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Psychopathology lies at the centre of effective psychiatric practice and mental health care, and Fish's Clinical Psychopathology has shaped the training and clinical practice of psychiatrists for over fifty years. The fourth edition of this modern classic presents the clinical descriptions and psychopathological insights of Fish's to a new generation of students and practitioners. It includes recent revisions of diagnostic classification systems, as well as new chapters that consider the controversies of classifying psychiatric disorder and the fundamental role and uses of psychopathology. Clear and readable, it provides concise descriptions of the signs and symptoms of mental illness and astute accounts of the varied manifestations of disordered psychological function, and is designed for use in clinical practice. An essential text for students of medicine, trainees in psychiatry and practising psychiatrists, it will also be useful to psychiatric nurses, mental health social workers and clinical psychologists.
Although rates of anxiety tend to decrease across late life, rates of anxiety increase among a subset of older adults, those with mild cognitive impairment (MCI) or dementia. Our understanding of anxiety in dementia is limited, in part, by a lack of anxiety measures designed for use with this population. This study sought to address limitations of the literature by developing a new measure of anxiety for cognitively impaired individuals, the anxiety in cognitive impairment and dementia (ACID) Scales, which includes both proxy (ACID-PR) and self-report (ACID-SR) versions.
The ACID-SR and ACID-PR were administered to 45 residents, aged 60 years and older, of three long-term care (LTC) facilities, and 38 professional caregivers at these facilities. Other measures of anxiety, and measures of depression, functional ability, cognition, and general physical and mental health were also administered.
Initial evaluation of its psychometric properties revealed adequate to good internal consistency for the ACID-PR and ACID-SR. Evidence for convergent validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by moderate-to-strong associations with measures of worry, depressive symptoms, and general mental health. Discriminant validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by weak correlations with measures of cognition, functional ability, and general physical well-being.
The preliminary results suggest that the ACID-SR and ACID-PR can obtain reliable and valid measures of anxiety among individuals with cognitive impairment. Given the subjective nature of anxiety, it may be prudent to collect self-report of anxiety symptoms even among those with moderate cognitive impairment.