Alarcon R D, Jenkins C S, Parker P E, Freeman A M
Department of Psychiatry, School of Medicine, University of Alabama, Birmingham.
Int Urol Nephrol. 1988;20(3):327-32. doi: 10.1007/BF02549524.
Neuropsychiatric complications of chronic renal haemodialysis cover a wide gamut of clinical syndromes. These pictures can be diagnostically classified as non-psychotic and psychotic-like syndromes. On the basis of a review of the literature, some nosological precisions are formulated, and a hypothesized cognitive-behavioural psychopathological continuum is presented. The hypothesis postulates that a central cognitive disturbance, due to multiple organic aetiopathogenic factors, results in a step-wise decline, initially disguised as an affective, neurotic or personality disorder, and further deteriorating into the well-known "dialysis dementia", with a variety of other clinical presentations in between. Additional research in the biological and psychosocial areas is needed to verify different aspects of these conditions, their validity in the context of the authors' hypothesis, and their relevance to the overall "quality of life" of chronic haemodialysis patients.
慢性肾血液透析的神经精神并发症涵盖了广泛的临床综合征。这些病症在诊断上可分为非精神病性和类精神病性综合征。在回顾文献的基础上，制定了一些疾病分类的精确标准，并提出了一个假设的认知行为心理病理连续体。该假设假定，由于多种器质性病因致病因素导致的中枢认知障碍会逐步恶化，最初表现为情感、神经症或人格障碍，进而进一步恶化为广为人知的“透析性痴呆”，其间还存在各种其他临床表现。需要在生物学和社会心理领域进行更多研究，以验证这些病症的不同方面、它们在作者假设背景下的有效性，以及它们与慢性血液透析患者整体“生活质量”的相关性。
