探讨帕金森病中的抑郁：意大利德尔菲共识关于现象学、诊断和管理。
Exploring depression in Parkinson's disease: an Italian Delphi Consensus on phenomenology, diagnosis, and management.
机构信息
University San Raffaele Rome and IRCCS San Raffaele, Rome, Italy.
Parkinson and Movement Disorders Unit, Center for Neurodegenerative Diseases (CENSE), Department of Neuroscience, University of Padua, Padua, Italy.
出版信息
Neurol Sci. 2023 Sep;44(9):3123-3131. doi: 10.1007/s10072-023-06740-w. Epub 2023 Apr 27.
BACKGROUND
Depression is a prodromic and a frequent non-motor symptom of Parkinson's disease, associated to reduced quality of life and poor outcomes. The diagnosis of depression in parkinsonian patients represents a challenge due to the overlapping of symptoms typical of the two conditions.
METHODS
A Delphi panel survey was performed to reach a consensus amongst different Italian specialists on four main topics: the neuropathological correlates of depression, main clinical aspects, diagnosis, and management of depression in Parkinson's disease.
RESULTS AND CONCLUSION
Experts have recognized that depression is an established risk factor of PD and that its anatomic substrate is related to the neuropathological abnormalities typical of the disease. Multimodal and SSRI antidepressant have been confirmed as a valid therapeutic option in the treatment of depression in PD. Tolerability, safety profile, and potential efficacy on broad spectrum of symptoms of depression including cognitive symptoms and anhedonia should be considered when selecting an antidepressant and the choice should be tailored on the patients' characteristics.
背景
抑郁症是帕金森病的前驱症状和常见非运动症状，与生活质量下降和预后不良有关。由于两种疾病的症状重叠，帕金森病患者的抑郁症诊断具有挑战性。
方法
通过德尔菲小组调查，就四个主要主题在不同的意大利专家之间达成共识：抑郁症的神经病理学相关性、主要临床方面、诊断和帕金森病患者的抑郁管理。
结果和结论
专家们已经认识到抑郁症是 PD 的既定风险因素，其解剖学基础与疾病的神经病理学异常有关。多模式和 SSRI 抗抑郁药已被证实是治疗 PD 中抑郁症的有效治疗选择。在选择抗抑郁药时，应考虑其耐受性、安全性概况以及对包括认知症状和快感缺失在内的广泛抑郁症状的潜在疗效，选择应根据患者的特点进行调整。
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