痴呆症诊断前后的精神疾病 痴呆症诊断前后的精神疾病
Minjia Mo1, Lluis Zacarias-Pons1,2,3, Minh Tuan Hoang1,4
1Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|October 17, 2023
概括
在痴呆症患者中,精神疾病显著增加,从诊断前3年开始,在诊断后不久达到顶峰,并保持多年升高. 这凸显了整个痴呆过程中综合精神病治疗的必要性.
科学领域:
- 神经学 神经学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 在痴呆症中精神病并发症的具体时间和序列尚不清楚.
- 调查这些时间模式对于及时干预和管理至关重要.
研究的目的:
- 检查与痴呆症诊断有关的各种精神疾病的时间风险模式.
- 在痴呆症诊断之前,在痴呆症诊断期间和之后分析精神疾病的风险.
主要方法:
- 一项基于人口的全国性队列研究,使用2000-2017年的瑞典登记册.
- 包括796,205名参与者,其中痴呆症患者与对照组匹配.
- 使用灵活的参数生存模型来评估时间依赖的风险.
主要成果:
- 与对照组相比,痴呆症患者的精神疾病风险始终较高.
- 风险从诊断前3年开始增加,诊断后一周达到峰值 (HR 4.74),并保持多年升高.
- 精神病药物使用,特别是抗抑郁药,在诊断后也达到顶峰.
结论:
- 痴呆症患者在诊断前和诊断后都会显著增加精神疾病风险.
- 这强调了主动精神病学干预在痴呆症护理的所有阶段的重要性.
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