International Psychogeriatrics


Case-Controlled Study of Nursing Home Residents Referred for Treatment of Vocally Disruptive Behavior

Brian Draper a1a2, John Snowdon a4, Susanne Meares a5, Jane Turner a6, Peter Gonski a2, Bryan McMinn a7, Helen McIntosh a8, Linda Latham a6, Deborah Draper a3 and Georgina Luscombe a1
a1 School of Psychiatry, University of New South Wales, Sydney, Australia
a2 School of Community Medicine, University of New South Wales, Sydney, Australia
a3 School of Community Medicine, University of New South Wales, Kensington, Australia
a4 Department of Psychological Medicine, University of Sydney, Sydney, Australia
a5 Department of Child, Adolescent and Family Psychiatry, Westmead Hospital, Westmead, Australia
a6 Department of Aged Care & Rehabilitation, Royal North Shore Hospital, St. Leonards, Australia
a7 Hunter Mental Health Service, James Fletcher Hospital, Newcastle, Australia
a8 Department of Aged Care Psychiatry, Prince of Wales Hospital, Randwick, Australia.

Article author query
draper b   [PubMed][Google Scholar] 
snowdon j   [PubMed][Google Scholar] 
meares s   [PubMed][Google Scholar] 
turner j   [PubMed][Google Scholar] 
gonski p   [PubMed][Google Scholar] 
mcminn b   [PubMed][Google Scholar] 
mcintosh h   [PubMed][Google Scholar] 
latham l   [PubMed][Google Scholar] 
draper d   [PubMed][Google Scholar] 
luscombe g   [PubMed][Google Scholar] 


The aim of this study was to identify factors associated with vocally disruptive behavior (VDB) in nursing home patients referred to aged care services for treatment, using a case-control methodology. Characteristics of the VDB, reasons for referral, perceived causal factors, and psychotropic use were noted. Twenty-five subjects and controls were examined with the Screaming Behavior Mapping Instrument, the Cornell Scale for Depression in Dementia, the Dementia Behavior Disturbance Scale, and measures of cognition, functional capacity, social activities, and emotional reactions of nursing staff. VDB was associated with other disturbed behaviors, depression, anxiety, severe dementia, functional impairment, communication difficulties, use of psychotropic medication, social isolation, and emotional distress in the nursing staff. Reasons for referral may relate more to the stress experienced by nursing home staff in managing VDB than to specific attributes of the VDB itself.

(Received August 6 1999)
(Accepted March 17 2000)