Schillerstrom Jason E, Horton Monica S, Royall Donald R
Department of Psychiatry, University of Texas Health Science Center at San Antonio, TX 78229, and the Geriatric Research Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Administration, USA.
Psychosomatics. 2005 Nov-Dec;46(6):508-16. doi: 10.1176/appi.psy.46.6.508.
Executive function can be defined as one's ability to plan, initiate, sequence, monitor, and inhibit complex goal-directed behaviors. Although executive impairment is generally associated with dementia, recent studies have suggested that patients with chronic diseases, such as hypertension, chronic obstructive pulmonary disease, and diabetes, may also have executive deficits independent of psychiatric comorbidities. Because executive function is associated with functional outcomes, medication compliance, and the capacity to give informed consent, it is important that it be assessed. However, it is the authors' impression that executive function is not adequately assessed in medical settings, despite the availability of reliable measures. This article reviews the impact of medical illness on executive function and discusses practical diagnostic instruments and treatment strategies. The changes in functional status associated with executive impairment as well as pathophysiology and treatment strategies are also discussed.
执行功能可被定义为一个人计划、启动、排序、监控和抑制复杂的目标导向行为的能力。虽然执行功能障碍通常与痴呆症相关，但最近的研究表明，患有慢性疾病（如高血压、慢性阻塞性肺疾病和糖尿病）的患者，可能也存在与精神疾病共病无关的执行功能缺陷。由于执行功能与功能结局、药物依从性以及知情同意能力相关，因此对其进行评估很重要。然而，作者的印象是，尽管有可靠的测量方法，但在医疗环境中执行功能并未得到充分评估。本文回顾了疾病对执行功能的影响，并讨论了实用的诊断工具和治疗策略。还讨论了与执行功能障碍相关的功能状态变化以及病理生理学和治疗策略。
