Jablensky A
Department of Psychiatry and Behavioral Science, University of Western Australia, 50 Murray Street, Perth WA6000, Australia.
Curr Psychiatry Rep. 2001 Aug;3(4):326-31. doi: 10.1007/s11920-001-0029-7.
The existence of a group of psychoses that are symptomatologically and prognostically different from schizophrenia and affective psychotic disorders is supported by clinical and epidemiologic evidence. Although such "atypical" psychoses account for up to 10% of all psychotic disorders, their aetiology, pathophysiology, and neuropathology remain insufficiently understood. Moreover, they have been described by different schools of psychiatry a variety of ways, including non-process schizophrenia, schizophreniform psychosis, reactive (or psychogenic) psychosis, bouffées délirantes, and cycloid psychoses, but the extent to which these diagnostic categories overlap or differ has not been systematically explored. Neither Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), nor International Classification of Disease, Tenth Revision (ICD-10), provides adequate diagnostic criteria and classificatory categories for this group of disorders. Special attention to the refinement of the diagnosis and classification of the acute and transient psychotic disorders in future versions of the two classifications will be warranted.
临床和流行病学证据支持存在一组在症状学和预后方面与精神分裂症及情感性精神障碍不同的精神病性障碍。尽管这类“非典型”精神病性障碍占所有精神病性障碍的比例高达10%,但其病因、病理生理学和神经病理学仍未得到充分理解。此外,不同的精神病学流派以多种方式描述过它们,包括非典型精神分裂症、精神分裂症样精神病、反应性(或心因性)精神病、急性妄想发作和循环性精神病,但这些诊断类别之间的重叠或差异程度尚未得到系统探讨。《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)均未为这组障碍提供充分的诊断标准和分类类别。在这两种分类法的未来版本中,有必要特别关注急性和短暂性精神病性障碍诊断和分类的细化。