J Clin Psychiatry. 2020 Sep 15;81(5):AD19038BR1C. doi: 10.4088/JCP.AD19038BR1C.
Along with cognitive decline, 90% of patients with dementia experience behavioral and psychological symptoms, such as psychosis, aggression, agitation, and depression. Dementia-related psychosis (DRP), which includes delusions and hallucinations, contributes to institutionalization, cognitive decline, and caregiver burden. Delusions and hallucinations tend to increase with the duration and severity of the disease, but there are also individual fluctuations. While a variety of symptoms can occur in all types of dementia, visual hallucinations are particularly common in the Lewy body dementias (dementia with Lewy bodies and Parkinson disease dementia). Mechanisms behind DRP are multifactorial, including different neurobiological factors as well as environmental, social, and psychological factors. This report examines the frequency, symptoms, and pathophysiology of DRP and communication about psychotic symptoms with patients with dementia (if possible) and their care partners.
除认知能力下降外,90%的痴呆患者还会出现行为和心理症状,如精神病、攻击性、躁动和抑郁。与痴呆相关的精神病(DRP)包括妄想和幻觉,会导致住院治疗、认知能力下降和照顾者负担加重。妄想和幻觉往往随疾病的持续时间和严重程度而增加,但也存在个体波动。虽然各种症状可能出现在所有类型的痴呆症中,但视觉幻觉在路易体痴呆症(路易体痴呆症和帕金森病痴呆症)中尤为常见。DRP 的发病机制是多因素的,包括不同的神经生物学因素以及环境、社会和心理因素。本报告探讨了 DRP 的频率、症状和病理生理学,以及与痴呆患者(如果可能)及其护理伙伴就精神病症状进行沟通。