精神医学65巻6号

2023年06月発行

特集 精神科医療の必須検査—精神科医が知っておきたい臨床検査の最前線

高齢者の初発幻覚妄想状態に際して必要な検査

著者： 小林良太¹ 森岡大智¹ 鈴木昭仁¹

所属機関： ¹山形大学医学部精神医学講座

ページ範囲：P.875 - P.883

文献概要

抄録
　高齢者の初発幻覚妄想状態は，若年例と比較して器質性精神障害をより考慮しなければならず，その背景としては，アルツハイマー病やレビー小体型認知症，頭部外傷後精神病などがある。近年の研究により，神経変性疾患の前駆期症状として，高齢発症の幻覚妄想状態が生じることが明らかになってきている。すなわち，非器質性精神障害と考えられていたものの中に，器質性精神障害が存在する可能性があり，主なものとして，レビー小体型認知症，前頭側頭型認知症などが挙げられる。本稿では，器質性精神障害としての幻覚妄想状態と，神経変性疾患の前駆期に生じる高齢発症の幻覚妄想状態における背景疾患とその鑑別に役立つ画像検査やその他の検査について解説する。

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