University of Manchester, UK.
Int J Geriatr Psychiatry. 2012 Feb;27(2):160-6. doi: 10.1002/gps.2704. Epub 2011 Apr 2.
The neuropsychiatric complications of Parkinson's disease (PD), which include behaviour disturbances such as apathy and the impulse control disorders (ICDs), may have a significant effect on patients with PD and their carers. The contribution of these behaviour disorders to carer burden is less understood. Therefore, the aim of this study was to explore the relationship that apathy and ICDs have with carer burden.
Non-demented (n = 71) PD-carer dyads (spouse or adult child) participated in the study. The PD participants were divided into three behavioural groups: ICD (n = 21), apathy (n = 22) and controls (n = 28). The three groups were compared for level of burden in their carers by using the Zarit Burden Interview. The PD participants were rated for levels of apathy, impulsivity and motor and psychiatric symptoms. Using a multivariate analysis, we sought the PD-related predictors of carer burden.
Significantly, greater burden was seen in carers of PD participants with ICDs (p = 0.002) or apathy (p = 0.004), compared with carers of PD participants without such behavioural disturbances. Linear regression models revealed that attentional ability accounted for burden in carers of the group with apathy, whereas dopaminergic load and depression accounted for burden in carers of the group with impulsivity.
PD-related behaviour disturbances, such as apathy and ICDs, as well as psychiatric complications, have significant negative implications for burden of care.
帕金森病（PD）的神经精神并发症，包括冷漠和冲动控制障碍（ICD）等行为障碍，可能对 PD 患者及其照顾者产生重大影响。这些行为障碍对照顾者负担的影响还不太清楚。因此，本研究的目的是探讨冷漠和 ICD 与照顾者负担的关系。
非痴呆（n=71）PD-照顾者对子（配偶或成年子女）参与了这项研究。PD 参与者被分为三组行为障碍：ICD（n=21）、冷漠（n=22）和对照组（n=28）。使用 Zarit 负担访谈，比较三组照顾者的负担水平。对 PD 参与者进行冷漠、冲动和运动及精神症状评分。通过多元分析，我们寻求 PD 相关因素对照顾者负担的预测。
显著的是，与无此类行为障碍的 PD 参与者的照顾者相比，ICD（p=0.002）或冷漠（p=0.004）的 PD 参与者的照顾者负担更重。线性回归模型显示，注意力能力解释了冷漠组照顾者的负担，而多巴胺能负荷和抑郁解释了冲动组照顾者的负担。
PD 相关行为障碍，如冷漠和 ICD，以及精神并发症，对照顾负担有显著的负面影响。
