Holder Sarah D, Wayhs Amelia
Baylor Family Medicine Residency at Garland, Garland, TX, USA.
Dallas, TX, USA.
Am Fam Physician. 2014 Dec 1;90(11):775-82.
Schizophrenia is the most common psychotic disease, with a global prevalence of less than 1%. It affects all ethnicities and is slightly more common in men. Patients with schizophrenia commonly experience debilitating social and occupational impairments, but some are able to function well with proper treatment. Symptom onset is generally between late adolescence and the mid-30s. There are two categories of symptoms: positive and negative. Hallucinations, delusions, and disorganized speech are examples of positive symptoms, whereas decreased emotional expression and lack of motivation are negative symptoms. Antipsychotic medications can treat some symptoms of schizophrenia but are associated with multiple adverse effects, including extrapyramidal symptoms and metabolic changes. Patients receiving antipsychotic medications, especially second-generation (or atypical) antipsychotics, should be monitored regularly for metabolic changes and cardiovascular risk factors. Persons with schizophrenia who undergo psychosocial therapy in addition to medical therapy have better outcomes. Patients diagnosed with schizophrenia have a higher overall mortality rate than the general public, partly because of the increased suicide risk associated with schizophrenia.
精神分裂症是最常见的精神病性疾病,全球患病率低于1%。它影响所有种族,在男性中略为常见。精神分裂症患者通常会经历使人衰弱的社交和职业功能障碍,但一些患者通过适当治疗能够良好地发挥功能。症状通常在青春期后期至35岁左右出现。症状分为两类:阳性症状和阴性症状。幻觉、妄想和言语紊乱是阳性症状的例子,而情感表达减少和缺乏动力则是阴性症状。抗精神病药物可以治疗精神分裂症的一些症状,但会伴有多种不良反应,包括锥体外系症状和代谢变化。接受抗精神病药物治疗的患者,尤其是第二代(或非典型)抗精神病药物治疗的患者,应定期监测代谢变化和心血管危险因素。除药物治疗外还接受心理社会治疗的精神分裂症患者有更好的治疗效果。被诊断为精神分裂症的患者总体死亡率高于一般公众,部分原因是与精神分裂症相关的自杀风险增加。