精神分裂症及其他精神病性障碍(英文).ppt

精神病学 Schizophrenia and Other Psychotic DisordersLiu Tie-qiao2 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3 Part one Introduction4 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.5 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‰。6 Epidemiology( 2)Incidence USA: 0.43‰~0.69‰ China : 0.11‰~0.35‰The reasons of these reported differences may be include: diagnostic criteria areasmethods of case finding, migration 7 Epidemiology( 3)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.8 Outcome evaluation(multi-dimensions)Clinical outcomeSocial functionQuality of lifeLiving conditionFamily conditionothers9 History（1） 1. Demence precoce(Morel,1857)2. Hebephrenia(Hecker,1871) 3. Catatonia(Kzhlbaum,1874) 4. Kraepelin(1896)thought all above descriptions are different types of the same disease-dementia praecox 10 History（2） E.Bleuler(1911)suggested that splitting of thought and affect was the central feature of the illness – schizophrenia He found that the outcome of this illness was neither universally poor nor associated with severe dementia. M.Bleuler- 4A symptoms：Association disorderApathyAmbivalenceAutism11 History（3）Schneider：first