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[幻觉的现象学、临床诊断与治疗]

[Phenomenology, clinical diagnostics and treatment of hallucinations].

作者信息

Hubl Daniela

机构信息

1 Universitätsklinik für Psychiatrie und Psychotherapie, Bern.

出版信息

Ther Umsch. 2018 Jun;75(1):19-29. doi: 10.1024/0040-5930/a000962.

Abstract

Phenomenology, clinical diagnostics and treatment of hallucinations Abstract. Hallucinations are perceptions without any stimulus. They occur typically in schizophrenia, but they can be found in other psychiatric or medical disorders as well. Recently, hallucinations have been increasingly reported to occur with a high prevalence in the general population and they are conceptualised as continuum from a physiological to pathological especially psychotic phenomenon. Schizophrenic hallucinations exhibit a special proximity to language and for this they can be considered as diagnostic. Clinically, physicians should explore detailed the semiology of hallucinations in the diagnostic workup. Neurobiology of acoustic hallucinations involve brain regions which are important for hearing, speaking and understanding. This observation is independent of the underlying aetiology of the hallucinations. Standard treatment of psychotic hallucinations consists of antipsychotic substances. In case of resistance electrical brain stimulation methods are increasingly applied. Especially repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are used.

摘要

幻觉的现象学、临床诊断与治疗 摘要。幻觉是在没有任何刺激的情况下产生的知觉。它们通常发生于精神分裂症,但也可见于其他精神或医学疾病。最近,有越来越多的报告称幻觉在普通人群中具有较高的发生率,并且它们被概念化为从生理现象到病理现象尤其是精神病性现象的连续体。精神分裂症性幻觉与语言表现出特殊的关联,因此可将其视为具有诊断意义。临床上,医生在诊断检查中应详细探究幻觉的症状学。幻听的神经生物学涉及对听力、言语和理解至关重要的脑区。这一观察结果与幻觉的潜在病因无关。精神病性幻觉的标准治疗包括使用抗精神病药物。在治疗抵抗的情况下,越来越多地应用脑电刺激方法。特别是重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS)被使用。

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