Shmilovich A A
Zh Nevrol Psikhiatr Im S S Korsakova. 2009;109(2):14-9.
A study included 213 patients diagnosed with schizoaffective disorder (56.3%) or paranoid schizophrenia (43.7%). In all patients, psychotic symptoms developed under the influence of psychogenic factors. The high percentage of pathological personality disorders (50.2%), neurotic disorders (52.1%) and psychogenic depressive disturbances (53.5%) in the premorbid were found that indirectly indicates a liability to psychogenically caused endogenous psychoses. Three stages of development of schizophrenia-spectrum psychosis under the influence of psychogenic factors were singled out: psychogenic, endogenous-reactive (interim states) and endogenous psychotic disorders. Clinically heterogenic interim syndromes were specified as endogenous-reactive dysthymia (51.2%), obsessive-delusional syndrome (7.5%), hysteriform psychosis (20.2%) and endoreactive paranoia (21.2%). Psychotraumatic events caused three variants of schizophrenia-spectrum psychosis: affective, neurosis-like and paranoia. In conclusion, variants of the pathokinesis of psychogenically caused schizophrenia-spectrum psychosis predict the further course of endogenous process.
一项研究纳入了213例被诊断为分裂情感性障碍(56.3%)或偏执型精神分裂症(43.7%)的患者。在所有患者中,精神症状在心理因素的影响下出现。病前人格障碍(50.2%)、神经症性障碍(52.1%)和心因性抑郁障碍(53.5%)的高比例被发现,这间接表明易患心因性所致的内源性精神病。在心理因素影响下,精神分裂症谱系精神病的发展分为三个阶段:心因性、内源性反应性(过渡状态)和内源性精神病性障碍。临床上异质性的过渡综合征被明确为内源性反应性心境恶劣(51.2%)、强迫妄想综合征(7.5%)、癔症样精神病(20.2%)和内源性反应性偏执狂(21.2%)。精神创伤事件导致了精神分裂症谱系精神病的三种变体:情感性、神经症样和偏执型。总之,心因性所致精神分裂症谱系精神病的病理运动变体可预测内源性病程的进一步发展。