Citation

Calvet B, Clément J. Presse Med. (1983) 2014; 44(2): 150-158.

Vernacular Title

Les cris récurrents chez le patient atteint de démence.

Affiliation

Centre hospitalier Esquirol, pôle universitaire de psychiatrie de l'adulte et de la personne âgée, 87025 Limoges cedex, France; Centre hospitalier Esquirol, centre mémoire de ressources et de recherche du Limousin, 87025 Limoges cedex, France; Inserm UMR1094 neuroépidémiologie tropicale, 87000 Limoges, France.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.lpm.2014.05.029

PMID

25534465

Abstract

Shouting in dementia is a frequent manifestation in institution and is often considered to be extremely disruptive. It remains the most misunderstood behavioral disorder. Shouting or screaming is not a necessarily pejorative qualifier as defined by public authorities and institutions. It can take a multitude of meanings and be characterized alternately as a "reflex", a "behavior", a "language", an "aggression". Shouting has a multifactorial causation. It can translate organic or somatic disorders, but also psychological, cognitive and/or environmental disturbances that clinicians should look for. The 5W method is a reliable and easy to use method in clinical practice to allow analysis of shouting in dementia. There is still too early and massive use of pharmacological approach in taking charge of the repetitive shouts in dementia. Instead, it is necessary to use a first-line non-pharmacological approach based on patient-centered, environment-centered and/or entourage-centered interventions after careful multidisciplinary assessment of this behaviour by the healthcare team.

Language: fr