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W P Bouman

Publications and source records attributed to W P Bouman.

11 recordsLinked to original sources
PubMed2001

Are psychiatrists guilty of "ageism" when it comes to taking a sexual history?

OBJECTIVE: To determine current perceived practice of consultant psychiatrists regarding taking a sexual history and management of sexual dysfunction of their patients. DESIGN: A postal questionnaire survey. PARTICIPANTS: A group of old age and general consultant psychiatrists. MEASURES: A questionnaire with two different case vignettes describing an elderly male complaining of low mood (the other vignette described a middle-aged man with the same complaint) and questions regarding taking a sexual history and management of sexual dysfunction. RESULTS: Response rate of 61% was obtained. Consultant psychiatrists (general and old age) take a sexual history much more frequently of middle-aged men than of elderly men (p<0.001). There are no statistically significant differences between the two groups of psychiatrists in their psychiatric assessment regarding taking sexual history and the management of sexual dysfunction in elderly men (p>0.05). Middle-aged men with sexual dysfunction are referred to a specialized clinic, whilst elderly men are referred to a community psychiatric nurse. CONCLUSIONS: These findings indicate that taking a sexual history is often omitted in the psychiatric assessment of elderly men. Elderly men with sexual dysfunction do not receive appropriate referral and treatment. Human sexuality and particularly aged sexuality is an area that requires more attention in psychiatric training.

Aged↗
PubMed2000

On telling the truth in Alzheimer's disease: a pilot study of current practice and attitudes.

Research suggests there has been a cultural change in the disclosure of diagnosis; most evidence relates to cancer and there is little knowledge of attitudes towards disclosing the diagnosis of Alzheimer's disease. A questionnaire was used to survey the current practice and attitudes of old-age psychiatrists and geriatricians in Nottingham, UK. The results of this pilot study suggest that only 40% of respondents regularly tell patients the diagnosis. Although physicians are aware of many benefits in disclosing, they have concerns regarding the certainty of diagnosis, the patient's insight, and potential detrimental effects. The advantages of disclosure and the ethical issues involved are discussed.

Alzheimer Disease↗
PubMed1998

Incidence of selective serotonin reuptake inhibitor (SSRI) induced hyponatraemia due to the syndrome of inappropriate antidiuretic hormone (SIADH) secretion in the elderly.

OBJECTIVE: The study determines the incidence of SSRI-induced hyponatraemia due to SIADH in an elderly psychiatric inpatient population. DESIGN: A retrospective case-note study. SETTING: An acute old age psychiatry ward. SAMPLE: Patients admitted from January 1 to December 31, 1996. MEASURES: Demographics, medication, psychiatric diagnoses, plasma sodium level and physical comorbidity were collected. Patients on SSRIs were selected and those developing hyponatraemia due to SIADH were identified. RESULTS: Of 32 patients taking SSRIs, four developed symptomatic hyponatraemia due to SIADH (12.5%). A further four developed asymptomatic hyponatraemia following introduction of an SSRI (12.5%), although laboratory confirmation of SIADH was lacking. CONCLUSIONS: The incidence of SSRI-induced hyponatraemia due to SIADH has not previously been established. This study shows a high incidence in elderly patients of this potentially dangerous complication. Clinical practice in the prescription of SSRIs to elderly people must change to include monitoring of electrolytes for early detection and reduction of morbidity.

Acute Disease↗
PubMed1997

Psychiatric manifestations of normal-pressure hydrocephalus: a short review and unusual case.

Normal-pressure hydrocephalus (NPH) is a common cause of potentially reversible dementia. It can present with psychiatric manifestations that may hinder its diagnosis. A 68-year-old man presented with a paranoid psychosis and mild cognitive impairment, but not neurological signs or classic "triad." Gait disturbance and urinary incontinence developed later in the course of illness after the diagnosis of NPH had already been made on computed tomographic (CT) scanning. A lumbo-peritoneal shunt was performed, followed by full remission of psychotic symptoms, as well as considerable improvement in functioning, continence, and gait. This case demonstrates the need to consider NPH when older patients present with psychotic symptoms, particularly in the presence of cognitive impairment, gait disturbance, or incontinence. The decision whether to perform a shunting operation is often difficult, because selection of patients with good prognosis is still inaccurate. CT scanning of the brain is an important investigation in older patients presenting with both functional and organic disorders.

Aged↗