients with dementia.
  
  
  METHODS
  We recruited patients with dementia from several nursing homes in the Limousin region of France. Depression was as diagnosed by the Cornell Scale for Depression in Dementia (CSDD) with a cut-off of 7, and BPSD were assessed using the Neuropsychiatric Inventory (NPI).
  
  
  RESULTS
  Of 319 patients with dementia, 42.9% (n =137) were depressed and 75.9% (n = 242) had BPSD. All BPSD were significantly (p < 0.0001) more prevalent among depressed patients, but no significant differences were observed according to sex and age. The NPI showed that the most common additional symptoms in depressed patients were agitation (43.2%), anxiety (42.3%) and irritability (40.1%). Four NPI-based factors were indentified (63.9% of the common variance): factor 1 (disinhibition, irritability, agitation, anxiety), factor 2 (sleep disturbance, aberrant motor behavior, apathy), factor 3 (elation, hallucination, delirium) and the last with eating disorders. Depression in dementia patients was significantly associated with disinhibition, irritability, agitation, and anxiety.
  
  
  CONCLUSIONS
  BPSD are common and a major problem. Before addressing them as isolated symptoms, it is important to consider comorbidity with depression in order to optimize the therapeutic approach.
authors.affiliation: CMRR-The Limousin Center for Memory Research, University of Limoges, France. aniejean@hotmail.com
authors.forename: Annie
authors.initials: A
authors.lastname: Prado-Jean
authors.forename: Philippe
authors.initials: P
authors.lastname: Couratier
authors.forename: Michel
authors.initials: M
authors.lastname: Druet-Cabanac
authors.forename: Philippe
authors.initials: P
authors.lastname: Nubukpo
authors.forename: Laurence
authors.initials: L
authors.lastname: Bernard-Bourzeix
authors.forename: Philippe
authors.initials: P
authors.lastname: Thomas
authors.forename: Nicole
authors.initials: N
authors.lastname: Dechamps
authors.forename: Helene
authors.initials: H
authors.lastname: Videaud
authors.forename: Thierry
authors.initials: T
authors.lastname: Dantoine
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Clément
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology*; D003704:Dementia / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales