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[痴呆症中重复发声的治疗策略:一项系统综述]

[Therapy strategies for repetitive vocalizations in dementia : A systematic review].

作者信息

Taubenheim Samuel, Quante Arnim

机构信息

Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.

Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Friedrich von Bodelschwingh-Klinik, Landhausstraße 33-35, 10717, Berlin, Deutschland.

出版信息

Neuropsychiatr. 2024 Oct 15. doi: 10.1007/s40211-024-00511-5.

Abstract

BACKGROUND

Vocalizations in dementia patients are repetitive verbal expressions that, due to their volume, frequency, and/or social inappropriateness, cause negative effects on patients and other individuals present. The prevalence ranges up to 30%. Given the increasing global incidence of dementia and the limited number of randomized controlled trials about treating repetitive vocalizations, this systematic review provides a summary of existing works on the effectiveness of potential pharmacotherapeutic and nonpharmacological therapies.

METHODS

The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on the International Prospective Register of Systematic Reviews (PROSPERO) registration page (registration number: CRD42023486344). Literature search was conducted in PubMed and Embase databases. Due to insufficient data, case reports were also included.

RESULTS

Of 2635 articles, 25 studies were included in the review. Efficacy was demonstrated for selective serotonin reuptake inhibitors (SSRIs), pregabalin, gabapentin, and the antipsychotics haloperidol and risperidone based on a few case reports, albeit with associated side effects. Nonpharmacological interventions also showed efficacy.

CONCLUSION

Both pharmacological and nonpharmacological interventions are effective treatment approaches for repetitive vocalizations in dementia patients. Due to the fact that there are hardly any randomized controlled studies available, the results of this systematic review must be interpreted with caution. The results of this review show that randomized controlled trials are required for many interventions.

摘要

背景

痴呆患者的发声是重复性言语表达,由于其音量、频率和/或社交不适当性,会对患者及在场的其他人产生负面影响。其患病率高达30%。鉴于全球痴呆发病率不断上升,而关于治疗重复性发声的随机对照试验数量有限,本系统评价总结了现有关于潜在药物治疗和非药物治疗有效性的研究。

方法

本系统评价遵循系统评价和Meta分析优先报告条目(PRISMA)指南,并在国际前瞻性系统评价注册库(PROSPERO)注册页面进行了注册(注册号:CRD42023486344)。在PubMed和Embase数据库中进行文献检索。由于数据不足,也纳入了病例报告。

结果

在2635篇文章中,25项研究被纳入本评价。基于少数病例报告,选择性5-羟色胺再摄取抑制剂(SSRIs)、普瑞巴林、加巴喷丁以及抗精神病药物氟哌啶醇和利培酮显示出疗效,尽管存在相关副作用。非药物干预也显示出疗效。

结论

药物和非药物干预都是治疗痴呆患者重复性发声的有效方法。由于几乎没有随机对照研究,本系统评价的结果必须谨慎解读。本评价结果表明,许多干预措施都需要进行随机对照试验。

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