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題名:The Association of Behavioral and Psychological Symptoms of Patients with Dementia and Comorbid Depression
書刊名:Taiwanese Journal of Psychiatry
作者:黃斯聖廖以誠
作者(外文):Huang, Si-shengLiao, Yi-cheng
出版日期:2017
卷期:31:4
頁次:頁337-345+a8
主題關鍵詞:失智症之行為精神症狀憂鬱失智症神經精神病徵量表Behavioral and psychological symptoms of dementiaDepressionDementiaNeuropsychiatric inventory
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
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目的:本研究的目的是分析台灣有憂鬱之失智症病人所相關之行為精神症狀。方法: 此橫斷性研究收集西元2001 年七月至2008 年十月至門診就診之兩百七十六位失智症病人。 使用神經精神病徵量表 (Neuropsychiatric Inventory,NPI) 中的憂鬱分項去評估病人之憂鬱症 狀。使用卡方檢定比較有憂鬱及無憂鬱兩組間,失智症病人個別行為精神症狀之出現比率 是否有顯著差異。結果:在合併憂鬱的失智症病人中,妄想 (p < 0.001)、幻覺 (p = 0.007)、 激動 (p = 0.001)、焦慮 (p < 0.001)、暴躁易怒 (p < 0.001)、睡眠及夜間行為 (p < 0.001)、和飲 食行為改變 (p = 0.04) 的出現比率顯著較高。以失智的嚴重度分兩組,在輕度失智的組別中 (CDR = 0.5 或 1)有合併憂鬱的病人其妄想、幻覺、激動、焦慮、暴躁易怒、與睡眠及夜 間行為的出現比率顯著較高。而在中度到重度失智的組別中(CDR = 2, 3, 或4),併有憂鬱 者,僅有妄想及暴躁易怒的出現比率顯著較高。結論:某些特定的行為精神症狀在憂鬱的失 智症病人中出現的比率較高,特別是在早期的失智症病人。為了避免早期機構化及疾病進 展,重要的是及早辨識及治療這些症狀。
Objective: The objective of this study was to study behavioral and psychological symptoms of dementia (BPSD) associated with depressive symptoms in patients with dementia. Methods: We did a cross-sectional survey involving 276 patients with dementia from July 2001 to October 2008. Depression was assessed with the depression domain of the Neuropsychiatric Inventory (NPI). We compared differences in the prevalence of individual BPSDs between patients with dementia and depression and those with dementia alone. Results: The NPI total score was significantly higher in the patients with at least one depressive symptom (p < 0.001). Considering each NPI domain separately, we found that delusion (p < 0.001), hallucination (p < 0.01), agitation (p = 0.001), anxiety (p < 0.001), irritability (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p < 0.05) significantly occurred more frequently in patients with dementia and depression. Grouped by severity, those with mild dementia with depressive symptoms (CDR = 0.5 or 1) significantly occurred more frequently with delusion (p < 0.001), hallucination (p < 0.05), agitation (p < 0.01), anxiety (p < 0.01), irritability/ lability (p < 0.001), and nighttime behavior disturbances (p < 0.001) than the group without depression. In the group with moderate-to-severe dementia with depression (CDR = 2, 3, or 4), only delusion (p < 0.05) and irritability/lability (p < 0.01) were significantly occurred more frequently than that in those patients without depression. Conclusion: Certain BPSDs occur more frequently in patients with both dementia and depressive symptoms. Depression and other associated BPSDs may manifest simultaneously in the early stage of dementia. For preventing early institutionalization and disease progression, early recognition and treatment of those symptoms are important.
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