Apathy and its treatment
Apathy and its treatment
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冷漠及其治疗
DOI：
--
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发表时间：
2007
影响因子：
2
通讯作者：
T. McAllister
中科院分区：
文献类型：
--
作者：
R. Roth;L. Flashman;T. McAllister
意见陈述冷漠是在许多神经、精神和其他疾病中观察到的常见问题。它独立于其他症状，并与各种负面结果相关。然而，对于冷漠的潜在心理或药物治疗方法却很少进行实证研究。已经调查了几种不同药物的影响，但很少有报告使用严格对照的研究设计。目前，增强中枢神经系统多巴胺释放和/或延迟多巴胺再摄取的药物似乎有望用于治疗冷漠。其中，非典型抗精神病药和哌醋甲酯受到了最大的关注，两者都已被证明可以减少一些患者群体的冷漠情绪。这些发现似乎与支持额叶皮层下回路异常在冷漠病因中的作用的证据一致。另一类已成为大量研究对象的药物是乙酰胆碱酯酶抑制剂。据报道，这些可以减少痴呆症患者和脑外伤患者的冷漠情绪。已经对几种心理干预措施进行了评估，主要针对老年人群，但大多数只是一项或极少数研究的主题。考虑到这一点，已经显示出希望的干预措施包括参与讨论小组和认知刺激。尽管有一些有希望的发现，但在提出任何明确的建议之前，对于对冷漠可能有用的药理学和心理干预措施进行进一步的大规模、严格对照的临床试验是至关重要的。在此期间，建议仔细评估任何特定患者可能导致冷漠的社会心理和生物学因素，并据此制定治疗计划。
Opinion statementApathy is a common problem observed in numerous neurologic, psychiatric, and other medical conditions. It is independent from other symptoms and has been associated with a variety of negative outcomes. However, little empirical research has been conducted on potential psychologic or pharmacologic treatments for apathy. The impact of several different medications has been investigated, but very few reports have used well-controlled study designs. At present, agents that potentiate dopamine release and/or delay dopamine reuptake in the central nervous system appear promising for use in apathy. Among these, atypical antipsychotics and methylphenidate have received the greatest attention, and both have been demonstrated to reduce apathy in several patient populations. These findings appear consistent with evidence supporting a role for frontal-subcortical circuitry abnormality in the etiology of apathy. Another class of medication that has been the subject of a larger number of investigations is the acetylcholinesterase inhibitors. These have been reported to reduce apathy in patients with dementia and individuals with traumatic brain injury. Several psychologic interventions have been assessed, largely in geriatric populations, but most have been the subject of only one or a very small number of studies. With this caveat, interventions that have shown promise include participation in discussion groups and cognitive stimulation. Despite some promising findings, further large-scale, well-controlled clinical trials of potentially helpful pharmacologic and psychologic interventions for apathy are essential before any firm recommendations can be made. In the interim, careful evaluation of possible psychosocial and biological contributors to apathy in any given patient is suggested, with treatment planning based accordingly.
冷漠与感染艾滋病毒的患者的伏核体积有关。
DOI：
10.1176/jnp.17.2.167
发表时间：
2005
期刊：
The Journal of neuropsychiatry and clinical neurosciences
影响因子：
--
作者：
Paul,RobertH;Brickman,AdamM;Navia,Bradford;Hinkin,Charles;Malloy,PaulF;Jefferson,AngelaL;Cohen,RonaldA;Tate,DavidF;Flanigan,TimothyP
通讯作者：
Flanigan,TimothyP