Hesdorffer Dale C
Gertrude H. Sergievsky Center and Department of Epidemiology,Columbia University,New York,New York,USA.
CNS Spectr. 2016 Jun;21(3):230-8. doi: 10.1017/S1092852915000929. Epub 2016 Feb 22.
Psychiatric disorders are common in many neurological disorders, including epilepsy, migraine, Alzheimer's disease, Parkinson's disease, essential tremor, and stroke. These comorbidities increase disease burden and may complicate the treatment of the combined disorders. Initial studies of the comorbidity of psychiatric and neurological disorders were cross-sectional, and time order of the associations was impossible to elucidate. More recent work has clarified time associations between psychiatric disorders and neurological disorders, particularly in epilepsy and stroke where epidemiological evidence suggests that there is a bidirectional relationship. This article takes an epidemiological approach to understanding these relationships and focuses mostly on epilepsy. Although, these relationships are understood in many neurological disorders, routine screening for psychiatric disorders in neurological disorders is infrequent, mostly due to the lack of partnerships between psychiatrists and neurologists and the paucity of neuropsychiatrists. Much more needs to be done to improve the detection and treatment of patients affected by neurological and psychiatric disorders. Understanding the scope of this overlap may inspire collaborations to improve the lives of people affected by both disorders.
精神障碍在许多神经疾病中很常见，包括癫痫、偏头痛、阿尔茨海默病、帕金森病、特发性震颤和中风。这些共病会增加疾病负担，并可能使合并疾病的治疗复杂化。早期关于精神障碍与神经疾病共病的研究是横断面研究，关联的时间顺序无法阐明。最近的研究已经明确了精神障碍与神经疾病之间的时间关联，特别是在癫痫和中风方面，流行病学证据表明存在双向关系。本文采用流行病学方法来理解这些关系，主要关注癫痫。尽管在许多神经疾病中都能理解这些关系，但在神经疾病中对精神障碍进行常规筛查的情况并不常见，主要原因是精神科医生和神经科医生之间缺乏合作以及神经精神科医生数量不足。要改善对受神经和精神疾病影响患者的检测和治疗，还需要做更多的工作。了解这种重叠的范围可能会激发合作，以改善受这两种疾病影响人群的生活。
