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Title レビー小体型認知症の精神症状
Subtitle 特集 レビー小体型認知症診療のstate-of-the-art
Authors 橋本衛
Authors (kana)
Organization 近畿大学医学部精神神経科学教室
Journal 老年精神医学雑誌
Volume 33
Number 5
Page 429-438
Year/Month 2022 / 5
Article 報告
Publisher ワールドプランニング
Abstract 「抄録」 レビー小体型認知症(DLB)では, 幻覚や妄想, 抑うつ, 不安, 睡眠障害など, さまざまな精神症状が病初期より高頻度にみられる. またDLBのなかには, 認知機能障害が出現する何年も前に, 抑うつや幻覚, 妄想などの精神症状で発症する症例があり, これらはpsychiatric-onset DLBと呼ばれ, その病態や鑑別診断が注目されている. DLBの精神症状の治療は, 他の認知症疾患と同様, 非薬物療法が薬物療法よりも優先されるが, 非薬物療法, 薬物療法のいずれも十分なエビデンスはない. そのため精神症状の治療方針の立案は個々の医師の裁量にゆだねられているが, 多彩な精神症状を認めるDLBでは, 「幻視にはドネペジル」のような画一的な治療ではなく, 患者ごとに治療の標的とすべき精神症状を見定め, 非薬物療法と薬物療法を組み合わせて実施することが望まれる.
Practice 臨床医学：内科系
Keywords レビー小体型認知症, 精神症状, prodromal DLB, 非薬物療法, 薬物療法
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