Fischer Corinne E, Ismail Zahinoor, Youakim James M, Creese Byron, Kumar Sanjeev, Nuñez Nicolas, Ryan Darby R, Di Vita Antonella, D'Antonio Fabrizia, de Lena Carlo, McGeown William J, Ramit Ravona, Rasmussen Jill, Bell Joanne, Wang Huali, Bruneau Marie-Andrée, Panegyres Peter K, Lanctôt Krista L, Agüera-Ortiz Luis, Lyketsos Constantine, Cummings Jeffrey, Jeste Dilip V, Sano Mary, Devanand D P, Sweet Robert A, Ballard Clive
Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.
Department of Psychiatry, University of Toronto, Toronto, Canada.
J Alzheimers Dis. 2020;73(3):1143-1156. doi: 10.3233/JAD-190828.
Psychotic symptoms are common in Alzheimer's disease (AD) and related neurodegenerative disorders and are associated with more rapid disease progression and increased mortality. It is unclear to what degree existing criteria are utilized in clinical research and practice.
To establish research criteria for the diagnosis of psychosis in AD.
The International Society to Advance Alzheimer's Research and Treatment (ISTAART) Neuropsychiatric Symptoms (NPS) Professional Interest Area (PIA) psychosis subgroup reviewed existing criteria for psychosis in AD and related dementias. Through a series of in person and on-line meetings, a priority checklist was devised to capture features necessary for current research and clinical needs. PubMed, Medline and other relevant databases were searched for relevant criteria.
Consensus identified three sets of criteria suitable for review including those of Jeste and Finkel, Lyketsos, and the Diagnostic and Statistical Manual for Mental Disorders, 5th edition. It was concluded that existing criteria could be augmented by including a more specific differentiation between delusions and hallucinations, address overlap with related conditions (agitation in particular), adding the possibility of symptoms emerging in the preclinical and prodromal phases, and building on developing research in disease biomarkers.
We propose criteria, developed to improve phenotypic classification of psychosis in AD, and advance the research agenda in the field to improve epidemiological, biomarker, and genetics research in the field. These criteria serve as a complement to the International Psychogeriatric Association criteria for psychosis in neurocognitive disorders.
精神病性症状在阿尔茨海默病（AD）及相关神经退行性疾病中很常见，并且与疾病进展加快和死亡率增加有关。目前尚不清楚现有标准在临床研究和实践中的应用程度。
建立AD中精神病诊断的研究标准。
国际阿尔茨海默病研究与治疗促进会（ISTAART）神经精神症状（NPS）专业兴趣领域（PIA）精神病亚组回顾了AD及相关痴呆中精神病的现有标准。通过一系列面对面和在线会议，设计了一份优先检查表，以获取当前研究和临床需求所需的特征。检索了PubMed、Medline和其他相关数据库以查找相关标准。
共识确定了三套适合审查的标准，包括杰斯特和芬克尔、利凯索斯以及《精神疾病诊断与统计手册》第5版的标准。得出的结论是，现有标准可以通过以下方式得到补充：对妄想和幻觉进行更具体的区分，解决与相关病症（尤其是激越）的重叠问题，增加症状在临床前和前驱期出现的可能性，并基于疾病生物标志物的研究进展。
我们提出的标准旨在改善AD中精神病的表型分类，并推进该领域的研究议程，以改善该领域的流行病学、生物标志物和遗传学研究。这些标准是对国际老年精神病学协会神经认知障碍中精神病标准的补充。
