Search PubMed⌕ Search

Biomedical subjects

I Simeone

Publications and source records attributed to I Simeone.

At least 19 recordsLinked to original sources
PubMed2000

Factor analysis supports the evidence of existing hyperactive and hypoactive subtypes of delirium.

OBJECTIVE: The aim of this study was to examine whether delirium has specific clinical subtypes. METHOD: One hundred and eighty-three elderly subjects meeting DSM-IIIR criteria for delirium were evaluated using a 19-item symptom check-list assessing different dimensions of delirium symptomatology. Exploratory factor analysis was conducted in order to examine which symptoms clustered. RESULTS: Factor analysis confirmed the existence of two different clusters of symptoms: first, symptoms of hyperalert/hyperactive features (agitation, hyper-reactivity, aggressiveness, hallucinations, delusions); and second, symptoms of hypoalert/hypoactive features (decreased reactivity, motor and speech retardation, facial inexpressiveness). CONCLUSION: This preliminary study seems to support the evidence of hypoactive and hyperactive subtypes of delirium, even though their aetiology and prognostic values need to be further examined.

Aged↗
PubMed2000

Etiologic and outcome profiles in hypoactive and hyperactive subtypes of delirium.

The existence of hyperactive, hypoactive, or mixed clinical subtypes of delirium is widely accepted. But relationships between these motor profiles and etiology or outcome remain unclear. The aim of this study was to compare etiologic and outcome profiles in a case series of 183 elderly patients (mean age = 84.1 years, SD = 5.9) consecutively admitted into the geriatric wards of two French university hospitals or referred to a geriatric psychiatry consultation-liaison unit within a Swiss university hospital. All patients met DSM-III-R criteria for delirium and were classified into clinical subtypes according to the results of a previous factor analysis of scores on a 19-item checklist rating a wide range of delirium symptoms. The hyperactive subtype was more frequent (n = 85, 46.5%) than the unspecified (n = 50, 27.3%) and hypoactive subtypes (n = 48, 26.2%). There was no significant difference in terms of etiologic or outcome profile between clinical subtype groups. The presence of acute metabolic disorders, cardiovascular disease, and hyperthermia as etiologic factors was significantly associated with full recovery of the episode at 3 weeks follow-up, whereas probable preexisting dementia was significantly associated with partial recovery or failure to recover.

Aged↗
PubMed1997

Are personality disorders more frequent in early onset geriatric depression?

This preliminary study evaluates the prevalence of personality disorders (PD) in a sample of 37 elderly recovered depressed and non-demented patients, using the French version of the Vragenlijst voor Kenmezken van de Persoonlijkheid (VKP) or Questionnaire on Personality Traits (QPT). The prevalence of definite personality disorder was 65% with predominance of Cluster C and particularly dependent and avoidant PD. The rate of PDs was higher in early onset (73%) than in late onset (45%) geriatric depression, even though there is only a trend towards statistical significance (Chi square = 2.588, p = 0.107). These results are consistent with those of previous reports using different PD assessment methods, supporting evidence that the QPT could be useful in PD assessment of elderly French speaking patients.

Age Factors↗
PubMed1996

[Confusion syndromes in hospitalized aged patients: polymorphism of symptoms and course. Prospective study of 183 patients].

Using explicit criteria contained in the DSM III R, we collected in a prospective cohort study clinical features, outcome and risk factors from two cohorts of delirium in hospitalized elderly patients: 138 hospitalized in geriatric department and 45 patients admitted to an acute and comprehensive care hospital. The clinical features were assessed using a quantitative scale (developed by Derouesné). Delirium was unrecognized or misdiagnosed by physicians in 34% of the cases. The onset was known only two thirds of cases. The incidence of hyperactive type, prolonged hospital stay, poor outcomes (persistent delirium leading up to dementia) were highest in subjects admitted in comprehensive hospital. The etiology of delirium is complex and multifactorial. An underlying cause was identified in 80% of patients. The length or the worsening of delirium was significantly higher in patients with psychiatric or dementia comorbidity (OR: 0.2; IC 95%: 0.1-0.5). The prognosis was better in patients without psychoactive medications (OR: 0.2; IC 95%: 0.1-0.4) or with metabolic abnormalities or acute diseases and disorders (OR: 3.3; IC 95%: 1.5-7.6). The predisposing factors to the development of dementia were prior use of psychoactive medications and signs of prior cognitive impairment. This article suggests delirium in elderly patients is associated with several outcomes. The prognosis should be improved at admission by specific scale and an evaluation of predisposing and precipitating factors.

Aged↗
PubMed1992

[Enduring loneliness. An interview survey of aged widows].

Interviews with 32 widows have given a clearer picture of the different ways of adaptation to solitude. The following types are distinguished: 1. the tormented (6 cases), who are crushed by loneliness and depression, even though they have the support of friends and relations 2. the isolated (7 cases), who may go for several days without seeing anyone 3. the misanthropes (3 cases): 'The less I see of my friends, the better I feel' 4. those who have found the answer to the problem of solitude in outside activities and contacts (5 cases) 5. those who have found tranquility after a lifetime of struggle (4 cases) 6. those with a naturally harmonious temperament who have overcome solitude and demonstrate the way to face it with courage, good sense and optimism (7 cases). This attempt at typology, which describes six different ways of living with solitude, has made possible a better analysis of the problem, its causes and its effects. Though solitude is often considered a negative aspect of growing old, it can also be a source of happiness, even of fulfillment. The capacity to live alone is something that has to be learned.

Adaptation, Psychological↗
PubMed1991

[The dimensions of isolation in the elderly].

For the aged, social isolation and loneliness are among the most frequent causes of hospitalization or placement in homes. A survey of 730 people over 65 shows that cohabitation becomes rarer with advancing age, a phenomenon that has grown increasingly important during the twentieth century. Social isolation, characterized by extremely infrequent contacts with other people, affects approximately one out of ten elderly people. Most at risk are those who retired from lower positions in employment, divorced people and widowers. The main causes are the absence of children and relatives in the immediate area, the fact of being divorced, the lack of professional apprenticeship and, above all, a psychological disposition to introversion. These concepts should form the basis for working out ways of preventing the generalization of a phenomenon which, in the absence of appropriate measures, might become a serious threat to the future of out society.

Aged↗
PubMed1990

[Psychodynamic aspects of behavioral disorders in the senescent patient and their psychodynamic approach].

Melanie Klein's therapy is comprised of elements likely to be transposed to senescence for a better understanding of certain disorders in pathological aging. To this day, several clinical states that appear for the first time at an advanced stage in life, such as certain forms of depression, deliria or intellectual deficiency, have not been satisfactorily explained psychodynamically. The author attempts to create a new approach with a Kleinien perspective.

Aged↗
PubMed1989

[Social networks of the elderly].

The results of a survey conducted among 535 elderly people living in their own homes in urban areas make it possible to analyse the familiar and social relationship of this population. Cohabitation becomes rare as age increases and as most people, especially women, lose their spouses. More than half of the elderly people surveyed had good contacts with family and/or friends, but, for about a quarter of them, social relations were extremely rare. The authors of this article try to define the influence of age, sex, matrimonial status and the socio-professional milieu on the various forms of relationship. These data lead to the identification of a number of groups of people particularly exposed to the risk of isolation: former manual workers or persons having had very subordinate functions (this generally corresponds to a low level of schooling); people who were divorced or separated; men having lost their spouses (overall, men have somewhat fewer contacts than women with family and friends). Widows, though 25% of them were very isolated, generally had good family and social relationships; nevertheless, they often felt at a disadvantage in social life. Practically, the aim of the authors will not be to tackle isolation and solitude of the aged in general, but to design specific measures which will meet the real needs of the various groups at risk.

Aged↗
PubMed1987

[A plan for a randomized evaluation study for improving the memory of the aged].

The training is realised through exercises carried out during courses and at home. The effectiveness of this training is assessed by psychometric tests (before/after) and a questionnaire for self evaluation (after). An equal number of subjects to be trained and controls are selected among 100 or so voluntary participants.

Aged↗