帕金森病不典型焦虑障碍的现象学：系统评价。
Phenomenology of Atypical Anxiety Disorders in Parkinson's Disease: A Systematic Review.
机构信息
UQ Centre for Clinical Research, Faculty of Medicine (NND, EJF), The University of Queensland, Brisbane, Australia; School of Psychology (NND, EJF), University of Queensland, Brisbane, Australia; Department of Neurology (NND), Royal Brisbane & Women's Hospital, Brisbane, Australia.
UQ Centre for Clinical Research, Faculty of Medicine (NND, EJF), The University of Queensland, Brisbane, Australia; School of Psychology (NND, EJF), University of Queensland, Brisbane, Australia.
出版信息
Am J Geriatr Psychiatry. 2022 Sep;30(9):1026-1050. doi: 10.1016/j.jagp.2022.02.004. Epub 2022 Feb 15.
OBJECTIVE
Anxiety is a prominent concern in Parkinson's disease (PD) that negatively impacts quality of life, increases functional disability, and complicates clinical management. Atypical presentations of anxiety are under-recognized and inadequately treated in patients with PD, compromising global PD care.
METHODS
This systematic review focuses on the prevalence, symptomology and clinical correlates of atypical presentations of PD-related anxiety following PRISMA guidelines.
RESULTS
Of the 60 studies meeting inclusion criteria, 14 focused on 'Anxiety Not Otherwise Specified (NOS)' or equivalent, 31 reported on fluctuating anxiety symptoms, and 22 reported on 'Fear of Falling (FOF)'. Anxiety NOS accounted for a weighted mean prevalence of 14.9%, fluctuating anxiety for 34.19%, and FOF for 51.5%. These latter two exceeded the average reported overall prevalence rate of 31% for anxiety disorders in PD. We identified a diverse array of anxiety symptoms related to motor and non-motor symptoms of PD, to complications of PD medication (such as "on" and "off" fluctuations, or both), and, to a lesser extent, to cognitive symptoms.
CONCLUSION
Atypical anxiety is common, clinically relevant, and heterogeneous in nature. A better understanding of the phenomenology, clinical course, and pathophysiology of varied forms of atypical anxiety in PD is needed to improve recognition, advance therapeutic development and ultimately optimize quality of life in PD.
目的
焦虑是帕金森病（PD）患者的一个突出问题，它会对生活质量产生负面影响，增加功能障碍，并使临床管理复杂化。PD 患者的焦虑不典型表现被低估和治疗不足，这影响了整体 PD 护理。
方法
本系统评价按照 PRISMA 指南，重点关注 PD 相关焦虑的不典型表现的患病率、症状学和临床相关性。
结果
在符合纳入标准的 60 项研究中，有 14 项专注于“未特定焦虑（NOS）”或同等内容，31 项报告了波动的焦虑症状，22 项报告了“恐摔（FOF）”。焦虑 NOS 的加权平均患病率为 14.9%，波动的焦虑为 34.19%，FOF 为 51.5%。后两者超过了 PD 中焦虑障碍的平均报告总体患病率 31%。我们确定了与 PD 的运动和非运动症状、PD 药物并发症（如“开”和“关”波动或两者兼有）相关的各种焦虑症状，以及在较小程度上与认知症状相关的各种焦虑症状。
结论
不典型焦虑很常见，具有临床相关性，且性质多种多样。需要更好地了解 PD 中各种不典型焦虑的现象学、临床过程和病理生理学，以提高识别率、推进治疗开发，并最终优化 PD 的生活质量。
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