Aarsland D, Larsen J P, Lim N G, Janvin C, Karlsen K, Tandberg E, Cummings J L
Section of Geriatric Psychiatry, Rogaland Psychiatric Hospital, Stavanger, Norway.
J Neurol Neurosurg Psychiatry. 1999 Oct;67(4):492-6. doi: 10.1136/jnnp.67.4.492.
Disturbances of cognition and emotion are common in patients with Parkinson's disease. Most previous studies of psychopathology in Parkinson's disease have focused on a single psychiatric diagnosis or condition. The objective of this study was to describe the range of neuropsychiatric symptoms in a representative sample of patients with Parkinson's disease.
The sample of 139 patients was drawn from an epidemiological study of Parkinson's disease in Rogaland county, Norway, and represented 93% of those who had survived during the 4 years since the initial assessment. The diagnosis of Parkinson's disease was based on published criteria. Neuropsychiatric symptoms were assessed using the neuropsychiatric inventory, a caregiver based structured interview, which assesses severity and frequency of 10 psychiatric symptoms present during the past month.
At least one psychiatric symptom was reported in 61% of the sample. The most common behaviours were depression (38%) and hallucinations (27%), and the least common symptoms were euphoria and disinhibition. The highest mean scores were found for depression, apathy, and hallucinations. Factor analysis showed that hallucinations, delusions, and irritability clustered into one factor, and apathy and anxiety constituted another factor. Psychiatric symptoms were more common among patients living in nursing homes compared with home dwelling patients, and correlated with stage of disease and cognitive impairment, but not with age or duration of disease. No relation to left or right sided parkinsonism was found.
This study emphasises the importance of psychiatric symptoms in Parkinson's disease, which were present in most patients. Clinicians should focus on the emotional and cognitive disturbances in addition to the motor manifestations of the disease.
认知和情绪障碍在帕金森病患者中很常见。以往大多数关于帕金森病精神病理学的研究都集中在单一的精神疾病诊断或状况上。本研究的目的是描述帕金森病患者代表性样本中的神经精神症状范围。
139名患者的样本取自挪威罗加兰郡帕金森病的一项流行病学研究，代表了自初始评估以来4年内存活患者的93%。帕金森病的诊断基于已发表的标准。使用神经精神症状问卷对神经精神症状进行评估，这是一种基于照料者的结构化访谈，评估过去一个月内出现的10种精神症状的严重程度和频率。
61%的样本报告了至少一种精神症状。最常见的行为是抑郁（38%）和幻觉（27%），最不常见的症状是欣快和脱抑制。抑郁、淡漠和幻觉的平均得分最高。因子分析表明，幻觉、妄想和易怒聚为一个因子，淡漠和焦虑构成另一个因子。与居家患者相比，住在养老院的患者精神症状更常见，且与疾病分期和认知障碍相关，但与年龄或病程无关。未发现与帕金森病的左侧或右侧病变有关。
本研究强调了帕金森病中精神症状的重要性,大多数患者都存在精神症状。临床医生除了关注疾病的运动表现外，还应关注情绪和认知障碍。
