区分冷漠和抑郁：综述神经认知障碍中冷漠和抑郁的行为、神经解剖和治疗相关方面的区别。
Distinguishing apathy from depression: A review differentiating the behavioral, neuroanatomic, and treatment-related aspects of apathy from depression in neurocognitive disorders.
机构信息
Departments of Psychiatry and of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
出版信息
Int J Geriatr Psychiatry. 2023 Feb;38(2):e5882. doi: 10.1002/gps.5882.
OBJECTIVES
This narrative review describes the clinical features of apathy and depression in individuals with neurocognitive disorders (NCDs), with the goal of differentiating the two syndromes on the basis of clinical presentation, diagnostic criteria, neuropathological features, and contrasting responses to treatments.
METHODS
Literature was identified using PubMed, with search terms to capture medical conditions of interest; additional references were also included based on our collective experience and knowledge of the literature.
RESULTS
Evidence from current literature supports the distinction between the two disorders; apathy and depression occur with varying prevalence in individuals with NCDs, pose different risks of progression to dementia, and have distinct, if overlapping, neurobiological underpinnings. Although apathy is a distinct neuropsychiatric syndrome, distinguishing apathy from depression can be challenging, as both conditions may occur concurrently and share several overlapping features. Apathy is associated with unfavorable outcomes, especially those with neurodegenerative etiologies (e.g., Alzheimer's disease) and is associated with an increased burden for both patients and caregivers. Diagnosing apathy is important not only to serve as the basis for appropriate treatment, but also for the development of novel targeted interventions for this condition. Although there are currently no approved pharmacologic treatments for apathy, the research described in this review supports apathy as a distinct neuropsychiatric condition that warrants specific treatments aimed at alleviating patient disability.
CONCLUSIONS
Despite differences between these disorders, both apathy and depression pose significant challenges to patients, their families, and caregivers; better diagnostics are needed to develop more tailored treatment and support.
目的
本叙述性综述描述了伴有神经认知障碍（NCD）个体的淡漠和抑郁的临床特征，旨在根据临床表现、诊断标准、神经病理学特征以及对治疗的反应差异来区分这两种综合征。
方法
使用 PubMed 检索与目标疾病相关的医学文献，并使用检索词捕获感兴趣的医疗条件；还根据我们的集体经验和对文献的了解纳入了其他参考文献。
结果
现有文献证据支持这两种疾病的区分；淡漠和抑郁在伴有 NCD 的个体中以不同的患病率发生，对向痴呆进展的风险不同，并且具有不同但重叠的神经生物学基础。尽管淡漠是一种独特的神经精神综合征，但区分淡漠和抑郁可能具有挑战性，因为这两种情况可能同时发生且具有几个重叠的特征。淡漠与不良结局相关，特别是与神经退行性病因（如阿尔茨海默病）相关的结局，并且对患者和照护者都有增加的负担。诊断淡漠不仅有助于为适当的治疗提供依据，而且有助于为这种疾病开发新的靶向干预措施。尽管目前没有针对淡漠的批准药物治疗，但本综述中描述的研究支持将淡漠作为一种独特的神经精神疾病，需要针对缓解患者残疾的特定治疗方法。
结论
尽管这些疾病存在差异，但淡漠和抑郁都对患者、他们的家庭和照护者构成重大挑战；需要更好的诊断方法来制定更具针对性的治疗和支持措施。
Zotero 插件