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神经疾病的精神症状:一篇叙述性综述。

Psychiatric Manifestations of Neurological Diseases: A Narrative Review.

作者信息

Maristany Anthony J, Sa Brianna C, Murray Cameron, Subramaniam Ashwin B, Oldak Sean E

机构信息

Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA.

Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine/Jackson Memorial Hospital, Miami, USA.

出版信息

Cureus. 2024 Jul 9;16(7):e64152. doi: 10.7759/cureus.64152. eCollection 2024 Jul.

Abstract

Neurological diseases often manifest with psychiatric symptoms, profoundly impacting patients' well-being and treatment outcomes. This comprehensive review examines the psychiatric manifestations associated with Alzheimer's disease, frontotemporal dementia (FTD), Parkinson's disease, multiple sclerosis (MS), stroke, epilepsy, Huntington's disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), and multiple system atrophy (MSA). Key psychiatric symptoms include agitation, depression, anxiety, apathy, hallucinations, impulsivity, and aggression across these diseases. In addition, ethical considerations in treating these symptoms are paramount, particularly regarding genetic testing implications, end-of-life discussions, informed consent, and equitable access to innovative treatments. Effective management necessitates interdisciplinary collaboration, personalized interventions, and a focus on patient autonomy. Understanding the psychiatric burden of neurological diseases is crucial for enhancing patients' quality of life. Further research is needed to elucidate underlying mechanisms and develop targeted interventions. This review underscores the importance of comprehensive assessment and ethical treatment practices to address psychiatric manifestations effectively.

摘要

神经疾病常伴有精神症状,对患者的幸福感和治疗效果产生深远影响。本综述全面探讨了与阿尔茨海默病、额颞叶痴呆(FTD)、帕金森病、多发性硬化症(MS)、中风、癫痫、亨廷顿舞蹈病、肌萎缩侧索硬化症(ALS)、创伤性脑损伤(TBI)和多系统萎缩(MSA)相关的精神症状。这些疾病的关键精神症状包括激越、抑郁、焦虑、淡漠、幻觉、冲动和攻击行为。此外,治疗这些症状时的伦理考量至关重要,尤其是在基因检测的影响、临终讨论、知情同意以及获得创新治疗的公平性方面。有效的管理需要跨学科协作、个性化干预,并注重患者的自主权。了解神经疾病的精神负担对于提高患者生活质量至关重要。需要进一步研究以阐明潜在机制并开发针对性干预措施。本综述强调了全面评估和符合伦理的治疗实践对于有效应对精神症状的重要性。

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本文引用的文献

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Ethical considerations in rapid and novel treatments in psychiatry.精神病学中快速新颖治疗的伦理考量。
Neuropsychopharmacology. 2024 Jan;49(1):291-293. doi: 10.1038/s41386-023-01635-y. Epub 2023 Jun 30.
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Pathological substrate of memory impairment in multiple system atrophy.多系统萎缩记忆障碍的病理基础。
Neuropathol Appl Neurobiol. 2022 Dec;48(7):e12844. doi: 10.1111/nan.12844. Epub 2022 Aug 12.
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Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.中风和创伤性脑损伤患者精神障碍的管理
Indian J Psychiatry. 2022 Mar;64(Suppl 2):S344-S354. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_34_22. Epub 2022 Mar 23.

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