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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Neuropsychiatric Complications of Parkinson Disease Treatments: Importance of Multidisciplinary Care
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Neuropsychiatric Complications of Parkinson Disease Treatments: Importance of Multidisciplinary Care

机译：帕金森病治疗的神经精神并发症：多学科护理的重要性

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摘要

Although Parkinson disease (PD) is defined clinically by its motor symptoms, it is increasingly recognized that much of the disability and worsened quality of life experienced by patients with PD is attributable to psychiatric symptoms. The authors describe a model of multidisciplinary care that enables these symptoms to be effectively managed. They describe neuropsychiatric complications of PD itself and pharmacologic and neurostimulation treatments for parkinsonian motor symptoms and discuss the management of these complications. Specifically, they describe the clinical associations between motor fluctuations and anxiety and depressive symptoms, the compulsive overuse of dopaminergic medications prescribed for motor symptoms (the dopamine dysregulation syndrome), and neuropsychiatric complications of these medications, including impulse control disorders, psychosis, and manic syndromes. Optimal management of these problems requires close collaboration across disciplines because of the potential for interactions among the pathophysiologic process of PD, motor symptoms, dopaminergic drugs, and psychiatric symptoms. The authors emphasize how their model of multidisciplinary care facilitates close collaboration among psychiatrists, other mental health professionals, neurologists, and functional neurosurgeons and how this facilitates effective care for patients who develop the specific neuropsychiatric complications discussed.
机译：尽管帕金森病（PD）在临床上是由其运动症状来定义的，但人们越来越认识到，PD患者所经历的许多残疾和生活质量下降可归因于精神病症状。作者描述了一种多学科护理模型，该模型可使这些症状得到有效管理。他们描述了PD本身的神经精神并发症以及帕金森氏运动症状的药物和神经刺激治疗，并讨论了这些并发症的管理。具体来说，他们描述了运动波动与焦虑和抑郁症状之间的临床关联，针对运动症状开处方的多巴胺能药物的强制性使用（多巴胺失调综合征）以及这些药物的神经精神病并发症，包括冲动控制障碍，精神病和躁狂综合征。由于PD的病理生理过程，运动症状，多巴胺能药物和精神病学症状之间可能存在相互作用，因此这些问题的最佳管理需要各学科之间的紧密合作。作者强调他们的多学科护理模型如何促进精神科医生，其他精神卫生专业人员，神经病学家和功能神经外科医生之间的密切合作，以及如何促进对所讨论的特定神经精神并发症的患者进行有效护理。

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