Exploration of the themes and content of psychotic symptoms in young-onset dementia (YOD) is limited to case analysis. The primary objective of this study was to determine the themes of psychotic symptoms in individuals diagnosed with YOD.

Comprehensive retrospective file review of discharge summaries.

Neuropsychiatry, a specialist mental health service located at the Royal Melbourne Hospital, Australia.

Inpatients at Neuropsychiatry admitted between 2018 and 2020 (inclusive).

Data extracted included descriptions and prevalence of psychotic symptoms as well as general demographic and clinical data. Data analysis was conducted using a thematic approach.

Twenty-three inpatients had a diagnosis of YOD with psychotic symptoms. Themes were identified in the domains of delusions (six themes), auditory hallucinations (five themes), and visual hallucinations (two themes). Strong recurring themes across the modalities of hallucinations and delusions were beliefs and experiences relating to paranoia, suspicion, harm, and abuse. Themes did not clearly intersect across the modalities of hallucinations and delusions. A degree of thematic heterogeneity existed within individuals, and individuals experienced delusions or hallucinations of multiple themes. The themes of the psychotic symptoms did not clearly relate to diagnostic category, nor to time from diagnosis.

This study is the first thematic analysis of psychotic symptoms in YOD and provides further understanding of patient phenomenology and experiences of psychosis in YOD.

While early diagnosis of younger-onset dementia (YOD) is crucial in terms of accessing appropriate services and future planning, diagnostic delays are common. This study aims to identify predictors of delay to diagnosis in a large sample of people with YOD and to investigate the impact of a specialist YOD service on this time to diagnosis.

A retrospective cross-sectional study.

The inpatient unit of a tertiary neuropsychiatry service in metropolitan Victoria, Australia.

People diagnosed with a YOD.

We investigated the following predictors using general linear modeling: demographics including sex and location, age at onset, dementia type, cognition, psychiatric diagnosis, and number of services consulted with prior to diagnosis.

A total of 242 inpatients were included. The mean time to diagnosis was 3.4 years. Significant predictors of delay included younger age at onset, dementia type other than Alzheimer’s disease (AD) and behavioral-variant frontotemporal dementia (bvFTD), and increased number of services consulted. These predictors individually led to an increased diagnostic delay of approximately 19 days, 5 months, and 6 months, respectively. A specialized YOD service reduced time to diagnosis by 12 months.

We found that younger age at onset, having a dementia which was not the most commonly occurring AD or bvFTD, and increasing number of services were significant predictors of diagnostic delay. A novel result was that a specialist YOD service may decrease diagnostic delay, highlighting the importance of such as service in reducing time to diagnosis as well as providing post-diagnostic support.

Older Chinese people are one of the largest and fastest growing immigrant groups in Western countries. The Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) are screening tools that have been specifically designed for older people. This study explored their validity, concurrent reliability, and cultural appropriateness for detecting depression and anxiety symptoms among older Chinese immigrants living in Melbourne, Australia.

A total of 87 Chinese people were recruited from Chinese senior groups. Five screening tools were used, including the GDS, the GAI, the Hospital Anxiety and Depression Scale (HADS), the Kessler 10 (K10), and the Patient Health Questionnaire (PHQ-9). Data were collected through standardized interviews.

The GDS and the GAI were found to be reliable and valid tools for detecting depression and anxiety in this sample. Based on the results of the five screening tools, approximately 20% of participants exhibited clinically significant symptoms of depression and 8% of anxiety. Unexpectedly, there was a higher rate of depression and anxiety symptoms among Mandarin speaking people compared with Cantonese speaking people.

This study adds to the evidence that older Chinese immigrants are at greater risk of depression than the general older population. It suggests that primary care and mental health services should be aware of and responsive to the increased risk of depression among this group and that further studies are needed to investigate what is contributing to this increased risk.