Diagnosis

This article explores the findings from a recent research project conducted by the Mental Health Foundation for the Alzheimer's Society. The project 'Out of the Shadows' draws out important messages for people with dementia and their carers about their preferences for care and support. The research involved a literature review, focus groups and one-to-one interviews. It investigated who they found out they had dementia, the assessment and diagnostic process, and how they coped after diagnosis.

This NICE quality standard covers recognition, assessment and management of bipolar disorder in adults (18 years and older) in primary and secondary care. It outlines eight quality statements designed to improve patient safety, patient experience and clinical effectiveness. The eight quality statements are: referral for specialist mental health assessment; personalised care plan; involving carers in care planning; psychological interventions; maintaining plasma lithium levels; valproate; assessing physical health; and supported employment programmes.

Aim: To document the behavioural and psychological symptoms in patients with a diagnosis of established Alzheimer's disease (AD) for at least 3 years.

Diagnosis plays a significant role in the shaping of individual identities and the quality of life for people with learning difficulties and their family carers. Diagnostic labels are constitutive of peoples' lives, in that they bring forth pathology, create problemsaturated stories and construct careers as patients and cases. Disabled identities of people with learning difficulties remain largely ‘embodied’ and within the definitional control of professionals.

Background There is no reliable and valid self-report measure of depressive symptoms for people with learning disabilities. Aims To develop a scale for individuals with learning disability, and a supplementary scale for carers. Method Items were generated from a range of assessment scales and through focus groups. A draft scale was piloted and field tested using matched groups of people with or without depression, and their carers.

Background: The relationship between the behavioural and psychological symptoms of dementia (BPSD) and negative outcomes in carers has been consistently demonstrated, however the quality of the assessment of the former in routine clinical settings is variable and validated interview-based scales are frequently underutilised.

Aims: To develop a carer self-report questionnaire, the Behavioural and Psychological Symptoms Questionnaire (BPSQ), for the assessment of the neuropsychiatric symptoms of dementia and associated carer distress.

Young people who develop dementia and their carers have all the distressing symptoms of older people who have this condition but with the added problems of having a career, financial commitments and often a young family. Explores the condition and the help that is available.

The need for accurate information about the mental health problems of multicultural communities requires valid measures of mental health for use in a number of languages and cultural contexts. Measures of psychopathological symptoms leading to a diagnosis have been especially criticised for their universal application, without attention to their limitations across cultures. Yet, measures are crucial to assess recovery and the performance of services, and to take account of carer and user views.

This learning object focuses primarily on the later stages of dementia and on managing the more significant or prominent challenges - and symptoms - associated with this level of dementia. The material aims to reflect, where possible, the experiences of people with dementia and their family carers. Many of the examples given are located in a care home setting although the issues are also very relevant to supporting a person with dementia in the community.

The research community is showing increasing interest in the analysis of the care trajectory of people with chronic health problems, especially dementias such as Alzheimer's disease. However, despite this interest, there is little research on the initial phases of the care trajectory. The fact that the first symptoms of dementia are generally noticed by those surrounding the elderly person suggests that the recognition of the disease is intimately linked to interactions not only amongst family members but also amongst friends, neighbours and health professionals.