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[非精神分裂症性精神障碍的治疗指南?]

[Treatment guidelines for non-schizophrenic psychotic disorders?].

作者信息

Jäger Markus, Frasch Karel, Weinmann Stefan, Becker Thomas

机构信息

Klinik für Psychiatrie II der Universität Ulm, Bezirkskrankenhaus Günzburg, Günzburg.

出版信息

Psychiatr Prax. 2007 Nov;34(8):370-6. doi: 10.1055/s-2007-970964. Epub 2007 Sep 5.

Abstract

OBJECTIVE

To provide an overview of diagnostics, outcome and treatment of "non-schizophrenic psychotic disorders" (ICD-10: delusional disorders, acute and transient psychotic disorders and schizoaffective disorders).

METHODS

Literature was identified by searches in "Medline" and "Cochrane Database of Systematic Reviews".

RESULTS

The frequency of "non-schizophrenic psychotic disorders" within the whole diagnostic group "schizophrenia, schizotypal and delusional disorders" (ICD-10) ranges between 22% and 49%. Patients with these disorders show a more favourable long-term outcome than those with schizophrenia. With regard to therapy, as yet only a small empirical database exists. The comparability of those studies is limited by the use of different diagnostic criteria. There are only few evidence-based treatment guidelines for these disorders.

CONCLUSIONS

There is a substantial need for controlled studies on the treatment of "non-psychotic schizophrenic disorders". Alternatively, clinical guidelines could be based on a dichotomy of affective and schizophrenic disorders or on a dimensional approach.

摘要

目的

概述“非精神分裂症性精神障碍”(国际疾病分类第十版:妄想性障碍、急性短暂性精神病性障碍和分裂情感性障碍)的诊断、预后及治疗情况。

方法

通过检索“医学索引数据库”和“考克兰系统评价数据库”获取相关文献。

结果

在整个“精神分裂症、分裂型及妄想性障碍”(国际疾病分类第十版)诊断组中,“非精神分裂症性精神障碍”的发生率在22%至49%之间。这些障碍患者的长期预后比精神分裂症患者更为良好。关于治疗,目前仅有一个小型的实证数据库。这些研究的可比性因使用不同诊断标准而受到限制。针对这些障碍的循证治疗指南非常少。

结论

对于“非精神分裂症性精神障碍”的治疗,迫切需要进行对照研究。或者,临床指南可以基于情感性障碍和精神分裂症性障碍的二分法,或者基于维度方法制定。

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