Evaluación e intervención psicomotora en psicogeriatría: conceptos y prácticas / No disponible

Con este artículo se pretende explicar los principales conceptos que están en la base de la aplicación de la psicomotricidad en el área de la psicogeriatría. Se abordarán las bases fundamentales del dominio científico de la psicomotricidad (conexión cuerpo-mente-relación), la especificidad de la relación entre terapeuta y paciente, la formación del psicomotricista y sus marcos profesionales. Se explicarán los efectos del envejecimiento en el sistema psicomotor (especialmente en la selección, programación y ejecución motora), indicando puntos fundamentales en el desempeño al nivel del equilibrio estático y dinámico, del tono, de la marcha, de la coordinación global e fina, de la estructuración espacial e temporal, de la noción y esquema corporal, de la percepción e integración sensorial y finalmente de la comunicación verbal y no verbal. También se explicitarán los principales síntomas psicomotores de síndromes neurodegenerativos como la enfermedad de Alzheimer y otras demencias. Seguidamente, se abordará la evaluación psicomotora de personas mayores, principalmente la aplicación de la versión portuguesa del Éxamen Geronto Psychomoteur1. Serán aclarados los principales objetivos de la intervención psicomotora y cómo se la encuadra, planea y ejecuta en el contexto de un equipo interdisciplinario de psicogeriatría. Por fin, se presentará la estructura general de una sesión de intervención psicomotora y los principales materiales utilizados

This article aims to explain the main concepts that are at the base of the application of psychomotricity in the psychogeriatric area. The fundamental bases of the scientific domain of psychomotricity (body-mind-relationship), the specificity of the relationship between psychomotor-therapist and patient, the training of the psychomotor therapist and its professional frameworks will be addressed. The effects of aging in the psychomotor system will be explained (especially in the selection, programming and motor execution), indicating fundamental points in the performance at the level of static and dynamic balance, tone, gait, global and fine coordination, spatial and temporal structuring, body notion and schema, sensory perception and integration', and finally of verbal and non-verbal communication. The main psychomotor symptoms of neurodegenerative syndromes such as Alzheimer's disease and other dementias will also be explained. Next, psychomotor assessment of older people will be addressed, mainly the application of the Portuguese version of the Éxamen Geronto Psychomoteur1. The main objectives of the psychomotor intervention and how it is framed, planned and executed in the context of an interdisciplinary psychogeriatric team will be clarified. Finally, the general structure of a psychomotor intervention session and the main materials used will be presented

Interferencias de las alucinaciones auditivas verbales recurrentes sobre el rendimiento en una tarea de shadowing (sombreado) en la esquizofrenia / No disponible

No disponible

Evaluation of a radio based ADL interaction recognition system in a day hospital for old age psychiatry with healthy probands.

In this contribution the evaluation of a system called "Eventlogger" is presented, which is installed in a day hospital for old age psychiatry. The Eventlogger is a radio based module with an adjustable communication range, able to recognize interaction of the user with objects or with other people. It is intended to function as a monitoring tool for the users' activities. Due to the demographic change monitoring systems for elderly people become more important. In this paper the "simple activities of daily living" (sADL) is introduced as well as the evaluation for the recognition of sADL in a day hospital for old age psychiatry with healthy probands is presented. Together with the first approaches of post processing for better results it is shown that the system is now ready to be used with patients of the day hospital for old age psychiatry.

[A shortened scale for overall, emotional and social loneliness]. / De ingekorte schaal voor algemene, emotionele en sociale eenzaamheid.

Loneliness is an indicator of social well-being and pertains to the feeling of missing an intimate relationship (emotional loneliness) or missing a wider social network (social loneliness). The 11-item De Jong Gierveld scale has proved to be a valid and reliable measuring instrument for overall, emotional and social loneliness, although its length has sometimes rendered it difficult to use the scale in large surveys. In this study, we empirically tested a shortened version of the scale on data from two surveys (N=9448). Confirmatory factor analyses confirmed the specification of two latent factors. Congruent validity and the relationship with determinants (partner status, health) proved to be optimal. The 6-item De Jong Gierveld scale is a reliable and valid measuring instrument for overall, emotional and social loneliness, which is suitable for large surveys.

Structural neuroimaging research methods in geriatric depression.

Geriatric depression consists of complex and heterogeneous behaviors unlikely to be caused by a single brain lesion. However, there is evidence that abnormalities in specific brain structures and their interconnections confer vulnerability to the development of late-life depression. Structural magnetic resonance imaging methods can be used to identify and quantify brain abnormalities predisposing to geriatric depression and in prediction of treatment response. This article reviews several techniques, including morphometric approaches, study of white matter hyperintensities, diffusion tensor imaging, magnetization transfer imaging, t2 relaxography, and spectroscopy, that have been used to examine these brain abnormalities with a focus on the type of information obtained by each method as well as each method's limitations. The authors argue that the available methods provide complementary information and that, when combined judiciously, can increase the knowledge gained from neuroimaging findings and conceptually advance the field of geriatric depression.

What is the best dementia screening instrument for general practitioners to use?

OBJECTIVE: The objective of this study was to review existing dementia screening tools with a view to informing and recommending suitable instruments to general practitioners (GPs) based on their performance and practicability for general practice. METHOD: A systematic search of pre-MEDLINE, MEDLINE, PsycINFO, and the Cochrane Library Database was undertaken. Only available full-text articles about dementia screening instruments written in English or with an English version were included. Articles using a translation of an English language instrument were excluded unless validated in a general practice, community, or population sample. RESULTS: The General Practitioner Assessment of Cognition (GPCOG), Mini-Cog, and Memory Impairment Screen (MIS) were chosen as most suitable for routine dementia screening in general practice. The GPCOG, Mini-Cog, and MIS were all validated in community, population, or general practice samples, are easy to administer, and have administration times of 5 minutes or less. They also have negative predictive validity and misclassification rates, which do not differ significantly from those of the Mini-Mental Status Examination. CONCLUSIONS: It is recommended that GPs consider using the GPCOG, Mini-Cog, or MIS when screening for cognitive impairment or for case detection.

Instruments to assess decision-making capacity: an overview.

OBJECTIVE: The main objective of this article is to evaluate and describe instruments for assessing decision-making capacity in psychiatry and psychogeriatrics, and to evaluate them for use in daily practice. METHODS: The instruments were selected in Medline articles. We focus on the relationship between these instruments and the concept of competence, represented in the following elements: context in which an instrument is developed, disclosure of information, standards to assess decision-making capacity, the scale or threshold model, and validity and reliability. RESULTS: The developmental context influences how information is provided and standards defined. Although it is not clear how decision-making capacity relates to competency judgments, most instruments provide good reliability. CONCLUSIONS: Comparison of the different instruments opens directions for future research. Although instruments can never replace a physician's judgment, they may provide a clear starting point for a discussion on competence. In daily practice assessments, attention should be given to information disclosure, the influence of our own normative values in evaluating standards of decision-making capacity, and the relation between decision-making capacity and competence.

The clinical applications of Mini-Mental State Examination in geropsychiatric inpatients.

OBJECTIVE: This study investigated the association between Mini-Mental State Examination (MMSE) scores and diagnosis, computerized tomographic scans or electroencephalogram findings in geropsychiatric inpatients (age > or = 65). METHOD: We analyzed the MMSE records of patients sixty-five and older who had been hospitalized in our psychiatric ward during a nine-year period. Case data were collected by review of chart records. RESULTS: In these patients, MMSE scores were significantly different among the seven diagnostic groups included. Demented patients had the lowest MMSE scores. Patients who had abnormal findings on computerized tomographic scans or electroencephalogram had lower MMSE than patients with normal findings. CONCLUSION: Our findings suggest that the MMSE is a useful screening instrument for organicity in the geropsychiatric inpatients. However, because of the lower average MMSE score in geropsychiatric inpatients, the optimal cut-offpoint of MMSE for dementia should be lower than those used in other populations.

A computerized laboratory alerting system in a psychogeriatric unit.

We evaluated the contribution of a computerized laboratory alerting system to patient care in a 34-bed psychogeriatric unit. With this system the results of routine laboratory tests are automatically retrieved and registered on a daily computer-based medication report. During the first 33 days in which the alerting system was in use, a senior psychiatrist monitored the total number of alerting messages sent, the number of new messages per day, the number indicating physician unawareness, the number already dealt with, and the number that initiated a decision to treat the patient or repeat a laboratory test. The alerting system retrieved a mean (+/- SD) of 0.77 +/- 0.11 messages per patient per day. Twelve percent were new messages and 88% were rotating messages. Three resident psychiatrist-case managers were unaware of half the rotating messages (i.e., 6% of all messages). Seven percent of the new messages initiated treatment, and 15% resulted in laboratory retesting. We conclude that the alerting system results in a simple, efficient report that contributes substantially to safe patient care.

Validation of a screening battery for psychogeriatric assessment.

The aims of this study were to identify the most important diagnostic questions that warrant assessment in psychogeriatric patients and to select and validate objective screening procedures for those areas. Four areas were identified by surveying the records of 87 psychogeriatric patients: organicity, depression, prognosis, and global psychopathology. Relevant assessment instruments, selected on the basis of a comprehensive literature survey, were administered to 61 psychogeriatric inpatients, and criterion ratings were obtained in each of the four diagnostic areas. The Mental Status Questionnaire correlated -.87 with the organicity criterion and also shoed the highest correlations with the other three criterion variables. A canonical correlation analysis showed that the organicity and depression criteria could be reliably separated by the predictors, and multiple regression analysis showed that each could be reliably predicted independently. It is noted that the population studied was largely chronic in nature, so that the findings are not necessarily applicable to other kinds of settings.