Contribution of PTSD/POW history to behavioral disturbances in dementia

As many World War II and Korean Conflict veterans suffering from posttrauma tic stress disorder (PTSD) grow older, increasing numbers will be diagnosed with dementia. We retrospectively analyzed patients with dementia, compari ng the behavioral disturbances of those with PTSD to those without PTSD. We hypothesized that due to the additive effect of the neurobiological and be havioral changes associated with PTSD and dementia, the dementia with PTSD group would show more agitation and disinhibition than the dementia without PTSD group. Sixteen patients: with diagnoses of dementia and PTSD were mat ched on age and Mini-Mental States Examination (MMSE) scores to 16 patients with dementia without PTSD, Demographic characteristics. co-morbid diagnos es, global Assessment of Functioning (GAF), Cohen-Mansfield Agitation Inven tory (CMAI), and paranoid items of Brief Psychiatric Rating Scale (BPRS) an d Positive and Negative Syndrome Scale for Schizophrenia (PANSS) were asses sed. The patients with diagnoses of dementia with PTSD did not differ signi ficantly in their clinical presentation, hospital course, and condition at discharge from patients with dementia without PTSD. Chi-square analysis sho wed that significantly more subjects in the PTSD group were prescribed anti -depressants compared to the non-PTSD group. Interestingly, within the PTSD group, the subgroup of patients who were former prisoners of war had a sig nificantly higher mean score for paranoia and significantly less verbal agi tation. This pilot study reveals that a diagnosis of PTSD alone is not suff icient to influence behavior in veterans with dementia, however, we also pr esent provocative results that patients with more severe trauma (POW) do ha ve changes in their behavior. Copyright (C) 2001 John Wiley & Sons. Ltd.