INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #30 Assessment of agitation and aggression in inpatients with alcohol-related cognitive disorders: A review of informant-based scales Willem Eikelboom, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands Yvonne Rensen, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands Gwenny Janssen, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands Roy Kessels, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands Category: Addiction/Dependence Keyword 1: Korsakoff's syndrome/Wernicke’s encephalopathy Keyword 2: aggression Keyword 3: neuropsychiatry Objective: Alcohol-related cognitive disorders range from mild to severe cognitive impairment including Korsakoff’s syndrome. In addition to deficits in memory and executive functioning, individuals with alcohol-related cognitive disorders also frequently show neuropsychiatric symptoms such as apathy, confabulations, and agitation. Assessment scales for apathy and confabulations have been validated in this population and are currently used in clinical practice, while this is not the case for agitation. Timely and adequate assessment of agitation is important as clinicians experience difficulties with managing agitation in inpatients with alcohol-related cognitive disorders. Several informant-based scales to measure agitation and aggression have already been developed and validated in dementia, (aged) psychiatry, and acquired brain injury. Therefore, we conducted a systematic literature search to identify existing scales that also might be applicable for the assessment of agitation in alcohol-related cognitive disorders. Participants and Methods: To identify potential scales, we searched for existing reviews on the assessment of agitation and/or aggression in older adults, dementia, (aged) psychiatry, and acquired brain injury. We only selected scales that were informant-based. Next, we conducted a systematic literature search in MEDLINE, PsychINFO, and EMBASE for each scale. After deduplication, titles and abstracts were screened for studies that reported on psychometric properties and studies that were conducted in alcohol use disorder (AUD). Most promising scales were selected based on best psychometric qualities and the use of the instrument in addiction care. Results: After excluding self-report instruments and composite scales, we included 23 informant-based scales that are used to measure agitation and/or aggression. Systematic literature searches for each instrument resulted in a total of k=3,949 papers that were screened for validation studies and studies conducted in AUD. The total number of studies reporting on psychometric properties were k=199 studies ranging from k=1 for the Agitation Calmness Evaluation Scale, Pittsburgh Agitation Scale, and the Positive and Negative Syndrome Scale Excited Component to k=36 for the Cohen-Mansfield Agitation Inventory. In addition, k=35 studies used any of the scales in AUD, of which were most frequently used the (Modified) Overt Aggression Scale, Staff Observation Aggression Scale-Revised, and Cohen-Mansfield Agitation Inventory. Based on preliminary analyses, the Cohen-Mansfield Agitation Inventory seems the most suitable scale to assess the manifestation of agitation and aggression retrospectively in the prior weeks. The Staff Observation Aggression Scale-Revised seems most promising to capture the nature and severity of prospective aggressive incidents. Conclusions: Preliminary analyses suggest the use of the Cohen-Mansfield Agitation Inventory and the Staff Observation Aggression Scale-Revised to measure agitation and aggression in inpatients with alcohol-related cognitive disorders. The outcomes of this review are highly informative for clinicians in addiction care as adequate assessment is essential for the management of agitation. Analyses are ongoing and will be extended to indices of test-rest and reliable change to advise on scales to use for treatment monitoring.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #30

Assessment of agitation and aggression in inpatients with alcohol-related cognitive disorders: A review of informant-based scales

Willem Eikelboom, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands
Yvonne Rensen, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands
Gwenny Janssen, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands
Roy Kessels, Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Venray, Netherlands

Category: Addiction/Dependence

Keyword 1: Korsakoff's syndrome/Wernicke’s encephalopathy
Keyword 2: aggression
Keyword 3: neuropsychiatry

Objective:

Alcohol-related cognitive disorders range from mild to severe cognitive impairment including Korsakoff’s syndrome. In addition to deficits in memory and executive functioning, individuals with alcohol-related cognitive disorders also frequently show neuropsychiatric symptoms such as apathy, confabulations, and agitation. Assessment scales for apathy and confabulations have been validated in this population and are currently used in clinical practice, while this is not the case for agitation. Timely and adequate assessment of agitation is important as clinicians experience difficulties with managing agitation in inpatients with alcohol-related cognitive disorders. Several informant-based scales to measure agitation and aggression have already been developed and validated in dementia, (aged) psychiatry, and acquired brain injury. Therefore, we conducted a systematic literature search to identify existing scales that also might be applicable for the assessment of agitation in alcohol-related cognitive disorders.

Participants and Methods:

To identify potential scales, we searched for existing reviews on the assessment of agitation and/or aggression in older adults, dementia, (aged) psychiatry, and acquired brain injury. We only selected scales that were informant-based. Next, we conducted a systematic literature search in MEDLINE, PsychINFO, and EMBASE for each scale. After deduplication, titles and abstracts were screened for studies that reported on psychometric properties and studies that were conducted in alcohol use disorder (AUD). Most promising scales were selected based on best psychometric qualities and the use of the instrument in addiction care.

Results:

After excluding self-report instruments and composite scales, we included 23 informant-based scales that are used to measure agitation and/or aggression. Systematic literature searches for each instrument resulted in a total of k=3,949 papers that were screened for validation studies and studies conducted in AUD. The total number of studies reporting on psychometric properties were k=199 studies ranging from k=1 for the Agitation Calmness Evaluation Scale, Pittsburgh Agitation Scale, and the Positive and Negative Syndrome Scale Excited Component to k=36 for the Cohen-Mansfield Agitation Inventory. In addition, k=35 studies used any of the scales in AUD, of which were most frequently used the (Modified) Overt Aggression Scale, Staff Observation Aggression Scale-Revised, and Cohen-Mansfield Agitation Inventory. Based on preliminary analyses, the Cohen-Mansfield Agitation Inventory seems the most suitable scale to assess the manifestation of agitation and aggression retrospectively in the prior weeks. The Staff Observation Aggression Scale-Revised seems most promising to capture the nature and severity of prospective aggressive incidents.

Conclusions:

Preliminary analyses suggest the use of the Cohen-Mansfield Agitation Inventory and the Staff Observation Aggression Scale-Revised to measure agitation and aggression in inpatients with alcohol-related cognitive disorders. The outcomes of this review are highly informative for clinicians in addiction care as adequate assessment is essential for the management of agitation. Analyses are ongoing and will be extended to indices of test-rest and reliable change to advise on scales to use for treatment monitoring.