PD的精神症状.pptx

2015-12-06 Parkinsons disease psychosis Psychosis in PD In a recent meta-analysis of prospective studies, visual hallucinations were reported in 16-37% of patients, auditory in less than 2-22% and delusions in about 1-14%. The number of variables that differed among studies make any estimate very approximate. Visual hallucinations tend to be complex and formed, may be clearly seen or not, tend to be stereotyped, tend to occur when the patient is in a low sensory environment and are thus more state-dependent than related to drug dose . Auditory hallucinations are often indistinct, with party sounds heard coming from another room, people talking indistinctly outside, music of various types. Sometimes the visual hallucinations talk to the patient and may carry on conversations. Delusions tend to be paranoid. The most common delusions are of stealing, thinking their house is not really theirs, spousal infidelitv, and being abandoned. Friedman J H. Parkinsons disease psychosis 2010: a review article[Z]. 2010:16,553~560 Differential Schizophrenia :Psychotic symptoms present in schizophrenia such as thought broadcasting, delusions of grandeur, voices talking about the patient, mind reading, being controlled by foreign forces, religiosity, are almost never seen other than in patients who have comorbid psychiatric problem. The number of cases of schizophrenia who develop IPD is difficult to determine due to the fact that all neuroleptics other than clozapine and quetiapine cause parkinsonism in some patients, so that the diagnosis of IPD on clinical grounds is often impossible in a patient on an anti-psychotic drug. SPECT scanning with cocaine analogs can reliably distinguish the drug induced from the cases of IPD exacerbated by the drugs. Bonnets syndrome, a disorder in which elderly people with visual impairment have benign visual hallucinations as release phenomena can be impossible to distinguish from PDP. Vivid dreams, REM intrusions, hypnogogic and hypnopom