关注帕金森病抑郁的评估与治疗

发布时间：2018-08-22 15:48

【摘要】：抑郁是帕金森病(Parkinson’s disease,PD)常见的非运动症状之一,由于往往与PD的运动症状及其他神经精神症状并发,临床上对其正确评估仍存在一定问题,因此,选择有效的、适合PD抑郁的评估量表至关重要。汉密尔顿抑郁量表、Beck抑郁量表、蒙哥马利抑郁量表、老年抑郁量表、康奈尔痴呆抑郁量表等可以有效地评价不同临床类型的PD抑郁。而且,不同临床类型的PD抑郁可能需要选择不同的治疗方法。其中,心理行为治疗有效,但在神经科容易被忽视。由于副作用较少,口服抗抑郁药仍然是最常用的手段,而剂末抑郁可通过调整多巴胺能药物得到改善。重复经颅磁刺激以及脑深部电刺激术等方法尚需更多临床对照研究验证。进一步提高PD抑郁的识别,开发更为有效的治疗方法,对帮助改善患者的生活质量至关重要。
[Abstract]:Depression is one of the common non-motor symptoms in Parkinson's disease (PD). Due to the concomitant of motor symptoms and other neuropsychiatric symptoms, there are still some problems in clinical evaluation of PD. Evaluation scales for PD depression are critical. The Hamilton Depression scale (Hamilton Depression scale), the Montgomery Depression scale, the elderly Depression scale and the Cornell Depression scale can be used to evaluate the different clinical types of PD depression. Moreover, different clinical types of PD depression may require different treatments. Among them, psychological behavior therapy is effective, but it is easy to be ignored in neurology. Because of fewer side effects, oral antidepressants are still the most commonly used method, and terminal depression can be improved by adjusting dopaminergic drugs. Repeated transcranial magnetic stimulation and deep brain electrical stimulation need more clinical controlled studies. Further improvement of PD depression recognition and development of more effective treatment are essential to improve patients' quality of life.
【作者单位】：北京医院国家老年医学中心神经内科;
【基金】：“十二五”国家科技支撑计划资助项目(编号:2012BAll0804、2012BAll0803) 首都卫生发展科研专项资助项目(编号:首发2011-4011-01)
【分类号】：R742.5;R749.4

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