Evidence map›Paper›PMID 26989095›Full record

SynthesisThe British journal of psychiatry : the journal of mental science2016

Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review.

Alexandra Feast, Martin Orrell, Georgina Charlesworth, Nina Melunsky, Fiona Poland, Esme Moniz-Cook

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of psychiatry : the journal of mental science, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
108citing papers in PubMed, 6 pooled it
14.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

108 citing papers in PubMed, 6 syntheses or guidelines pooled it, 239 citations in OpenAlex.

  1. Pooled it
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  4. Algorithm-based pain management for people with dementia in nursing homes.The Cochrane database of systematic reviews · 2022
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  20. Burden and well-being among dementia caregivers in Puerto Rico: the role of behavioral and psychological symptoms of dementia.The journals of gerontology. Series B, Psychological sciences and social sciences · 2026
    Article

48 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Alexandra FeastAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK a.feast@ucl.ac.uk.
Martin OrrellAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK.
Georgina CharlesworthAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK.
Nina MelunskyAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK.
Fiona PolandAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK.
Esme Moniz-CookAlexandra Feast, MPhil, Division of Psychiatry, University College London, and Research and Development Department, North East London National Health Service (NHS) Foundation Trust, Ilford; Martin Orrell, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Institute of Mental Health, University of Nottingham; Georgina Charlesworth, PhD, Research and Development Department, North East London NHS Foundation Trust, Ilford, and Research Department of Clinical, Educational, and Health Psychology, University College London; Nina Melunsky, MSc, Research and Development Department, North East London NHS Foundation Trust, Ilford; Fiona Poland, PhD, Faculty of Medicine and Health Sciences, University of East Anglia; Esme Moniz-Cook, PhD, Faculty of Health and Social Care, University of Hull, UK.
North East London NHS Foundation Trust · GBNational Health Service · GBUniversity of East Anglia · GBUniversity of Hull · GB

Funding

Department of Health RP-PG-0606-1067Marie Curie MCCC-FPR-11-UMarie Curie MCCC-PRO-11-U
6 · The paper itself

Abstract

backgroundTailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes.

aimsTo understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered.

methodA systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012.

resultsWe identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in 'feeling bereft'; and perceptions of transgressions against social norms associated with 'misunderstandings about behaviour' in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging.

conclusionsFamily carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their 'personhood'. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers.

Indexed as

DementiaHealth Knowledge, Attitudes, PracticeCaregiversFamily RelationsHumansProblem Behavior

Identifiers

PMID26989095
PMCPMC4853642
OpenAlexW2299075669

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.