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帕金森病精神病的筛查、诊断与管理:专家小组建议

Screening, Diagnosis, and Management of Parkinson's Disease Psychosis: Recommendations From an Expert Panel.

作者信息

Pahwa Rajesh, Isaacson Stuart H, Small Gary W, Torres-Yaghi Yasar, Pagan Fernando, Sabbagh Marwan

机构信息

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.

Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA.

出版信息

Neurol Ther. 2022 Dec;11(4):1571-1582. doi: 10.1007/s40120-022-00388-y. Epub 2022 Jul 29.

Abstract

INTRODUCTION

Hallucinations and delusions present with psychosis are debilitating non-motor symptoms of Parkinson's disease, with a prevalence of up to 50-70% at some point during the course of the disease. Often patients and caregivers do not report the presence of hallucinations or delusions unless specifically questioned. A panel of experts in neurology and geriatric psychiatry convened to develop a simple screening tool and guidance on diagnosis and treatment of Parkinson's disease psychosis (PDP).

METHODS

The working group reviewed literature for existing PDP guidelines on diagnosis and management and identified gaps in recommendations. The group discussed and developed a screening tool and treatment guidance that addressed the gaps in existing methodology based on their clinical experience.

RESULTS

The proposed screening tool consists of two parts: (1) a brief pre-visit screening portion to be completed by the patient and caregiver, and (2) a clinician portion to be completed via clinical interview of the patient and caregiver. If psychotic symptoms are present, an appropriate treatment plan is developed for PDP based on evaluation.

CONCLUSIONS

This simple screening tool and treatment guidance offers a practical clinical approach for clinicians in the diagnosis and management of PDP.

摘要

引言

伴有精神病性症状的幻觉和妄想是帕金森病令人衰弱的非运动症状,在疾病过程中的某些阶段,其患病率高达50%-70%。通常,除非被特别询问,患者和照料者不会报告幻觉或妄想的存在。一个由神经病学和老年精神病学专家组成的小组召开会议,以开发一种简单的筛查工具,并就帕金森病精神病(PDP)的诊断和治疗提供指导。

方法

该工作组查阅了有关PDP诊断和管理的现有指南的文献,并确定了建议中的差距。该小组根据他们的临床经验,讨论并开发了一种筛查工具和治疗指南,以弥补现有方法中的差距。

结果

提议的筛查工具包括两个部分:(1)患者和照料者要完成的简短的就诊前筛查部分,以及(2)通过对患者和照料者进行临床访谈来完成的临床医生部分。如果存在精神病性症状,则根据评估为PDP制定适当的治疗计划。

结论

这种简单的筛查工具和治疗指南为临床医生诊断和管理PDP提供了一种实用的临床方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd22/9588124/c7701a66c45d/40120_2022_388_Fig1_HTML.jpg

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