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STUDENT DIGITAL NEWSLETTER ALAGAPPA INSTITUTIONS |
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Julie O?iordan MBChB FRCA
He reported witnessing the loss of his mother cholesterol medication frequent urination best abana 60pills, two brothers and a nephew along with friends cholesterol levels stress generic abana 60 pills amex, neighbors and other relatives He presented with symptoms of depression cholesterol test los angeles buy cheap abana 60 pills on-line, flashbacks cholesterol check up fasting 60pills abana fast delivery, exaggerated startled response as well as nightmares of the war events. Within 2 weeks of starting clonidine, he reported improvement in the severity and duration of his nightmares and improved quality of his sleep After one month of initiation of clonidine, his dose was increased to 0. The patient continues to maintain remission one year after initiation of treatment. H is a 33 year old Iraq and Afghanistan wars active military soldier who was involved in several combat scenarios in which lives were lost. He was treated with cognitive processing therapy, citalopram 20mg po q daily, clonazepam 1mg po bid as well as prazosin 4 mg po qhs. However, his nightmares did not respond significantly until prazosin was replaced with clonidine. Clonidine is a centrally acting alphaagonist agent that is used to treat hypertension stimulates alphaadrenoreceptors in the brain stem. This action results in reduced sympathetic outflow from the central nervous system. Conclusion Clonidine will continue to be increasingly valuable in treatment of nightmares. Consensus statement on popsttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. The current study looked at the data for 255 patients from same geographical area (south west london) to test some of these assumptions. Most also completed a social, medical and family history questionnaire and the Symptom Checklist90R. However, comorbid Anorexia Nervosa and Somatization Disorder were more frequent among females; comorbid Antisocial Personality Disorder was most frequent among males. Conclusion: Gender appears to play a minimal role in clinical histories of patients with ObsessiveCompulsive Disorder. Sex differences in the phenotypic expression of obsessivecompulsive disorder: an exploratory study from Brazil. Evidence for cortical dysfunction in autism: a proton magnetic resonance spectroscopic imaging study. In vivo 1Hmagnetic resonance spectroscopy study of amygdalahippocampal and parietal regions in autism. Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. The diagnosis and neuropsychological assessment of adult attention deficit/hyperactivity disorder: Scientific study and practical guidelines. Working memory deficits in children with low achievements in the national curriculum at 7 years of age. Neuropsychology of adults with attentiondeficit/ hyperactivity disorder: A metaanalytic review. Efficacy of a novel biphasic controlledrelease methylphenidate formula in adults with AttentionDeficit/ Hyperactivity Disorder: Results of a doubleblind, placebocontrolled crossover study. Healthrelated quality of life in children and adolescents who have a diagnosis of attentiondeficit/hyperactivity disorder. A metaanalytic review of stopping performance in attentiondeficit/ hyperactivity disorder: Deficient inhibitory motor control? Interestingly, while correlation studies revealed no relationship between daytime sleepiness and sleep quality, there appears to be a correlation between sleep quality and fatigue. This suggests that while sleep quality may not result in daytime sleepiness, it may give rise to the experience of fatigue. This is clinically important, as it implies that fatigue, rather than daytime sleepiness, is a marker of poor sleep quality. It also raises the question of whether sleepiness is a pathological condition rather than a symptom of poor sleep quality. Regarding objective data, 36 consents have been obtained from patients, and data have been collected from 28 out of these 36 patients. On performance intelligence subscale, there were significant differences between three groups only Digit symbol. Among intelligence quotient, there were significant differences between the groups on Performance Intelligence only. Conclusion: Patients with severe psychopathological symptoms did not showed intelligence decrement but global memory abilities are severely impaired. Since mental activity is closely related with emotion, factors like depression and anxiety should also be considered. However, currently there is no study on mental activity where depression and anxiety have been considered. Therefore we tried to examine the relationship between mental activity and cognitive function after adjusting depression and anxiety in the elderly. Method: this study was based on the baseline data derived from a large prospective study called the Suwon Project, which was a cohort comprising of nonrandom convenience samples of ethnic Koreans aged 60 years and above. Conclusion: Our result suggested that watching television, listening to the radio, reading book and newspaper may be associated with cognitive function in not cognitive impaired elderly in the community after adjusting age, sex, educational level, depression and anxiety. But, it was a crosssectional study; thus, the results of the study must be interpreted with caution. We studied all the patients referred to our unit retrospectively from its opening in February 2008 to November 2010. Of those admitted (n=110), all of them received individual treatment with psychologist, psychiatrist and endocrinologist, 43,63% received also some kind of group therapy (psychotherapy, psychoeducation and relaxation group) and 37,27% supervised meal. Conclusion the rise in the number of patients referred since its opening, proves the need and acceptance of the day therapy in the area of influence. The use of a multidisciplinary staff, reliance on group treatment as the primary means of therapy, inclusion of more advanced patients in the administration of treatment to newer patients, and the inclusion of the day program within a larger treatment model. The provision of day hospitalization for the treatment of eating disorders is an area deserving of more research. Although initial results appear encouraging, the everchanging structure of the programs and the mobility of patients within the different levels of care often complicate data collection. The abdomen was distended with normal bowel sounds; mild guarding without rebound tenderness was appreciated. An exploratory laparotomy revealed a cohesive foreign body of gauzelike material, 13 x 12 x 8cm in measurement, isolated to the sigmoid colon. The postoperative interview revealed the ingestion of cloth throughout the prior year. She described consuming fragments of towels in periods of stress as a means of "feeling better. The onset of pica started around age 20 when she consumed sand as a means of stress reduction. Conclusion: Currently, pica is categorized under "Feeding and Eating Disorders of Infancy or Early Childhood. As more and more cases of adult onset pica are reported, the classification may warrant reconsideration. Male eating disorder risk factors include alcoholism, homosexuality, and history of obesity, teasing, and physical abuse [13]. Men are more susceptible to excessive exercise to deal with body image concerns [4]. The patient returned to a weight of 160 lbs over a 12month period although he refused outpatient treatment. In December 2009, recurrent marital stressors triggered a relapse of decreased caloric intake and excessive exercise. The patient was stabilized medically, but continued to loose weight during admission, and was discharged home at a weight of 110lbs. He continues to be treated on an inpatient basis and is working compliantly toward his goals.
Syndromes
Von Economo neuron density in the anterior cingulate cortex is reduced in early onset schizophrenia cholesterol medication guidelines buy 60pills abana mastercard. Divergent social functioning in behavioral variant frontotemporal dementia and Alzheimer disease: reciprocal networks and neuronal evolution cholesterol levels ati 60 pills abana with amex. Selective reduction of von Economo neuron number in agenesis of the corpus callosum cholesterol quoi manger purchase abana 60pills without a prescription. The anterior cingulate cortex in autism: heterogeneity of qualitative and quantitative cytoarchitectonic features suggests possible subgroups cholesterol lowering foods list uk generic abana 60 pills on line. Aim: the objective of this study was to determine if the P3 amplitudes are similarly impacted in individuals with alcoholism and depression, and if this effect is additive in subjects with both diagnoses. The visual oddball P3 amplitudes from three parietal electrodes were compared across four groups (age range 1855 years). Results: the clinical groups had significantly lower P3 amplitude than unaffected controls. In keeping with the literature, females always had slightly higher P3 amplitude than males across all groups. It allows the electrical stimulation of the cerebral cortex by means of coilgenerated magnetic fields (1). Results Two subjects dropped out in the first week of treatment and were not included in the analyses. Side effects were minor and limited to the first days of treatment (headache, insomnia). Nevertheless, little is known about causal mechanisms that determine different latency to treatments (23). To date, most information related to the onset and latency to first treatments is not specifically investigated by any diagnostic/psychometric instrument and is mostly retrospectively derived. A great latency among first symptoms and the decision to see a clinician was reported: only 50. Especially, the deficit of working memory has been thought to be one of critical cognitive errors in patients with substance dependence. Interestingly, the deficit of working memory is reported to be associated with the dysfunction in prefrontal cortex. We hypothesized that excessive online game playing would be associated with the deficit of prefrontal cortex. Moreover, recovery from excessive online game playing would improve the activity of prefrontal cortex in response to working memory stimulation. Brain activity in response to working memory stimulation (simple and complex calculation) at baseline and 4 weeks of abstinence period was assessed by 3. Conclusion Over a 4 week period of abstinence, the severity of online game play and brain activation in response to working memory stimulation in prefrontal cortex of adolescents with excessive online game play were increased. These findings are similar to those observed in patients with substance dependence after stopping substance abuse. We suggest that the effect of online game addiction on working memory may similar to observed in patients with substance dependence. Subjects: Subjects are derived from a larger cohort of consecutive depressed adolescent psychiatric outpatients (n=218) and their controls (n=200) at 8 year followup of the cohort (mean age 25 years). Comorbid psychiatric diagnoses are allowed with the excepetion of current or recent substancse use disorders. Medication and other treatments are recored in detail and lifetime course of psychiatric disorders is assessed by diagnostic interviews during the followup. The results of the volumetric analyses will be presented in the poster as the analyses can be initiated in the beginning of 2011. Results: the statistical analyses are intiated in the beginning of 2011 and the results will be presented in the poster. Such an approach could provide important information with regard to neurocognitive risk markers that would help inform early detection and intervention for neuropsychological rehabilitation. Method Participants included 12 euthymic patients with a diagnosis of bipolar disorder I (4 treated with lithium, 4 with valproic acid y 4 without medication for at least two months previous to evaluation) and 4 controls. Inclusion criteria were participants who were righthanded, 1860 years old, with between 5 and 16 years of education, and without a history of brain lesions, epilepsy, electroconvulsive therapy treatment, other diagnoses including substance abuse, or the use of benzodiazepines during the month before the study or other psychiatric medication in the previous six months. Blood samples were taken to measure current therapeutic levels of lithium or valproic acid for those patients taking them. There were no significant differences in demographic variables between the participant groups. Description of the experimental paradigm A paradigm is an experimental task designed to study the relation between cognitive functions and cerebral function. It was designed to evaluate working memory for numbers that combined blocks with related events. Response times were recorded and analysed, along with the synchronised cerebral activity. However, there was no significant difference when activation was compared during the patient groups (p>0. Discussion the studied paradigm has proved useful in studying cerebral activation in working memory. Confirmation of the differing activation in bipolar patients compared to controls requires replication in a large sample of participants to investigate other associated deficits and specific effects of medication. Treatment with donepezil hydrochloride (5 mg/day) was started immediately after clinical diagnosis and diagnostic imaging. Six to twelve months later, individual patients were clinically diagnosed again with one of the tests. Results: Overall, 300 articles were retrieved by the systematic literature search and 112 of these articles were relevant to this study. Methods: Data were taken from a geographically representative, crosssectional study of nonprofessional caregivers conducted in 2009. Conclusion: Caregiver experiences are strong predictors of dosage form preference; specifically, prior experience administering oral treatments and concern over the side effects associated with them. Further research is needed to clarify mediators and moderators of caregiver preference, and the consequences of these choices. The fielding of this study was conducted by Knowledge Networks and funded by Novartis Pharmaceuticals. But whether it affects mortality in patients with the disease is not consistently confirmed. Results: Eight with and 81 patients without the e4 allele were had died by December 2006. There were no differences between e4positive and e4negative group in age at baseline, sex and education. Conclusions: this study provide the first information about the effect of the e4 allele on mortality in Korean elderly with normal cognition. Subjects were dichotomized into 88 patients with and 112 patients without at least one e4 allele. Results: Forty patients with and 49 patients without the e4 allele were had died by December 2008. But the measuremenr of the cognitive function by the objective screeinng tests such as MiniMental State Examination is biased by the age and education of the subjects. Methods: 134 patients over 60 years with hip fractures participated in this study. They completed the preoperative evaluation which covered cognitive functions, depressive symptoms, demographic characteristics and other various factors. The sex, comorbidities, and the laboratory test scores did not show significant differences between the two groups. On conducting this survey, we complied with the "Ethical Guideline for Epidemiological Survey" issued by the Ministry of Health, Labour and Welfare in Japan. However, since a decrease in serum potassium level was seen in some of the patients, periodic examinations are necessary. So there is a possible relation between the deficit in executive and cognitive cerebral function and depression or relation between the serotonin system and cholinergic system in relation with disease comorbidity cognitivedepression.
However cholesterol test vitamin c generic abana 60pills line, increase of energy expenditure in human with ziprasidone is not clear cholesterol in whole eggs discount 60pills abana mastercard, even though less weight gain is clear in ziprasidone treatment cholesterol test strips lloyds pharmacy abana 60pills for sale. In Sweden list of cholesterol lowering foods safe 60 pills abana, mental illness such as stress and psychosomatic symptoms in adolescent girls is one of the most urgent health problems we face. Knowledge of beneficial effects of regular physical activity on mental health are widespread. Dance is a popular form of exercise also known to increase a sense of selfcontrol which can contribute to reduce stress. The purpose of this study was to evaluate whether an intervention with dance could influence psychosomatic health in adolescent girls. Methods: A randomised, controlled trial with a longterm followup, carried out in central Sweden. A total of 160 adolescent girls with low selfrated health, psychosomatic problems and recurrent feelings of stress were enrolled. The increase in selfrated health at the oneyear followup was significantly higher in the dance intervention group compared to the control group (p=0. One of the explanations to this improvement can possibly be that the dance group rated an increase in energy and decrease in fatigue. The dance intervention group also had significant fewer visits to the school nurse compared to the control group (p<0. Conclusion: the current findings suggest that an intervention with dance twice weekly for 8 months can have high compliance and improve selfrated health in adolescent girls. One of the most frequent comorbidities is that of depressive symptoms and pain including headache. A wide variety of antidepressants have been used to treat tension headache in patients with major depressive episode. Alterations in noradrenergic and serotonergic neurotransmitter systems have been implicated in the pathophysiology of major depressive disorder and chronic pain. The purpose of this study was to investigate the clinical therapeutic effects of duloxetine treating tensiontype headache in major depressive disorder patients. Exclusion criteria included severe cognitive impairment, substance abuse or dependence, bipolar or schizoaffective disorder, suicidal behavior, and other severe mental or medical illness. All patients who reported improvement in headache, also showed improvement in depressive symptoms. However, two of them showed some improvement in mood states, both subjectively and objectively. Conclusions these data suggest that duloxetine may be effective in reducing tensiontype headache in patients with major depressive disorder. Following a 1week screening period with the stable dose of risperidone, a 6 week openlabel switch study from risperidone to paliperidone was conducted. After then, the dosage was freely adjusted, according to the observation of clinical response and tolerability. Using this switching schedule, patients with schizoprhenia showed significant additional improvement in their clinical symptoms without significant adverse effect after 6 weeks. The reason(s) for this are unknown reasons (lack of funding, publication bias, etc). Multiple potential associations of funding source with study design and outcome. Exact incidence of Serotonin syndrome is not known partly because more than 85% of physicians are unaware of diagnosis of serotonin syndrome (1). Several criteria for serotonin syndrome have been used for diagnosis in literature such as Sternbach criteria and Hunters serotonin toxicity criteria. This review is an effort to summarize the treatment options from literature which include withdrawal of suspected medication, supportive measure such as cooling, intravenous fluids, medications such as benzodiazepine and the antihistamine cyproheptadine, admission to intensive care unit and more aggressive measures in severe case and at least one report of lipid therapy for the treatment of serotonin syndrome. There is a need for developing widely accepted and validated criteria for serotonin syndrome and creating more awareness of serotonin syndrome so that it can be recognized early thus minimizing delay in treatment and chances of complications. Method: this was a randomized, 6month, openlabel trial of switching to ziprasidone (n=30) or staying on current antipsychotic medication (n=25) for nondiabetic, stable schizophrenia patients on olanzapine or risperidone treatment. After study conclusion, nonswitch subjects were offered a switch to ziprasidone and followed for an additional 26 weeks. Insulinmodified frequently sampled intravenous glucose tolerance testing with minimal model analysis was performed at baseline and week 26 of all study periods, along with clinical and imaging measures of adiposity. Psychiatric hospitalization rates were comparable in both cohorts (nonswitch 16% vs. Conclusions: Metabolic benefits may occur from lifestyle modification or antipsychotic switching. Careful switching of stable schizophrenia patients to ziprasidone does not entail significant psychiatric risk. A study in the North of England has shown that risperidone long acting injectable form has reduced number of admissions and number of days stayed in hospital. Adherence has improved and it may be the causer of preventing relapse in these patients. This raises the possibility that they could have a different level of clinical efficacy. There is only one published Wyeth sponsored study reporting the efficacy of a placebo controlled, Duloxetine referenced comparison of 50 mg and 100 mg Desvenlafaxine. Methods: the outpatient records of all patients who were ever prescribed either Duloxetine (N=378) or Desvenlafaxine (N= 142) were included in this study. Results: 62% of Duloxetine patients took it for more than 6 months compared to 66% of Desvenlafaxine patients. Patients on Desvenlafaxine were on significantly more additional antidepressants (Bupropion or Mirtazapine) than those on Duloxetine (42% vs. There was no difference in the frequency of use of other psychotropic medications (antipsychotics, mood stabilizers, stimulants, sedatives). Conclusion: Duloxetine and Desvenlafaxine are equally effective in treating depression in this outpatient private practice. Patients on Duloxetine needed less augmentation with an additional antidepressant than patients on Desvenlafaxine. The Committee received nominations from psychiatry residency training directors nationwide, selected 15 members and formed 2 subgroups in order to work on the development of multimodel training modules for bipolar disorder and depression. A variety of teaching modalities such as Jeopardytype game, podcasts, case presentations and team based learning exercises were used. Importance: the bipolar module is an innovative tool for teaching psychopharmacology which enables psychiatric trainees and other psychiatrists to master a large volume of information. However a large degree of overlap is present in the genetic liability factors for major psychosis occurrence and response to treatment. However taking into account that neither the genotype nor the allelic analyses confirmed such association as well as several limitations including the use of different drugs and the moderately small sample size of our study, further research is needed to draw more definitive conclusions. There were 5 selfreports of possible hypertensive crisis or hypertension, though objective clinical data were not submitted in any case. However, given the relatively modest exposure numbers, continued safety monitoring is recommended. Method: We performed a retrospective chart review of 348 patients hospitalized from January 2009 to January 2010 in the department of firstepisode psychosis at Tirat Carmel Mental Health Center (Israel), and for whom antipsychotic treatment was indicated. The diagnosis of akathisia was established following a consensus diagnosis procedure, based on the clinical description of akathisia and/or evidence for the administration of antiakathisia agents (betablockers, serotonin2A receptor antagonists). Physicians and caregivers should continue to be aware of this clinically significant adverse effect of antipsychotic therapy. Lowdose mirtazapine: a new option in the treatment of antipsychoticinduced akathisia. Selective Serotonin Reuptake Inhibitors as well as Tricyclic Antidepressants can cause a increased hyperhidrosis. The exact pharmacological mechanism of this side effect is unknown, as no research data are available. Literature about hyperhydrosis as a side effect as well as the treatment possibilities is mainly based upon case histories or an overview of small groups of patients. Beside busperidone and seldomly carbamazepine other psychopharmacological medication has no such effect. An review of the literature about the psychopharmacological aspects of hyperhidrosis in antidepressant and other psychopharmacological medication will be described. In both cases the causality of drug induced hyperhydrosis was assessed with the Naranjo adverse drug reactions probability scale.
Scores are made in terms of efficiency cholesterol chart of foods purchase 60pills abana otc, rule breaks cholesterol ratio 2.2 generic abana 60 pills amex, misinterpretations and task failures cholesterol ratio 3.1 buy 60pills abana fast delivery. The planning difficulties elicited by the test mirrored those that the patient experienced in everyday life cholesterol medication duration order abana 60 pills visa. Hayling Test Patients complete 30 sentences, read by the examiner, from which the last word is omitted. In the first 15 sentences, the subject completes the sentence with a word that makes sense: `The captain wanted to stay with the sinking. In the second set of sentences, the subject must come up with a final word that does not make sense in the sentence: `London is a very busy. Response latency is the main measure and the difference between the first and second phases of the test is an indicator of response suppression time. Brixton Test this measures the ability to detect rules in sequences of nonverbal stimuli. The object is to predict where the next filled circle will be after a short sequence (Burgess & Shallice 1997). Tower of London Test Shallice (1982) introduced this test, derived from the Tower of Hanoi oriental puzzle. It is a test of planning, in that the subject must look ahead and divide the task into a series of subtasks, and carry these out in the correct sequence in order to obtain the desired solution. Different grades of difficulty can be presented in terms of the minimum number of moves allowed to reproduce the pattern. Object Sorting Test consists of a miscellaneous group of objects that must be sorted into designated groups (according to form, colour, use, etc. The Colour Form Sorting Test utilises circles, squares and triangles in different colours that must be sorted according to one common property and then another. Shallice (1982) found that patients with left frontal lesions performed significantly worse than patients with brain lesions in other locations. They have been shown to be sensitive to brain damage, and can have special advantages for detecting minor degrees of clouding of consciousness. In routine clinical practice the simple procedures outlined in Chapter 1 will often suffice for obtaining an estimate of sustained attention. A further series of tests requires the subject to react rapidly in response to signals that arrive in a preset random manner. Efficient performance requires the prolonged maintenance of a high level of attention, and rapid activation of perceptual and motor mechanisms. The simple estimation of reaction times has often shown good differentiation between brain-damaged subjects and controls (Blackburn & Benton 1955; Benton & Joynt 1959). Braindamaged adults and children were shown to be significantly poorer at the test than normal controls. Trail Making Test the Trail Making Test consists of 25 circles distributed over a sheet of paper. In the first part the circles are numbered, and the subject must draw a line connecting them in numerical sequence as quickly as possible. In the second part the circles contain both numbers and letters and the subject must alternate between numbers and letters as he proceeds in ascending sequence. Performance on the test requires spatial analysis, motor control, alertness, concentration and ability to shift attention between alternatives. More generally, Reitan (1958) demonstrated excellent differentiation between brain-damaged and non-braindamaged subjects, and this has since been repeatedly confirmed. However, both age and education have significant effects on performance, and depression has been shown to interact with the slowing produced by ageing (Lezak 1995). Various tests in the group explore ability to abstract common properties of objects, to break up a whole into parts, and to shift from one frame of reference to another. This type of test relies heavily on qualitative observations, being concerned with the methods employed by the subject as well as with the end-point achieved, and it is difficult to obtain objective methods of scoring. The aim has been not only to detect brain damage but also to indicate whether this is likely to be focal or diffuse, lateralised to the right or left hemisphere, and whether acute and progressive or relatively static. The lever required at each exposure is determined by certain unifying concepts among the group of pictures, and the subject must discover the rules by repeated trial and error. It is thus a relatively complex concept formation test that requires the subject to note similarities and differences, to set up hypotheses and to test and modify them. It requires tactile form discrimination, manual dexterity and coordination, and the visualisation of spatial configurations. Component tests include the following, some of which are based on paradigms derived from animal work. The battery is used most in research contexts and also to evaluate new treatments. The original was rather limited in the coverage of human psychological functions. Paired associate learning is a stringent test for episodic memory and associative learning. There are also spatial span (a visuospatial analogue of the Digit Span Test) and spatial working memory tests. Attention tests these tests measure different aspects of attention and reaction time. They include the simple and choice reaction time tasks with different response modes and increasing complexity. Efficient performance on this task requires the ability to search among the targets and ignore the distractor patterns that have elements in common with the target. This test may help to differentiate between primary movement disorders and dementing conditions. Computerised psychological tests Tests that can be administered by computer have an obvious attraction for certain purposes, either to economise with the time of a psychologist when large numbers of patients need to be examined in research, or to allow very detailed exploration of specific psychological functions. In both contexts they have special advantages in permitting accurate recording of response times in addition to examining levels of performance. The likely neural substrate for this task is thought to be the orbitofrontal prefrontal cortex. They include computerised versions of standard tests such as graded naming and verbal recognition memory. These are not psychometric tests in the ordinary sense, but questionnaires filled in by doctors, nurses or relatives who have observed the patient closely. Standardisation is often incomplete, but the questionnaires can give useful information in certain settings. Some have especial value in quantifying the degree of impairment when patients are too severely incapacitated to yield scores on formal psychometric tests. Others are useful for research purposes in allowing the separation of groups according to overall severity of disability. In clinical practice they can serve as an approximate screening device, or they can be repeated after an interval of time to gauge the rate of decline or improvement. One group of questions contains items concerning competence in personal, domestic and social activities, such as ability to perform household tasks, to cope with small sums of money, to find the way in familiar surroundings and to recall recent outings and visits. The next group concerns changes of habits, such as impairment of eating, dressing and sphincter control. The third is relevant to change in personality, interest and drive, such as increased rigidity, egocentricity, coarsening of affect, impaired emotional control or the abandonment of habitual interests. Good reliability between raters has been shown both for individual items and for diagnoses made on the basis of the schedule (Copeland et al. The ability of these factors to discriminate between organic and non-organic disorders of the elderly has been demonstrated (Gurland et al.
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