van der Linde Rianne M, Dening Tom, Matthews Fiona E, Brayne Carol
Institute of Public Health, University of Cambridge, UK.
Int J Geriatr Psychiatry. 2014 Jun;29(6):562-8. doi: 10.1002/gps.4037. Epub 2013 Oct 16.
A wide range of behavioural and psychological symptoms (BPSD) are common in dementia, and it has been suggested that groups of correlated symptoms should be studied together. Here, we describe the groups of BPSD that have been identified in the literature and how they have been used to study associations, burden, treatment and underlying biology.
The literature database PubMed was searched for articles that identified clusters or factors of BPSD or used previously defined symptom groups.
Sixty-two studies were included. Generally, the following symptom groups were suggested: affective symptoms, including depression and anxiety; psychosis, including delusions and hallucinations; hyperactivity, including irritability and aggression; and euphoria. Symptoms that did not show consistent results include apathy, eating disturbances, night-time behaviour disturbances, disinhibition and aberrant motor behaviour. Symptom groups differed in their associations, treatment and biology.
Studies investigating symptom groups show relatively consistent results. Studying symptom groups allows similar symptoms to be studied together, which might strengthen results and may point to differences in their aetiology and treatment. However, a large amount of the individual variability of the symptoms could not be explained by the factors, and authors should carefully address their research question and hypotheses to decide if symptoms should be studied in groups or individually. Clinicians need to consider each symptom in its own right and also to be aware of the interrelations between them when assessing patients and developing strategies for treatment.
多种行为和心理症状（BPSD）在痴呆症中很常见，有人建议应将相关症状组放在一起研究。在此，我们描述文献中已确定的BPSD症状组，以及它们如何被用于研究关联、负担、治疗和潜在生物学机制。
在文献数据库PubMed中搜索确定BPSD症状簇或因素或使用先前定义症状组的文章。
纳入62项研究。一般来说，提出了以下症状组：情感症状，包括抑郁和焦虑；精神病性症状，包括妄想和幻觉；多动，包括易激惹和攻击行为；以及欣快。未显示一致结果的症状包括冷漠、饮食紊乱、夜间行为紊乱、脱抑制和异常运动行为。症状组在其关联、治疗和生物学机制方面存在差异。
对症状组进行研究显示出相对一致的结果。研究症状组可以将相似症状放在一起研究，这可能会加强研究结果，并可能指出其病因和治疗方面的差异。然而，症状的大量个体变异性无法用这些因素来解释，作者应仔细考虑其研究问题和假设，以决定症状应分组研究还是单独研究。临床医生在评估患者和制定治疗策略时，需要分别考虑每个症状，同时也要意识到它们之间的相互关系。
