Harima Hirohiko
Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital.
Seishin Shinkeigaku Zasshi. 2011;113(12):1235-40.
The term "acute psychosis" is commonly used as a provisional diagnosis in psychiatric acute settings, especially in emergency, when there is not sufficient information available to give a specific categorical diagnosis. The provisional diagnosis "acute psychosis" involves psychotic conditions with acute onset, psychotic conditions with unknown course and acute behavioural disorders with unknown subjective experiences. Because this provisional diagnosis is not a proper category, dimensional assessment of psychopathology including delusions, hallucinations, disorganization, mood/affect, catatonia and disorder of consciousness is required to start specific treatment. As "acute psychosis" is nosologically ill defined in the dichotomy of schizophrenia and mood disorder, traditional types such as bouffée délirante, cycloid psychoses and reactive psychosis are useful in practice as frames of reference. Because the provisional diagnosis of "acute psychosis" involves non-psychotic disorders such as adjustment disorders and personality disorders, the perspective of genetic understanding is helpful in making a non-dimensional differential diagnosis.
“急性精神病”这一术语在精神科急症环境中通常用作临时诊断，尤其是在急诊时，此时没有足够信息进行具体的分类诊断。临时诊断“急性精神病”包括急性起病的精神病性状况、病程不明的精神病性状况以及主观体验不明的急性行为障碍。由于这一临时诊断并非一个恰当的类别，因此在开始具体治疗前，需要对包括妄想、幻觉、紊乱、情绪/情感、紧张症和意识障碍在内的精神病理学进行维度评估。由于“急性精神病”在精神分裂症和心境障碍的二分法中在疾病分类学上定义不明确，传统类型如急性谵妄性精神病、循环性精神病和反应性精神病在实践中作为参考框架很有用。因为“急性精神病”的临时诊断涉及诸如适应障碍和人格障碍等非精神病性障碍，遗传学理解的视角有助于进行非维度的鉴别诊断。
