Contribution of psychosis and depression to behavioral disturbances in geropsychiatric inpatients with dementia
Contribution of psychosis and depression to behavioral disturbances in geropsychiatric inpatients with dementia
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DOI：
10.1093/gerona/54.3.m157
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发表时间：
1999-03-01
影响因子：
5.1
通讯作者：
Yudofsky, SC
中科院分区：
文献类型：
--
作者：
Kunik, ME;Snow-Turek, AL;Yudofsky, SC
背景痴呆症中的特定行为障碍可能与潜在的疾病如精神病和抑郁症的存在有关。本研究的目的是探讨老年精神科痴呆患者的抑郁和精神病与行为障碍的关系。回顾了1993年10月至1995年5月期间的所有入院病例，以确定那些被诊断为痴呆的休斯顿退伍军人事务部老年精神病学单位的患者; 208例患者被纳入研究。建立分层回归模型，探讨抑郁和精神病性症状、抑郁和精神病性诊断对CMAI评分的影响。抑郁和精神病性症状与行为障碍均呈显著正相关。精神病症状与攻击性行为症状相关，抑郁症状与不断寻求帮助、抱怨和消极态度相关。痴呆的严重程度解释了CMAI评分的显著差异，并与行为障碍呈正相关;思维障碍症状比抑郁障碍更能解释行为障碍的差异。抑郁和精神病性症状与痴呆患者的整体行为障碍有关。精神病性症状和抑郁症状与不同类型的行为障碍有关。我们的研究结果支持了这样一种观点，即潜在的抑郁或精神病可能部分地解释了不同的行为障碍，并且不是所有的行为障碍都应该被全球标记为“激动”。“未来的研究应该解决行为障碍患者的特定治疗问题。
Background Specific behavioral disturbances in dementia may be associated with underlying disorders such as the presence of psychosis and depression. The objective of this study was to examine the association of depression and psychosis with behavioral disturbances in geropsychiatric inpatients with dementia.Methods. All admissions between October 1993 and May 1995 were reviewed to identify those patients admitted to the Houston Veterans Affairs Geropsychiatry Unit with a diagnosis of dementia; 208 patients were included in the study. Hierarchical regression models were constructed to explore the contribution of depressive and psychotic symptoms, and depression and psychosis diagnoses to Cohen-Mansfield Agitation Inventory (CMAI) scores.Results. Both depression and psychotic symptoms were significantly and positively correlated with behavioral disturbances. Psychotic symptoms were associated with aggressive behavioral symptoms, and depressive symptoms were associated with constant requests for help, complaining, and negativism. Dementia severity accounted for significant variance in CMAI scores and was positively associated with behavioral disturbance; thought disorder symptoms accounted for more behavioral disturbance variance than did depressive symptoms.Conclusions. Both depressive and psychotic symptoms were associated with overall behavioral disturbances in patients with dementia. Psychotic symptoms and depressive symptoms were associated with different types of behavioral disturbances. Our findings support the contention that underlying depression or psychosis may partially account for different behavioral disturbances and that not all behavioral disturbances should be globally labeled "agitation." Future studies should address symptom-specific treatment of behaviorally disturbed patients.