Perception and Identification of Behavioral and Psychological Symptoms of Dementia (BPSD) in China Medical Community

Baoyu Chen,1,* Qi Wang,1,* Chaobo Bai,1 Jing Chen,1 Danhua Zhao,1 Yuan Li,1 Junyi Chen,1 Xintong Guo,1 Jinjin Wang,1 Hongguang Chen,1 Xiaoxing Lai,2 Qiaoqin Wan,3 Zhiwen Wang,3 Nan Hu,4 Bing-Wei Zhang,4 Xuqiao Chen,5 Tao Ma,6 Junliang Yuan1 1Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, 100191, People’s Republic of China; 2Department of Health Care, Peking Union Medical College Hospital, Beijing, 100730, People’s Republic of China; 3School of Nursing, Peking University, Beijing, 100191, People’s Republic of China; 4Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116011, People’s Republic of China; 5Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA; 6Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA*These authors contributed equally to this workCorrespondence: Junliang Yuan, Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 hua Yuan Bei Road, Haidian District, Beijing, 100191, People’s Republic of China, Email [email protected]: Behavioral and psychological symptoms of dementia (BPSD), as neuropsychiatric manifestations within dementia, constitute core features of dementia. However, there remains a gap in understanding the recognition of BPSD in China. Our current study was to explore the clinical awareness and treatment approaches for BPSD in China, focusing especially on the perspectives of neurologists and psychiatrists.Methods: A multicenter national survey was designed and a semi-structured questionnaire was distributed to healthcare professionals including doctors and nurses across all provinces of China. The questionnaire incorporated either closed (yes/no) and multiple-choice questions. The questions centered on the following areas: the perceived global frequency and relevance of BPSD; the assessment tools employed for evaluating BPSD; pharmacological approaches for addressing psychosis, apathy, agitation, aggression, depression, anxiety, sleep, and nutrition disorders; drug-related side effects; non-pharmacological treatment strategies. The anonymity of questionnaire responses was maintained to encourage participants to candidly express their viewpoints.Results: The majorities of respondents recognized the importance of BPSD. There were apparent differences in the perception of BPSD between neurologists and psychiatrists, encompassing variances in symptoms recognition, diagnostic approaches, and treatment strategies. A notable high percentage of neurology (27.8%) and psychiatry staff (23.6%) would not choose non-pharmacological interventions. Meanwhile, antipsychotics was overused in China. For aggression and agitation, more than half of neurologist and psychiatrist preferred antipsychotics. For psychosis, more than 80% of doctors chose antipsychotics. Nearly one-third of the medical staff expressed a preference for traditional Chinese medicine including ginkgo biloba extract.Conclusion: In summary, this study in China has shed light on the features related to perception, recognition, management, treatment options, and observed side effects associated with BPSD. Our findings have the potential to significantly enhance the understanding of BPSD characteristics among medical practitioners and offering valuable insights into improved management and treatment strategies of neuropsychic symptoms of dementia in China.Keywords: dementia, BPSD (behavioral and psychological symptoms of dementia), BPSD management, psychosis