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治疗常见运动过度障碍中的精神障碍。

Treatment of psychiatric disturbances in common hyperkinetic movement disorders.

机构信息

a Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital , Sapienza University of Rome , Rome , Italy.

b Department of Human Neurosciences , Sapienza University of Rome , Rome , Italy.

出版信息

Expert Rev Neurother. 2019 Jan;19(1):55-65. doi: 10.1080/14737175.2019.1555475. Epub 2018 Dec 10.

Abstract

: This paper reviews studies that have assessed the treatment of psychiatric disturbances in dystonia, tic disorders, Tourette syndrome, Huntington's disease, and essential tremor. : We searched for papers in English in Pubmed using the following keywords: blepharospasm, cervical dystonia, arm dystonia, laryngeal dystonia, spasmodic dysphonia, tic disorders, Tourette syndrome, Huntington's chorea, essential tremor, depression, anxiety, obsessive compulsive disorders, attention deficit hyperactivity disorders, psychosis, apathy. : Although psychiatric disturbances are frequent in hyperkinetic movement disorders, few controlled studies have assessed the treatment of psychiatric disturbances in such disorders. In dystonia, none of the controlled studies conducted to date have demonstrated the efficacy of drug treatment for depression or anxiety. In TS, controlled studies have demonstrated the usefulness of drug treatment on obsessive compulsive disorders and attention deficit hyperactivity disorders. Behavioral interventions may also play a role. No controlled studies have been conducted on HD nor have any studies addressed the treatment of psychiatric disturbances in ET. We conclude that there is the need of controlled studies to better evaluate pharmacological and non-pharmacological treatment of psychiatric disturbances in hyperkinetic movement disorders.

摘要

本文回顾了评估眼睑痉挛、颈部肌张力障碍、手臂肌张力障碍、喉部肌张力障碍、痉挛性发声障碍、抽动障碍、图雷特综合征、亨廷顿舞蹈病、原发性震颤等运动障碍中精神障碍治疗的研究。我们使用以下关键词在 Pubmed 中搜索英文文献:眼睑痉挛、颈部肌张力障碍、手臂肌张力障碍、喉部肌张力障碍、痉挛性发声障碍、抽动障碍、图雷特综合征、亨廷顿舞蹈病、原发性震颤、抑郁、焦虑、强迫症、注意缺陷多动障碍、精神病、淡漠。

虽然精神障碍在多动性运动障碍中很常见,但很少有对照研究评估此类疾病中精神障碍的治疗。在肌张力障碍中,迄今为止进行的对照研究均未证明药物治疗对抑郁或焦虑有效。在 TS 中,对照研究证明了药物治疗强迫症和注意缺陷多动障碍的有效性。行为干预也可能发挥作用。尚无针对 HD 的对照研究,也没有研究解决 ET 中精神障碍的治疗问题。我们得出的结论是,需要进行对照研究以更好地评估多动性运动障碍中精神障碍的药物和非药物治疗。

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