Chen Baoyu, Wang Qi, Bai Chaobo, Chen Jing, Zhao Danhua, Li Yuan, Chen Junyi, Guo Xintong, Wang Jinjin, Chen Hongguang, Lai Xiaoxing, Wan Qiaoqin, Wang Zhiwen, Hu Nan, Zhang Bing-Wei, Chen Xuqiao, Ma Tao, Yuan Junliang
Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, 100191, People's Republic of China.
Department of Health Care, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
Clin Interv Aging. 2024 Dec 11;19:2099-2108. doi: 10.2147/CIA.S483118. eCollection 2024.
Behavioral and psychological symptoms of dementia (BPSD), as neuropsychiatric manifestations within dementia, constitute core features of dementia. However, there remains a gap in understanding the recognition of BPSD in China. Our current study was to explore the clinical awareness and treatment approaches for BPSD in China, focusing especially on the perspectives of neurologists and psychiatrists.
A multicenter national survey was designed and a semi-structured questionnaire was distributed to healthcare professionals including doctors and nurses across all provinces of China. The questionnaire incorporated either closed (yes/no) and multiple-choice questions. The questions centered on the following areas: the perceived global frequency and relevance of BPSD; the assessment tools employed for evaluating BPSD; pharmacological approaches for addressing psychosis, apathy, agitation, aggression, depression, anxiety, sleep, and nutrition disorders; drug-related side effects; non-pharmacological treatment strategies. The anonymity of questionnaire responses was maintained to encourage participants to candidly express their viewpoints.
The majorities of respondents recognized the importance of BPSD. There were apparent differences in the perception of BPSD between neurologists and psychiatrists, encompassing variances in symptoms recognition, diagnostic approaches, and treatment strategies. A notable high percentage of neurology (27.8%) and psychiatry staff (23.6%) would not choose non-pharmacological interventions. Meanwhile, antipsychotics was overused in China. For aggression and agitation, more than half of neurologist and psychiatrist preferred antipsychotics. For psychosis, more than 80% of doctors chose antipsychotics. Nearly one-third of the medical staff expressed a preference for traditional Chinese medicine including ginkgo biloba extract.
In summary, this study in China has shed light on the features related to perception, recognition, management, treatment options, and observed side effects associated with BPSD. Our findings have the potential to significantly enhance the understanding of BPSD characteristics among medical practitioners and offering valuable insights into improved management and treatment strategies of neuropsychic symptoms of dementia in China.
痴呆的行为和心理症状（BPSD）作为痴呆中的神经精神表现，是痴呆的核心特征。然而，我国在对BPSD的认识方面仍存在差距。我们当前的研究旨在探讨我国对BPSD的临床认知及治疗方法，尤其关注神经科医生和精神科医生的观点。
设计了一项全国多中心调查，并向中国所有省份的包括医生和护士在内的医护人员发放了半结构化问卷。该问卷包含封闭式（是/否）和多项选择题。问题集中在以下方面：BPSD的总体感知频率和相关性；用于评估BPSD的评估工具；针对精神病、冷漠、激越、攻击行为、抑郁、焦虑、睡眠和营养障碍的药物治疗方法；药物相关副作用；非药物治疗策略。问卷回复保持匿名，以鼓励参与者坦率地表达他们的观点。
大多数受访者认识到BPSD的重要性。神经科医生和精神科医生在对BPSD的认知上存在明显差异，包括症状识别、诊断方法和治疗策略的差异。相当高比例的神经科（27.8%）和精神科工作人员（23.6%）不会选择非药物干预措施。与此同时，抗精神病药物在中国被过度使用。对于攻击行为和激越，超过一半的神经科医生和精神科医生更喜欢使用抗精神病药物。对于精神病，超过80%的医生选择抗精神病药物。近三分之一的医护人员表示更喜欢包括银杏叶提取物在内的传统中药。
总之，我国的这项研究揭示了与BPSD的认知、识别、管理、治疗选择以及观察到的副作用相关的特征。我们的研究结果有可能显著提高医生对BPSD特征的理解，并为改善我国痴呆神经精神症状的管理和治疗策略提供有价值的见解。
