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[致幻剂持续性感知障碍(HPPD)与闪回现象——鉴别诊断及解释模型]

[Hallucinogen Persisting Perception Disorder (HPPD) and Flashback Phenomena – Differential Diagnosis and Explanation Models].

作者信息

Hermle L, Ruchsow M, Täschner K L

机构信息

Psychiatrie und Psychotherapie, Christophsbad, Göppingen.

Forensische Psychiatrie, Institut für psychiatrische Begutachtung, Stuttgart.

出版信息

Fortschr Neurol Psychiatr. 2015 Sep;83(9):506-15. doi: 10.1055/s-0035-1553717. Epub 2015 Sep 30.

Abstract

OBJECTIVE

The purpose of this article is to provide an overview of the current research on "Hallucinogen Persisting Perception Disorder" (HPPD) and "Flashback" phenomena. The definition and diagnostic features of "Flashback" and HPPD remained often unclear and since the 1960 s interchangeable.

METHODS

Relevant literature was identified by means of a computerized MEDLINE search including the years 1994-2014. Finally 75 journal articles out were included in the review.

RESULTS

Consistent with the ICD-10 (F16.70) definition "Flashback" is often used to describe brief visual perceptual, mood, and altered states of consciousness effects reminiscent of acute hallucinogen intoxication effects. Many users regard flashback phenomena as benign and even pleasant. HPPD is described in DSM-5 as a visual perceptual disorder, sometimes persisting for months or years causing severe individual distress. The prevalence of flashback and HPPD is unknown. It is considered to be remarkable in view of the relatively few case reports published out of millions of hallucinogen users since the 1960 s and 1970 s. Despite a multitude of etiological and therapeutic approaches the exact pathophysiological mechanisms underlying HPPD remain elusive. At present HPPD appears to be further a DSM-5-genuine but still puzzling disorder. The different consequences including new therapeutic approaches are discussed in clinical context.

摘要

目的

本文旨在概述当前关于“致幻剂持续性感知障碍”(HPPD)和“闪回”现象的研究。“闪回”和HPPD的定义及诊断特征常常不明确,自20世纪60年代以来二者一直可互换使用。

方法

通过计算机检索MEDLINE数据库(涵盖1994年至2014年)来识别相关文献。最终,75篇期刊文章被纳入该综述。

结果

与国际疾病分类第10版(F16.70)的定义一致,“闪回”常被用于描述短暂的视觉感知、情绪及意识状态改变,这些效应让人联想到急性致幻剂中毒效应。许多使用者认为闪回现象是良性的,甚至是令人愉悦的。DSM-5将HPPD描述为一种视觉感知障碍,有时会持续数月或数年,给个体带来严重困扰。闪回和HPPD的患病率尚不清楚。鉴于自20世纪六七十年代以来,在数百万致幻剂使用者中发表的病例报告相对较少,这一患病率被认为是值得关注的。尽管有多种病因学和治疗方法,但HPPD的确切病理生理机制仍不清楚。目前,HPPD似乎更是一种DSM-5中特有的但仍令人困惑的疾病。本文在临床背景下讨论了包括新治疗方法在内的不同后果。

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