Lincolon4736

The behavioural variant of frontotemporal dementia (bvFTD) strongly resembles primary psychiatric disorders. Furthermore, a bvFTD mimic may occur, without neurodegenerative aetiology.

To offer psychiatrist clinical tools for making or ruling out a bvFTD diagnosis.

To present the results of the first prospective cohort study on bvFTD patients and primary psychiatric patients. Results are discussed within the context of the international literature.

Frontotemporal atrophy on imaging confirms a suspected bvFTD diagnosis. Merely fulfilling the bvFTD clinical criteria, with or without frontotemporal hypometabolism on functional imaging, may also result from primary psychiatric disorders or the bvFTD-phenocopy syndrome. A high level of stereotypy, hyperorality, a low level of depressive symptoms, impaired social cognition or absent insight increases the probability of bvFTD. Biomarker or genetic tests and follow-up are recommended. CONCLUSIONS A bvFTD diagnosis should be made multidisciplinary. Without the confirmation of atrophy or genetics, great reserve in making the diagnosis is in place and careful analyses for psychiatric aetiologies is advised.

Frontotemporal atrophy on imaging confirms a suspected bvFTD diagnosis. Merely fulfilling the bvFTD clinical criteria, with or without frontotemporal hypometabolism on functional imaging, may also result from primary psychiatric disorders or the bvFTD-phenocopy syndrome. A high level of stereotypy, hyperorality, a low level of depressive symptoms, impaired social cognition or absent insight increases the probability of bvFTD. Biomarker or genetic tests and follow-up are recommended. CONCLUSIONS A bvFTD diagnosis should be made multidisciplinary. Without the confirmation of atrophy or genetics, great reserve in making the diagnosis is in place and careful analyses for psychiatric aetiologies is advised.

Psychotic depression is a severe disease with a lifetime prevalence between 0.35 and 1%. Several guidelines suggest electroconvulsion therapy (ECT) as first choice treatment, however, in practice a pharmacological approach is often used first.

To offer an overview of scientific literature concerning the pharmacotherapeutic treatment of psychotic depression.

We searched 'Pubmed' for Dutch or English articles, published after 1999.

The search strategy produced 26 articles, of which 6 were excluded because of a too small study population. In the references of used literature 4 more articles were witheld. 24 articles were included. Despite the severity of the disease and the high prevalence, the research regarding treatment of psychotic depression is limited. Besides ECT, we consider combination therapy with an antidepressant and an antipsychotic as the most supported treatment, for a duration of at least four months. After four months tapering off the antipsychotic can be considered.

Based on the discussed research, it's difficult to arrive at conclusions regarding the choice of products. Olanzapine or quetiapine were investigated the most in combination with an SSRI. The combination of an SNRI (venlafaxine) and quetiapine shows good results. selleck chemicals llc The distinct effect of treatment with a TCA calls for further investigation.

Based on the discussed research, it's difficult to arrive at conclusions regarding the choice of products. Olanzapine or quetiapine were investigated the most in combination with an SSRI. The combination of an SNRI (venlafaxine) and quetiapine shows good results. The distinct effect of treatment with a TCA calls for further investigation.

The high and intensive care (HIC) model provides a framework for acute admission wards and is being implemented since 2013 by all mental healthcare institutions in the Netherlands.

To investigate how the HIC model has been implemented between 2014 and 2018 and how the implementation of the HIC model is associated to coercive measures.

Between 2014 and 2018, 79 audits were organized in two phases within 25 institutions to measure the degree of implementation of HIC using a model fidelity scale, the HIC monitor. HIC monitor scores were compared to data on coercion to determine the relationship between implementation of the HIC model and coercive measures.

Scores on the HIC monitor increased over time, especially in terms of vision, hospitality and facilities. However, a third of wards scored lower on the HIC monitor in the second audit compared to the first audit. Institutions that score higher use less seclusion and use less forced medication.

Progress in the implementation of the HIC model is visible and institutions that are further in the implementation of the HIC model apply less coercion. Securing implementation proves difficult. Attention should be paid to the national staff shortage and systematic evaluation of coercion.

Progress in the implementation of the HIC model is visible and institutions that are further in the implementation of the HIC model apply less coercion. Securing implementation proves difficult. Attention should be paid to the national staff shortage and systematic evaluation of coercion.

Yearly, over 1.000.000 people receive mental health care treatment in the Netherlands. Treatment usually results in improvement in quality of life. Concurrently, each professional recognizes clinically refractory cases in which improvement fails to occur with severe ongoing burden for the client. In the Netherlands, for these clinically refractory cases the Centre of Consultation and Expertise (CCE) is available. The CCE is an independent nation-wide organisation offering free consultations to care providers. Therefore, CCE-consultations provide a unique insight in and overview of refractory cases.

Providing overview of and insight into backgrounds and themes that play a role in (the reduction of) refractory cases.

Descriptive study of quantitative and qualitative data from 472 consultations in mental health care.

83% of cases could be explained with 4 exemplary vignettes of refractoriness self-harm, aggression, self-neglect and socially unacceptable behaviour.

Refractory cases result from an interaction pattern that unintentionally maintains or aggravates the situation. This study offers an overview of approaches that proved to be helpful in providing new perspective for clients and professionals in many therapy refractory cases in Dutch mental health care.

Refractory cases result from an interaction pattern that unintentionally maintains or aggravates the situation. This study offers an overview of approaches that proved to be helpful in providing new perspective for clients and professionals in many therapy refractory cases in Dutch mental health care.