Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Kahoku-City, Ishikawa, Japan.
J Clin Psychiatry. 2012 Dec;73(12):1548-54. doi: 10.4088/JCP.11m07614.
To clarify whether hospitalized patients with behavioral and psychological symptoms of dementia (BPSD) show gender differences in manifested symptoms and outcomes.
A chart review study of patients hospitalized from April 2006 to March 2008 for the treatment of BPSD was conducted. We evaluated the prevalence of symptoms in each of 7 clusters constituting a subscale of the Behavioral Pathology in Alzheimer's Disease Rating Scale and the incidence of favorable discharge, defined as discharge to the patient's own home or care facility. Dementia was diagnosed according to DSM-IV.
The study cohort comprised 122 men and 170 women. The men were more likely than the women to present with aggressiveness (78% vs 52%, P < .001) and diurnal rhythm disturbances (89% vs 79%, P < .05) and less likely to present with paranoid, delusional ideation (12% vs 41%, P < .001); hallucination (7% vs 29%, P < .001); affective disturbances (20% vs 40%, P < .001); and anxieties and phobias (15% vs 44%, P < .001). Incidence of favorable discharge was lower in the men (58% vs 77%, P = .001). Even after matching for age, sociodemographic factors, and physical and cognitive functions, the differences in these symptoms persisted, with the exception of diurnal rhythm disturbances. Incidence of favorable discharge was lower in the men (60% vs 77%, P = .0173).
The data demonstrated gender differences in BPSD and outcomes among hospitalized patients. The findings should be considered when deciding on the optimal management plan for patients with BPSD.
阐明痴呆患者的行为和心理症状（BPSD）在表现症状和结果方面是否存在性别差异。
对 2006 年 4 月至 2008 年 3 月期间因 BPSD 住院治疗的患者进行了图表回顾研究。我们评估了构成阿尔茨海默病行为病理评定量表亚量表的 7 个症状簇中每个症状的患病率，以及出院时的预后，定义为出院回家或入住护理机构。根据 DSM-IV 诊断痴呆。
研究队列包括 122 名男性和 170 名女性。男性比女性更有可能出现攻击性（78%比 52%，P<0.001）和昼夜节律紊乱（89%比 79%，P<0.05），而更不可能出现妄想、妄想观念（12%比 41%，P<0.001）；幻觉（7%比 29%，P<0.001）；情感障碍（20%比 40%，P<0.001）；焦虑和恐惧症（15%比 44%，P<0.001）。男性的预后良好出院率较低（58%比 77%，P=0.001）。即使在匹配年龄、社会人口统计学因素以及身体和认知功能后，这些症状仍存在差异，昼夜节律紊乱除外。男性的预后良好出院率较低（60%比 77%，P=0.0173）。
数据表明住院患者的 BPSD 和预后存在性别差异。在为 BPSD 患者制定最佳管理计划时应考虑这些发现。
