Diagnostic Issues in Dementia: Advancing the Research Agenda for DSM-V

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Advancing the Research Agenda for DSM-V, Diagnostic Issues in Dementia comprises nine chapters with research suggestions for consideration for the upcoming DSM-V process, reflecting the nascent effort toward a new diagnostic nomenclature in the still rapidly evolving field of dementia.

Here, 18 experts provide critical pieces of the dementia diagnostic story: • The all-important neuropathological criteria of Alzheimer's disease and the aging brain; current epidemiologic ...

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Overview

Advancing the Research Agenda for DSM-V, Diagnostic Issues in Dementia comprises nine chapters with research suggestions for consideration for the upcoming DSM-V process, reflecting the nascent effort toward a new diagnostic nomenclature in the still rapidly evolving field of dementia.

Here, 18 experts provide critical pieces of the dementia diagnostic story: • The all-important neuropathological criteria of Alzheimer's disease and the aging brain; current epidemiologic literature and the challenges of making even minor changes in the general definition of dementia; and a scholarly review of the diagnostic nomenclature across the existing criteria, with numerous critiques and suggestion for future research• The growing evidence for mild cognitive impairment as an identifiable entity suitable for inclusion in DSM-V; the current neuropsychological profiling that serves as the centerpiece of the diagnostic criteria for dementia and suggests that new instruments evaluating even broader aspects of cognition, including executive function, will be important in helping to identify dementia at an earlier stage of development• The various behavioral syndromes associated with dementia, with emphasis on the need for great diagnostic clarity to help focus appropriate therapy in this area of increased burden for patients and family caregivers• Biomarkers in dementia that may already be appropriate for inclusion in our diagnostic criteria; the current diagnostic utility of specific imaging modalities, which, combined with expanding ligand technology or markers of genetic predisposition, might further enhance diagnostic accuracy• A review of the tremendous explosion of information in this field, asserting that, with the exception of the rare Mendelian disorders, genetic profiles are not yet ready to make substantial contributions to nosology

Despite all of these exciting findings, the editors state that we are still dealing with primarily clinical syndromes and therefore are still using clinical diagnostic criteria established at consensus conferences. In the spirit of scientific humility, they assert that these experts' views must be considered within the vast and expanding literature related to the dementias. Given the associated but still generally nonspecific biological mechanisms underlying these syndromes, new scientific developments might occur at any time and immediately affect the interpretations and considerations presented here.

This remarkably concise and insightful collection reviews today's -- and suggests directions for tomorrow's -- important diagnostic and research issues in dementia, and as such is a "must read" for clinicians and researchers alike.

American Psychiatric Publishing

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Editorial Reviews

From the Publisher

This book, which was first published in the Journal of Geriatric Psychiatry and Neurology, is an interesting view into the DSM process for the dementia diagnoses. Neurologists, Psychiatrist, geriatric psychiatrists, neuropsychiatries, and behavioral neurologists would be interested in this book.

American Psychiatric Publishing

Doody's Review Service
Reviewer: Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description: This book summarizes the proposed changes for the diagnosis of dementia in preparation of the publication of DSM-V. Just as the DSM-IV and DSM-IV-TR definitions have been based and driven by committee consensus, are not necessarily based on experimental evidence, and are not necessarily related to the biological nature of the condition described, the DSM-V will be similarly based. Most diagnostic categories continue to be just behavioral and historical descriptions that are plagued with validity problems, with most not even meeting Robins & Guze or Kendell's validity criteria. The book is valuable in that it provides insight into how construction of the DSM works and how the diagnostic entities are subject to the idiosyncrasies of the committee members. For example, Lewy Body disease is regarded by the chapter authors of questionable validity, whereas others might consider that Lewy Body Disease "could within this decade be one of the best characterized and potentially treatable neurodegenerative disorders of late life." (McKeith IG: Consensus guidelines for the clinical and pathologic diagnosis of dementia with lewy bodies (DLB): Report of the consortium on DLB international workshop. J Alzheimers Dis 2006; 9:417-423.) This book is written and edited by nationally recognized clinician-researchers in the field. It is a glimpse into the future which appears not much different than the past.
Purpose: The purpose is to inform the reader of the justification for the proposed changes in the DSM-V.
Audience: The intended audience includes psychiatrists and psychologists.
Features: The book covers such topics as Alzheimer disease and aging, epidemiological, definitional, and nomenclature issues in dementia, diagnostic criteria, mild cognitive impairment, neuropsychological testing, neuropsychiatric syndromes, biomarkers, neuroimaging, and genetics. Each chapter ends with references from the pertinent literature. Interestingly, the preamble to the book is a disclosure statement from all the contributors. It deserves some merit, although it is unknown whether disclosure alone reduces any biases. (Bero LA: Managing financial conflicts of interest in research. J Am Coll Dent 2005; 72:4-9.)
Assessment: This book, which was first published in the Journal of Geriatric Psychiatry and Neurology, is an interesting view into the DSM process for the dementia diagnoses. Neurologists, psychiatrists, geriatric psychiatrists, neuropsychiatrists, and behavioral neurologists would be interested in this book.
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Product Details

  • ISBN-13: 9780890422984
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 5/28/2007
  • Pages: 165
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.40 (d)

Meet the Author

Trey Sunderland, M.D., is with the National Institute of Mental Health in Bethesda, Maryland.

Dilip V. Jeste, M.D., is Estelle and Edgar Levi Chair in Aging; Director, Sam and Rose Stein Institute for Research on Aging; and Distinguished Professor of Psychiatry and Neurosciences at the University of California, San Diego in San Diego, California.

Olesgegun Baiyewu, M.D., is Professor of Psychiatry in the Department of Psychiatry in the College of Medicine at the University of Ibadan in Ibadan, Nigeria.

Paul J. Sirovatka, M.S., is Associate Director for Research Policy Analysis at the Division of Research/American Psychiatric Institute for Research and Education in Arlington, Virginia.

Darrel A. Regier, M.D., M.P.H., is Executive Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Washington, D.C.

American Psychiatric Publishing

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Table of Contents

Contributors. Disclosure statement. Foreword. Preface: modern diagnostic approaches in dementia: on the cusp of change. Alzheimer's disease and the aging brain. Dementia: epidemiological considerations, nomenclature, and a tacit consensus definition. Diagnostic criteria in dementia: a comparison of current criteria, research challenges, and implications for DSM-V and ICD-11. Mild cognitive impairment should be considered for DSM-V. Neuropsychological testing in the diagnosis of dementia. Diagnostic categories and criteria for neuropsychiatric syndromes in dementia: research agenda for DSM-V. Biomarkers in the diagnosis of Alzheimer's disease: are we ready? Neuroimaging as a surrogate marker of disease. Genetics and dementia nosology. Index.

American Psychiatric Publishing

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