Fujimori H, Nakatani Y, Sakaguchi M
Tokyo, Metropolitan Bokuto Hospital, Japan.
Fortschr Neurol Psychiatr. 1989 Sep;57(9):383-94. doi: 10.1055/s-2007-1001134.
3 cases with chronic methamphetamine psychoses (MAP-P) were studied from the clinical psychiatric point of view and discussed: 1.) The average time of occurrence of psychotic symptoms in our 3 cases after beginning of MAP abuse was two or three years. 2.) Although the psychotic states (often schizophrenia-like) were stable for a short time, the symptoms recurred promptly after reinjection of a small amount of MAP, unspecific stress or drinking sake (flashback phenomenon). The recurrence may happen even after several years. 3.) In cases of chronic MAP-P disturbances of consciousness are rare. Chronic process of MAP-P cases may show acute transient disturbances of consciousness (flashback phenomenon). 4.) The change of affects and behaviour ranges between irritable and indifferent attitudes. While there are close connections between the disturbance of feeling and change of personality (Wesensänderung), it is very difficult to decide whether premorbid character traits are dominant or there is a change of personality or emotional disturbance. 5.) About acute psychic symptoms which are responsible for recurrence of MAP-P, MAP-abusers make the experience that their intimate personal affairs are overlooked and become public (uncovered defensive experiences). In chronic cases of MAP-P we often meet patients with hypertrophic self-feeling or delusion of grandeur predominant in the symptomatology. 6.) In our cases sensations were amalgamated into each other and there were hallucinatory experiences without clear division between them. 7.) In chronic cases the auditory hallucinations criticized or censured the patients for their behaviour. Thought echoing (Gedankenlautwerden) was found. We found signs of mind reading (Gedankenausbreitung).
从临床精神病学角度对3例慢性甲基苯丙胺精神病(MAP-P)患者进行了研究并讨论如下:1.)我们这3例患者在开始滥用甲基苯丙胺后出现精神病症状的平均时间为两到三年。2.)尽管精神病状态(通常类似精神分裂症)在短时间内较为稳定,但在再次注射少量甲基苯丙胺、遭遇非特异性应激或饮酒后(闪回现象),症状会迅速复发。这种复发甚至可能在数年之后发生。3.)在慢性MAP-P病例中,意识障碍较为罕见。慢性MAP-P病例的病程可能会出现急性短暂性意识障碍(闪回现象)。4.)情感和行为的变化范围在易怒和冷漠态度之间。虽然情感障碍与人格改变(性格改变)之间存在密切联系,但很难确定病前性格特征是否占主导,还是存在人格改变或情感障碍。5.)关于导致MAP-P复发的急性精神症状,甲基苯丙胺滥用者会有这样的体验,即他们的私密个人事务被忽视并公开(被揭露的防御性体验)。在慢性MAP-P病例中,我们经常遇到症状以夸大自我感觉或夸大妄想为主的患者。6.)在我们的病例中,各种感觉相互融合,存在幻觉体验且彼此之间没有明确区分。7.)在慢性病例中,幻听会对患者的行为进行批评或指责。发现了思维回响(思想鸣响)。我们还发现了读心术(思想扩散)的迹象。