title: Vocally disruptive behavior (VDB) in the institutionalized elderly: a naturalistic multiple case report.
abstract: Employing a naturalistic multiple case study approach, we investigated the current clinical practice in the treatment and care of VDB among a convenience sample of 85 patients cared for in specialized old age psychiatric clinics and nursing homes in French and German-speaking Switzerland. We wished to clinically characterize VDB patients, to identify common approaches used to treat VDB in everyday practice, and to explore how the efficiency of the interventions employed was judged by the responsible carers. Data were collected by means of a questionnaire. Most patients with VDB in this study had dementia, of whom 75% had at least one current or premorbid psychiatric disorder and 25% had premorbid personality disorder. A majority of patients received multiple psychosocial care interventions that were often judged to be effective, but the potential of psychosocial interventions is underused. Many patients did not receive psychotropic medication specifically targeted at VDB, but about 70% of all prescriptions were judged to have positive effects. Premorbid psychiatric and personality disorders or traits are likely candidates to be entered into the etiopathogenic equation of VDB and set a new frame for approaches used to treat these underlying disorders.
authors.affiliation: Service Universitaire de Psychiatrie de l'Age Avancé (SUPAA), Département de Psychiatrie-CHUV, Rte du Mont, 1008 Prilly VD, Switzerland. armin.von-gunten@chuv.ch
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
authors.forename: Mélanie
authors.initials: M
authors.lastname: Favre
authors.forename: Caroline
authors.initials: C
authors.lastname: Gurtner
authors.forename: Christoph
authors.initials: C
authors.lastname: Abderhalden
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000188:drug therapy; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011595:Psychomotor Agitation / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012920:Social Behavior Disorders / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome; D014705:Verbal Behavior
chemical_list: D011619:Psychotropic Drugs