痴呆症患者精神行为症状的危险因素解析及应对技巧

Analysis of risk factors and coping techniques for behavioral and psychological symptoms of dementia

痴呆症精神行为症状可伴随整个病程而出现,给患者和照护者造成困扰不低于痴呆症认知减退本身。“患者-照护者-环境”危险因素群提供发病支撑。患者方面涉及痴呆症神经病理、原有人格和精神障碍、其他共患病及潜在未诊断疾病、未满足的需要等因素。照护者因素涉及照护者压力下的负性照护状态,影响自身健康的同时进一步加剧患者症状。环境因素方面涉及不再适宜的居住环境、生活方式改变、社会角色的变化及环境中缺乏适量刺激因素等。对于预防及应对,需要在预防痴呆症危险因素的同时,对精神行为多维危险因素进行控制。推崇以患者为中心、以照护者为重点、以非药物为首并在必要时联合药物治疗的个性化整体控制方案。

Behavioral and psychological symptoms of dementia can occur with the whole course of the dementia,causing problems for patients and caregivers not less than the cognitive decline of dementia itself.The risk factor group of"patient-caregiver-environment"supports the onset of disease symptoms.Patients factors involve neuropathy of dementia,pre-existing personality and mental disorders,co-morbidity and potential undiagnosed diseases and unmet needs.The caregiver factors concern the negative care state under the“caregiver pressure”,which affects their own health and further aggravates the patient's symptoms.Environmental factors contain no longer suitable living environment,changes in lifestyle and social roles and the lack of appropriate stimuli in the environment.For prevention and response,it is necessary to control the risk factors,at the same time,to promote personalized holistic control programs that focus on patients,caregivers and first-line non-drug therapy,which is combined with drug therapy when it is necessary.