title: Associations between conflictual relationships, psychopathology, and the use of psychotropic drugs among older people living in residential facilities.
abstract: BACKGROUND
  Psychiatric symptoms and conflictual relationships (CR) may negatively affect the delivery of care in residential facilities (RF). This study aims to analyze neuropsychiatric symptoms, their correlations with CR among older people living in RF, and their associations with the prescription of psychotropic drugs.
  
  
  METHODS
  A total of 1215 RF residents in five Italian regions were selected for this cross-sectional study. Psychiatric symptoms and CR were assessed with the Neuropsychiatric Inventory and the Resident Assessment Instrument, respectively. Associations between Neuropsychiatric Inventory items, CR, and the use of psychotropic drugs were tested via multiple logistic regressions.
  
  
  RESULTS
  About half (52.7%) of the RF residents experienced one or more clinically relevant neuropsychiatric symptoms. At least one category of CR was reported for 223 residents (19%). Although reciprocal associations were found between different categories of CR, only conflictuality with other residents was associated with the use of antipsychotics (odds ratio (OR) = 2.12). Significant associations were found with irritability (with staff: OR = 2.35; with relatives: OR = 3.09), aberrant motor behaviour (with staff: OR = 2.02), and elation (with relatives: OR = 10.55).
  
  
  CONCLUSIONS
  Neuropsychiatric symptoms and CR are common among RF residents and are reciprocally associated. Further research with longitudinal design is needed to better understand this relationship.
authors.affiliation: Mental Health Department, ULSS 16, University of Padua, Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Scocco
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Elena
authors.initials: E
authors.lastname: Toffol
authors.affiliation: Mental Health Department, ULSS 15, Camposampiero, Padua, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Frasson
authors.affiliation: Faculty of Education, University of Bolzano, Bolzano, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cavrini
authors.affiliation: Department of Mental Health, ASL, Syracuse, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Argentino
authors.affiliation: Regional Ministry of Health, Calabria Region, Catanzaro, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Azzarito
authors.affiliation: Health District, ASL 4, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Federici
authors.affiliation: Geriatrics Division, Hospital Santissima Trinità, Cagliari, Italy.
authors.forename: Paolo F
authors.initials: PF
authors.lastname: Putzu
authors.affiliation: IRCCS Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D009735:Nursing Homes; D015995:Prevalence; D011599:Psychopathology; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012112:Residential Facilities
chemical_list: D011619:Psychotropic Drugs
keywords: aged; conflictual relationships; psychopathological symptoms; psychotropic drugs; residential facilities