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Major Neurocognitive Disorder with Behavioral Disturbance (Behavioral and Psychological Symptoms of Dementia—BPSD)

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Abstract

DSM-5 specifies major neurocognitive disorder (MNCD) as “with” or “without” behavioral disturbance. According to the Alzheimer’s Disease International: World Alzheimer Report 2014 (World Alzheimer Report 2014), 98% of people with MNCD will experience non-cognitive, or behavioral, symptoms at some point in their illness. These behavioral and psychological symptoms of dementia (BPSD) can include depression, anxiety, apathy, agitation, wandering, aggressive behavior, repetitive complaints, obsessive-compulsive behaviors, delusions, hallucinations, and disordered sleep.

The non-cognitive symptoms (NCS) and neuropsychiatric symptoms (NPS), which often accompany MNCD, can disrupt living situations and delivery of medical treatment. As a result, they are likely to precipitate placement out of the home or exclusion from a long-term living situation. Psychiatric inpatient hospitalization or admission to a similar unit may be the result. Management of BPSD is also crucial because both patient and others in the facility may be at risk of injury and/or assault. This chapter reviews the phenomenology and diagnosis of BPSD, as well as treatment and management options in the inpatient setting.

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Authors and Affiliations

  1. VA St. Louis Health Care System, Department of Psychiatry and Behavioral Neuroscience at St. Louis University School of Medicine, St. Louis, MO, USA

    Christopher O’Connell

  2. Department of Psychiatry and Stanford/VA Alzheimer’s Center, VA Health Care System, Palo Alto, CA, USA

    Howard H. Fenn

  3. Palo Alto Veterans’ Institute for Research (PAVIR), VA Palo Alto Health Care System, Palo Alto, CA, USA

    Rita Hitching

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Correspondence to Howard H. Fenn .

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Editors and Affiliations

  1. Department of Psychiatry and Stanford/VA Alzheimer’s Center, VA Health Care System, Palo Alto, CA, USA

    Howard H. Fenn

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  3. Department of Psychiatry, Baylor Scott and White Central Texas, Division College of Medicine, Texas A & M University, Health Science Center, Temple, TX, USA

    James A. Bourgeois

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O’Connell, C., Fenn, H.H., Hitching, R. (2019). Major Neurocognitive Disorder with Behavioral Disturbance (Behavioral and Psychological Symptoms of Dementia—BPSD). In: Fenn, H., Hategan, A., Bourgeois, J. (eds) Inpatient Geriatric Psychiatry . Springer, Cham. https://doi.org/10.1007/978-3-030-10401-6_6

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