Dementia due to neurosyphilis with persistently negative CSF VDRL.
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Adult↗
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Results for “Neurocognitive Disorders”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Cardiac encephalopathy and congestive heart failure: a hypothesis about the relationship.
Many patients with congestive heart failure develop neurologic dysfunction. This may take the form of a cardiac encephalopathy that shares clinical features with other metabolic encephalopathies. The causes are multiple. There is a particular, previously unreported, syndrome that occasionally develops in some patients with congestive heart failure that resembles the findings in patients with normal pressure hydrocephalus. This syndrome is characterized by apathy and abulia with preserved alertness; it is caused by fluid retention within the cranial cavity. The syndrome may also develop in patients with other conditions that cause anasarca, e.g., severe liver or kidney disease or hypoalbuminemia. Because patients with these conditions are often quite ill, it has been difficult to verify the pathophysiologic aspects of the syndrome so that its mechanism must remain a hypothesis that awaits more definitive study in a series of patients. I have not seen this syndrome discussed in any cardiology or neurology texts or reports, and it seems to be completely unknown to cardiologists and neurologists. I have recognized about one patient per year with this syndrome.
Aged↗
The brain as an HIV reservoir: Recent findings using autopsy tissues from people with HIV.
HIV persistence within anatomical reservoirs remains the primary barrier to achieving an HIV cure. While antiretroviral therapy effectively suppresses plasma viremia, it does not eliminate integrated proviral genomes that persist in long-lived cellular compartments. The central nervous system (CNS) is a clinically important HIV reservoir, characterized by immune privilege and the persistence of tissue-resident infection despite effective antiretroviral therapy (ART). Evidence from postmortem studies reveals that HIV DNA, RNA, and even intact replication-competent proviruses remain detectable in brain tissue from virally suppressed people with HIV. Evidence derived primarily from in situ approaches and viable-cell studies supports myeloid-lineage reservoirs, particularly microglia and CNS-associated macrophages, as key cellular sources of persistence, while the extent and biological relevance of astrocyte infection remains debated. These reservoirs exhibit transcriptional activity and are associated with chronic neuroinflammation, which may contribute to HIV-associated neurocognitive disorders, despite systemic viral suppression. Here, we synthesize recent findings from autopsy brain studies, including work enabled by major biorepositories, such as the National NeuroHIV Tissue Consortium and rapid-autopsy programs, including the Last Gift, both of which are essential for studying HIV reservoirs in the CNS. We summarize methodologies for detecting and characterizing HIV in brain tissue, highlight heterogeneous patterns of regional distribution and compartmentalization, and review emerging links between CNS persistence and neuroinflammation. We conclude with priorities for harmonized tissue processing, multi-modal single-cell and spatial profiling, and coordinated cross-cohort analyses to clarify the contribution of CNS reservoirs to neuroHIV pathogenesis and systemic rebound.
Humans↗
Night sleep electroencephalogram power spectral analysis in excessive daytime sleepiness disorders.
A group of 53 patients (40 males, 13 females) with mean age of 49 years, ranging from 30 to 70 years, was evaluated in the following excessive daytime sleepiness (EDS) disorders: obstructive sleep apnea syndrome (B4a), periodic movements in sleep (B5a), affective disorder (B2a), functional psychiatric non affective disorder (B2b). We considered all adult patients referred to the Center sequentially with no other distinctions but these three criteria: (a) EDS was the main complaint; (b) right handed; (c) not using psychotropic drugs for two weeks prior to the all-night polysomnography. EEG (C3/A1, C4/A2) samples from 2 to 10 minutes of each stage of the first REM cycle were chosen. The data was recorded simultaneously in magnetic tape and then fed into a computer for power spectral analysis. The percentage of power (PP) in each band calculated in relation to the total EEG power was determined of subsequent sections of 20.4 s for the following frequency bands: delta, theta, alpha and beta. The PP in all EDS patients sample had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage. PP distribution in the delta range increased progressively from stage 1 to stage 4; stage REM levels were close to stage 2 levels. In an EDS patients interhemispheric coherence was high in every band and sleep stage. B4a patients sample PP had a tendency to decrease progressively from the slowest to the fastest frequency bands, in every sleep stage; PP distribution in the delta range increased progressively from stage 1 to stage 4; stage REM levels were between stage 1 and stage 2 levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
The geriatric mental status interview (GMS).
The Geriatric Mental Status interview (GMS) is a semi-structured interview technique for assessing psychopathology in elderly patients. It is administered by a trained interviewer in a session of less than one hour. Between 100 and 200 question are asked and almost 500 items are rated. Twenty-one factor scores have been identified and the reliability of the ratings has been established. The interview is acceptable to the patient and is useful for making diagnostic distinctions and evaluation progress
Aged↗
The usefulness of a psychological test battery.
This paper discusses the usefulness of a battery of psychological tests administered to a group of psychiatric geriatric patients in New York and London, as an assessment of cognitive impairment. Two of the tests, the Paired Associate Learning Test, and the Digit Copying Test, were highly related to the diagnosis of organic brain syndrome or functional disorder made independently by a psychiatrist in a clinical interview. Prognostic predictions in disagreement cases were no better or no worse by psychiatric diagnosis than by psychological tests. Compared to a simple clinical test of disorientation derived from the psychiatric interview, psychological tests were more highly correlated to independent measures of patients' self-care capacity and duration of hospitalization, but equally related to psychiatric diagnosis. The verbal subtest proved to be the more useful of the psychological tests given. The logistics and difficulties of administering psychological tests to this specialized population are discussed, e.g. patients' physical limitations, communication problems; as well as efforts in this study to minimize these problems.
Aged↗
Distinctions between organic brain syndrome and functional psychiatric disorders: based on the geriatric mental state interview.
Discriminant function analysis was employed to study the ability of the Geriatric Mental Status interview to distinguish between patients diagnosed by the project as having an organic brain syndrome or a functional psychiatric disorder. In both New York and London, patients with organic brain syndrome scored significantly higher (p less than 0.05) than those with functional disorders on the factors of impaired memory, disorientation and incomprehensibility and significantly lower on the factors of depression and somatic concerns. Discriminant functions calculated from data on the New York and London patients separately significantly distinguished not only the patients on whom the functions were based but the patients in the other sample as well.
Affective Symptoms↗
Follow-up of psychiatric comorbidity in the general hospital.
Although appropriate follow-up is an important task in the consultation setting, little attention has been directed to its frequency, or the risk profile for minimal or maximal follow-up. Eight hundred twenty-three patients from 1983 to 1986 were examined at the Mount Sinai Hospital using a computerized psychiatric consultation database that recorded demographic information, reason for referral, DSM-III 5 Axes diagnosis, recommendations and number of follow-up interviews. Forty-two percent of the consultations had three or less (minimum) follow-up visits. The minimum follow-up group were significantly less often referred for depression or diagnosed as depression (p = .01), had fewer psychosocial stressors (Axis III) (p = .03), and recommendations for psychosocial treatment by the psychiatric consultant (p = .0001), but had significantly more personality disorders (Axis II) (p = .04). Sixty-two percent of the consultation patients were correctly classified into the follow-up groups by the variables: 1) marital status; 2) living situation; 3) problem assessed as chronic illness or pain; 4) absence of an Axis I diagnosis or diagnostic uncertainty; and 5) number of recommendations by the consultant.
Chronic Disease↗
Neuropsychiatric complications of AIDS: a literature review.
Acquired immune deficiency syndrome (AIDS) has become a major public health problem with over 12,000 cases and 6,000 deaths reported to date. Although there has been an explosion of knowledge in the virology, immunology and pathology of AIDS, relatively little has been written on the neuropsychiatric aspects. This report reviews the existing literature on the neuropsychiatric complications of AIDS. As many as 40 percent of patients with AIDS have neurologic complications at some point in their illness. These complications include either focal deficits attributable to opportunistic organisms infecting the CNS or diffuse encephalopathy caused by viral infection or lymphoma infiltration. Psychiatric complications include major depression, adjustment disorder with depressed mood, and organic brain syndrome with affective, delusional or demented features. Inpatient and consulting psychiatrists must be alert to these complications of AIDS so as to make accurate diagnoses and deliver appropriate therapy. Further studies, integrating both psychiatric and neurologic perspectives, are needed to better elucidate the neuropsychiatric complications of AIDS and help plan appropriate therapeutic interventions.
Acquired Immunodeficiency Syndrome↗
Assessment of the older psychiatric inpatient.
Instruments, whether used in psychometrics or in other fields, must have a practical application if they are to repay the care spent in their use and development. The Geriatric Mental State schedule was developed in response to the need to answer the question whether functional psychiatric disorders were being misdiagnosed as organic brain syndrome and, if so, to what extent this influenced treatment and outcome. In the hospitals studied it was found that American psychiatrists were more likely to diagnose organic brain syndrome than British psychiatrists. Although elderly patients with affective disorder were less likely to be given American patients was as good, if not better, than the outcome in the British patients.
Affective Symptoms↗
Development and Validation of Machine Learning Models for Predicting Early Cognitive Decline Using Home Sensor-Derived Behavioral Data: Sensors in-Home for Elder Wellbeing (SINEW) Cohort Study.
BACKGROUND: As the global population continues to age, the prevalence of geriatric conditions, including dementia and frailty, is also increasing. Early identification of individuals at an elevated risk of these conditions, such as those presenting with mild cognitive impairment (MCI) or prefrailty, can provide a critical window for prompt intervention aimed at preventing or reversing disease progression. To promote such early identification, there is a burgeoning interest in the use of digital sensor technology and predictive modeling. OBJECTIVE: This study aimed to use a continuous, home-based monitoring sensor system for older adults to distinguish those exhibiting normal aging from those with MCI, early dementia, prefrailty, or frailty, and to predict their transition from normal aging to one of these conditions. METHODS: This longitudinal cohort study will recruit 200 community-dwelling adults aged ≥65 years with normal cognition or MCI at baseline. A multi-sensor system will be installed in participants' homes, including passive infrared motion sensors, door contact sensors, bed sensors, medication box sensors, wearable activity bands, and Bluetooth proximity beacons. These devices will continuously capture spatiotemporal activity patterns, mobility indicators, sleep behaviors, and medication-taking routines. Annual assessments will include standardized cognitive tests (eg, Montreal Cognitive Assessment, Mini-Mental State Examination, Rey Auditory-Verbal Learning Test, digit span, Color Trails Test, semantic fluency, Stroop), frailty measures (modified Fried phenotype, gait speed, grip strength), mental health scales, sleep quality, and psychosocial indicators. Sensor-derived features-such as gait variability, activity regularity, sleep fragmentation, and medication adherence patterns-will be integrated with clinical data to develop supervised machine learning models. Planned approaches include logistic regression, random forests, gradient boosting, and deep learning. Model performance will be evaluated using cross-validation and independent test sets. Primary metrics will include area under the receiver operating characteristic curve, sensitivity, specificity, precision, recall, and F1-score. Models will be benchmarked against gold-standard clinical diagnoses and validated using temporal subsets of the dataset. RESULTS: Enrollment for this study started in November 2019 and will continue until March 2030. As of June 2025, we have enrolled 138 participants. Full data analysis has yet to begin. CONCLUSIONS: We aim to develop a reliable and effective sensor system for in-home use that will facilitate the early detection of cognitive and physical decline. In so doing, it will add to our current understanding of digital biomarkers. It is common for older adults to seek clinical intervention only when their cognitive impairment has already reached an advanced stage. The implementation of readily deployable sensor systems within community settings presents us with opportunities for prompt intervention, which holds the potential for delaying or reversing disease progression and allowing for a greater number of functional and meaningful years.
Humans↗
Psychosocial therapies in diabetes: report of the Psychosocial Therapies Working Group.
OBJECTIVE: To review key advances in the behavioral science literature related to psychosocial issues and therapies for persons with diabetes, to discuss barriers to research progress, and to make recommendations for future research. RESEARCH DESIGN AND METHODS: Key findings from the literature on psychosocial research in diabetes are reviewed separately for children and adults. Specific issues covered include psychosocial adjustment and psychiatric disorders, neurocognitive functioning, quality of life, and psychosocial therapies. Barriers that must be addressed to allow research in this area to progress are discussed. Recommendations are then made concerning high-priority areas for advancing research in the field. CONCLUSIONS: A substantial amount of behavioral science research has demonstrated that psychosocial factors play an integral role in the management of diabetes in both children and adults. Research has also shown the efficacy of a number of psychosocial therapies that can improve regimen adherence, glycemic control, psychosocial functioning, and quality of life. More research in this area is needed to develop psychosocial intervention programs for specific patient populations and to demonstrate the cost-effectiveness of these approaches.
Adolescent↗
Reliability of the WAIS-R with a mixed patient sample.
Reliability of the WAIS-R for a mixed sample of psychiatric and neurological patients was determined. Split-half reliabilities and standard errors of measurement were computed for all subtests (exept Digit Span and Digit Symbol) and the Verbal, Performance, and Full Scale IQs. Only the Arithmetic subtest had a reliability estimate which was significantly lower than that of the 35-44-yr.-old standardization group. All other reliabilities and standard errors of measurement approximated those reported for the normative group. It was concluded that the WAIS-R is a reliable instrument for evaluating patients in a clinical setting.
Adult↗
Relationship between WAIS-R and wide range achievement test in a sample of mixed patients.
Correlations between the WAIS-R Verbal, Performance, and Full Scale IQs, WAIS-R subtest scaled scores, and Wide Range Achievement Test Reading, Spelling, and Arithmetic standard scores were computed for a sample of 60 patients at a V.A. medical center who were referred for routine psychological evaluation. The Full Scale IQ and Verbal IQ yielded large correlations with the three achievement area standard scores (rs of .60 to .76). However, Performance IQs correlated moderately with reading and spelling scores (rs of .41 and .42), but a larger correlation obtained with arithmetic scores (r = .66). The results support the concurrent validity of the WAIS-R.
Achievement↗
Neuropsychological performance and suicidal behavior in adult psychiatric inpatients.
Although various studies have shown that suicidal persons exhibit greater cognitive deficiencies than both normals and other psychiatric patients, researchers as yet have been unable to account for the source(s) of the differences. Some of these differences (e.g., cognitive rigidity and impaired problem solving) hint of possible organic involvement. This study explored the relationship of neuropsychological functioning to suicidal behavior by comparing 20 suicidal and 27 nonsuicidal psychiatric inpatients on several tests of neuropsychological functioning. Although results showed no significant differences between the two groups on most measures, both groups showed evidence of notably high levels of cortical dysfunction relative to test norms. Thirty-five percent of suicidal patients and 44% of nonsuicidal patients scored in the impaired range. Implications of this high frequency of impairment for the treatment of suicidal and nonsuicidal psychiatric patients are discussed.
Adult↗
A multi-vantaged approach to measurement of behavioral and affect states for clinical and psychobiological research.
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Adult↗
WAIS-R scatter with psychiatric inpatients: I Intrasubtest scatter.
Intrasubtest scatter values for eight WAIS-R subtests were estimated for a sample of 150 psychiatric inpatients and compared with those reported for a comparable portion of the WAIS-R standardization group by Kaplan, Fein, Morris, and Delis in 1991, using the normal deviate (z) test. The standardization group's intrasubtest scatter was significantly greater than those reported for the psychiatric inpatients on all subtests except Arithmetic and Information. These results suggested that, contrary to expectation, limited intrasubtest scatter may characterize WAIS-R protocols of psychiatric inpatients, while the presence of scatter may characterize normal WAIS-R performance.
Adolescent↗
Chronic psychiatric patients' use of caffeine: pharmacological effects and mechanisms.
The uses and effects of caffeine as a psychoactive drug in chronic psychiatric inpatient groups are described. Caffeine use and abuse is linked etiologically to diverse psychiatric disorders; its mechanisms of action are examined in relation to anxiety, anxiety neuroses, psychosis, schizophrenia, and caffeine intoxication and dependence. It is postulated that deleterious effects may result from the interaction of caffeine with commonly prescribed psychotropic drugs. A possible model of caffeine abuse is discussed. Increased public education about potential health problems related to caffeine consumption is suggested, and further controls of caffeine in psychiatric settings are recommended.
Arousal↗