精神分裂症与其他精神病性障碍（schizophrenia and other psychotic disorders）课件.ppt

精神分裂症与其他精神病性障碍 (schizophrenia and other psychotic disorders) 中南大学精神卫生研究所 陈晓岗 The mental health institute of south-central university Chen Xiaogang MD.,Ph.D. 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．掌握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 The ?definition of Schizophrenia in? CCMD-3 ?? Schizophrenia comprises a group of psychotic disorders of unknown specific etiology often presented with a gradual onset of abnormalities in perception, thought, motion and behavior since young adulthood. Consciousness is usually maintained. Intelligence is intact, but in some cases, there is some degree of cognitive impairment. The natural course of the disorder is chronic remitting but sometimes deteriorating. Epidemiology 1 Prevalence ： Point prevalence in China (1982): 4.75‰（rural area 3.42‰，urban 6.06 ‰ )。 Total prevalence in China(1982):5.69‰，(6.55 ‰ 1999)。 Lifetime prevalence in USA（1988）13‰。 Epidemiology 2 Age：the age of onset in 50% of patients is 20~30 year old，over 80% of patients is 16~35year old. Gender： Schizophrenia occurs equally in men and women(in abroad) The prevalence in men is more than women (1.6:1) in China. The mean age of onset is about 2 to 5 years earlier in men than women. History（1） Schneider -first rank symptoms（首级症状） 1.thought hearing (思维化声) 2. Third-person hallucinations (争论性幻听) 3. Hallucinations in the form of a commentary(评论性幻听) 4. thought withdrawal or insertion (思维被夺/被插入) 5. Thought broadcasting /diffusion(思维被广播或扩散) 6. Forced feeling (强加的情感) 7. forced impulsive (强加的冲动) 8. forced behavior (强加的行为) 9. somatic passivity experience (躯体被动体验) 10. delusional perception (妄想性知觉)  Etiology 一、 biological factors 1．genetics 2．The neurodevelopmental hypothesis 3．Changes in brain structure 4．Biochemical abnormalities 二、personality factors 三、psycho-social factors Genetics 1 Studies Method: Family studies Twin studies Adoption studies Genetics 2 The results of family studies: The risk of Schizophrenia. Schizoaffe