Córcoles David, Malagón Angeles, Bellsolà Magdalena, Gonzalez Ana, Cortizo Romina, Leon Jordi, Bulbena Antoni, Pérez Victor, Martín Luis M
Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España.
Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España.
Aten Primaria. 2018 May;50(5):267-273. doi: 10.1016/j.aprim.2017.01.015. Epub 2017 Jun 13.
The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion.
Descriptive and observational study.
Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona.
A total of 104 patients over 65years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease.
All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule.
55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior.
When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done.
本研究旨在评估神经精神症状是否会干扰基层医疗中认知障碍的检测，并描述其中哪些症状会造成更多混淆。
描述性观察研究。
与巴塞罗那的基层医疗中心合作的流动精神科单位。
共有104名65岁以上的患者从基层医疗临床医生处转诊至流动精神科单位，这些临床医生怀疑患者患有精神疾病。
所有患者均接受了DSM-IV-TR诊断。我们将简易精神状态检查表（MMSE）、神经精神科问卷、严重精神疾病量表、功能总体评估、临床总体印象和世界卫生组织残疾评估表纳入研究。
从基层医疗转诊来的患者中，55.8%的患者MMSE评分有改变。与疑似认知障碍更常相关的神经精神症状是妄想、幻觉、激越、脱抑制、易激惹和无目的运动行为。
当在无严重精神障碍（SMD）病史的老年人中检测到严重精神障碍的精神症状时，应怀疑存在认知障碍并进行筛查测试。
