阿尔茨海默病非认知精神症状分析

目的　探讨轻、中度阿尔茨海默病 (AD)的非认知精神症状学特点。方法　采用简明精神病量表(BPRS)、汉密尔顿抑郁量表 (HAMD)、汉密尔顿焦虑量表 (HAMA)调查 30例AD患者和 2 0名正常老年人。全部病例和对照均进行头颅MRI检查。结果　 6 6 .7%的AD患者伴精神症状 ,其中 ,幻觉 16 .7% ,妄想 2 3.3% ,抑郁2 6 .7% ,焦虑 2 6 .7% ,行为障碍 46 .7%。精神症状发生与性别、发病年龄、受教育水平、病前职业无关 ,焦虑在较年轻患者组中出现率高于较年老组。智能损害严重者 ,行为障碍也多见。伴幻觉、妄想者有更多的易激惹和攻击行为。AD患者中 ,抑郁与焦虑呈正相关 ,抑郁出现率高于正常老年人。结论　精神症状在轻、中度AD患者中常见 ,管理及指导治疗时应予以考虑。

An Psychopathological Analysis of Alzheimer's Disease

Objective To evaluate the psychopathological characteristics of mild and moderate Alzheimer's disease (AD).Method Thirty patients and 20 normal control subjects were assessed,using BPRS,HAMD and HAMA.Results 66.7% of the patients showed psychiatric symptoms,including hallucination (16.7%),delusion (23.3%),depression(26.7%),anxiety (26.7%) and behavioral disorder (46.7%).There was no relation between psychiatric symptoms and sex,age at onset,education level and work type.Anxiety occurred much more in younger patients.Patients with lower MMSE score showed more behavioral disorders.Patients with psychotic symptoms had severer irritation and aggression,and those with depression was more likely to have anxiety.AD patients were found to have depression much more than the normal agings.Conclusion Psychiatric symptoms were found common in mild and moderate AD patients.Attention shoud be paid in management and treatment.