情感性障礙病患之護理.ppt

情感性障礙病患之護理 講師：馬玉琴 2006.09.28 差異 Mood Emotion affect 情感障礙疾病(Mood Disorders) 情緒特質產生異常或紊亂的一種精神疾病，包含躁症(Mania)和鬱症(Depression)兩種，「躁」是情緒高昂;「鬱」則情緒異常低落。情感障礙疾病在思考或認知功能上的異常，並不像精神分裂症那麼嚴重，且病癒後智能方面少有損害。而越早發作的躁鬱病，預後愈差。 Bipolar I and Bipolar II Disorder Bipolar I Disorder Single manic episode Only one manic episod No past major depressive episodes Most recent episode: hypomanic Current hypomania At least one previous manic episode Bipolar I and Bipolar II Disorder Most recent episode: mixed Meets criteria for both manic and depressive current episode At least one past major depressive or mixed episode Most recent episode: depressed Current depressive episode At least one past manic or mixed episode Bipolar I and Bipolar II Disorder Bipolar II Disorder No previous full manic episode At least one past major depressive episode and past or current hypomanic episode Etiologic Factors Related to Mood Disorder Neurobiologic Factors neurotransmission Neuroendocrine dysregulation Genetic transmission Ethologic Factors Evolutionary Psychobiology/Biology Etiologic Factors Related to Mood Disorder Psychosocial Factors PSYCHOAMALYTIG THEORY Depression is a result of loss. Mania is a defense against depression COGNITIVE THEORY Depression is a result of negative processing of thoughts. Etiologic Factors Related to Mood Disorder LEARNED HELPLESSNESS Depression is a result of a perceived lack of control over events. LIFE EVENTS AND STRESS THEORY Significant life events cause stress, which results in depression or mania. PERSONALITY THEORY Etiologic Factors Related to Mood Disorder 攻擊性內轉理論-精神分析 整合性觀點-憂鬱是化學及 經驗 .行為互相在腦內的結果 躁症症狀 1．身體層面:睡眠需求減少，食慾及口慾增強，故其煙癮或酒量需求大，因無法安靜進食，故體重會快速下降。患者常忽略便意及膀胱脹，有便秘、尿瀰留情形。活動量增加。顯較衝動、忙碌，部份病患會奇裝異服、濃妝豔抹、打扮不合宜。性 慾強，可能會有不恰當的性活動增加。 躁症症狀 2．情緒層面：情緒高昂、亢奮、誇大，且情緒變化大、喜怒無常、易怒。 3．智能層面：思考速度快、聯想力強、意念飛躍，說話急速，話多且滔滔不絕無終極目的。意力難集中、易分心，易受外界刺激而分散，常對任何事皆感興趣，但耐力及持續力差，且挫折忍受度低。 躁症症狀 4．社會層面：對團體活動干擾大、好管閒事、好爭辯、過度要求，會有操縱性行為，此可能因自卑所致。自我控制力差，有攻擊與粗暴行為。 5．靈性層面：感到世界