帕金森氏病与抑郁PPT格式课件下载.pptx

帕金森氏病与抑郁PPT格式课件下载.pptx

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WPA/PTDEducationalProgramonDepressiveDisorders.GavardJA,etal.DiabetesCare.1993;

16（8）:

1167-1178.,躯体疾病伴发抑郁的患病率,8/28/2019,5,帕金森病与抑郁,共病？

合并？

固有华中症科技状大学？

同济医学院附属协和医院,8/28/2019,6,PD临床特征,运动症状（DA神经元减少50%以上）运动减少/运动不,能华中科技大学同济医学院附属协和医院,僵直静止性震颤姿势平衡障碍,非运动症状（累及胆碱能、肾上腺素能、5-HT、GABA）精神：

抑郁，焦虑，,认知损害，幻觉，淡漠，睡眠紊乱,自主神经：

便秘，血压偏低，多汗，性功能障碍，排尿障碍，流涎,感觉障碍：

麻木，疼痛，痉挛，不安腿综合征，嗅觉障碍,ZiemssenT.Non-motordysfunctioninParkinsonsdisease.ParkinsonismandRelatedDisorders13（2007）323332,8/28/2019,7,DilleyM.AdvancesinPsychiatricTreatment（2006）,vol.12.23-34.http:

/apt.rcpsych.org/,8/28/2019,8,AsystematicreviewofprevalencestudiesofdepressioninParkinsonsdisease.ReijndersJS,EhrtU,WeberWE,AarslandD,LeentjensAF.DepartmentofPsychiatry,MaastrichtUniversityHospital,Maastricht,TheNetherlands.PrevalenceratesofdepressivedisordersinParkinsonsdisease（PD）varywidelyacrossstudies,rangingfrom2.7%tomorethan90%.Theaimofthissystematicreviewwastocalculateaverageprevalencesofdepressivedisorderstakingintoaccountthedifferentsettingsanddifferentdiagnosticapproachesofstudies.UsingMedlineonPubmed,asystematicliteraturesearchwascarriedoutforstudiesofdepressioninParkinsonsdisease.Atotalof104articleswereincludedandassessedforquality;

51articlesfulfilledthequalitycriteria.Multiplepublicationsfromthesamedatabasewerenotincludedinthemeta-analysis.Intheremaining36articles,theweightedprevalenceofmajordepressivedisorderwas17%ofPDpatients,thatofminordepression22%anddysthymia13%.Clinicallysignificantdepressivesymptoms,irrespectiveofthepresenceofaDSMdefineddepressivedisorder,werepresentin35%.Instudiesusinga（semi）structuredinterviewtoestablishDSMcriteria,thereportedprevalenceofmajordepressivedisorderwas19%,whileinstudiesusingDSMcriteriawithoutastructuredinterview,thereportedprevalenceofmajordepressivedisorderwas7%.Populationstudiesreportlowerprevalenceratesforbothmajordepressivedisorderandtheclinicallysignificantdepressivesymptomsthanstudiesinothersettings.ThissystematicreviewsuggeststhattheaverageprevalenceofmajordepressivedisorderinPDissubstantial,butlowerthangenerallyassumed.2007MovementDisorderSociety,华中科技大学同济医学院附属协和医院,PD的抑郁患病率-荟萃分析,PD中抑郁障碍的患病率2.7%90%原因：

取样方法、诊断标准和方法,对符合标准报告的荟萃分析：

重性抑郁17%，轻度抑郁22%，心境恶劣13%无论是否符合DSM-IV定义的抑郁障碍，,有明显抑郁临床症状者35%社区研究中的患病率相对较低,8/28/2019,9ReijndersJS.MovDisord.2008Jan30;

23

（2）:

183-9,IncreasedriskofdevelopingParkinsonsdiseaseforpatientswithmajoraffectivedisorder:

aregisterstudy.NilssonFM,KessingLV,BolwigTG.DepartmentofPsychiatry,06233,Rigshospitalet,Blegdamsvej9,UniversityofCopenhagen,DK-2100Copenhagen,Denmark.OBJECTIVE:

ToinvestigatewhetherpatientswithadiagnosisofaffectivedisorderareatanincreasedriskofdevelopingParkinsonsdiseasecomparedwithmedicallyillcontrolgroups.METHOD:

Bylinkageofpublichospitalregistersfrom1977to1993,threestudycohortswereidentified:

patientswithaffectivedisorderepisodes（maniaordepression）andpatientswithosteoarthritisordiabetes.TimetothefirstdiagnosisofParkinsonsdiseasewasestimatedwiththeuseofsurvivalanalysis.RESULTS:

Atotalof164385patientsenteredthestudybase.TheriskofbeinggivenadiagnosisofParkinsonsdiseasewassignificantlyincreasedforpatientswithaffectivedisorder,oddsratio2.2（CI95%1.7-2.8）comparedwithosteoarthritis,anddepressivedisorders,oddsratio2.2（CI95%1.7-2.9）comparedwithosteoarthritis.CONCLUSION:

ThisstudysupportsthehypothesisofacommonaetiologyformajoraffectivedisorderandParkinsonsdisease.ActaPsychiatrScand.2002Sep;

106（3）:

202-11MajordepressivedisorderinParkinsonsdisease:

aregister-basedstudy.NilssonFM,KessingLV,SrensenTM,AndersenPK,BolwigTG.DepartmentofPsychiatry,Rigshospitalet,UniversityofCopenhagen,Denmark.fmnrh.dkOBJECTIVE:

ToinvestigatewhetherpatientswithParkinsonsdisease（PD）wereatanincreasedriskofdevelopingmajordepressioncomparedwithpatientshavingothermedicalillnesseswithacomparabledegreeofdisability.METHOD:

CaseregisterlinkagestudyofDanishPsychiatricCentralRegister（DPCR）andDanishNationalHospitalRegister（DNHR）.Threestudycohortswereidentified:

allpatientswithPD,osteoarthritis,anddiabetes.Therateofdischargediagnosisofdepressiononre-admissionwasestimatedusingcompetingrisksmodelsinsurvivalanalyses.Theratesfor