PDF(Pubmed)
Abstract：
BACKGROUND: Hypersexuality (HS) accompanying neurological conditions remains poorly characterized despite profound psychosocial impacts. Objective We aimed to systematically review the literature on HS in patients with neurological disorders. Study selection and analysis We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. Findings The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson\'s disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Conclusions and clinical implications Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines.
UNASSIGNED: CRD42017036478.
UNASSIGNED: CRD42017036478.
摘要：
背景：尽管有深刻的社会心理影响，但伴随神经系统疾病的性欲异常（HS）的特征仍然很差。目的系统评价HS治疗神经系统疾病的相关文献。研究选择和分析我们进行了系统评价，以确定在神经系统疾病中报告HS的研究。HS被定义为一种以过度和持续关注性思想为特征的疾病，催促,以及对个人造成重大困扰或损害的行为，社会,或职业功能。人口统计数据，评估技术，关联元素,表型表现，并提取了管理策略。研究结果最终分析包括79项关于HS的研究，包括81个神经系统疾病队列中的32662名患者。帕金森病是最常见的研究病症（55.6%），其次是各种类型的痴呆(12.7%)。问卷调查是评估HS最常见的评估方法，尽管技术差异很大。多巴胺能途径的改变已成为基于停药效果的作用机制。然而,标准化治疗方案仍需改进，在文献记载的方法中具有显著的异质性。关键缺陷包括参与者抽样中选择偏差的风险，不受控制的残余混杂因素，以及缺乏对报告结果的盲化评估。结论和临床意义尽管在过去十年中有所增长，关于HS的研究在神经系统疾病中仍然有限，质量和方法学标准化缺陷挥之不去。关键优先事项包括推进评估工具，阐明潜在的神经生物学，制定管理指引。
■CRD42017036478。
■CRD42017036478。
