Behavioural and psychological symptoms of Alzheimer's disease associated with caregiver burden and depression
Behavioural and psychological symptoms of Alzheimer's disease associated with caregiver burden and depression
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DOI：
10.1080/24750573.2018.1541646
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发表时间：
2019-10-02
影响因子：
0.7
通讯作者：
Ilnem, Mehmet Cem
中科院分区：
文献类型：
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作者：
Bozgeyik, Gamze;Ipekcioglu, Derya;Ilnem, Mehmet Cem
目的：本研究的目的是探讨阿尔茨海默病的行为和心理症状与照顾者负担和抑郁之间的关系。 方法：在这项前瞻性临床研究中，71 名 65 岁以上、根据 DSM IV 诊断标准诊断为阿尔茨海默病的患者入住 Bakirkoy Prof. Dr. Mazhar Osman 研究和培训医院的精神病学、神经病学和 该研究纳入了 2014 年 4 月至 2014 年 11 月期间的神经外科医师及其 71 名护理人员。使用社会人口统计学和临床数据表评估患者和护理人员的信息。使用标准化简易精神状态检查（SMMSE）和整体恶化量表（GDS）来确定疾病的严重程度和阶段。神经精神量表（NPI）用于评估患者的行为和心理症状。使用 Zarit 护理人员负担量表 (ZCBS) 和汉密尔顿抑郁评定量表 (HAM-D) 评估护理人员的负担和抑郁情况。采用SPSS 22.0程序对数据进行统计分析。结果：护理人员平均年龄52岁，其中81.7%（n：58）为女性，53.5%（n：38）为患者女儿。 50.7% (n: 36) 的看护者负担较轻，15.5% (n: 11) 的看护者负担较重，33.8% (n: 24) 的看护者负担较重。 19.7% (n: 14) 的看护者患有轻度抑郁症，19.7% (n: 14) 的看护者患有中度抑郁症，4.2% (n: 3) 的看护者患有重度抑郁症。最常见的行为和心理症状是：冷漠（60.6%）、妄想（57.7%）、抑郁/烦躁（56.3%）、幻觉（53.5%）、烦躁（47.9%）、焦虑（32.4%）、异常运动行为（29.6%）、激动/攻击性（26.8%）、饮食食欲变化（26.8%）和兴高采烈/欣快感（1.4%）。行为和心理症状较多的患者护理人员有更多的护理负担和抑郁症。对照顾者负担有显着影响的症状是妄想、幻觉、激动/攻击性、抑郁/烦躁、焦虑、冷漠、去抑制、易怒、异常运动行为。与看护者抑郁症相关的行为和心理症状包括激越/攻击性、焦虑、去抑制、易怒。在NPE与ZCBS因子组的相关性分析中，只有显示经济负担的因子4没有表现出显着的相关性。结论：结果显示，阿尔茨海默病患者的行为和心理症状增加了照顾者的负担，并导致照顾者抑郁。需要采取预防措施来防止出现此类症状并进行有效的快速干预。需要进一步进行前瞻性设计的多中心研究，涉及不同的文化、来自更广泛人群的患者、不同的护理环境。
OBJECTIVE: The aim of the study was to investigate the relationship between behavioural and psychological symptoms of Alzheimer's disease with caregiver burden and depression.METHODS: In this prospective and clinic-based study, 71 patients over 65 years of age diagnosed with Alzheimer's disease according to DSM IV diagnostic criteria who were admitted to Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery between April 2014 and November 2014 and their 71 care givers were included in the study. Information on patients and caregivers were assessed using the sociodemographic and clinical data form. The Standardized Mini Mental State Examination (SMMSE) and the Global Deterioration Scale (GDS) were used to determine disease severity and stage. The Neuropsychiatric Inventory (NPI) was used to assess the behavioural and psychological symptoms of the patients. Caregivers' burden and depression were assessed using the Zarit Caregiver Burden Scale (ZCBS) and the Hamilton Depression Rating Scale (HAM-D). SPSS 22.0 program was used for the statistical analysis of data.RESULTS: The average age of the caregivers was 52, 81.7% (n: 58) were female and 53.5% (n: 38) were the patients' daughters. Caregiver burden was found to be mild in 50.7% (n: 36), moderate in 15.5% (n: 11) and heavy in 33.8% (n: 24) of caregivers. Depression was found to be mild in 19.7% (n: 14), moderate in 19.7% (n: 14) and severe in 4.2% (n: 3) of caregivers. The most common behavioural and psychological symptoms were; apathy (60.6%), delusions (57.7%), depression / dysphoria (56.3%), hallucinations (53.5%), irritability (47.9%), anxiety (32.4%), abnormal motor behaviour (29.6%), agitation / aggression (26.8%), eating-appetite changes (26.8%) and elation / euphoria (1.4%). Patient caregivers in the group with more behavioural and psychological symptoms had more caregiving burden and depression. Symptoms having a significant effect on caregiver burden were delusions, hallucinations, agitation/aggression, depression/dysphoria, anxiety, apathy, disinhibition, irritability, abnormal motor behaviour. Behavioural and psychological symptoms that correlate with caregiver depression are agitation/aggression, anxiety, disinhibition, irritability. In the correlation analysis between NPE and ZCBS factor groups, only the factor 4 showing the economic burden did not show any significant correlation.CONCLUSION: Results show that behavioural and psychological symptoms in Alzheimer's patients increase the caregiver burden and cause caregiver depression. Preventive measures to prevent the emergence of such symptoms and effective ad rapid intervention are required. Further multi-center studies with a prospective design, involving different cultures, patients from a wider population, different care settings are required.