失智症之行為精神症狀

Behavioral and Psychological Symptoms of Dementia

黃正平(Jen-Ping Hwang)

《台灣精神醫學》 20卷1期 (2006/03) Pp. 3-18

https://doi.org/10.29478/TJP.200603.0002

摘要

失智症合併精神行為症狀（簡稱BPSD），在臨床上不但常見（約佔12-70%），而且是家屬照顧病患最大之負荷來源，但大部份的學者只著重在認知功能障礙之研究，對BPSD並不重視。目前，失智症之認知功能障礙還未有明顯治療的效果，相較於BPSD在臨床上確能得到立即明顯的改善效果，不但能減輕家屬照顧的負擔，也能提昇病患及家屬的生活品質，大大降低提早送病患到安養院之機率。本文回顧各種不同失智症BPSD之比較，BPSD之類別、原因、臨床評估、鑑別診斷及治療，並比較國外及近十年本研究小組之研究結果，發現國內的失智症BPSD發生頻率及治療BPSD之抗精神病藥物劑量要比國外高，可能是本研究小組採用老年精神科急性住院的中、重度失智症病患為研究樣本之故。本文最後期盼臨床治療照顧失智症之醫療工作同仁，能對BPSD有進一步的認識及處理，以提昇失智症病患及家屬之醫療品質。

關鍵字

失智症 ； 行為精神症狀 ； 照顧者

並列摘要

Behavioral and psychological symptoms of dementia (BPSD) is common in clinical psychiatry, and it is the major source of caregiver and family burnout, may provoke the elderly abuse, can cause premature institutionalization, increase cost of care, and result in poor quality of life. However, most investigators focus on the studies of cognitive dysfunction of dementia, and the investigation of BPSD has been of less concern. As the matter of fact, BPSD can be treated effectively and safety, compared to its counterpart of cognitive impairment, and may result of increasing quality of life of patients and their family, reducing caregiver distress as well as lower the risk of premature institutionalization. The article reviewed the past literatures and our research team studies in recent 10 years. We found that the frequency of BPSD and the dosage of antipsychotics were higher higher than those of past literature reports, the part of reason may be due to most of our demented samples rated as moderate-severe in severity and came from our acute geropsychiatric ward. Finally we emphasized that the recognition and appropriate management of BPSD are important factors in improving our care of patients with dementia and their caregivers.

並列關鍵字

dementia ； behavioral and psychological symptoms ； caregiver

參考文獻

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