Hepple J
Department of Mental Health, Peninsula Medical School, Somerset BA20 2BN, UK.
Int J Geriatr Psychiatry. 2004 Oct;19(10):961-7. doi: 10.1002/gps.1194.
This paper reports a case series of ten patients collected over a 12-year period of clinical work in old age psychiatry in the UK by the author.
The core features of the syndrome are: apparent cognitive impairment, regression and increasing physical dependency beginning in late middle or early old age, without evidence for an organic dementia from investigations or from taking into account the course of the illness. The syndrome is more common in women from a higher socio-economic background with past psychiatric histories dominated by depressive symptoms. The syndrome usually progresses to the point where long term institutional care is needed although the mean survival from onset is 13 years.
The author suggests that conversion pseudodementia in older people is caused by a catastrophic reaction to cumulative loss in later life in individuals who have predisposing borderline and narcissistic personality traits. Treatment using psychotherapeutic approaches may limit the progression of the syndrome if it is recognised at an early stage.
本文报告了作者在英国老年精神病学12年临床工作期间收集的10例患者的病例系列。
该综合征的核心特征为：明显的认知障碍、衰退以及从中年晚期或老年早期开始日益加重的身体依赖，无论是检查结果还是考虑疾病进程均无器质性痴呆的证据。该综合征在社会经济背景较高、既往精神病史以抑郁症状为主的女性中更为常见。尽管从发病开始的平均生存期为13年，但该综合征通常会发展到需要长期机构护理的程度。
作者认为，老年人的转化性假性痴呆是由具有边缘型和自恋型人格特质倾向的个体对晚年累积丧失的灾难性反应所致。如果在早期阶段得到识别，采用心理治疗方法进行治疗可能会限制该综合征的进展。
