躯体疾病所致精神障碍英文.pptVIP

精神病学 Organic Mental Disorders due to Physical Diseases Chen Jin-dong M.D Definition Mental disorders arise from brain dysfunction which is clearly caused by disease outside the brain. Etiology various systemic disturbances: Infection Endocrine disturbance Nutritional and metabolic disorders et al. Clinical manifestation Acute brain syndrome: delirium. Chronic brain syndrome: cognitive impairment personality changes Others: depression, elation, delusion, hallucination, psychomotor agitation and stupor. Common clinical features(1) 1.Psychiatric symptoms usually appear in the peak of the physical diseases. 2.Psychiatric symptoms usually fluctuate with physical disease.?? 3. The symptoms are less severe in daylight and severe in night or vary with physical disease.? 4. Course and prognosis mainly depend on the treatment of primary diseases. (2) 5.The prognosis is better if psychiatric symptom lasts for a shorter period; in severe case, patients may leave behind personality change and intellectual disturbance. (3) 6. Commonly associated with physical and NS signs and positive laboratory results. (4) Diagnoses Evidence of physical disease Evidence indicates that physical disease cause mental disorders Presence of atypical symptom of mental disorders Diagnostic Criteria(CCMD-3) A. Symptom criteria： (1) Presence of a systemic disease as evident in the clinical history, physical examination and lab investigation results; CCMD-3 (2) (2) Onset and course of the mental disturbance follow that of the underlying systemic disorder with one of the following clinical features: i. cognitive impairment; ii. amnesic syndrome; iii. personality change; iv. disorder of consciousness (e.g. delirium); v. psychotic symptoms(e.g. hallucination, delusion, or catatonic syndrome); vi. affective disorder; vii. neurosis-like symptoms; viii.mixed or atypical presentation; CCMD-3 (3) (3) When there is no evidence of mental disorders due to other causes such as psy