Good M I
Child Psychiatry Services, West-Ros-Park Mental Health Center, Boston, Massachusetts 02131.
J Clin Psychopharmacol. 1989 Apr;9(2):88-93.
Transient amnesias, fugues, twilight states, automatisms, depersonalization, and furors or explosive disorders can occur in association with, or be caused by, various medications or substance-induced organic brain states. Agents capable of precipitating dissociative-like states include alcohol, barbiturates and similarly acting hypnotics, benzodiazepines, scopolamine, clioquinol, beta-adrenergic blockers, marijuana and certain psychedelic drugs, general anesthetics, and others. The presentations of substance-induced dissociative states may resemble those of functional dissociative disorders, or organic and psychogenic dissociative factors may coexist and be intertwined or indistinguishable. Organic dissociative states are distinct from intoxication, amnestic disorder, frank delirium, or other organic mental disorders as specified in DSM-III and DSM-III-R, yet these diagnostic manuals have no inclusive category or coherent nosological approach to dissociative states not strictly psychogenic in etiology. Substance-induced and other organic dissociative disorders can have clinical, medicolegal, and neuropsychological significance. They provide a unique opportunity for the study of mind-brain relationships and should be included in psychiatric nosology.
短暂性遗忘症、神游症、朦胧状态、自动症、人格解体以及狂怒或爆发性障碍可能与各种药物或物质所致的器质性脑状态相关联，或由其引起。能够引发类似分离状态的药物包括酒精、巴比妥类药物及作用类似的催眠药、苯二氮䓬类药物、东莨菪碱、氯碘喹啉、β-肾上腺素能阻滞剂、大麻及某些致幻药物、全身麻醉药等。物质所致分离状态的表现可能类似于功能性分离障碍，或者器质性和心理性分离因素可能同时存在、相互交织或难以区分。器质性分离状态不同于中毒、遗忘障碍、明显的谵妄或《精神疾病诊断与统计手册》第三版（DSM-III）及《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中所规定的其他器质性精神障碍，然而这些诊断手册对于病因并非严格心理性的分离状态并没有包容性的类别或连贯的分类方法。物质所致及其他器质性分离障碍具有临床、法医学和神经心理学意义。它们为研究心脑关系提供了独特的机会，应纳入精神疾病分类学中。
