Jessen F, Spottke A
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland.
Nervenarzt. 2010 Jul;81(7):815-6, 818-22. doi: 10.1007/s00115-010-3002-z.
Behavioral and psychological symptoms of dementia (BPSD) represent a severe burden for patients and caregivers. The causes are disease-related neurobiological changes which increase the vulnerability to respond to external triggers with BPSD. Consequently, external factors (e.g. communication, milieu) are the primary target for treatment and also prevention of BPSD. Psychosocial interventions with the focus on the patient or on the caregivers are the core elements of BPSD therapy. If psychosocial interventions are not efficacious or only insufficiently applicable, pharmacological treatment may need to be initiated. Pharmacological treatment of BPSD has been less intensely investigated as treatment of cognition and function in dementia. However, recommendations can be given. This review follows the S3 guidelines on dementia published by the German Societies for Psychiatry and Psychotherapy (DGPPN) and Neurology (DGN) which address BPSD extensively.
痴呆的行为和心理症状(BPSD)给患者和照料者带来了沉重负担。其病因是与疾病相关的神经生物学变化,这增加了因外部触发因素而出现BPSD的易感性。因此,外部因素(如沟通、环境)是治疗以及预防BPSD的主要目标。以患者或照料者为重点的社会心理干预是BPSD治疗的核心要素。如果社会心理干预无效或仅部分适用,则可能需要启动药物治疗。与痴呆认知和功能的治疗相比,对BPSD的药物治疗研究较少。然而,仍可给出相关建议。本综述遵循德国精神病学与心理治疗学会(DGPPN)和神经病学学会(DGN)发布的关于痴呆的S3指南,该指南对BPSD进行了广泛阐述。