神经系统疾病中的神经精神症状表现

English | 2024 | ISBN: 9819718201 | 206 Pages | PDF EPUB (True) | 4 MB

Psychiatric symptoms (or mood/emotional disturbances) are diverse in patients with neurological diseases, that include depression, anxiety, emotional incontinence, anger, fatigue, and apathy. These symptoms are common; more than 1/3 of the patients suffer from these symptoms. Unfortunately, they have been neglected because 1) unlike other neurological symptoms such as motor dysfunction, speech disturbances or visual field defect, these symptoms are not visible and difficult to be noticed unless they are specifically examined by a physician who is properly educated on this problem 2) they are often not regarded as neurological symptoms either by the patients or their caregivers 3) they are relatively poorly studied by both neurologists and psychiatrists, and accordingly, are unfamiliar to the physicians. Especially, although `depression’ is well known to physicians, other symptoms such as emotional incontinence, anger, fatigue or apathy are not appropriately assessed by physicians, and frequently misdiagnosed as depression. Moreover, there are difficulties in diagnosing depression in patients neurological diseases. For example, the individual items included in depression diagnosis such as sleep disturbances, appetite loss, or fatigue can result from neurological diseases or comorbid physical conditions in patients with neurological diseases. Therefore, a diagnosis of `depression’ should be made cautiously. Finally, it should be understood that the importance of different mood/ emotional syndromes differ among various neurological diseases; for instance, although emotional incontinence and anger occur in as many as 20-30 % of stroke patients, apathy and fatigue are more important symptoms than these for patients with neuro-degenerative disease.

神经系统疾病患者的 psychiatric症状（或情绪/情感紊乱）种类繁多，包括抑郁、焦虑、情绪失控、愤怒、疲劳和淡漠。这些症状很常见；超过三分之一的患者会遭受这些症状的影响。不幸的是，这些症状被忽视了，原因如下： 1) 这些症状不像如运动功能障碍、语言障碍或视野缺损等其他神经系统症状一样明显且容易察觉，除非经过专门教育的专业医生进行仔细检查。 2) 患者及其照护者往往不会将这些症状视为神经系统的病症。 3) 这些症状在神经科医生和精神科医生中研究得不够充分，因而对医生来说并不熟悉。 特别是，尽管“抑郁”这一术语被医学界熟知，但其他如情绪失控、愤怒、疲劳或淡漠等症状并未得到适当评估，并常被误诊为抑郁。 此外，在患有神经系统疾病的患者中诊断抑郁症也有困难。例如，抑郁症诊断中的个别项目，如睡眠障碍、食欲减退或疲劳现象，可能是由于患者的神经系统疾病或并发的身体状况引起的。因此，在做出抑郁症诊断时要谨慎行事。 最后，应该认识到不同的情绪/情感症状在各种神经系统疾病中的重要性是不同的；比如，尽管情绪失控和愤怒在多达20-30%的中风患者中出现，但在患有神经退行性疾病患者的症状中，淡漠和疲劳更为重要。

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