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老年精神科患者的轻度行为障碍:临床特征与精神病理学严重程度

Mild Behavioral Impairment in Psychogeriatric Patients: Clinical Features and Psychopathology Severity.

作者信息

Elefante Camilla, Brancati Giulio Emilio, Ismail Zahinoor, Ricciardulli Sara, Beatino Maria Francesca, Lepri Vittoria, Famà Antonella, Ferrari Elisabetta, Giampietri Linda, Baldacci Filippo, Ceravolo Roberto, Maremmani Icro, Lattanzi Lorenzo, Perugi Giulio

机构信息

Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.

Departments of Psychiatry, Clinical Neurosciences, Community Health Sciences, and Pathology and Laboratory Medicine, Hotchkiss Brain Institute & O'Brien Institute for Public Health, University of Calgary, Calgary, AB T2N 1N4, Canada.

出版信息

J Clin Med. 2023 Aug 21;12(16):5423. doi: 10.3390/jcm12165423.

Abstract

The Mild Behavioral Impairment (MBI) concept was developed to determine whether late-onset persistent neuropsychiatric symptoms (NPSs) may be early manifestations of cognitive decline. Our study aims to investigate the prevalence and differentiating features of MBI with respect to major neurocognitive disorders (MNDs) and primary psychiatric disorders (PPDs). A total of 144 elderly patients who were referred to our psychogeriatric outpatient service were recruited. The severity of mental illness was evaluated by means of the Clinical Global Impression Severity scale, the severity of psychopathology was evaluated by means of the Brief Psychiatric Rating Scale (BPRS), and overall functioning was evaluated by means of the Global Assessment of Functioning scale. The sample included 73 (50.6%) patients with PPDs, 40 (27.8%) patients with MBI, and 31 (21.5%) patients with MNDs. Patients with MNDs reported the greatest severity of mental illness, the highest BPRS Total, Psychosis, Activation, and Negative Symptom scores, and the lowest functioning. Patients with MBI and PPDs had comparable levels of severity of mental illness and overall functioning, but MBI patients reported higher BPRS Total and Negative Symptom scores than PPD patients. Patients with MBI frequently reported specific clinical features, including a higher severity of apathy and motor retardation. These features merit further investigation since they may help the differential diagnosis between MBI and PPDs.

摘要

轻度行为损害(MBI)概念的提出是为了确定迟发性持续性神经精神症状(NPSs)是否可能是认知衰退的早期表现。我们的研究旨在调查MBI相对于主要神经认知障碍(MNDs)和原发性精神障碍(PPDs)的患病率及鉴别特征。共招募了144名转诊至我们老年精神科门诊服务的老年患者。通过临床总体印象严重程度量表评估精神疾病的严重程度,通过简明精神病评定量表(BPRS)评估精神病理学的严重程度,并通过功能总体评定量表评估整体功能。样本包括73名(50.6%)PPD患者、40名(27.8%)MBI患者和31名(21.5%)MND患者。MND患者报告的精神疾病严重程度最高,BPRS总分、精神病、激活和阴性症状得分最高,功能最低。MBI患者和PPD患者的精神疾病严重程度和整体功能水平相当,但MBI患者报告的BPRS总分和阴性症状得分高于PPD患者。MBI患者经常报告特定的临床特征,包括更高的冷漠和运动迟缓严重程度。这些特征值得进一步研究,因为它们可能有助于MBI和PPD之间的鉴别诊断。

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