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感觉剥夺与精神疾病:关联、评估及管理策略

Sensory Deprivation and Psychiatric Disorders: Association, Assessment and Management Strategies.

作者信息

Sahoo Swapnajeet, Naskar Chandrima, Singh Ajaypal, Rijal Rika, Mehra Aseem, Grover Sandeep

机构信息

Dept. of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Psychol Med. 2022 Sep;44(5):436-444. doi: 10.1177/02537176211033920. Epub 2021 Sep 21.

Abstract

BACKGROUND

Sensory deprivation (SD) is a widely prevalent condition that leads to various health-related consequences and is also an important cause of disability worldwide. Earlier, SD experiments were used as research modalities to alter human behavior. In recent years, the focus has shifted to understand how SD can affect the mental health of individuals (with congenital or acquired sensory impairments). This narrative review focuses on the current understanding about the association of SD and psychiatric disorders.

METHODS

A comprehensive literature search was done PubMed, Scopus, PsycINFO, and Google Scholar and in the cross-references of relevant articles. Keywords included "sensory deprivation," "blindness," "deafness," "mental illness," "psychiatric disorders," "prevalence," "assessment," and "management" in various combinations. Only original articles (abstract and full text) published in English till October 2020 were included.

RESULTS

The prevalence of anxiety, depression, dementia, suicidality, and psychosis in persons with SD is higher than the general population (highest being in persons with dementia with comorbid SD). Several mechanisms/hypotheses have been proposed to explain these associations. Assessment of SD includes a thorough history taking, with adequate awareness about the difficulties faced during a psychiatric interview in this population. Modifications in the psychometric assessment procedures are warranted. Management depends on a multi-disciplinary approach that includes proper referral to specialties, pharmacological management (depending on diagnosis as well as taking care of ototoxic/ocular side-effect profile of the drugs), and nonpharmacological supportive measures.

CONCLUSIONS

SD is a complex condition, and evidence suggests that persons with SD have higher psychiatric morbidity. A comprehensive assessment, along with holistic management approach is warranted.

摘要

背景

感觉剥夺(SD)是一种广泛存在的状况,会导致各种与健康相关的后果,也是全球残疾的一个重要原因。早期,SD实验被用作改变人类行为的研究方式。近年来,重点已转向了解SD如何影响个体(先天性或后天性感觉障碍者)的心理健康。本叙述性综述聚焦于对SD与精神障碍关联的当前认识。

方法

在PubMed、Scopus、PsycINFO和谷歌学术上进行了全面的文献检索,并检索了相关文章的参考文献。关键词包括“感觉剥夺”“失明”“失聪”“精神疾病”“精神障碍”“患病率”“评估”和“管理”等各种组合。仅纳入截至2020年10月以英文发表的原创文章(摘要和全文)。

结果

SD患者中焦虑、抑郁、痴呆、自杀倾向和精神病的患病率高于普通人群(痴呆合并SD者中最高)。已经提出了几种机制/假说以解释这些关联。SD的评估包括详细的病史采集,充分了解该人群在精神科访谈中面临的困难。心理测量评估程序有必要进行调整。管理依赖于多学科方法,包括适当转诊至专科、药物治疗(取决于诊断以及注意药物的耳毒性/眼毒性副作用)和非药物支持措施。

结论

SD是一种复杂的状况,有证据表明SD患者有更高的精神疾病发病率。需要进行全面评估以及整体管理方法。

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本文引用的文献

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Depression in elderly patients with hearing loss: current perspectives.老年听力损失患者的抑郁:当前观点。
Clin Interv Aging. 2019 Aug 14;14:1471-1480. doi: 10.2147/CIA.S195824. eCollection 2019.

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