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

  • Christopher O’Connell
  • Howard H. FennEmail author
  • Rita Hitching
Chapter

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.

Keywords

Non-cognitive symptoms Major neurocognitive disorder BPSD Agitation Behavioral disturbance 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Christopher O’Connell
    • 1
  • Howard H. Fenn
    • 2
    Email author
  • Rita Hitching
    • 3
  1. 1.VA St. Louis Health Care SystemDepartment of Psychiatry and Behavioral Neuroscience at St. Louis University School of MedicineSt. LouisUSA
  2. 2.Department of Psychiatry and Stanford/VA Alzheimer’s CenterVA Health Care SystemPalo AltoUSA
  3. 3.Palo Alto Veterans’ Institute for Research (PAVIR), VA Palo Alto Health Care SystemPalo AltoUSA

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