萧条(经济学)
精神科
医学
痴呆
疾病
重性抑郁障碍
抑郁症的治疗
抗抑郁药
临床心理学
心理学
认知
替代医学
病理
焦虑
经济
宏观经济学
作者
Alessandro Padovani,Angelo Antonini,Paolo Barone,Giuseppe Bellelli,Andrea Fagiolini,Luigi Ferini Strambi,Sandro Sorbi,Fabrizio Stocchi
标识
DOI:10.1007/s10072-023-06891-w
摘要
In Alzheimer's disease (AD), the progressive cognitive impairment is often combined with a variety of neuropsychiatric symptoms, firstly depression. Nevertheless, its diagnosis and management is difficult, since specific diagnostic criteria and guidelines for treatment are still lacking. The aim of this Delphi study is to reach a shared point of view among different Italian specialists on depression in AD.An online Delphi survey with 30 questions regarding epidemiology, diagnosis, clinical features, and treatment of depression in AD was administered anonymously to a panel of 53 expert clinicians.Consensus was achieved in most cases (86%). In the 80% of statements, a positive consensus was reached, while in 6% a negative consensus was achieved. No consensus was obtained in 14%. Among the most relevant findings, the link between depression and AD is believed to be strong and concerns etiopathogenesis and phenomenology. Further, depression in AD seems to have specific features compared to major depressive disorder (MDD). Regarding diagnosis, the DSM 5 diagnostic criteria for MDD seems to be not able to detect the specific aspects of depression in AD. Concerning treatment, antidepressant drugs are generally considered the main option for depression in dementia, according to previous guidelines. In order to limit side effects, multimodal and SSRI antidepressant are preferred by clinicians. In particular, the procognitive effect of vortioxetine seems to be appealing for the treatment of depression in AD.This study highlights some crucial aspects of depression in AD, but more investigations and specific recommendations are needed.
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