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[分离性障碍与精神分裂症的鉴别诊断]

[Differential diagnosis between dissociative disorders and schizophrenia].

作者信息

Shibayama Masatoshi

机构信息

Department of Psychology, Tokyo Woman's Christian University.

出版信息

Seishin Shinkeigaku Zasshi. 2011;113(9):906-11.

Abstract

The differential diagnosis of dissociative disorders includes many psychiatric disorders, such as schizophrenia, bipolar disorders (especially bipolar II disorder), depressive disorder (especially atypical depression), epilepsy, Asperger syndrome, and borderline personality disorder. The theme of this paper is the differential diagnosis between dissociative disorders and schizophrenia. Schneiderian first-rank symptoms in schizophrenia are common in dissociative disorders, especially in dissociative identity disorder (DID). Many DID patients have been misdiagnosed as schizophrenics and treated with neuroleptics. We compared and examined Schneiderian symptoms of schizophrenia and those of dissociative disorders from a structural viewpoint. In dissociative disorders, delusional perception and somatic passivity are not seen. "Lateness" and "Precedence of the Other" originated from the concept of "Pattern Reversal" (H. Yasunaga)" is characteristic of schizophrenia. It is important to check these basic structure of schizophrenia in subjective experiences in differential diagnosis between dissociative disorders and schizophrenia.

摘要

分离性障碍的鉴别诊断包括许多精神疾病,如精神分裂症、双相情感障碍(尤其是双相II型障碍)、抑郁障碍(尤其是非典型抑郁症)、癫痫、阿斯伯格综合征和边缘型人格障碍。本文的主题是分离性障碍与精神分裂症之间的鉴别诊断。精神分裂症的施奈德一级症状在分离性障碍中很常见,尤其是在分离性身份障碍(DID)中。许多DID患者被误诊为精神分裂症患者并接受了抗精神病药物治疗。我们从结构角度比较并检查了精神分裂症和分离性障碍的施奈德症状。在分离性障碍中,不存在妄想性知觉和躯体被动体验。源自“模式反转”(安永博)概念的“延迟”和“他者的优先性”是精神分裂症的特征。在分离性障碍与精神分裂症的鉴别诊断中,检查精神分裂症的这些基本结构在主观体验中很重要。

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