21 de enero de 2012

TRASTORNOS NEUROPSIQUIÁTRICOS EN LA ENFERMEDAD DE PARKINSON

FUENTE ORIGINAL: http://www.uninet.edu/union99/congress/confs/npsy/03Noe.html


CONFERENCES

TOPIC: NEUROPSYCHIATRY

Enrique Noé Sebastián, Pablo Irimia Sieira, Eduardo Martinez-Vila & Mª Rosario Luquin Piudo

Departamento de Neurología. Clínica Universitaria de Navarra. Facultad de Medicina. Universidad de Navarra. Pamplona. Spain. E-Mail: emartinezv@unav.es

Abstract

Parkinson disease (PD) is usually associated with neuropsychiatric complications such as depression, anxiety and apathy. Besides, psychiatryc symptoms are one of the most common side effects of antiparkinsonian drug-therapy. Depression is the most frequent emotional disorder reported in patients with Parkinsonís disease (PD). Up to 20% of parkinsonian patients meet DSM-IV criteria for major depressive episode and another 20% for dysthymia, while the prevalence of depression in normal aged population is about 2-8%. The relationship between PD and depression has not been fully established. Some investigators have suggested that depressive symptoms in PD are causally related to the underlying neuropathological process, affecting predominantly serotoninergic and dopaminergic pathways. Alternatively, depression in PD may represent a normal reaction to the progressive physical impairment induced by the disease. Otherwise, up to 20% of parkinsonian patients present levodopa-induced psychiatric complications. Visual hallucinations are the commonest, but delusions, confusional states, sexual disorders and sleep disorders have also been described. Serotonine and dopamine have been implicated in the neuropathological basis of these disorders. To sum up, this paper reviews the main neuropsychiatric disorders associated with PD and describe the neuropathological hypothesis proposed to explain these symptoms.

Resumen
 
Con frecuencia la EP se complica con una amplia variedad de trastornos neuropsiquiátricos que incluyen, entre otros, la depresión, la ansiedad y la apatía. Además los pacientes con EP pueden presentar complicaciones psiquiátricas como efecto secundario de los fármacos utilizados en el tratamiento de la enfermedad. La depresión es el síntoma psicopatológico no cognitivo más frecuente de cuantos aparecen en la EP alcanzando a prácticamente el 50% de los pacientes con EP. La aparición de síntomas depresivos parece relacionarse con factores exógenos como la progresiva incapacidad motora que limita las actividades cotidianas de los pacientes y con factores endógenos que probablemente incluyen alteraciones en los sistemas