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The Satisfaction with Appearance Scale (SWAP) was administered to 165 burn victims. SWAP showed a high level of internal consistency (Cronbach's alpha, r(a)=0.87); an 84-subject retest measured reliability (r(tt)=0.59). SWAP is both a reliable and valid measure of body image for a burn-injured population. (Author/MAK)

Using epidemiologic survey data of elderly residents in six public housing developments, assesses the need for mental health care. Found that 37% of the predominantly African American sample needed mental health services. Males, older residents, those with no Medicare insurance, and those with daily living impairments were most at risk. (RJM)

Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Advanced imaging methods are not routinely used in community or general practices for the diagnosis or differentiation of forms of dementia. Nonetheless, in patients who have been evaluated by a dementia expert, FDG-PET helps to distinguish Alzheimer disease from frontotemporal dementia. In patients with suspected dementia with Lewy bodies, functional imaging of the dopamine transporter (ioflupane) using SPECT may be helpful. In patients with suspected normal-pressure hydrocephalus, DTPA cisternography and HMPAO SPECT/CT brain may provide assessment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Acute changes in mental status represent a broad collection of symptoms used to describe disorders in mentation and level of arousal, including the more narrowly defined diagnoses of delirium and psychosis. A wide range of precipitating factors may be responsible for symptom onset including infection, intoxication, and metabolic disorders. Neurologic causes that may be detected on neuroimaging include stroke, traumatic brain injury, nonconvulsive seizure, central nervous system infection, tumors, hydrocephalus, and inflammatory disorders. Not infrequently, two or more precipitating factors may be found. Neuroimaging with CT or MRI is usually appropriate if the clinical suspicion for an acute neurological cause is high, where the cause of symptoms is not found on initial assessment, and for patients whose symptoms do not respond appropriately to management. There was disagreement regarding the appropriateness of neuroimaging in cases where a suspected, nonneurologic cause is found on initial assessment. Neuroimaging with CT is usually appropriate for patients presenting with delirium, although the yield may be low in the absence of trauma or a focal neurological deficit. Neuroimaging with CT or MRI may be appropriate in the evaluation of new onset psychosis, although the yield may be low in the absence of a neurologic deficit. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

The article responds to the issue article "Distress Associated with Dementia-Related Psychosis and Agitation in Relation to Healthcare Utilization and Costs" by Donovan T. Maust, Helen C. Kales, Ryan J. McCammon, et al.

The article focuses on the activities of the Council on Aging and its committees. It notes that the council and its components serve as source of expertise in geriatric psychiatry for general psychiatrists and provide general information on geropsychiatric issues to nonpsychiatric physicians and other health professionals. Furthermore, they also serve as the chief policy body for geropsychiatric matters within American Psychiatry Association (APA). Prescribing of antipsychotic medications for Alzheimer's disease patients, development of a draft position statement on integrated care of the elderly and council self-assessment and discussion of long-term goals are some of the issues discussed by the council during the APA September Components Meeting on September 6, 2008.

The article discusses the activities of the committees of the Council on Aging. It is composed of the council and the committees such as the Committee on Ethnic Minority Elderly, the Committee on Access and Effectiveness of Psychiatric Services for the Elderly, and the Committee on Long-Term Care and Treatment for the Elderly. The missions of the council and its components are to serve as a source of expertise in geriatric psychiatry for general psychiatrists and to provide general information on geropsychiatric issues. It remains to be the main source for American Psychiatric Association, specifically the Department of Government Relations.