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《神經(jīng)系統(tǒng)疾病伴發(fā)抑郁焦慮障礙的診斷治療專家共識(shí)課件_2》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在教育資源-天天文庫(kù)。
1、神經(jīng)系統(tǒng)疾病伴發(fā)抑郁焦慮障礙的診斷治療專家共識(shí)目的和意義常見(jiàn)神經(jīng)系統(tǒng)疾病均易伴發(fā)或共病抑郁焦慮障礙腦血管病和卒中認(rèn)知功能障礙帕金森病多發(fā)性硬化癲癇原發(fā)性頭痛共病使得疾病遷延不愈、顯著地增加了疾病的負(fù)擔(dān)旨在提高醫(yī)師對(duì)神經(jīng)系統(tǒng)疾病伴發(fā)抑郁焦慮障礙的認(rèn)識(shí)和處理,體現(xiàn)“以人為本”的醫(yī)學(xué)宗旨,更好地實(shí)踐生物-心理-社會(huì)的醫(yī)學(xué)模式概要流行病學(xué)神經(jīng)系統(tǒng)疾病伴發(fā)抑郁焦慮障礙的特點(diǎn)神經(jīng)科抑郁/焦慮狀態(tài)常見(jiàn)的軀體化表現(xiàn)抑郁和焦慮狀態(tài)的初查和識(shí)別抑郁癥的治療目標(biāo)神經(jīng)科抑郁焦慮障礙的治療抗抑郁劑的藥物相互作用流行病學(xué)流行病學(xué)帕金森病(PD)伴抑郁焦慮障礙1~7PD患者的抑郁障礙患病率為8%~
2、76%,平均25%~40%約40%患者有焦慮障礙有研究認(rèn)為抑郁和焦慮障礙可能先于患者的運(yùn)動(dòng)癥狀出現(xiàn)1.BenedettiF,BernasconiA,PontiggiaA.Depressionandneurologicaldisorders.CurrOpinPsychiatry,2006,19:14–18.2.TuckerGJ.Neurologicaldisordersanddepression.SeminarsClinicalNeuropsychiatry,2002,7:213-220.3.RickardsH.Depressioninneurologicaldisor
3、ders:anupdate.CurrOpinPsychiatry,2006,19:294–298.4.RickardsH.Depressioninneurologicaldisorders:Parkinson’sdisease,multiplesclerosis,andstroke.JNeurolNeurosurgPsychiatry,2005,76;48-52.5.RingHA,Serra-MestresJ.Neuropsychiatryofthebasalganglia.JNeurolNeurosurgPsychiatry,2002,72:12–21.6.Okun
4、MS,WattsRL.DepressionassociatedwithParkinson’sdisease:.Neurology,2002,58(Suppl1):S63–S70.7.EhrtU,AarslandD.PsychiatricaspectsofParkinson'sdisease.CurrOpinPsychiatry,2005,18:335-341.流行病學(xué)多發(fā)性硬化(MS)伴抑郁焦慮障礙1~7終身患病率近50%,是普通人群的3倍社區(qū)問(wèn)卷調(diào)查研究發(fā)現(xiàn)41%患者有抑郁,其中29%為中-重度抑郁對(duì)3000例16歲以上MS患者的死因調(diào)查顯示,15%的患者死于自殺流
5、行病學(xué)調(diào)查結(jié)果顯示35.7%的患者合并各種焦慮,其中18.6%為廣泛性焦慮、10%為驚恐發(fā)作1.BenedettiF,BernasconiA,PontiggiaA.Depressionandneurologicaldisorders.CurrOpinPsychiatry,2006,19:14–18.2.TuckerGJ.Neurologicaldisordersanddepression.SeminarsClinicalNeuropsychiatry,2002,7:213-220.3.RickardsH.Depressioninneurologicaldisorder
6、s:anupdate.CurrOpinPsychiatry,2006,19:294–298.4.RickardsH.Depressioninneurologicaldisorders:Parkinson’sdisease,multiplesclerosis,andstroke.JNeurolNeurosurgPsychiatry,2005,76;48-52.5.KesslerRC,BerglundP,DemlerO,etal.Theepidemiologyofmajordepressivedisorder:JAMA2003,289:3095–3105.6.Jansse
7、nsAC,BuljevacD,vanDoornPA.Predictionofanxietyanddistressfollowingdiagnosis.MultScler,2006,12:794-801.7.SiegertRJ,AbernethyDA.Depressioninmultiplesclerosis:areview.JNeurolNeurosurgPsychiatry,2005,76;469-475.流行病學(xué)癲癇伴抑郁焦慮障礙1~6抑郁癥的患病率為50%~55%住院患者中,控制良好者的抑郁發(fā)病率為10%、患病率為20%,控制不良者則分別為20