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de Vries IRH, Oudman E, Postma A. Personality traits and personality problems in Korsakoff syndrome patients. J Clin Exp Neuropsychol 2024; 46:233-245. [PMID: 38640075 DOI: 10.1080/13803395.2024.2344840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
Personality research is of relevance because it provides insights into the psychological strengths and vulnerabilities of a person. Korsakoff's syndrome (KS) is a severe neuropsychiatric disorder following acute thiamine deficiency, usually as a consequence of alcohol-use disorders. Research on personality traits of KS patients is currently limited. The aim of the current exploratory study was therefore to examine the personality traits and problems of KS patients. We assessed self-reported and informant-reported personality traits and problems in institutionalized KS patients (n = 30). Results indicate that the psychotic personality organization was more frequently present in KS patients compared to a psychiatric reference population, leading to increased vulnerability for the development of severe psychiatric issues. Informants observed more premorbid and current cluster B ("emotional") and C ("anxious") personality behavior in comparison to the general population. Also, rigid- and socially avoidant behavior in KS patients was observed to increase over the years. They also observed personality problems such as emotional-, unpredictable-, dramatic-, anxious and fearful behavior in the present and in the past. KS patients reported themselves as healthy individuals, indicating a lack of self-awareness. We recommend training programs for the medical team focussed on psycho-education and supportive interventions for patients with complex personality problems concomitant to KS.
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Affiliation(s)
- Ineke Roelfina Hendrika de Vries
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Slingedael Korsakoff Centre, Lelie Care Group, Rotterdam, The Netherlands
| | - Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Slingedael Korsakoff Centre, Lelie Care Group, Rotterdam, The Netherlands
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Slingedael Korsakoff Centre, Lelie Care Group, Rotterdam, The Netherlands
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Maccarone KJ, Barni EE, Ben-Porath YS. The utility of the MMPI-3 in predicting substance use related problems in a clinical neuropsychology sample. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 37453800 DOI: 10.1080/23279095.2023.2235451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Assessing for problematic substance use in neuropsychological assessments is crucial for differential diagnosis and attribution of symptom causes. The current investigation examines the utility of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3 in predicting such substance use in a clinical neuropsychology sample. Participants included 208 outpatient neuropsychological examinees. Correlations and risk ratios were calculated for externalizing-psychopathology-related scales and external substance use criteria. Hierarchical regressions examined the incremental prediction of criteria by MMPI-3 externalizing scales above the Substance Abuse (SUB) scale. Results indicate that MMPI-3 externalizing scales are associated with substance-use-related criteria as conceptually expected. Additionally, we report significantly increased risk of experiencing substance-use-related problems at various T score elevations on multiple externalizing scales. Finally, SUB served as the primary predictor of substance-use-related criteria. These findings support the ability of the MMPI-3 to assess for past or current substance use and negative consequences of substance use in a clinical neuropsychology setting.
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Affiliation(s)
- Keefe J Maccarone
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Emily E Barni
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
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Konstantakopoulos G, Trova A, Tzavellas E, Stefanatou P, David AS, Paparrigopoulos T. Development and validation of the Schedule for the Assessment of Insight in Alcohol Dependence (SAI-AD): Dimensions and correlates of insight in alcohol use disorder. Drug Alcohol Depend 2023; 248:109917. [PMID: 37207614 DOI: 10.1016/j.drugalcdep.2023.109917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION The objectives of this study were to develop a multidimensional, clinician-rated scale that assess impaired insight into illness in patients with alcohol use disorder (AUD) and to examine its reliability, validity and internal structure. Moreover, we investigated the relationships of overall insight and its dimensions with demographic and clinical characteristics in AUD. METHODS We developed the Schedule for the Assessment of Insight in Alcohol Dependence (SAI-AD), based on scales that has already been used in psychosis and other mental disorders. Sixty-four patients with AUD were assessed with SAI-AD. Hierarchical cluster analysis and multidimensional scaling were used to identify insight components and assess their inter-relationships. RESULTS The SAI-AD demonstrated good convergent validity (r = -0.73, p < 0.001) and internal consistency (Cronbach's alpha = 0.72). Inter-rater and test-retest reliabilities were high (intra-class correlations 0.90 and 0.88, respectively). Three subscales of SAI-AD were identified which measure major insight components: awareness of illness, recognition of symptoms and need for treatment, and treatment engagement. Higher levels of depression, anxiety and AUD symptom severity were associated with overall insight impairment but not with recognition of symptoms and need for treatment, or with treatment engagement. Illness duration was specifically and positively associated with the treatment engagement component of insight. CONCLUSIONS Insight is a multidimensional construct in AUD and its major components appear to be associated with different clinical aspects of the disorder. The SAI-AD is a valid and reliable tool for the assessment of insight in AUD patients.
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Affiliation(s)
- George Konstantakopoulos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece; Research Department of Clinical, Education and Health Psychology, University College London, UK.
| | - Anna Trova
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Elias Tzavellas
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Pentagiotissa Stefanatou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Anthony S David
- UCL Institute of Mental Health, Division of Psychiatry, University College London, UK
| | - Thomas Paparrigopoulos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
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Gerridzen IJ, Doejaaren E, Veenhuizen RB, Hertogh CMPM, Joling KJ. Prevalences and Indications of Psychotropic Drug Prescriptions in Nursing Home Residents with Korsakoff Syndrome. J Clin Med 2023; 12:jcm12093133. [PMID: 37176574 PMCID: PMC10178976 DOI: 10.3390/jcm12093133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Psychotropic drugs (PD) are often prescribed to nursing home residents with Korsakoff syndrome (KS). It is unknown whether these drugs are prescribed correctly or whether they are prescribed off-label, for example, to treat behavioral symptoms. To get more insight into PD prescriptions, a descriptive study was performed. The type, category and indications of PD prescriptions of 285 participants were analyzed using medication charts and questionnaires. Behavioral symptoms were investigated with the Neuropsychiatric Inventory-Questionnaire. The results showed that atypical antipsychotics (57.1%) were prescribed more frequently than typical antipsychotics (49.3%). Of the antidepressants, selective serotonin/norepinephrine reuptake inhibitors (63.1%) were most frequently prescribed, followed by tricyclic antidepressants (23.4%). Of the benzodiazepines, anxiolytics (85.7%) were more prescribed than hypnotics (24.5%). Besides psychiatric disorders, PD were also prescribed to treat behavioral symptoms varying from 29.9% (antipsycho-tics) to 26.3% (benzodiazepines) and 9.3% (antidepressants). Furthermore, prescriptions were high if behavioral symptoms were present. To conclude, PD are often prescribed to residents with KS for an unapproved indication, namely behavioral symptoms. Additional research is needed to obtain further insight into the current prescribing culture and the effectiveness of PD. The insights thus obtained may, ultimately, contribute to the appropriate prescription of PD for people with KS.
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Affiliation(s)
- Ineke J Gerridzen
- Atlant, Korsakoff Centre of Expertise, Kuiltjesweg 1, 7361 TC Beekbergen, The Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Els Doejaaren
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Ruth B Veenhuizen
- Atlant, Korsakoff Centre of Expertise, Kuiltjesweg 1, 7361 TC Beekbergen, The Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Karlijn J Joling
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
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Laniepce A, Segobin S, André C, Bertran F, Boudehent C, Lahbairi N, Maillard A, Mary A, Urso L, Vabret F, Cabé N, Pitel AL, Rauchs G. Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory. J Clin Med 2023; 12:jcm12062440. [PMID: 36983439 PMCID: PMC10058993 DOI: 10.3390/jcm12062440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Alcohol Use Disorder (AUD) results in sleep disturbances that may have deleterious impacts on cognition, especially on memory. However, little is known about the sleep architecture in patients with Korsakoff's syndrome (KS). This study aims at characterizing sleep disturbances in KS compared to AUD without KS and at specifying the relationships with cognitive impairments. Twenty-nine AUD patients (22 without KS and 7 with KS) and 15 healthy controls underwent a neuropsychological assessment and a polysomnography. The severity of sleep-disordered breathing and sleep fragmentation was similar in AUD and KS patients compared to controls. Sleep architecture differed between both patient groups: the proportion of slow-wave sleep was reduced in AUD patients only, while a lower proportion of rapid-eye movement (REM) sleep was specifically observed in KS patients. The proportion of REM sleep correlated with the severity of episodic memory deficits when AUD and KS were examined together. These data provide evidence for both similarities and specificities regarding sleep alterations in AUD patients with and without KS. They also indicate that altered sleep architecture may contribute to the pathophysiology of alcohol-related memory disorders.
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Affiliation(s)
- Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNIROUEN, CRFDP (EA 7475), 76000 Rouen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Claire André
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
| | - Françoise Bertran
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Unité D'exploration et de Traitement des Troubles du Sommeil, CHU de Caen, 14000 Caen, France
| | - Céline Boudehent
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Addiction Department, CHU de Caen, 14000 Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Angéline Maillard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Alison Mary
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Laurent Urso
- Addiction Department, Centre Hospitalier de Roubaix, 59100 Roubaix, France
| | - François Vabret
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
- Addiction Department, CHU de Caen, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
- Institut Universitaire de France (IUF), 75231 Paris, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
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van Dorst MEG, Rensen YCM, Husain M, Kessels RPC. Behavioral, Emotional and Social Apathy in Alcohol-Related Cognitive Disorders. J Clin Med 2021; 10:2447. [PMID: 34072955 PMCID: PMC8197845 DOI: 10.3390/jcm10112447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
Apathy is a fundamental neuropsychiatric symptom of Korsakoff's syndrome (KS) and has also been reported in patients with alcohol use disorder with no (AUD) or less severe cognitive impairments (ARCI). However, research on the nature of apathy is limited in these groups. Aim of this study was to examine the multidimensional nature of apathy in patients with KS, ARCI and AUD. Moreover, we examined differences between apathy ratings by patients and their professional caregivers, and related apathy to everyday functioning and overall cognition. Twenty-five patients with KS, 25 patients with ARCI and 23 patients with AUD participated in this study. Apathy was measured using the apathy motivation index (AMI), which distinguishes behavioral, emotional and social apathy. Both patients and professional caregivers reported social apathy as the most prominent symptom, compared to behavioral and emotional apathy. Apathy ratings did not differ across the three patient groups. Discrepancies between patient and caregiver ratings were observed in patients with KS and ARCI, with more severe apathy reported by caregivers. Caregiver-reported behavioral and social, but not emotional, apathy was related to everyday functioning. These results show that apathy is present in a substantial proportion of patients with alcohol addiction with or without cognitive impairments.
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Affiliation(s)
- Maud E. G. van Dorst
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (Y.C.M.R.); (R.P.C.K.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Yvonne C. M. Rensen
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (Y.C.M.R.); (R.P.C.K.)
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 2JD, UK;
- Department of Experimental Psychology, University of Oxford, Oxford OX1 2JD, UK
| | - Roy P. C. Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (Y.C.M.R.); (R.P.C.K.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 XZ Nijmegen, The Netherlands
- Tactus Addiction Care, 7418 ET Deventer, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
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Heirene RM, John B, O’Hanrahan M, Angelakis I, Roderique-Davies G. Professional Perspectives on Supporting Those with Alcohol-Related Neurocognitive Disorders: Challenges & Effective Treatment. ALCOHOLISM TREATMENT QUARTERLY 2021. [DOI: 10.1080/07347324.2021.1898294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Robert M. Heirene
- Brain & Mind Centre, School of Psychology, University of Sydney, Sydney, Australia
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, UK
| | - Bev John
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, UK
| | - Marie O’Hanrahan
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, UK
| | - Ioannis Angelakis
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, UK
| | - Gareth Roderique-Davies
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, UK
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Exploring the prevalence of substance-induced neurocognitive disorder among polysubstance users, adding subjective and objective evidence of cognitive impairment. Psychiatry Res 2020; 288:112944. [PMID: 32339804 DOI: 10.1016/j.psychres.2020.112944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/17/2022]
Abstract
UNLABELLED The objective of this study was to explore the prevalence of substance-induced neurocognitive disorder (NCD) in a sample of polysubstance users, adding both objective- and subjective cognitive impairment. METHOD We collected cross-sectional data from 33 community-based residential facilities in Mexico City. Montreal Cognitive Assessment was used for measurement of objective cognitive impairment, and a DSM-5-based interview for subjective impairment. Years and days of recent use of alcohol, marijuana, cocaine and inhalants were collected for regression analyses. RESULTS 753 participants were analyzed; from these, 50.5% show objective impairment, 71% and 58.5% self-reported any cognitive deficit and cognitive decline, respectively. Between 21.8%-36.5% would qualify for NCD when integrating both objective- and subjective impairment (deficit or decline). Significant weak associations were found between objective impairment and subjective deficits in all cognitive domains except social cognition. Regression models adding both objective- and subjective measures explained more variation in the years of alcohol, inhalant and cocaine use, and in recent marijuana use, than the objective measure alone, but associations were inconsistent. CONCLUSION Though significant in proportion, the prevalence of NCD in this population can only be partially related to substance use. Further integrative approaches are needed to refine the epidemiology of this disorder.
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Gerridzen IJ, Hertogh CM, Joling KJ, Veenhuizen RB, Verschuur EM, Janssen T, Depla MF. Caregivers' perspectives on good care for nursing home residents with Korsakoff syndrome. Nurs Ethics 2020; 28:358-371. [PMID: 32436458 PMCID: PMC8151566 DOI: 10.1177/0969733020921507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the Netherlands, people with severe cognitive deficits due to Korsakoff syndrome are generally admitted to a specialized nursing home. Professional caregivers experience that these residents are often not aware of their deficits, and consequently, their willingness to accept care is relatively low. However, these residents need permanent support when performing daily tasks due to severe cognitive deficits. The combination of objective care needs and low subjective responsiveness makes caring for people with Korsakoff syndrome a complex undertaking. It is unknown how professional caregivers deal with this complex task and how they manage the associated ethical challenges. OBJECTIVES The aim of this study was to explore the professional caregivers' perspectives on good care for residents with Korsakoff syndrome. METHODS A qualitative study design was used. Data were collected via semi-structured interviews. The Framework Method was used for the thematic analyses of the interview data. PARTICIPANTS AND RESEARCH CONTEXT Five specialized nursing homes participated in this study. Twelve professional caregivers, including nurses, nursing assistants, and support workers, were selected based on the ability to provide rich information on the study topics and to capture a variety of demographic and professional characteristics. ETHICAL CONSIDERATIONS The institutional review board of the VU University Medical Center Amsterdam approved the research protocol. The study was conducted in accordance with the ethical principles for medical research involving human subjects. FINDINGS Three perspectives on good care emerged: (1) making daily life a joint effort, (2) being steadfast, and (3) treating with respect. DISCUSSION AND CONCLUSION Professional caregivers try to achieve responsiveness in people with Korsakoff syndrome in three different ways. These perspectives reflect fundamentally different views on the care relationship and the autonomy of the resident. By elucidating the three perspectives, we hope to promote the practitioners' reflection on their own ideas about good care for people with Korsakoff syndrome.
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Affiliation(s)
- Ineke J Gerridzen
- 522567Amsterdam UMC, the Netherlands; Nursing Home Markenhof, the Netherlands
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Galindo-Aldana GM, Murillo-Macías C, Cedano-Gasca A, Padilla-López A, García-León IA. Drug Trend Study in Mexican Population: Consumption and Cognitive Dysfunction Correlates. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.15446/revfacmed.v67n4.64157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Drug abuse screening tests (DAST) are a useful tool in decision making regarding the planning and implementation of drug-related public health policies. In addition, they constitute a rapid way to obtain data on the effects of drug consumption in specific populations.Objective: To describe the correlation between drug abuse (per type of drug) and cognitive dysfunction prevalence based on the information reported in a DAST.Materials and methods: A DAST was administered to 1299 individuals from 5 cities in Baja California, Mexico. In addition, an internal consistency reliability test was conducted to determine the internal consistency level of the instrument.Results: Several correlations between the consumption of different drugs were found. The main associations were found between methamphetamine and marijuana consumption. In addition, a positive correlation between the age at first drug use and cognitive impairment was found.Conclusions: DAST are brief administration instruments that allow obtaining data on drug abuse and drug addiction patterns. In addition, they can be used to identify the interaction between the consumption patterns of different drugs and the possible association between age at first drug use and cognitive dysfunction.
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Sullivan EV, Pfefferbaum A. Brain-behavior relations and effects of aging and common comorbidities in alcohol use disorder: A review. Neuropsychology 2019; 33:760-780. [PMID: 31448945 PMCID: PMC7461729 DOI: 10.1037/neu0000557] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Alcohol use disorder (AUD) is a complex, dynamic condition that waxes and wanes with unhealthy drinking episodes and varies in drinking patterns and effects on brain structure and function with age. Its excessive use renders chronically heavy drinkers vulnerable to direct alcohol toxicity and a variety of comorbidities attributable to nonalcohol drug misuse, viral infections, and accelerated or premature aging. AUD affects widespread brain systems, commonly, frontolimbic, frontostriatal, and frontocerebellar networks. METHOD AND RESULTS Multimodal assessment using selective neuropsychological testing and whole-brain neuroimaging provides evidence for AUD-related specific brain structure-function relations established with double dissociations. Longitudinal study using noninvasive imaging provides evidence for brain structural and functional improvement with sustained sobriety and further decline with relapse. Functional imaging suggests the possibility that some alcoholics in recovery can compensate for impairment by invoking brain systems typically not used for a target task but that can enable normal-level performance. CONCLUSIONS Evidence for AUD-aging interactions, indicative of accelerated aging, together with increasing alcohol consumption in middle-age and older adults, put aging drinkers at special risk for developing cognitive decline and possibly dementia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Center for Health Sciences, SRI International, Menlo Park, CA
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Gerridzen IJ, Joling KJ, Depla MF, Veenhuizen RB, Verschuur EM, Twisk JW, Hertogh CM. Awareness and its relationships with neuropsychiatric symptoms in people with Korsakoff syndrome or other alcohol-related cognitive disorders living in specialized nursing homes. Int J Geriatr Psychiatry 2019; 34:836-845. [PMID: 30854733 PMCID: PMC6593674 DOI: 10.1002/gps.5093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 03/05/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Impaired awareness of functional deficits is often observed in people with Korsakoff syndrome (KS) and may result in refusal of care, although this area has been understudied. This study aimed to investigate levels of impaired awareness and their relationships with neuropsychiatric symptoms (NPS) in people with KS residing in specialized nursing homes. METHODS A cross-sectional, observational study was conducted among 215 residents with KS or other alcohol-related cognitive disorders. Awareness was measured with the Patient Competency Rating Scale (PCRS). NPS and subsyndromes were measured with the Neuropsychiatric Inventory-Questionnaire (NPI-Q). Adjusted multilevel regression analyses were performed to examine the relationships between the level of awareness and NPS. RESULTS The mean level of impaired awareness was 39.3 (SD = 19.9) indicating moderate impairment. Twenty-nine percent of the residents had no or mildly impaired awareness; 37% were moderately impaired, and 34% were severely impaired. Residents with moderately impaired awareness showed more severe apathy than residents with no or mildly impaired awareness (difference 1.23; 95% CI 1.02-1.48; p = 0.03). No associations were found between the level of awareness and other NPI outcomes. Cognitive functioning seems to have the strongest impact on the association between level of awareness and NPS in KS residents. CONCLUSIONS Impaired awareness of functional deficits is highly common in KS residents; however, apart from apathy, is not significantly related with NPS. Additional research should further examine, which interventions are effective in dealing with impaired awareness in these people, particularly when apathy is present.
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Affiliation(s)
- Ineke J. Gerridzen
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research instituteVU University Medical CenterAmsterdamThe Netherlands,Nursing home MarkenhofAtlantBeekbergenThe Netherlands
| | - Karlijn J. Joling
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research instituteVU University Medical CenterAmsterdamThe Netherlands
| | - Marja F. Depla
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research instituteVU University Medical CenterAmsterdamThe Netherlands
| | - Ruth B. Veenhuizen
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research instituteVU University Medical CenterAmsterdamThe Netherlands
| | | | - Jos W.R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Cees M.P.M. Hertogh
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research instituteVU University Medical CenterAmsterdamThe Netherlands
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Laniepce A, Segobin S, Lannuzel C, Boudehent C, Ritz L, Urso L, Vabret F, Eustache F, Beaunieux H, Rauchs G, Pitel A. Neuropsychological and Neuroimaging Examinations of Self‐Reported Sleep Quality in Alcohol Use Disorder With and Without Korsakoff's Syndrome. Alcohol Clin Exp Res 2019; 43:952-964. [DOI: 10.1111/acer.13997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/27/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Alice Laniepce
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Shailendra Segobin
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Coralie Lannuzel
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Céline Boudehent
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
- Addiction Department Centre Hospitalier Universitaire de Caen Caen France
| | - Ludivine Ritz
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Laurent Urso
- Addiction Department Centre Hospitalier de Roubaix Roubaix France
| | - François Vabret
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
- Addiction Department Centre Hospitalier Universitaire de Caen Caen France
| | - Francis Eustache
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Hélène Beaunieux
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Géraldine Rauchs
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Anne‐Lise Pitel
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
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14
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Gerridzen IJ, Hertogh CM, Depla MF, Veenhuizen RB, Verschuur EM, Joling KJ. Neuropsychiatric Symptoms in People With Korsakoff Syndrome and Other Alcohol-Related Cognitive Disorders Living in Specialized Long-Term Care Facilities: Prevalence, Severity, and Associated Caregiver Distress. J Am Med Dir Assoc 2018; 19:240-247. [DOI: 10.1016/j.jamda.2017.09.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 09/13/2017] [Accepted: 09/18/2017] [Indexed: 11/27/2022]
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Abstract
In this review, we present a survey on Korsakoff's syndrome (KS), a residual syndrome in patients who suffered from a Wernicke encephalopathy (WE) that is predominantly characterized by global amnesia, and in more severe cases also by cognitive and behavioral dysfunction. We describe the history of KS and its definition, its epidemiology, and the lack of consensus criteria for its diagnosis. The cognitive and behavioral symptoms of KS, which include anterograde and retrograde amnesia, executive dysfunction, confabulation, apathy, as well as affective and social-cognitive impairments, are discussed. Moreover, recent insights into the underlying neurocognitive mechanisms of these symptoms are presented. In addition, the evidence so far on the etiology of KS is examined, highlighting the role of thiamine and alcohol and discussing the continuity hypothesis. Furthermore, the neuropathology of KS is reviewed, focusing on abnormalities in the diencephalon, including the mammillary bodies and thalamic nuclei. Pharmacological treatment options and nonpharmacological interventions, such as those based on cognitive rehabilitation, are discussed. Our review shows that thiamine deficiency (TD) is a crucial factor in the etiology of KS. Although alcohol abuse is by far the most important context in which TD occurs, there is no convincing evidence for an essential contribution of ethanol neurotoxicity (EN) to the development of WE or to the progression of WE to KS. Future research on the postmortem histopathological analysis of brain tissues of KS patients is crucial for the advancement of our knowledge of KS, especially for associating its symptoms with lesions in various thalamic nuclei. A necessary requirement for the advancement of studies on KS is the broad acceptance of a comprehensive definition and definite diagnostic criteria. Therefore, in this review, we propose such a definition of KS and draft outlines for prospective diagnostic criteria.
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Affiliation(s)
- Nicolaas Jm Arts
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Neuropsychiatry Center Thalamus, Institution for Integrated Mental Health Care Pro Persona, Wolfheze
| | - Serge Jw Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray
| | - Roy Pc Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Department of Neuropsychology and Rehabilitation Psychology, Donders Institute for Brain, Cognition and Behaviour, Radboud University.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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