Lebert F
Centre Hospitalier Universitaire, Centre de la Mémoire, Hôpital Roger-Salengro, Lille.
Encephale. 1999 Nov;25 Spec No 5:19-21; discussion 22.
Alzheimer's disease patient can be addressed sometimes in psychiatry. At the early stage of the disease, the reason can be depressive symptoms or paranoiac reactions. Later, agitation associated with psychotic symptoms is the principal reason of hospitalization in psychiatry. The knowledge of the management of dementia has dramatically progressed, by example, antidepressant agents are not used as a diagnostic method. Psychiatric and behavioral assessment, neuropsychological tests, assessment of activities of daily life are very useful during the first consultation. Before the second consultation with the neuropsychological assessment, the stop of negative treatment, the treatment of depressive mood and the CT-scan must be realized. When the patient is hospitalized for agitation, the global assessment must be conducted after the hospitalization during consultation or day-hospital. Now, the psychiatrist must treat not only behavioral signs but specifically the disease too.
阿尔茨海默病患者有时会在精神病科就诊。在疾病早期,原因可能是抑郁症状或偏执反应。后来,与精神病性症状相关的激越成为患者入住精神病科的主要原因。痴呆症管理方面的知识有了显著进展,例如,抗抑郁药不再用作诊断方法。在首次会诊时,精神科和行为评估、神经心理测试以及日常生活活动评估非常有用。在进行第二次神经心理评估会诊前,必须停止消极治疗、治疗抑郁情绪并进行CT扫描。当患者因激越住院时,必须在住院后于会诊期间或日间医院进行全面评估。如今,精神科医生不仅要治疗行为症状,还要针对疾病本身进行治疗。