Rabins P V
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21287-7279, USA.
J Clin Psychiatry. 1998;59 Suppl 13:36-8.
The psychiatrist can play several important roles in the care of persons with Alzheimer's disease and other dementing illnesses. Diagnostic issues for which psychiatrists have specific skills include identifying early cases, performing a differential diagnosis, and distinguishing reversible depression from depression associated with irreversible dementia and irreversible dementia without depression. Treatment should include management of behavioral, noncognitive, and cognitive symptoms. Environmental and pharmacologic therapies have proven efficacious in treating noncognitive behavioral symptoms. Neuroleptic antipsychotic drugs are effective in treating aggressive behaviors and delusions. The treatment of cognitive symptoms currently rests on cholinergic enhancement. Finally, the psychiatrist can play important roles in educating the public and supporting the distressed caregiver.
精神科医生在阿尔茨海默病及其他痴呆性疾病患者的护理中可发挥多种重要作用。精神科医生具备特定技能的诊断问题包括识别早期病例、进行鉴别诊断，以及区分可逆性抑郁与与不可逆性痴呆相关的抑郁和无抑郁的不可逆性痴呆。治疗应包括对行为、非认知和认知症状的管理。环境和药物疗法已被证明对治疗非认知行为症状有效。抗精神病药物在治疗攻击行为和妄想方面有效。目前认知症状的治疗依赖于胆碱能增强。最后，精神科医生在教育公众和支持痛苦的护理人员方面可发挥重要作用。
