Nages Nagaratnam, MD, FRCP, FRACP, FRCPA, FACC, Consultant Physician in
Geriatric Medicine, Formerly of Department of Geriatric Medicine, Blacktown-Mt-Druitt Health, Blacktown, NSW, AUS.
Kujan Nagaratnam, MB, FRACP, Consultant Physician in Geriatric Medicine, Department of Geriatric Medicine, Blacktown-Mt Health, Blacktown, NSW, AUS.

Screaming is widely viewed as a common behavioural disturbance in dementia. It influences the performance in daily life of the patient, adds to the burden and embarrassment experienced by the caregiver and the frustrations encountered by the treating physician, and is a decisive factor for institutionalization. This article outlines an approach to screaming and its possible neuroanatomical substrates and neurotransmitter systems. The ultimate basis for discussion will be the strategies available for management of this challenging behaviour.

Key words: screaming, disruptive vocalization, dementia, limbic system, frontal-subcortical circuitry.