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    Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

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    Publication date
    2015-09
    Author
    Elsey, C.
    Drew, P.
    Jones, Danielle K.
    Blackburn, D.
    Wakefield, S.
    Harkness, K.
    Venneri, A.
    Reuber, M.
    Keyword
    Dementia; Differential diagnosis; Communication; Functional memory disorders; Conversation analysis
    Rights
    © 2015 Elsevier B.V. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
    Peer-Reviewed
    Yes
    
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    Abstract
    Objective This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases. Methods Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging. Results Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses. Conclusion Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD. Practical implications Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care.
    URI
    http://hdl.handle.net/10454/8324
    Version
    Accepted Manuscript
    Citation
    Elsey C, Drew P, Jones D, Blackburn D, Wakefield S, Harkness K, Venneri A and Reuber M (2015) Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics. Patient Education & Counseling. 98(9): 1071-1077.
    Link to publisher’s version
    doi:10.1016/j.pec.2015.05.021
    Type
    Article
    Collections
    Health Studies Publications

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