焦虑
萧条(经济学)
帕金森病
心理干预
生活质量(医疗保健)
精神科
随机对照试验
医学
认知
不利影响
疾病
临床试验
心理学
临床心理学
心理治疗师
内科学
宏观经济学
经济
作者
Gregory M. Pontone,Kelly A. Mills
标识
DOI:10.1016/j.jagp.2021.02.037
摘要
Depression and anxiety are highly prevalent and have major adverse effects on function and quality of life in Parkinson's disease (PD). Optimal management requires that motor symptoms and psychiatric symptoms be simultaneously addressed. While there is fairly robust evidence for the treatment of motor symptoms, there are no completed randomized controlled trials to guide pharmacological treatment of anxiety in PD and no nonpharmacologic interventions have proven efficacious. Several high-quality trials for depression in PD suggest a number of antidepressants and cognitive behavioral therapy may help, but there is no data on rates of recurrence, comparative efficacy, or augmentation strategies. In order to address the gaps in knowledge, the authors provide a summary of the current evidence for treating depression and anxiety in PD and offer an algorithm that extends beyond the current literature based on clinical experience working in a multidisciplinary specialty center.
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