The spectrum of sociopathy in dementia.

The spectrum of sociopathy in dementia.
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痴呆症的社会病态谱系。

DOI:
10.1176/jnp.23.2.jnp132
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发表时间:
2011
期刊:
The Journal of neuropsychiatry and clinical neurosciences
影响因子:
--
通讯作者:
Saul,RonaldE
Saul,RonaldE
中科院分区:
--
文献类型:
--
作者:
Mendez,MarioF;Shapira,JillS;Saul,RonaldE

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尽管人们因头部外伤和急性中风而广为人知,但痴呆症引起的反社会行为却鲜为人知和理解。这项研究回顾了 33 名曾触犯法律的痴呆症患者。他们被分为两组:22 人有冲动的反社会行为,11 人有非冲动行为。冲动的患者表现出非暴力行为,例如不受抑制的性行为或病态偷窃,并且神经影像学显示有不成比例的额叶尾状萎缩。大多数非冲动型患者表现出激动偏执,有时伴有反应性攻击、妄想信念或失语性偏执,并有高级记忆和其他认知障碍。冲动的患者往往患有额部疾病,例如额颞叶痴呆或亨廷顿病,而非冲动的患者往往患有阿尔茨海默病或严重失语症。社会病态导致痴呆症有不同的原因。两种常见的机制是去抑制(以额叶为主的疾病)和激越偏执(伴有更大的认知障碍)。这些形式的反社会人格与反社会/精神病人格显着不同。
Although well-known from head trauma and acute strokes, sociopathic behavior from dementia is less known and understood. This study reviewed 33 dementia patients who had been in trouble with the law. They were divided into two groups: 22 who committed impulsive sociopathic acts and 11 who committed non-impulsive acts. The impulsive patients demonstrated nonviolent acts, such as disinhibited sexual behavior or pathological stealing, and had disproportionate frontal-caudate atrophy on neuroimaging. The majority of non-impulsive patients demonstrated agitation-paranoia, sometimes with reactive aggression, delusional beliefs, or aphasic paranoia, and had advanced memory and other cognitive impairment. The impulsive patients tended to have frontally predominant illnesses such as frontotemporal dementia or Huntington's disease, whereas the non-impulsive group tended to have Alzheimer's disease or prominent aphasia. Sociopathy has different causes in dementia. Two common mechanisms are disinhibition, with frontally predominant disease, and agitation-paranoia, with greater cognitive impairment. These forms of sociopathy differ significantly from the antisocial/psychopathic personality.
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