神经退行性疾病中的抑郁症状。

Depressive symptoms in neurodegenerative diseases.

作者信息

Baquero Miquel, Martín Nuria

机构信息

Miquel Baquero, Nuria Martín, Servei de Neurologia, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain.

出版信息

World J Clin Cases. 2015 Aug 16;3(8):682-93. doi: 10.12998/wjcc.v3.i8.682.

Abstract

Depressive symptoms are very common in chronic conditions. This is true so for neurodegenerative diseases. A number of patients with cognitive decline and dementia due to Alzheimer's disease and related conditions like Parkinson's disease, Lewy body disease, vascular dementia, frontotemporal degeneration amongst other entities, experience depressive symptoms in greater or lesser grade at some point during the course of the illness. Depressive symptoms have a particular significance in neurological disorders, specially in neurodegenerative diseases, because brain, mind, behavior and mood relationship. A number of patients may develop depressive symptoms in early stages of the neurologic disease, occurring without clear presence of cognitive decline with only mild cognitive deterioration. Classically, depression constitutes a reliable diagnostic challenge in this setting. However, actually we can recognize and evaluate depressive, cognitive or motor symptoms of neurodegenerative disease in order to establish their clinical significance and to plan some therapeutic strategies. Depressive symptoms can appear also lately, when the neurodegenerative disease is fully developed. The presence of depression and other neuropsychiatric symptoms have a negative impact on the quality-of-life of patients and caregivers. Besides, patients with depressive symptoms also tend to further decrease function and reduce cognitive abilities and also uses to present more affected clinical status, compared with patients without depression. Depressive symptoms are treatable. Early detection of depressive symptoms is very important in patients with neurodegenerative disorders, in order to initiate the most adequate treatment. We review in this paper the main neurodegenerative diseases, focusing in depressive symptoms of each other entities and current recommendations of management and treatment.

摘要

抑郁症状在慢性疾病中非常常见。神经退行性疾病也是如此。许多因阿尔茨海默病以及帕金森病、路易体病、血管性痴呆、额颞叶变性等相关病症导致认知衰退和痴呆的患者,在疾病过程中的某个阶段会或多或少地出现抑郁症状。抑郁症状在神经系统疾病中具有特殊意义,特别是在神经退行性疾病中,因为存在大脑、心理、行为和情绪之间的关系。许多患者可能在神经系统疾病的早期阶段出现抑郁症状,此时没有明显的认知衰退,仅有轻微的认知恶化。传统上,在这种情况下抑郁症构成了一项可靠的诊断挑战。然而,实际上我们可以识别和评估神经退行性疾病的抑郁、认知或运动症状,以确定它们的临床意义并制定一些治疗策略。抑郁症状也可能在神经退行性疾病充分发展后出现。抑郁和其他神经精神症状的存在会对患者和护理人员的生活质量产生负面影响。此外,与没有抑郁的患者相比,有抑郁症状的患者往往功能进一步下降,认知能力降低,并且临床状况更差。抑郁症状是可治疗的。在神经退行性疾病患者中早期发现抑郁症状对于启动最适当的治疗非常重要。我们在本文中回顾主要的神经退行性疾病,重点关注每种疾病的抑郁症状以及当前的管理和治疗建议。

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