Psychosis in Neurodegenerative Dementias: A Systematic Comparative Review

IF 3.4 3区医学 Q2 NEUROSCIENCES

Journal of Alzheimer's Disease Pub Date : 2024-04-30 DOI:10.3233/jad-231363

Coralie Cressot, Agathe Vrillon, Matthieu Lilamand, Hélène Francisque, Aurélie Méauzoone, Claire Hourregue, Julien Dumurgier, Emeline Marlinge, Claire Paquet, Emmanuel Cognat

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引用次数: 0

Abstract

Background:Psychosis, characterized by delusions and/or hallucinations, is frequently observed during the progression of Alzheimer’s disease (AD) and other neurodegenerative dementias (ND) (i.e., dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD)) and cause diagnostic and managementdifficulties. Objective:This review aims at presenting a concise and up-to-date overview of psychotic symptoms that occur in patients with ND with a comparative approach. Methods:A systematic review was conducted following the PRISMA guidelines. 98 original studies investigating psychosis phenotypes in neurodegenerative dementias were identified (40 cohort studies, 57 case reports). Results:Psychosis is a frequently observed phenomenon during the course of ND, with reported prevalence ranging from 22.5% to 54.1% in AD, 55.9% to 73.9% in DLB, and 18% to 42% in FTD. Throughout all stages of these diseases, noticeable patterns emerge depending on their underlying causes. Misidentification delusions (16.6–78.3%) and visual hallucinations (50–69.6%) are frequently observed in DLB, while paranoid ideas and somatic preoccupations seem to be particularly common in AD and FTD, (respectively 9.1–60.3% and 3.10–41.5%). Limited data were found regarding psychosis in the early stages of these disorders. Conclusions:Literature data suggest that different ND are associated with noticeable variations in psychotic phenotypes, reflecting disease-specific tendencies. Further studies focusing on the early stages of these disorders are necessary to enhance our understanding of early psychotic manifestations associated with ND and help in differential diagnosis issues.

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神经退行性痴呆症中的精神病：系统性比较综述

背景：以妄想和/或幻觉为特征的精神病在阿尔茨海默病（AD）和其他神经退行性痴呆（ND）（即路易体痴呆（DLB）和额颞叶痴呆（FTD））的进展过程中经常出现，给诊断和管理带来困难。目的：本综述旨在以比较的方法对 ND 患者出现的精神病性症状进行简明扼要的最新概述。方法：按照 PRISMA 指南进行了系统性综述。确定了 98 项调查神经退行性痴呆症患者精神病表型的原始研究（40 项队列研究，57 项病例报告）。结果：精神病是神经退行性痴呆症病程中经常出现的现象，据报道，发病率在AD中为22.5%至54.1%，在DLB中为55.9%至73.9%，在FTD中为18%至42%。在这些疾病的各个阶段，都会出现明显的模式，这取决于其根本原因。错认妄想（16.6%-78.3%）和视幻觉（50%-69.6%）经常出现在 DLB 中，而偏执想法和躯体妄想似乎在 AD 和 FTD 中尤为常见（分别为 9.1%-60.3%和 3.10%-41.5%）。有关这些疾病早期精神病的数据有限。结论：文献数据表明，不同的ND与精神病表型的明显差异有关，反映了疾病的特异性倾向。有必要对这些疾病的早期阶段进行进一步研究，以加深我们对与 ND 相关的早期精神病表现的了解，并帮助解决鉴别诊断问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Alzheimer's Disease 医学-神经科学

CiteScore

6.40

自引率

7.50%

发文量

1327

审稿时长

2 months

期刊介绍： The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.