Sigfried N.t.m. Schouws - Academia.edu (original) (raw)

Papers by Sigfried N.t.m. Schouws

Research paper thumbnail of Neuropsychological profiles in behavioural variant Frontotemporal Dementia and Psychiatric disorders

Research paper thumbnail of O2‐14‐04: Identifying Behavioral Variant Frontotemporal Dementia Among Patients with a Late‐Onset Frontal Lobe Syndrome: Summary Results of the Lof Study

Alzheimers & Dementia, Jul 1, 2018

Research paper thumbnail of Impact of Imaging and Cerebrospinal Fluid Biomarkers on Behavioral Variant Frontotemporal Dementia Diagnosis within a Late-Onset Frontal Lobe Syndrome Cohort

Dementia and Geriatric Cognitive Disorders, Oct 17, 2015

The criteria for behavioral variant frontotemporal dementia (bvFTD) incorporate MRI and [18F]-FDG... more The criteria for behavioral variant frontotemporal dementia (bvFTD) incorporate MRI and [18F]-FDG-PET. Cerebrospinal fluid (CSF) analysis is merely advised for excluding Alzheimer's disease. We aimed to assess the impact of biomarkers on diagnostic certainty and contingent changes of bvFTD diagnosis within the clinically relevant neuropsychiatric differential diagnosis of subjects with a late-onset frontal lobe syndrome (LOF). We included 137 patients with LOF, aged 45-75 years, 72% males. Biomarker disclosure was considered contributing after any substantial difference in diagnostic certainty or a diagnostic change. Percentages of contributing biomarkers were compared between three major diagnostic groups (bvFTD, psychiatry, other neurological disorders). Certainty levels in stable diagnostic groups were compared to those with a diagnostic change. Biomarkers contributed in 53, 60 and 41% of the LOF patients for MRI, [18F]-FDG-PET and CSF, respectively. Biomarkers changed the diagnosis in 14% of cases towards bvFTD and in 13% from bvFTD into an alternative. Those that changed had a lower level of a priori diagnostic certainty compared to stable diagnoses. Our study not only supports the widely accepted use of MRI and [18F]-FDG-PET in diagnosing or excluding bvFTD, but also shows that CSF biomarkers aid clinicians in the diagnostic process.

Research paper thumbnail of Laat-ontstane schizofrenie : Een dementia non-praecox? Overzicht en aanbevelingen voor de differentiêle diagnostiek

Tijdschrift voor psychiatrie, 2006

Research paper thumbnail of The functioning assessment short test for older adults (FAST-O), a time-efficient manner to assess daily functioning?

Bipolar Disorders, Jun 1, 2020

Research paper thumbnail of Cognitive profiling in older patients with an affective disorder: Exploring differences and similarities

Bipolar Disorders, Jun 1, 2020

Research paper thumbnail of Reliability and validity of the functioning assessment short test for older adults with bipolar disorder (FAST-O)

International Journal of Bipolar Disorders, Oct 2, 2020

Background: Many frequently used instruments fail to assess psychosocial functioning in patients ... more Background: Many frequently used instruments fail to assess psychosocial functioning in patients with bipolar disorder. The Functioning Assessment Short Test (FAST) was developed in order to tackle this problem and to assess the main functioning problems experienced by patients with bipolar disorder. However, the original FAST is not fully applicable in older adults due to the domain of occupational functioning. The aim of our study was to validate an adapted version for Older adults (FAST-O) in a group of older adults with bipolar disorder (OABD). Methods: 88 patients aged 50 years and over diagnosed with bipolar disorder were included. We adapted the items in the area of "work-related functioning" of the FAST into items assessing "societal functioning". Several measurements were conducted in order to analyse the psychometric qualities of the FAST-O (confirmatory factor analysis for internal structure, Cronbach's alpha for internal consistency, Spearman's rho for concurrent validity, Mann-Whitney U test for discriminant validity). Results: Mean age in the study sample was 65.3 (SD = 7.5) and 57.3% was female. The internal structure was most similar to the internal structure of the original FAST. The internal consistency was excellent (Cronbach's alpha = .93). The concurrent validity when correlated with the Social and Occupational Functioning Assessment Scale was low, but significant. The FAST-O was also able to distinguish between euthymic and symptomatic OABD patients. Conclusions: The FAST-O has strong psychometric qualities. Based on our results, we can conclude that the FAST-O is a short, efficient solution in order to replace global rating scales or extensive test batteries in order to assess daily functioning of older psychiatric patients in a valid and reliable manner.

Research paper thumbnail of Associations between cognitive functioning, mood symptoms and coping styles in older age bipolar disorder

Journal of Affective Disorders, Aug 1, 2018

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  Better executive functioning is associated to more active copping.  Less depressive symptoms are associated to more active coping.  Mood is a more important contributor to active coping as compare to cognition.  No associations between cognition, mood and passive coping were found.

Research paper thumbnail of The relationship between cognitive and social functioning in older patients with bipolar disorder

Journal of Affective Disorders, Nov 1, 2018

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  Global cognitive functioning, learning and memory and executive functioning are positively associated with global social functioning  Global social functioning as judged by the clinician is independent of self-reported social functioning  Attention and verbal fluency are not associated with global social functioning

Research paper thumbnail of Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life depression

Acta Psychiatrica Scandinavica, Jul 12, 2018

Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life d... more Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life depression. Objective: There is ongoing concern about the possible negative impact of ECT on neurocognitive functioning in older patients. In this study, we aimed to characterize the long-term cognitive effects of ECT in patients with late-life depression, using an extensive neuropsychological battery. Methods: A total of 110 patients aged 55 years and older with unipolar depression, referred for ECT were included. The neuropsychological test battery was assessed prior to ECT and 6 months after the last ECT session. Results: There were no statistically significant group-level changes from baseline to 6 months post-ECT in any of the neuropsychological measurements. Individual differences in cognitive performance were detected using the Reliable Change Index. Conclusion: Patients with late-life depression do not show deleterious cognitive effects 6 months following an ECT index course, although there are considerable differences at an individual level. Clinicians should not hesitate to prescribe ECT in older patients, as most of these patients will tolerate the treatment course and a small group will even experience a cognitive enhancement. However, clinicians should be aware that a small group of patients can experience cognitive sideeffects. Further study is needed to predict which patients have a higher risk of developing cognitive side-effects.

Research paper thumbnail of Functioning Assessment Short Test for Older Adults

Research paper thumbnail of Physical comorbidity in Older-Age Bipolar Disorder (OABD) compared to the general population - a 3-year longitudinal prospective cohort study

Journal of Affective Disorders, Jun 1, 2021

BACKGROUND The aim of this study was to examine the accumulation of chronic physical diseases in ... more BACKGROUND The aim of this study was to examine the accumulation of chronic physical diseases in Older-Age Bipolar Disorder (OABD) as well as in individuals from the general aging population over a 3-year period. METHODS This prospective longitudinal study compared 101 patients with OABD receiving outpatient care (DOBi cohort) with 2545 individuals from the general aging population (LASA cohort). The presence of eight major chronic diseases was asked at baseline and 3-year follow-up. Total number of diseases was the main outcome measure. Self-rated health (SRH, scale 1-5) was examined as a secondary outcome. Multilevel linear modelling of change was performed to estimate and test the observed change in both samples. RESULTS At baseline, the number of chronic diseases was lower (b= -0.47, p<0.01) and self-rated health comparable (b=0.27, p=0.13) in DOBi than in LASA. Over 3 years the number of chronic diseases increased faster in DOBi than in LASA (b=0.51 versus b=0.35, p(interaction)=0.03). When corrected for employment, depressive symptoms, waist circumference, smoking, and alcohol use, this difference was no longer significant. SRH decreased faster in DOBi than in LASA (b=-0.24 versus b=-0.02, p(interaction)=0.04). LIMITATIONS Information on chronic diseases was collected using self-report. CONCLUSIONS A faster accumulation of chronic physical diseases and a faster decline in health perception was observed in OABD than in participants from the general population. The observed differences could partly be attributed to baseline differences in psychosocial, lifestyle, and health behaviour factors. Our findings urgently call for the use of integrated care in BD.

Research paper thumbnail of Social cognition provides early distinction between phenocopy syndrome of behavioural variant frontotemporal dementia and behavioural variant frontotemporal dementia

Alzheimers & Dementia, Dec 1, 2021

BackgroundPatients displaying clinical features of bvFTD but lacking abnormalities on neuroimagin... more BackgroundPatients displaying clinical features of bvFTD but lacking abnormalities on neuroimaging in the absence of clinical progression over time are considered to represent the phenocopy syndrome of bvFTD (phFTD). Clinical overlap between bvFTD and phFTD hampers their diagnostic distinction whereas it is essential to provide adequate treatment and prognosis. We aimed to assess whether there are differences in patient characteristics and caregiver‐reported symptoms between phFTD and bvFTD that can provide tools for early distinction.MethodWe compared phFTD with probable/definite bvFTD with respect to patient characteristics and caregiver‐reported symptoms, that comprised the domains behaviour, global cognitive functioning, social cognition and ADL. Total test scores were compared between groups followed by multiple logistic regression analysis. ROC curves were plotted to assess diagnostic value.ResultA total of 53 patients were included (n = 28 phFTD, n= 25 bvFTD). Compared to bvFTD, phFTD patients performed better in terms of social cognition yet had more behavioural symptoms and worse ADL performance reported by the caregiver. When combining social cognition, behavioural symptoms and ADL performance we found a sensitivity and specificity of 85.71% and 80.0% for a diagnosis of phFTD.ConclusionSocial cognition was spared in phFTD compared to bvFTD patients implying to be a valuable tool in distinguishing phFTD from bvFTD. Worse ADL performance and increased behavioural symptoms reported by caregivers in phFTD is remarkable and indicates further research is needed to asses if patient‐based tools are superior to caregiver‐based tools when suspecting phFTD.

Research paper thumbnail of Laat-ontstane schizofrenie: een dementia non-praecox?

Tijdschrift voor psychiatrie, 2006

Research paper thumbnail of Twee verdachten met hersenletsel en crimineel gedrag. De bijdrage van de neuroloog aan forensisch psychiatrische diagnostiek

Tijdschrift voor psychiatrie, 2011

: Interest in the neurobiology of criminal behaviour is increasing. Recent research emphasises th... more : Interest in the neurobiology of criminal behaviour is increasing. Recent research emphasises the important role played by the frontal lobe in the processing of emotional and social information and in the controlling of behaviour. Damage to specific frontal structures in the brain may therefore lead to antisocial and criminal behaviour. On the basis of the case histories of two suspects with brain lesions, the impact of such damage on the forensic psychiatric diagnosis is discussed. A plea is made for the more frequent involvement of a neurologist in the diagnostic evaluation usually undertaken by the forensic psychiatrist.

Research paper thumbnail of Symptom Severity Mixity in Older-Age Bipolar Disorder: Analyses From the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD)

American Journal of Geriatric Psychiatry, Oct 1, 2022

Research paper thumbnail of Demographic and clinical characteristics of lithium‐treated older adults with bipolar disorder

Acta Psychiatrica Scandinavica, Jul 26, 2022

ObjectivesThere is limited information on the characteristics of older adults with bipolar disord... more ObjectivesThere is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults.The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing &amp; Geriatric Experiments in Bipolar Disorder (GAGE‐BD).Experimental ProceduresCross‐sectional analysis of the GAGE‐BD dataset to determine differences and similarities between lithium users and non‐users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5% females) from 12 study sites. Two subgroups (‘Lithium’; ‘Non‐lithium’) were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.ResultsOABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non‐users among those with evidence of rapid cycling and non‐bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non‐users.ConclusionWe found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross‐sectional approach and data harmonisation.

Research paper thumbnail of Essential data dimensions for prospective international data collection in older age bipolar disorder (OABD): Recommendations from the GAGE‐BD group

Bipolar Disorders

BackgroundBy 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be a... more BackgroundBy 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be aged ≥50 years. However, older age bipolar disorder (OABD) remains understudied. There are limited large‐scale prospectively collected data organized in key dimensions capable of addressing several fundamental questions about BD affecting this subgroup of patients.MethodsWe developed initial recommendations for the essential dimensions for OABD data collection, based on (1) a systematic review of measures used in OABD studies, (2) a Delphi consensus of international OABD experts, (3) experience with harmonizing OABD data in the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD, n ≥ 4500 participants), and (4) critical feedback from 34 global experts in geriatric mental health.ResultsWe identified 15 key dimensions and variables within each that are relevant for the investigation of OABD: (1) demographics, (2) core symptoms of depression and (3) mania, (4) cognitio...

Research paper thumbnail of Long-term Outcome Following Electroconvulsive Therapy for Late-Life Depression: Five-Year Follow-up Data From the MODECT Study

The American Journal of Geriatric Psychiatry

Research paper thumbnail of Proactieve cognitieve psychiatrie bij het ouder worden

Tijdschrift voor psychiatrie, 2021

COGNITIVE SYMPTOMS ARE COMMONLY REPORTED IN PATIENTS WITH UNIPOLAR OR BIPOLAR MOOD DISORDER. THE ... more COGNITIVE SYMPTOMS ARE COMMONLY REPORTED IN PATIENTS WITH UNIPOLAR OR BIPOLAR MOOD DISORDER. THE PREVALENCE OF COGNITIVE SYMPTOMS INCREASES WITH AGEING. THE PRESENCE AND EXTENT OF COGNITIVE SYMPTOMS HAS A DIRECT NEGATIVE IMPACT ON RECOVERY OF THE PSYCHIATRIC ILLNESS AND QUALITY OF LIFE.
AIM: IMPROVING OUTCOME OF OLDER PATIENTS WITH A UNIPOLAR OR BIPOLAR MOOD DISORDER.
METHOD: REVIEW OF AVAILABLE INTERVENTIONS TO IMPROVE COGNITIVE FUNCTIONING DIRECT OR INDIRECT.
RESULTS: STRATEGY TRAINING, TRAINING OF COGNITIVE FUNCTIONS AND PHYSICAL EXERCISE HAVE SHOWN TO BE EFFECTIVE TO IMPROVE COGNITIVE FUNCTIONING AND ITS POSSIBLE ADVANTAGES FOR PSYCHIATRIC POPULATIONS ARE CURRENTLY STUDIED IN THE NETHERLANDS. TREATMENT OF COMORBID INSOMNIA BY COGNITIVE BEHAVIORAL THERAPY MAY IMPROVE COGNITIVE FUNCTIONING INDIRECTLY BY DISCONTINUATION OF SLEEP MEDICATION, IMPROVEMENT OF SLEEP AND MOOD RELATED COGNITIVE SYMPTOMS.
CONCLUSION: A PROACTIVE APPROACH, INCLUDING SCREENING AND TREATMENT OF COGNITIVE SYMPTOMS BEFORE IMPAIRMENT OCCURS, IS WARRANTED TO OPTIMIZE OUTCOME OF THE AGEING PSYCHIATRIC PATIENT. TIJDSCHRIFT VOOR PSYCHIATRIE 63(2021)2, 120-124.

Research paper thumbnail of Neuropsychological profiles in behavioural variant Frontotemporal Dementia and Psychiatric disorders

Research paper thumbnail of O2‐14‐04: Identifying Behavioral Variant Frontotemporal Dementia Among Patients with a Late‐Onset Frontal Lobe Syndrome: Summary Results of the Lof Study

Alzheimers & Dementia, Jul 1, 2018

Research paper thumbnail of Impact of Imaging and Cerebrospinal Fluid Biomarkers on Behavioral Variant Frontotemporal Dementia Diagnosis within a Late-Onset Frontal Lobe Syndrome Cohort

Dementia and Geriatric Cognitive Disorders, Oct 17, 2015

The criteria for behavioral variant frontotemporal dementia (bvFTD) incorporate MRI and [18F]-FDG... more The criteria for behavioral variant frontotemporal dementia (bvFTD) incorporate MRI and [18F]-FDG-PET. Cerebrospinal fluid (CSF) analysis is merely advised for excluding Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. We aimed to assess the impact of biomarkers on diagnostic certainty and contingent changes of bvFTD diagnosis within the clinically relevant neuropsychiatric differential diagnosis of subjects with a late-onset frontal lobe syndrome (LOF). We included 137 patients with LOF, aged 45-75 years, 72% males. Biomarker disclosure was considered contributing after any substantial difference in diagnostic certainty or a diagnostic change. Percentages of contributing biomarkers were compared between three major diagnostic groups (bvFTD, psychiatry, other neurological disorders). Certainty levels in stable diagnostic groups were compared to those with a diagnostic change. Biomarkers contributed in 53, 60 and 41% of the LOF patients for MRI, [18F]-FDG-PET and CSF, respectively. Biomarkers changed the diagnosis in 14% of cases towards bvFTD and in 13% from bvFTD into an alternative. Those that changed had a lower level of a priori diagnostic certainty compared to stable diagnoses. Our study not only supports the widely accepted use of MRI and [18F]-FDG-PET in diagnosing or excluding bvFTD, but also shows that CSF biomarkers aid clinicians in the diagnostic process.

Research paper thumbnail of Laat-ontstane schizofrenie : Een dementia non-praecox? Overzicht en aanbevelingen voor de differentiêle diagnostiek

Tijdschrift voor psychiatrie, 2006

Research paper thumbnail of The functioning assessment short test for older adults (FAST-O), a time-efficient manner to assess daily functioning?

Bipolar Disorders, Jun 1, 2020

Research paper thumbnail of Cognitive profiling in older patients with an affective disorder: Exploring differences and similarities

Bipolar Disorders, Jun 1, 2020

Research paper thumbnail of Reliability and validity of the functioning assessment short test for older adults with bipolar disorder (FAST-O)

International Journal of Bipolar Disorders, Oct 2, 2020

Background: Many frequently used instruments fail to assess psychosocial functioning in patients ... more Background: Many frequently used instruments fail to assess psychosocial functioning in patients with bipolar disorder. The Functioning Assessment Short Test (FAST) was developed in order to tackle this problem and to assess the main functioning problems experienced by patients with bipolar disorder. However, the original FAST is not fully applicable in older adults due to the domain of occupational functioning. The aim of our study was to validate an adapted version for Older adults (FAST-O) in a group of older adults with bipolar disorder (OABD). Methods: 88 patients aged 50 years and over diagnosed with bipolar disorder were included. We adapted the items in the area of "work-related functioning" of the FAST into items assessing "societal functioning". Several measurements were conducted in order to analyse the psychometric qualities of the FAST-O (confirmatory factor analysis for internal structure, Cronbach's alpha for internal consistency, Spearman's rho for concurrent validity, Mann-Whitney U test for discriminant validity). Results: Mean age in the study sample was 65.3 (SD = 7.5) and 57.3% was female. The internal structure was most similar to the internal structure of the original FAST. The internal consistency was excellent (Cronbach's alpha = .93). The concurrent validity when correlated with the Social and Occupational Functioning Assessment Scale was low, but significant. The FAST-O was also able to distinguish between euthymic and symptomatic OABD patients. Conclusions: The FAST-O has strong psychometric qualities. Based on our results, we can conclude that the FAST-O is a short, efficient solution in order to replace global rating scales or extensive test batteries in order to assess daily functioning of older psychiatric patients in a valid and reliable manner.

Research paper thumbnail of Associations between cognitive functioning, mood symptoms and coping styles in older age bipolar disorder

Journal of Affective Disorders, Aug 1, 2018

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  Better executive functioning is associated to more active copping.  Less depressive symptoms are associated to more active coping.  Mood is a more important contributor to active coping as compare to cognition.  No associations between cognition, mood and passive coping were found.

Research paper thumbnail of The relationship between cognitive and social functioning in older patients with bipolar disorder

Journal of Affective Disorders, Nov 1, 2018

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  Global cognitive functioning, learning and memory and executive functioning are positively associated with global social functioning  Global social functioning as judged by the clinician is independent of self-reported social functioning  Attention and verbal fluency are not associated with global social functioning

Research paper thumbnail of Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life depression

Acta Psychiatrica Scandinavica, Jul 12, 2018

Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life d... more Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life depression. Objective: There is ongoing concern about the possible negative impact of ECT on neurocognitive functioning in older patients. In this study, we aimed to characterize the long-term cognitive effects of ECT in patients with late-life depression, using an extensive neuropsychological battery. Methods: A total of 110 patients aged 55 years and older with unipolar depression, referred for ECT were included. The neuropsychological test battery was assessed prior to ECT and 6 months after the last ECT session. Results: There were no statistically significant group-level changes from baseline to 6 months post-ECT in any of the neuropsychological measurements. Individual differences in cognitive performance were detected using the Reliable Change Index. Conclusion: Patients with late-life depression do not show deleterious cognitive effects 6 months following an ECT index course, although there are considerable differences at an individual level. Clinicians should not hesitate to prescribe ECT in older patients, as most of these patients will tolerate the treatment course and a small group will even experience a cognitive enhancement. However, clinicians should be aware that a small group of patients can experience cognitive sideeffects. Further study is needed to predict which patients have a higher risk of developing cognitive side-effects.

Research paper thumbnail of Functioning Assessment Short Test for Older Adults

Research paper thumbnail of Physical comorbidity in Older-Age Bipolar Disorder (OABD) compared to the general population - a 3-year longitudinal prospective cohort study

Journal of Affective Disorders, Jun 1, 2021

BACKGROUND The aim of this study was to examine the accumulation of chronic physical diseases in ... more BACKGROUND The aim of this study was to examine the accumulation of chronic physical diseases in Older-Age Bipolar Disorder (OABD) as well as in individuals from the general aging population over a 3-year period. METHODS This prospective longitudinal study compared 101 patients with OABD receiving outpatient care (DOBi cohort) with 2545 individuals from the general aging population (LASA cohort). The presence of eight major chronic diseases was asked at baseline and 3-year follow-up. Total number of diseases was the main outcome measure. Self-rated health (SRH, scale 1-5) was examined as a secondary outcome. Multilevel linear modelling of change was performed to estimate and test the observed change in both samples. RESULTS At baseline, the number of chronic diseases was lower (b= -0.47, p<0.01) and self-rated health comparable (b=0.27, p=0.13) in DOBi than in LASA. Over 3 years the number of chronic diseases increased faster in DOBi than in LASA (b=0.51 versus b=0.35, p(interaction)=0.03). When corrected for employment, depressive symptoms, waist circumference, smoking, and alcohol use, this difference was no longer significant. SRH decreased faster in DOBi than in LASA (b=-0.24 versus b=-0.02, p(interaction)=0.04). LIMITATIONS Information on chronic diseases was collected using self-report. CONCLUSIONS A faster accumulation of chronic physical diseases and a faster decline in health perception was observed in OABD than in participants from the general population. The observed differences could partly be attributed to baseline differences in psychosocial, lifestyle, and health behaviour factors. Our findings urgently call for the use of integrated care in BD.

Research paper thumbnail of Social cognition provides early distinction between phenocopy syndrome of behavioural variant frontotemporal dementia and behavioural variant frontotemporal dementia

Alzheimers & Dementia, Dec 1, 2021

BackgroundPatients displaying clinical features of bvFTD but lacking abnormalities on neuroimagin... more BackgroundPatients displaying clinical features of bvFTD but lacking abnormalities on neuroimaging in the absence of clinical progression over time are considered to represent the phenocopy syndrome of bvFTD (phFTD). Clinical overlap between bvFTD and phFTD hampers their diagnostic distinction whereas it is essential to provide adequate treatment and prognosis. We aimed to assess whether there are differences in patient characteristics and caregiver‐reported symptoms between phFTD and bvFTD that can provide tools for early distinction.MethodWe compared phFTD with probable/definite bvFTD with respect to patient characteristics and caregiver‐reported symptoms, that comprised the domains behaviour, global cognitive functioning, social cognition and ADL. Total test scores were compared between groups followed by multiple logistic regression analysis. ROC curves were plotted to assess diagnostic value.ResultA total of 53 patients were included (n = 28 phFTD, n= 25 bvFTD). Compared to bvFTD, phFTD patients performed better in terms of social cognition yet had more behavioural symptoms and worse ADL performance reported by the caregiver. When combining social cognition, behavioural symptoms and ADL performance we found a sensitivity and specificity of 85.71% and 80.0% for a diagnosis of phFTD.ConclusionSocial cognition was spared in phFTD compared to bvFTD patients implying to be a valuable tool in distinguishing phFTD from bvFTD. Worse ADL performance and increased behavioural symptoms reported by caregivers in phFTD is remarkable and indicates further research is needed to asses if patient‐based tools are superior to caregiver‐based tools when suspecting phFTD.

Research paper thumbnail of Laat-ontstane schizofrenie: een dementia non-praecox?

Tijdschrift voor psychiatrie, 2006

Research paper thumbnail of Twee verdachten met hersenletsel en crimineel gedrag. De bijdrage van de neuroloog aan forensisch psychiatrische diagnostiek

Tijdschrift voor psychiatrie, 2011

: Interest in the neurobiology of criminal behaviour is increasing. Recent research emphasises th... more : Interest in the neurobiology of criminal behaviour is increasing. Recent research emphasises the important role played by the frontal lobe in the processing of emotional and social information and in the controlling of behaviour. Damage to specific frontal structures in the brain may therefore lead to antisocial and criminal behaviour. On the basis of the case histories of two suspects with brain lesions, the impact of such damage on the forensic psychiatric diagnosis is discussed. A plea is made for the more frequent involvement of a neurologist in the diagnostic evaluation usually undertaken by the forensic psychiatrist.

Research paper thumbnail of Symptom Severity Mixity in Older-Age Bipolar Disorder: Analyses From the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD)

American Journal of Geriatric Psychiatry, Oct 1, 2022

Research paper thumbnail of Demographic and clinical characteristics of lithium‐treated older adults with bipolar disorder

Acta Psychiatrica Scandinavica, Jul 26, 2022

ObjectivesThere is limited information on the characteristics of older adults with bipolar disord... more ObjectivesThere is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults.The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing &amp; Geriatric Experiments in Bipolar Disorder (GAGE‐BD).Experimental ProceduresCross‐sectional analysis of the GAGE‐BD dataset to determine differences and similarities between lithium users and non‐users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5% females) from 12 study sites. Two subgroups (‘Lithium’; ‘Non‐lithium’) were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.ResultsOABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non‐users among those with evidence of rapid cycling and non‐bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non‐users.ConclusionWe found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross‐sectional approach and data harmonisation.

Research paper thumbnail of Essential data dimensions for prospective international data collection in older age bipolar disorder (OABD): Recommendations from the GAGE‐BD group

Bipolar Disorders

BackgroundBy 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be a... more BackgroundBy 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be aged ≥50 years. However, older age bipolar disorder (OABD) remains understudied. There are limited large‐scale prospectively collected data organized in key dimensions capable of addressing several fundamental questions about BD affecting this subgroup of patients.MethodsWe developed initial recommendations for the essential dimensions for OABD data collection, based on (1) a systematic review of measures used in OABD studies, (2) a Delphi consensus of international OABD experts, (3) experience with harmonizing OABD data in the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD, n ≥ 4500 participants), and (4) critical feedback from 34 global experts in geriatric mental health.ResultsWe identified 15 key dimensions and variables within each that are relevant for the investigation of OABD: (1) demographics, (2) core symptoms of depression and (3) mania, (4) cognitio...

Research paper thumbnail of Long-term Outcome Following Electroconvulsive Therapy for Late-Life Depression: Five-Year Follow-up Data From the MODECT Study

The American Journal of Geriatric Psychiatry

Research paper thumbnail of Proactieve cognitieve psychiatrie bij het ouder worden

Tijdschrift voor psychiatrie, 2021

COGNITIVE SYMPTOMS ARE COMMONLY REPORTED IN PATIENTS WITH UNIPOLAR OR BIPOLAR MOOD DISORDER. THE ... more COGNITIVE SYMPTOMS ARE COMMONLY REPORTED IN PATIENTS WITH UNIPOLAR OR BIPOLAR MOOD DISORDER. THE PREVALENCE OF COGNITIVE SYMPTOMS INCREASES WITH AGEING. THE PRESENCE AND EXTENT OF COGNITIVE SYMPTOMS HAS A DIRECT NEGATIVE IMPACT ON RECOVERY OF THE PSYCHIATRIC ILLNESS AND QUALITY OF LIFE.
AIM: IMPROVING OUTCOME OF OLDER PATIENTS WITH A UNIPOLAR OR BIPOLAR MOOD DISORDER.
METHOD: REVIEW OF AVAILABLE INTERVENTIONS TO IMPROVE COGNITIVE FUNCTIONING DIRECT OR INDIRECT.
RESULTS: STRATEGY TRAINING, TRAINING OF COGNITIVE FUNCTIONS AND PHYSICAL EXERCISE HAVE SHOWN TO BE EFFECTIVE TO IMPROVE COGNITIVE FUNCTIONING AND ITS POSSIBLE ADVANTAGES FOR PSYCHIATRIC POPULATIONS ARE CURRENTLY STUDIED IN THE NETHERLANDS. TREATMENT OF COMORBID INSOMNIA BY COGNITIVE BEHAVIORAL THERAPY MAY IMPROVE COGNITIVE FUNCTIONING INDIRECTLY BY DISCONTINUATION OF SLEEP MEDICATION, IMPROVEMENT OF SLEEP AND MOOD RELATED COGNITIVE SYMPTOMS.
CONCLUSION: A PROACTIVE APPROACH, INCLUDING SCREENING AND TREATMENT OF COGNITIVE SYMPTOMS BEFORE IMPAIRMENT OCCURS, IS WARRANTED TO OPTIMIZE OUTCOME OF THE AGEING PSYCHIATRIC PATIENT. TIJDSCHRIFT VOOR PSYCHIATRIE 63(2021)2, 120-124.