苯丙胺所致精神障碍的临床诊治（郭中孟20150326更新）.ppt

世界毒品报告2013 苯丙胺类兴奋剂（ATS） 有迹象表明，苯丙胺类兴奋剂的市场正在扩大：缉获量和消费量均在增加，生产似乎在扩大，而新的市场正在发展之中。 除致幻剂（LSD）外的苯丙胺类兴奋剂的使用在全球依然普遍，并且看来在多数地区均有增加。 2011年，全球年满15-64岁的人群中，估计有0.7%的人也就是3,380万人在以往一年使用了苯丙胺类兴奋剂。 甲基苯丙胺仍然是苯丙胺类兴奋剂行业的支柱；占2011年苯丙胺类兴奋剂全球缉获量的71%。 甲基苯丙胺药丸仍然是东亚和东南亚占主导地位的苯丙胺类兴奋剂。 2011年缉获了1.228亿颗药丸，虽然与2010年相比（1.344亿颗药丸）下降了9%；结晶体甲基苯丙胺（冰毒）的缉获量增加到8.8吨，达到最近五年来的最高点，表明该物质已经成为迫在眉睫的威胁。 2015.3.25国家禁毒委发布《2015中国禁毒报告》 2014年，全国累计登记吸毒人员295.5万名，其中滥用阿片类毒品人员145.8万名，滥用合成毒品人员145.9万名（2010年为36万），分别占49.3%和49.4% 全年共查处吸毒人员88.7万余人次，新发现登记吸毒人员46.3万余名，强制隔离戒毒新收戒26.4万余人次，社区戒毒社区康复新报到12.4万余名，全国三年未复吸人员达到100.8万名，各项数据同比均有大幅增长。 2014年，全国缴获各类毒品合计68.95吨。其中冰毒类毒品25.9吨，氯胺酮11.2吨，海洛因9.3吨，大麻4吨。 amphetamine-induced psychosis（1） Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. amphetamine-induced psychosis（2） To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve more completely compared to schizophrenic psychosis. amphetamine-induced psychosis（3） The increased vulnerability for acute amphetamine induced psychosis seen among those with schizophrenia, schizotypal personality and, to a certain degree other psychiatric disorders, is also shared by non-psychiatric individuals who previously have experienced amphetamine-induced psychosis. amphetamine-induced psychosis（4） Schizophrenia spectrum disorder and amphetamine-induced psychosis are further linked together by the finding of several susceptibility genes common to both conditions. These genes probably lower the threshold for becoming psychotic and increase the risk for a poorer clinical course of the disease.