阿滋海默氏癡呆症患者之錯認症狀

Misidentification in Psychiatric Inpatients of Alzheimer's Dementia

劉金明(King-Ming Liu) ； 黃正平(Jen-Ping Hwang) ； 蔡世仁(Shih-Jen Tsai) ； 楊誠弘(Chen-Hong Yang) ； 簡玉城(Yuk-Shing Kan)

《Journal of Medical Sciences》 17卷1期 (1996/08) Pp. 24-30

摘要

阿滋海默氏癡呆症，需要長期的照顧，如果合併有其他精神症狀或干擾行為，將增加照顧者的負擔或被安置到慢性機構。其中錯認症狀是過去較少受到注意的精神症狀之一。本文以民國78年8月起至83年5月在台北榮民總醫院精神部老年精神科住院的54位阿滋海默氏癡呆症患者為樣本研究其錯認症狀的盛行率、內容形式及與一般資料、認知功能、精神症狀及行為障礙的相關性。結果顯示有21位（38.9％）有錯認症狀。其中以錯認有他人在自己家中佔最多，有12位；其次有9位錯認現在住的房子不是自己的家；有6位錯認親人配偶是別人或偽裝者；有5位錯認為電視上的事件是眞實；及錯認鏡中自己的影像是別人有4位。比較阿滋海默氏癡呆症患者有及無錯認症狀，發現併有錯認症狀之患者大部分有主要照顧者和較多的幻覺、憂鬱、焦慮、攻擊行為、收集行為、漫遊、走失記錄及日夜作息混亂。由此結果可見錯認症狀在阿滋海默氏癡呆症是一普遍的症狀。併有錯認症狀的患者，易出現暴力及其他精神症狀，困擾照顧者。這些錯認症狀是可以治療的，因此讓患者的家屬了解，及早發現並送醫診療，以避免傷害的發生。臨床醫師亦應對此一症狀有所認識，才能提供適切的處置。

關鍵字

阿滋海默氏癡呆症 ； 錯認症狀 ； 精神症狀

並列摘要

Psychiatric symptoms and behavioral problems are well-recognized concomitant of the progression of Alzheimer's disease which may disturb their caregivers. However, they may be amenable to pharmacological intervention. Among them, misidentification has received less attention.This study was designed to investigate the prevalence of misidentification symptom in patients admitted to the geropsychiatric ward of general hospital who met the criteria for probable Alzheimer's disease. Additonally, an attempt was made to identify the characteristics and psychiatric symptoms which might be associated with misidentification exhibited by such patients.Fifty-four with probable Alzheimer's disease were included in this study. Misidentification was found in 21 (38.9%) of the patients; 12 of them misidentified other people in the house, 9 thought one's house is not one's home, 6 misidentified other people. 5 misidentified television images as being real, 4 misidentified mirror image. Patients with misidentifications have more psychiatric and behavioral symptoms, such as hallucination, anxiety, aggression, hoarding behaviors, wandering, recordings of loss away from home and sleep-wake disturbance.These results suggest that misidentifications are common symptoms in AD patients. Most of them have caregivers but more psychiatric symptoms and disturbed behaviors accompanied misidentification were found that may jeopardize their caregivers. Early detection and treatment of this symptoms may lessen the burdens of the caregiver and decrease the risk factors for institutionalization.

並列關鍵字

Alzheimer's disease ； misidentification ； psychiatric symptoms