Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis.
Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis.
复制标题
神经肌动蛋白诱导的疾病中的躁郁症综合征患有精神病。
DOI：
10.2147/ndt.s99577
复制
发表时间：
2016
影响因子：
3.2
通讯作者：
Okubo Y
中科院分区：
文献类型：
--
作者：
Ueda S;Sakayori T;Omori A;Fukuta H;Kobayashi T;Ishizaka K;Saijo T;Okubo Y
抗精神病药不仅会引起身体上的不良反应，还会引起精神上的影响，从而导致思维、情感、认知和行为方面的缺陷。这种情况被称为抗精神病药物诱导的缺陷综合症(NIDS)，包括冷漠、缺乏主动性、快感缺乏、冷漠、情感迟钝和对疾病缺乏洞察力。尽管这个古老的概念现在似乎几乎被遗忘了，但抗精神病药物，无论是典型的还是非典型的，都会使抑郁症或双相情感障碍类似于其他更难治的疾病，容易导致误诊和不适当的治疗。作者描述了三例双相情感障碍合并精神病的抑郁期叠加NID的病例，主治精神科医生未能认识到NID，阻碍了患者接受有效的治疗和实现缓解。所有患者在减少抗精神病药物和强化治疗后均获得缓解，包括双相抑郁的电惊厥治疗。NIDS的概念最初是为精神分裂症引入的，但在其他疾病中很少得到强调。然而，近年来，非典型抗精神病药物更多地用于双相情感障碍患者。因此，精神病学家也应该记住并谨慎对待NIDS在有无精神病的双相情感障碍的药物治疗中。作者认为，在当前的精神病学中，NIDs的概念需要重新评估。
Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS), which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist’s failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry.