INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2001; 16: 504±512. DOI: 10.1002/gps.382 Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors Henry Brodaty 1,2 *, Brian Draper 3,4 , Dania Saab 5 , Lee-Fay Low 6 , Vicki Richards 5 , Helen Paton 5 and David Lie 7 1 Professorof Psychogeriatrics, School of Psychiatry, University of New South Wales, Australia 2 Director, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia 3 Senior Lecturer, Schools of Psychiatry and Community Medicine, University of New South Wales, Australia 4 Assistant Director, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia 5 Formerly Research Assistant, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia 6 Research Assistant, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia 7 Formerly Research Fellow, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia SUMMARY Background There is wide variation in the rates of behavioural and psychological symptoms of dementia BPSD) reported in nursing homes. Aims This study aimed to investigate: 1) the prevalence of BPSD in nursing home residents using the BEHAVE-AD; 2) the relationships of BPSD with a) demographic, b) dementia, c) diurnal and d) nursing home variables; and 3) the inter- relationships between different types of BPSD, as measured by subscales of the BEHAVE-AD. Results Over 90% of residents exhibited at least one behavioural disturbance. Speci®cally, there was evidence of psycho- sis in 60%, depressed mood in 42% and activity disturbances or aggression in 82% of residents. Younger, more functionally impaired residents with a chart diagnosis of psychosis had higher BPSD rates, as did those residing in larger nursing homes. Individual BPSD were signi®cantly intercorrelated. Conclusions BPSD are ubiquitous in nursing home residents. Behavioural disturbances are frequently associated with psychosis and/or depression. The ®ndings suggest the need for psychogeriatric services to nursing homes and smaller facil- ities. Copyright # 2001 John Wiley & Sons, Ltd. key words Ð psychosis; depression; behavioural disturbances; dementia; nursing home INTRODUCTION Behavioural and psychological symptoms of demen- tia BPSD) is a term designed to encompass many of the non-cognitive manifestations of dementia Finkel, 1998). Behavioural symptoms include physi- cal and verbal aggression, wandering, agitation, sex- ual disinhibition and screaming, whilst psychological symptoms include depression, anxiety, delusions and hallucinations. BPSD can cause distress and reduce the quality of life of persons with dementia and their caregivers and result in earlier institutionalization Swearer, 1994). Between 60 and 90% of people with dementia will experience BPSD at some time during the course of their illness Tariot and Blazina, 1994). However, there is considerable variation in reported prevalence Received 15 June 2000 Copyright # 2001 John Wiley & Sons, Ltd. Accepted 10 October 2000 *Correspondence to: Prof. H. Brodaty, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick 2031, NSW, Australia. Tel: +61-2-93823749. Fax: +61-2-93823762. E-mail: h.brodaty@unsw.edu.au Contract/grant sponsor: National Action Plan for Dementia Care. Commonwealth Department of Health and Family Services, Commonwealth Government of Australia. Contract/grant sponsor: School of Psychiatry, University of New South Wales.