Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-09T16:13:18.291Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychiatric and neuropsychological correlates of delusions in Alzheimer's disease

Published online by Cambridge University Press:  09 July 2009

R. Migliorelli ,
G. Petracca ,
A. Tesón ,
L. Sabe ,
R. Leiguarda  and
S. E. Starkstein
R. Migliorelli
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
G. Petracca
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
A. Tesón
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
L. Sabe
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
R. Leiguarda
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
S. E. Starkstein*
Affiliation:
Department of Behavioral Neurology and Neuropsychiatry, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina
*
1 Address for correspondence: Dr Sergio E. Starkstein, Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni, Montaneses 2325, 1428 Buenos Aires, Argentina.
Get access Rights & Permissions [Opens in a new window]

Synopsis

We examined the prevalence, phenomenology, and clinical correlates of delusions in a consecutive series of 103 patients with probable Alzheimer's disease (AD). Patients were examined with the Present State Exam and the Dementia–Psychosis Scale. Twenty-one patients (20%) met DSM-III-R criteria for a delusional disorder. The most frequent delusion type was paranoid (71%), followed by hypochondriacal (67%), the Capgras syndrome (29%), house misidentification (29%), and grandiose delusions (29%). Out of the 21 AD patients with delusions, 76% had three or more different types of delusions simultaneously. The frequency of delusions was not significantly associated with age, education, or age at dementia onset, and the type and severity of cognitive impairments was similar for AD patients with and without delusions. However, AD patients with delusions had significantly higher mania and anosognosia scores.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 3 , May 1995 , pp. 505 - 513
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer, A. (1907). Über eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitung für Psychiatrie und Psychisch- und Gerichtliche Medizin 64, 146–148.Google Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders–Revised. American Psychiatric Press: Washington, DC.Google Scholar
Bech, P., Kastrup, M. & Rafaelsen, O. J. (1986). Mini-compendium of rating scales for states of anxiety, depression, mania, schizophrenia, with corresponding DSM-III syndromes. Acta Psychiatrica Scandinavica 73 (suppl. 236), 29–31.Google Scholar
Berrios, G. E. & Brook, P. (1985). Delusions and the psychopathology of the elderly with dementia. Acta Psychiatrica Scandinavica 72, 296–301.CrossRefGoogle ScholarPubMed
Benton, A. L. (1968). Differential behavioral effects in frontal lobe disease. Neuropsychologia 6, 53–60.CrossRefGoogle Scholar
Benton, A. L. (1974). The Revised Visual Retention Test, 4th edn.The Psychological Corporation: New York.Google Scholar
Burns, A., Jacoby, R. & Levy, R. (1990). Psychiatric phenomena in Alzheimer's disease. 1. Disorders of thought content. British Journal of Psychiatry 157, 72–76.CrossRefGoogle Scholar
Buschke, H. & Fuld, P. A. (1974). Evaluating storage, retention, and retrieval in disordered memory and learning. Neurology 24, 1019–1025.CrossRefGoogle ScholarPubMed
Cummings, J. L. (1992). Psychosis in neurologic disease: neurobiology and pathogenesis. Neuropsychiatry, Neuropsychology and Behavioral Neurology 5, 144–150.Google Scholar
Cummings, J. L. & Benson, D. F. (1992). Dementia: A Clinical Approach. Butterworth–Heinemann: Boston.Google Scholar
De Renzi, E. & Faglioni, P. (1978). Development of a shortened version of the Token Test. Cortex 14, 41–49.CrossRefGoogle Scholar
Devanand, D. P., Miller, L., Richards, M., Marder, K., Bell, K., Mayeux, R. & Stern, Y. (1992). The Columbia University Scale for psychopathology in Alzheimer's disease. Archives of Neurology 49, 371–376.CrossRefGoogle ScholarPubMed
Drevets, W. C. & Rubin, E. H. (1987). Erotomania and senile dementia of Alzheimer type. British Journal of Psychiatry 151, 400–402.CrossRefGoogle ScholarPubMed
Drevets, W. C. & Rubin, E. H. (1989). Psychotic symptoms and the longitudinal course of senile dementia of the Alzheimer type. Biological Psychiatry 25, 39–48.CrossRefGoogle ScholarPubMed
Flynn, F. G., Cummings, J. L. & Gornbein, J. (1991). Delusions in dementia syndromes: investigation of behavioral and neuropsychological correlates. Journal of Neuropsychiatry and Clinical Neurosciences 3, 364–370.Google ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research 12, 189–198.CrossRefGoogle Scholar
Förstl, H., Burns, A., Luthert, P., Cairns, N. & Levy, R. (1993). The Lewy-body variant of Alzheimer's disease: clinical and pathological findings. British Journal of Psychiatry 162, 385–392.CrossRefGoogle ScholarPubMed
Granger, C. V., Hamilton, B. B. & Kayton, R. (1986). Guide for Use of the Uniform Data Set for Medical Rehabilitation. Uniform Data System for Medical Rehabilitation: Buffalo, NY.Google Scholar
Hachinski, V. C., Iliff, L. D., Zilhka, L., Du Boulay, G. H., McAllister, V. L., Marshall, J., Russell, R. W. R. & Symon, L. (1975). Cerebral blood flow in dementia. Archives of Neurology 40, 97–103.Google Scholar
Jeste, D. V., Wragg, R. E., Salmon, D. P., Harris, M. J. & Thal, L. J. (1992). Cognitive deficits of patients with Alzheimer's disease with and without delusions. American Journal of Psychiatry 149, 184–189.Google ScholarPubMed
Kaplan, E. F., Goodglass, H. &Weintraub, S. (1983). The Boston Naming Test. Lea & Febiger: Philadelphia.Google Scholar
Kertesz, A. (1982). Western Aphasia Battery. Grune and Stratton: New York.Google Scholar
Kumar, V. (1987). Capgras syndrome in a patient with dementia. British Journal of Psychiatry 150, 251.CrossRefGoogle Scholar
Lang, A. E. & Fahn, S. (1989). Assessment of Parkinson's Disease. In Quantification of Neurologic Deficit (ed. Munsat, T. L.). Butterworths: Boston.Google Scholar
Lopez, O. L., Becker, J. T., Brenner, R. P., Rosen, J., Bajulaiye, O. I. & Reynolds, C. F. (1991). Alzheimer's disease with delusions and hallucinations: neuropsychological and electroencephalographic correlates. Neurology 41, 906–912.CrossRefGoogle ScholarPubMed
McGlynn, S. M. & Kazniak, A. W. (1991). When metacognition fails: impaired awareness of deficits in Alzheimer's disease. Journal of Cognitive Neuroscience 3, 183–189.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M. F., Katzman, R., Price, D. & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34, 939–944.CrossRefGoogle ScholarPubMed
Mayeux, R., Stern, Y. & Spanton, S. (1985). Heterogeneity in dementia of the Alzheimer type: evidence of subgroups. Neurology 35, 453–461.CrossRefGoogle ScholarPubMed
Mendez, M. F. (1992). Delusional misidentification of persons in dementia. British Journal of Psychiatry 160, 414–416.CrossRefGoogle ScholarPubMed
Mendez, M. F., Martin, R. J., Smyth, K. A. & Whitehouse, P. J. (1990). Psychiatric syndromes associated with Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences 2, 28–33.Google Scholar
Mendez, M. F., Martin, R. J., Smyth, K. A. & Whitehouse, P. J. (1992). Disturbances of person identification in Alzheimer's disease. Journal of Nervous and Mental Disease 180, 94–96.CrossRefGoogle ScholarPubMed
Mercer, B., Wapner, W., Gardner, H. & Benson, D. F. (1977). A study of confabulation. Archives of Neurology 34, 429–433.CrossRefGoogle ScholarPubMed
Migliorelli, R., Tesón, A., Sabe, L., Petracchi, M., Leiguarda, R. & Starkstein, S. E. (1994). Prevalence and correlates of dysthymia and major depression in Alzheimer's disease. American Journal of Psychiatry (in the press).Google Scholar
Nelson, H. E. (1976). A modified card sorting test sensitive to frontal lobe defects. Cortex 12, 313–324.CrossRefGoogle ScholarPubMed
Rabins, P. V., Mace, N. L. & Lucas, M. J. (1982). The impact of dementia on the family. Journal of the American Medical Association 248, 333–335.CrossRefGoogle ScholarPubMed
Raven, J. C., Court, J. H. & Raven, J. (1986). Manual for Raven's Progressive Matrices and Vocabulary Scales. H. K. Lewis: London.Google Scholar
Reisberg, B. & Ferris, S. H. (1985). A clinical rating scale for symptoms of psychosis in Alzheimer's disease. Psychopharmacology Bulletin 21, 101–103.Google ScholarPubMed
Reisberg, B., Borenstein, J., Salob, S. P., Ferris, S. H., Franssen, E. & Georgotas, A. (1987). Behavioural symptoms in Alzheimer's disease: phenomenology and treatment. Journal of Clinical Psychiatry 48 (Suppl. 5), 9–15.Google ScholarPubMed
Reisberg, B., Franssen, E., Sclan, S., Kluger, A. &Ferris, S. H. (1989). Stage specific incidence of potentially remediable behavioral symptoms in aging and Alzheimer disease: a study of 120 patients using the BEHAVE-AD. Bulletin of Clinical Neurosciences 54, 95–112.Google Scholar
Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills 8, 271–276.CrossRefGoogle Scholar
Renvoize, E. B., Kent, J. & Klar, H. M. (1987). Delusional infestation and dementia: a case report. British Journal of Psychiatry 150, 403–405.CrossRefGoogle ScholarPubMed
Rubin, E. H. (1992). Delusions as part of Alzheimer's disease. Neuropsychiatry, Neuropsychology and Behavioral Neurology 5, 108–113.Google Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M. & First, M. B. (1992). The structured clinical interview for DSM-III-R(SCID). I. History, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle Scholar
Starkstein, S. E., Mayberg, H. S., Berthier, M. L., Fedoroff, P., Price, T. R., Dannals, R. F., Wagner, H. N., Leiguarda, R. & Robinson, R. G. (1990). Mania after brain injury: neuroradiological and metabolic findings. Annals of Neurology 27, 652–659.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Migliorelli, R., Tesón, A., Sabe, L., Vazquez, S., Turjanski, M., Robinson, R. G. & Leiguarda, R. (1994). The specificity of cerebral blood flow changes in patients with frontal lobe dementia. Journal of Neurology, Neurosurgery and Psychiatry, 57, 790–796.CrossRefGoogle ScholarPubMed
Stern, Y. K., Mayeux, R., Sano, M., Hauser, W. A. & Bush, T. (1987). Predictors of disease course in patients with probable Alzheimer's disease. Neurology 37, 1649–1653.CrossRefGoogle ScholarPubMed
Wechsler, D. (1955). Wechsler Adult Intelligence Scale Manual. Psychological Corporation: New York.Google Scholar
Wing, J. K., Cooper, E. & Sartorius, N. (1974). Measurements and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wragg, R. E. & Jeste, D. V. (1989). Overview of depression and psychosis in Alzheimer's disease. American Journal of Psychiatry 146, 577–587.Google ScholarPubMed