Bringing dementia-care back into psychiatry

• Main Author: Ajit Avasthi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Journal of Geriatric Mental Health
• Subjects: Care; dementia; India
• Online Access: http://www.jgmh.org/article.asp?issn=2348-9995;year=2018;volume=5;issue=1;spage=10;epage=15;aulast=Avasthi
• ISSN: 2348-9995; 2395-3322

Dementia with over 46 million people suffering from it has become an illness which cannot be ignored. The confusion regarding whether dementia is a neurological or a psychiatric illness has been existing for a long. Conventionally, dementia has been viewed as a neurological illness with the organicity of the same being given utmost importance. However, we cannot ignore the vast contribution of psychiatry in the discovery of dementia. Furthermore, the new concept regarding psychiatric and neurological illnesses has challenged the fact that dementia is a completely neurological illness, especially considering the vast similarities between psychiatric disorders and dementia. This confusion regarding whether it is a neurological or a psychiatric illness has created difficulty in the management of these patients. The similarities between dementia and psychiatric disorders are visible at the level of localization of lesions, the symptoms, especially the behavioral and the psychotic symptoms, the methods of diagnosis, and the treatment strategies, especially the nonpharmacological ones, which are in fact more effective than the pharmacological strategies. The nonpharmacological aspects include not only behavioral strategies but also focus on breaking the bad news and addressing the caregiver burden and the legal aspects. All this puts a psychiatrist at an advantage in treating these patients, when compared to other specialists, given our expertise with history taking, mental status examination, pharmacological management of the behavioral issues, and especially nonpharmacological aspects.