Effet de l'initiation d'un traitement par benzodiazépine sur le déclin cognitif chez la personne âgée

Effet de l'initiation d'un traitement par benzodiazépine sur le déclin cognitif chez la personne âgée PDF Author: Marie-Sara Marchand
Publisher:
ISBN:
Category :
Languages : fr
Pages : 132

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Book Description
La France est un des pays où la consommation de psychotropes et notamment celle de benzodiazépines (BZD) est la plus élevée. Chez les sujets âgés, l’utilisation au long cours de BZD est associée à un risque accru de présenter différents événements graves, notamment un risque accru de démence. Le mécanisme expliquant cette association n’est pas élucidé, et l’effet des BZD sur les performances cognitives, en particulier à long-terme, reste controversé. L’objectif principal de cette étude était d’étudier l’association entre l’exposition incidente aux BZD et l’évolution du déclin cognitif chez des sujets initialement non déments. La population d’étude était issue de la cohorte PAQUID, réalisée chez des sujets de 65 ans et plus résidant en Dordogne et Gironde et offrant jusqu’à 20 ans de suivi. Parmi les sujets non utilisateurs de BZD à l’inclusion et non déments au suivi à 3 ans (T3) dans la cohorte PAQUID, 102 exposés incidents aux BZD et 715 non exposés à T3 ont été identifiés. L’évolution de leurs fonctions cognitives a été étudiée en considérant les résultats obtenus au Mini Mental Status Examination (MMSE) et à l’Isaac Set Test (IST) aux visites de suivi réalisées tous les 2-3 ans après T3 (T5 à T20). L’association entre l’exposition incidente aux BZD et l’évolution des performances cognitives a été étudiée à l’aide de modèles non linéaires mixtes considérant un processus latent comme variable à expliquer. Des analyses secondaires portant sur l’évolution de la symptomatologie dépressive, des troubles du sommeil et de l’anxiété ont été réalisées afin d’étudier un éventuel biais protopathique. L’exposition incidente aux BZD n’était pas associée à une différence d’évolution des performances cognitives des sujets évaluées au regard du MMSE ou de l’IST, ni à court-terme ni au long-terme. L’analyse secondaire n’a pas mis en évidence de différence d’évolution de la symptomatologie dépressive, des troubles du sommeil ou de l’anxiété, qui aurait pu témoigner d’un possible biais protopathique dans l’association entre BZD et démence. Indépendamment du risque de démence, l’initiation après 65 ans d’un traitement par BZD ne paraissait pas associée à un risque accru de dégradation des performances cognitives à long terme.

Effet de l'initiation d'un traitement par benzodiazépine sur le déclin cognitif chez la personne âgée

Effet de l'initiation d'un traitement par benzodiazépine sur le déclin cognitif chez la personne âgée PDF Author: Marie-Sara Marchand
Publisher:
ISBN:
Category :
Languages : fr
Pages : 132

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Book Description
La France est un des pays où la consommation de psychotropes et notamment celle de benzodiazépines (BZD) est la plus élevée. Chez les sujets âgés, l’utilisation au long cours de BZD est associée à un risque accru de présenter différents événements graves, notamment un risque accru de démence. Le mécanisme expliquant cette association n’est pas élucidé, et l’effet des BZD sur les performances cognitives, en particulier à long-terme, reste controversé. L’objectif principal de cette étude était d’étudier l’association entre l’exposition incidente aux BZD et l’évolution du déclin cognitif chez des sujets initialement non déments. La population d’étude était issue de la cohorte PAQUID, réalisée chez des sujets de 65 ans et plus résidant en Dordogne et Gironde et offrant jusqu’à 20 ans de suivi. Parmi les sujets non utilisateurs de BZD à l’inclusion et non déments au suivi à 3 ans (T3) dans la cohorte PAQUID, 102 exposés incidents aux BZD et 715 non exposés à T3 ont été identifiés. L’évolution de leurs fonctions cognitives a été étudiée en considérant les résultats obtenus au Mini Mental Status Examination (MMSE) et à l’Isaac Set Test (IST) aux visites de suivi réalisées tous les 2-3 ans après T3 (T5 à T20). L’association entre l’exposition incidente aux BZD et l’évolution des performances cognitives a été étudiée à l’aide de modèles non linéaires mixtes considérant un processus latent comme variable à expliquer. Des analyses secondaires portant sur l’évolution de la symptomatologie dépressive, des troubles du sommeil et de l’anxiété ont été réalisées afin d’étudier un éventuel biais protopathique. L’exposition incidente aux BZD n’était pas associée à une différence d’évolution des performances cognitives des sujets évaluées au regard du MMSE ou de l’IST, ni à court-terme ni au long-terme. L’analyse secondaire n’a pas mis en évidence de différence d’évolution de la symptomatologie dépressive, des troubles du sommeil ou de l’anxiété, qui aurait pu témoigner d’un possible biais protopathique dans l’association entre BZD et démence. Indépendamment du risque de démence, l’initiation après 65 ans d’un traitement par BZD ne paraissait pas associée à un risque accru de dégradation des performances cognitives à long terme.

Computers and Games for Mental Health and Well-Being

Computers and Games for Mental Health and Well-Being PDF Author: Yasser Khazaal
Publisher: Frontiers Media SA
ISBN: 2889454967
Category : Video games in education
Languages : en
Pages : 311

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Book Description
Recent years have seen important developments in the computer and game industry, including the emergence of the concept of serious games. It is hypothesized that tools such as games, virtual reality, or applications for smartphones may foster learning, enhance motivation, promote behavioral change, support psychotherapy, favor empowerment, and improve some cognitive functions. Computers and games may create supports for training or help people with cognitive, emotional, or behavioral change. Games take various formats, from board games to informatics to games with interactive rules of play. Similarly, computer tools may vary widely in format, from self-help or assisted computerized training to virtual reality or applications for smartphones. Some tools that may be helpful for mental health were specifically designed for that goal, whereas others were not. Gamification of computer-related products and games with a numeric format tend to reduce the gap between games and computers tools and increase the conceptual synergy in such fields. Games and computer design share an opportunity for creativity and innovation to help create, specifically design, and assess preventive or therapeutic tools. Computers and games share a design conception that allows innovative approaches to overcome barriers of the real world by creating their own rules. Yet, despite the potential interest in such tools to improve treatment of mental disorders and to help prevent them, the field remains understudied and information is under-disseminated in clinical practice. Some studies have shown, however, that there is potential interest and acceptability of tools that support various vehicles, rationales, objectives, and formats. These tools include traditional games (e.g., chess games), popular electronic games, board games, computer-based interventions specifically designed for psychotherapy or cognitive training, virtual reality, apps for smartphones, and so forth. Computers and games may offer a true opportunity to develop, assess, and disseminate new prevention and treatment tools for mental health and well-being. Currently, there is a strong need for state-of-the-art information to answer questions such as the following: Why develop such tools for mental health and well-being? What are the potential additions to traditional treatments? What are the best strategies or formats to improve the possible impact of these tools? Are such tools useful as a first treatment step? What is the potential of a hybrid model of care that combines traditional approaches with games and/or computers as tools? What games and applications have already been designed and studied? What is the evidence from previous studies? How can such tools be successfully designed for mental health and well-being? What is rewarding or attractive for patients in using such treatments? What are the worldwide developments in the field? Are some protocols under development? What are the barriers and challenges related to such developments? How can these tools be assessed, and how can the way that they work, and for whom, be measured? Are the potential benefits of such products specific, or can these additions be attributed to nonspecific factors? What are the users’ views on such tools? What are the possible links between such tools and social networks? Is there a gap between evidence-based results and market development? Are there any quality challenges? What future developments and studies are needed in the field?

Practice Guideline for the Treatment of Patients with Delirium

Practice Guideline for the Treatment of Patients with Delirium PDF Author: American Psychiatric Association
Publisher: American Psychiatric Publishing
ISBN:
Category : Medical
Languages : en
Pages : 84

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Book Description
TABLE OF CONTENTS: Statement of Intent. Introduction. Development Process. I. Summary of Recommendations. A. Coding System. B. General Considerations. II. Disease Definition, Epidemiology. and Natural History. A. Definition and Clinical Features. B. Associated Features. C. Differential Diagnosis. D. Prevalence and Course. E. Causes. F. Use of Formal Measures. III. Treatment Principles and Alternatives. A. Psychiatric Management. B. Environmental and Supportive Interventions. C. Somatic Interventions. IV. Formulation and Implimentation of a Treatment Plan. A. Psychiatric Management. B. Choice of Specific Environmental and Supportive Interventions. C. Choice of Somatic Intervention. D. Issues of Competency and Consent. V. Clinical Features Influencing Treatment. A. Comorbid Psychiatric Disorders. B. Comorbid General Medical Conditions. C. Advanced Age. VI. Reviewers and Reviewing Organizations. VII. References.

Circadian Rhythm Sleep-Wake Disorders

Circadian Rhythm Sleep-Wake Disorders PDF Author: R. Robert Auger
Publisher: Springer Nature
ISBN: 3030438031
Category : Medical
Languages : en
Pages : 251

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Book Description
This book resolves to bridge the communication gap between research and clinical practice for circadian rhythm sleep-wake disorders. Beginning with a scientific background on biological timekeeping, opening chapters describe the crucial nature of maintaining delicate temporal organization of physiological and molecular events within the body. Following this are discussions on circadian physiology and methods of circadian assessments. Subsequent chapters then relay comprehensive information regarding the International Classification of Sleep Disorders-defined circadian rhythm sleep-wake disorders (CRSWDs), specifically discussing etiology and epidemiology, but focusing on evidence-based treatment data. Concluding discussions provide guidance for the application of light therapy and discuss future roles for optimized lighting environments. Nuanced and market-demanded, Circadian Rhythm Sleep-Wake Disorders: An Evidence-Based Guide for Clinicians and Investigators is an invaluable resource for Sleep Medicine clinicians, circadian researchers, and other interested parties.

Office Emergencies

Office Emergencies PDF Author: Marjorie A. Bowman
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 420

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Book Description
Inside, you'll find practical information on how to handle the most common emergencies that present in primary care offices and urgent care centers -- whether in person or over the telephone.

American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders

American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders PDF Author: American Psychiatric Association
Publisher: American Psychiatric Publishing
ISBN: 9780890423837
Category : Mental illness
Languages : en
Pages : 0

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Book Description
American Psychiatric Association (APA) Practice Guidelines provide recommendations to help psychiatrists make treatment decisions that are supported by the best available evidence, including from current research and expert consensus. The guidelines are developed by expert work groups, who review available evidence using an explicit methodology. Iterative drafts undergo wide review by other experts, allied organizations, and the APA membership. Every guideline is also reviewed and approved for publication by the APA Assembly and Board of Trustees. This process balances the conclusions of scientific research with the practical experience of professionals working in the field. In addition to providing recommendations that may improve patient care, the guidelines may be used for education by medical students and residents, psychiatrists seeking recertification, other mental health professionals, and the general public. Researchers may use the guidelines to identify important clinical questions for which more research could be expected to improve treatment decision making. The thirteen "Practice Guidelines" are Psychiatric Evaluation of Adults, Second Edition Delirium Alzheimer's Disease and Other Dementias of Late Life HIV/AIDS Substance Use Disorders, Second Edition Schizophrenia, Second Edition Major Depressive Disorder, Second Edition Bipolar Disorder, Second Edition Panic Disorder Acute Stress Disorder and Posttraumatic Stress Disorder Eating Disorders, Third Edition Borderline Personality Disorder Suicidal Behaviors These guidelines help you Understand clinical features and symptoms Make a confident differential diagnosis Evaluate interventions commonly used to treat specific disorders Select the appropriate site of service Educate the patient and family Assess the efficacy and risks of available medications Develop an individualized treatment plan Interactive continuing medical education programs for many of the individual practice guidelines are available on the APA's web site (www.psych.org/cme). Each program offers "AMA PRA Category 1 Credits" that are accepted by the APA and the American Medical Association. The American Board of Psychiatry and Neurology (ABPN) has reviewed the APA Practice Guidelines CME Program and has approved it as part of a comprehensive lifelong learning program, which is mandated by the American Board of Medical Specialties as a necessary component of maintenance of certification.

Headache and Depression

Headache and Depression PDF Author: G. Nappi
Publisher:
ISBN:
Category : Health & Fitness
Languages : en
Pages : 360

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Book Description


The Pineal

The Pineal PDF Author: Richard Relkin
Publisher:
ISBN:
Category : Pineal gland
Languages : en
Pages : 232

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Book Description


Interprofessional Capability Framework

Interprofessional Capability Framework PDF Author: HIpE
Publisher:
ISBN: 9780646551241
Category :
Languages : en
Pages : 16

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Book Description


Vulnerability to Drug Abuse

Vulnerability to Drug Abuse PDF Author: Meyer Glantz
Publisher: Amer Psychological Assn
ISBN: 9781557984128
Category :
Languages : en
Pages : 533

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Book Description
This text offers insights into the complex and disturbing questions of drug abuse by examining the range of factors that affect vulnerability, focusing specifically on factors and patterns associated with the transition from drug use to drug abuse.