schizophrenia and other psychotic disorders课件

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1、精神病学2SchizophreniaandOtherPsychoticDisordersLiuTie-qiao3学习目标1．掌握精神分裂症的临床表现、诊断和鉴别诊断、治疗和预防复发策略2．了解精神分裂症疾病的分型、预后特征3．了解精神分裂症疾病的病因学4.了解其它精神病性障碍的概念4PartoneIntroduction5ThedefinitionofSchizophreniain CCMD-3Schizophreniacomprisesagroupofpsychoticdisordersofunknownspec

2、ificetiologyoftenpresentedwithagradualonsetofabnormalitiesinperception,thought,motionandbehaviorsinceyoungadulthood.Consciousnessisusuallymaintained.Intelligenceisintact,butinsomecases,thereissomedegreeofcognitiveimpairment.Thenaturalcourseofthedisorderischroni

3、cremittingbutsometimesdeteriorating.6Epidemiology(1)Prevalence：PointprevalenceinChina(1982):4.75‰（ruralarea3.42‰，urban6.06‰)。TotalprevalenceinChina(1982):5.69‰，(6.55‰1999)。LifetimeprevalenceinUSA（1988）13‰。7Epidemiology(2)IncidenceUSA:0.43‰~0.69‰China:0.11‰~0.35

4、‰Thereasonsofthesereporteddifferencesmaybeinclude:diagnosticcriteriaareasmethodsofcasefinding,migration8Epidemiology(3)Age：theageofonsetin50%ofpatientsis20~30yearold，over80%ofpatientsis16~35yearold.Gender：Schizophreniaoccursequallyinmenandwomen(inabroad)Theprev

5、alenceinmenismorethanwomen(1.6:1)inChina.Themeanageofonsetisabout2to5yearsearlierinmenthanwomen.9Outcomeevaluation(multi-dimensions)ClinicaloutcomeSocialfunctionQualityoflifeLivingconditionFamilyconditionothers10History（1）1.Demenceprecoce(Morel,1857)2.Hebephre

6、nia(Hecker,1871)3.Catatonia(Kzhlbaum,1874)4.Kraepelin(1896)thoughtallabovedescriptionsaredifferenttypesofthesamedisease-dementiapraecox11History（2）E.Bleuler(1911)suggestedthatsplittingofthoughtandaffectwasthecentralfeatureoftheillness–schizophreniaHefoundthatth

7、eoutcomeofthisillnesswasneitheruniversallypoornorassociatedwithseveredementia.M.Bleuler-4Asymptoms：AssociationdisorderApathyAmbivalenceAutism12History（3）Schneider：firstranksymptoms1.Thoughthearing2.Third-personhallucinations3.Hallucinationsintheformofacommentar

8、y4.Thoughtwithdrawalorinsertion5.Thoughtbroadcasting/diffusion6.Forcedfeeling7.Forcedimpulsive8.Forcedbehavior9.Somaticpassivityexperience10.Delusionalperception13Part2Etiol