Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Mov Disord. 2011 May;26(6):1022-31. doi: 10.1002/mds.23664.
Although diagnosed by characteristic motor features, Parkinson's disease may be preceded, and is frequently accompanied by, a wide range of cognitive and neuropsychiatric features. In addition to the most commonly studied disorders of dementia, depression, and psychosis, other relatively common and clinically significant psychiatric complications include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. These problems may be underrecognized and are frequently undertreated. The emergent focus on nonmotor aspects of Parkinson's disease over the past quarter of a century is highlighted by a nonlinear increase in the number of articles published devoted to this topic. Although the development of newer antidepressants, atypical antipsychotics, and cholinesterase inhibitors in recent years has had a positive benefit on the management of these troublesome and distressing symptoms, responses are frequently suboptimal, and this remains an area of major unmet therapeutic need.
尽管帕金森病可以通过典型的运动特征来诊断，但它可能会先于一系列广泛的认知和神经精神特征出现，并且经常伴随着这些特征。除了最常研究的痴呆、抑郁和精神病障碍外，其他相对常见且具有临床意义的精神并发症包括冲动控制障碍、焦虑症状、睡眠和觉醒障碍以及冷漠。这些问题可能未被识别，并且经常治疗不足。过去四分之一个世纪对帕金森病非运动方面的关注日益增加，这突出体现在专门针对这一主题的文章数量呈非线性增长。尽管近年来新型抗抑郁药、非典型抗精神病药和胆碱酯酶抑制剂的发展对这些麻烦和令人痛苦的症状的管理产生了积极的影响，但反应往往并不理想，这仍然是一个主要的未满足的治疗需求领域。
