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[癔症性精神病:临床特征与病程]

[Hysterical psychosis: clinical aspects and disease course].

作者信息

Chinchilla A, López-Ibor J J, Cebollada A, Carrasco J L, Vega M, Jordá L, Viñas R, Sánchez P, Moreno I, Camarero M

出版信息

Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1989 Jul-Aug;17(4):231-6.

PMID:2801265
Abstract

30 patients admitted to our psychiatric service with the initial diagnosis of psychogenic psychosis, dissociative psychosis or hysterical pseudo-psychosis are studied anamnestically and in their catamnesis (average follow up 5.1 years). The objective of the study was to see if these disorders are independent nosologic entities or are masking other ones, such as affective, schizophrenic or neurotic disorders. In this study we found a greater percentage of women (3/1) with a previous hysterical personality in more than 50%; many of the patients were hospitalised in order to clarify the diagnosis; in 70% we found psychogenic triggers; a greater predominance of an abrupt onset of the disorder (which would favour the concept of reaction); 60% had fluctuating symptoms (not so common in endogenous psychosis). In almost 100% there was a complete remission during the hospitalization period (average 22.7 days), which would bring them closer to the present concept of brief reactive psychosis. With a follow up of an average of five years, the diagnosis is maintained in 93.3% of the cases. The majority of the patients fulfilled the criteria for hysterical psychosis as defined by Hollender and Hirsch. We think that these disorders are well delimited, both clinically and nosologically, not having received up until now an exact placing in modern classification systems (DSM-III, ICD-10, etc.).

摘要

对我院精神科收治的30例初始诊断为心因性精神病、分离性精神病或癔症性假性精神病的患者进行了病史及随访研究(平均随访5.1年)。本研究的目的是观察这些疾病是独立的病种,还是掩盖了其他疾病,如情感性、精神分裂症或神经症性疾病。在本研究中,我们发现超过50%的女性患者(比例为3/1)有既往癔症性人格;许多患者住院是为了明确诊断;70%的患者我们发现了心因性诱因;疾病突然起病的情况更为多见(这支持反应性概念);60%的患者症状有波动(这在内源性精神病中不常见)。几乎100%的患者在住院期间(平均22.7天)完全缓解,这使它们更符合目前短暂反应性精神病的概念。平均随访五年后,93.3%的病例维持原诊断。大多数患者符合Hollender和Hirsch所定义的癔症性精神病标准。我们认为,这些疾病在临床和病种学上都有明确界定,至今在现代分类系统(DSM-III、ICD-10等)中尚未得到确切定位。

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