Psychosis in Cognitive Impairment Initiative

A REPORT ON PSYCHOSIS IN COGNITIVE IMPAIRMENT INITIATIVE OF THE IPA
Tzung-Jeng Hwang, MD, PhD
Department of Psychiatry, National Taiwan University Hospital, Taiwan

IPA has been a leader in defining neuropsychiatric symptoms in dementia. Taking the opportunity of the 2019 AD/PD meeting in Lisbon, Portugal, IPA convened a group of experts to re-examine the definition of psychosis in dementia on 31 March 2019. The purpose was to provide updated criteria for clinical use and research application.

Beginning at 8 AM, IPA President Dr. Mary Sano made the opening remarks and provided the goal of this meeting. Dr. George Grossberg then reviewed the terminology and history of IPA’s past engagement in this field. Dr. Jeff Cummings presented the process for definition development and potential application in clinical trials and research. After that, Dr. Dilip Jeste reviewed the current criteria (which he and Dr. Finkle created 20 years ago), their strengths and weaknesses, and opportunities for improvement. This was followed by a presentation of the survey results by Dr. Sano. The pre-meeting survey conveyed many thoughts on how to further improve the current criteria.

The afternoon session started with Dr. Debby Tsuang’s talk on dementia with Lewy body and other dementia-related psychosis. Dr. Debby Gerritsen then discussed commonly used psychosis rating scales and how they would influence definition development. Dr. Raymond Koopmans described the impact of psychosis on caregivers, costs, and health outcomes. There was then a discussion on regulatory aspects of a definition of psychosis. Finally, Dr. Cummings, the discussion leader, led the group discussion on how to bring the project to fruition. The consensus meeting was adjourned at 4:30 pm.

Throughout the day, all the participants actively exchanged their thoughts and ideas, and reached a preliminary consensus. Further work will be continued in the future. Overall this was a wonderful and successful meeting.