Bartelet Marjukka, Waterink Wim, van Hooren Susan
Open University of the Netherlands, Heerlen, The Netherlands.
Open University of the Netherlands, Heerlen, The Netherlands Zuyd University of Applied Sciences, Heerlen, The Netherlands.
J Alzheimers Dis. 2014;42 Suppl 3:S119-24. doi: 10.3233/JAD-132378.
In nursing homes, extreme sexual behavior is one of the most challenging behaviors in dementia. Despite this, however, there is no conformity in the literature regarding how to label and define this type of behavior. Examples of labels used include inappropriate sexual behavior, improper sexual behavior, sexually disinhibited behavior, or hyper sexuality. According to recent theoretical perspectives, extreme sexual behavior may be regarded as a part of disinhibited behavior or could be considered as an independent neuropsychiatric symptom. In this multicenter study, it was investigated whether there is a relationship between extreme sexual behavior and the typical neuropsychiatric symptoms seen in dementia. In 179 residents diagnosed with dementia, extreme sexual behavior was measured using an observation scale. Twelve neuropsychiatric symptoms were measured by the Neuropsychiatric Inventory. Multivariate analysis of covariance with gender showed that residents with observed extreme sexual behavior (n = 43) only showed a higher score on neuropsychiatric symptom 'disinhibition', as compared to residents with non-observed sexual behavior (n = 136). In addition, the effect size was large. These findings indicate that among residents with dementia, extreme sexual behaviors should not be considered as an independent neuropsychiatric symptom. Instead, disinhibition may be an important underlying mechanism for extreme sexual behavior and thus validates the label 'sexually disinhibited behavior'.
在养老院中，极端性行为是痴呆症患者最具挑战性的行为之一。然而，尽管如此，关于如何对这类行为进行标记和定义，文献中并没有统一的标准。所使用的标记示例包括不当性行为、不适当性行为、性抑制行为或性欲亢进。根据最近的理论观点，极端性行为可能被视为抑制行为的一部分，或者可被视为一种独立的神经精神症状。在这项多中心研究中，调查了极端性行为与痴呆症中常见的典型神经精神症状之间是否存在关联。在179名被诊断为痴呆症的居民中，使用观察量表对极端性行为进行测量。通过神经精神科问卷对12种神经精神症状进行测量。对性别进行协方差分析的多变量分析显示，与未观察到性行为的居民（n = 136）相比，观察到极端性行为的居民（n = 43）仅在神经精神症状“抑制障碍”方面得分更高。此外，效应量很大。这些发现表明，在患有痴呆症的居民中，极端性行为不应被视为一种独立的神经精神症状。相反，抑制障碍可能是极端性行为的一个重要潜在机制，因此证实了“性抑制行为”这一标记。
