神经退行性疾病精神症状的诊断和治疗进展:叙述性综述。

IF 2.9 4区 医学 Q2 CLINICAL NEUROLOGY
Andreea L Seritan
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引用次数: 0

摘要

背景:大约15%的老年人可能会经历精神病现象。以精神病表现的原发性精神障碍(妄想、幻觉和思维或行为紊乱)占不到一半。高达60%的晚期精神病症状是由系统性医学或神经系统疾病引起的,尤其是神经退行性疾病。建议进行彻底的医学检查,包括实验室检查、必要时的额外程序和神经影像学研究。这篇叙述性综述总结了作为神经退行性疾病连续体(包括前驱期和明显期)一部分的精神病症状的流行病学和现象学的最新证据。结果:前驱症状是明显神经退行性综合征发作前的一系列症状。前驱精神病特征,特别是妄想症,与几年内被诊断为神经退行性疾病的可能性增加有关。及时识别前驱症状对早期干预至关重要。与神经退行性疾病相关的精神病的治疗包括行为和躯体策略,尽管证据很少,而且大多局限于病例报告、病例系列或专家共识指南,很少有随机对照试验。结论:精神病表现的复杂性需要跨专业团队进行管理,提供协调、综合的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review.

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review.

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review.

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review.

Background: Approximately 15% of older adults may experience psychotic phenomena. Primary psychiatric disorders that manifest with psychosis (delusions, hallucinations, and disorganized thought or behavior) account for less than half. Up to 60% of late-life psychotic symptoms are due to systemic medical or neurological conditions, particularly neurodegenerative diseases. A thorough medical workup including laboratory tests, additional procedures if indicated, and neuroimaging studies is recommended. This narrative review summarizes current evidence regarding the epidemiology and phenomenology of psychotic symptoms encountered as part of the neurodegenerative disease continuum (including prodromal and manifest stages). Results: Prodromes are constellations of symptoms that precede the onset of overt neurodegenerative syndromes. Prodromal psychotic features, particularly delusions, have been associated with an increased likelihood of receiving a neurodegenerative disease diagnosis within several years. Prompt prodrome recognition is crucial for early intervention. The management of psychosis associated with neurodegenerative diseases includes behavioral and somatic strategies, although evidence is scarce and mostly limited to case reports, case series, or expert consensus guidelines, with few randomized controlled trials. Conclusion: The complexity of psychotic manifestations warrants management by interprofessional teams that provide coordinated, integrated care.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
40
审稿时长
>12 weeks
期刊介绍: Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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