Ferreri Florian, Bourla Alexis, Capron Jean, Quillerou Bluenn, Rossignol Julien, Borden Alaina, Guechot Jérome, Lamaziere Antonin, Nuss Philippe, Mekinian Arsène, Mouchabac Stéphane
Sorbonne université, Paris Univ-06, Paris, service de psychiatrie et de psychologie médicale, hôpital Saint-Antoine, 75012, Paris, France.
Sorbonne université, Paris Univ-06, Paris, service de psychiatrie et de psychologie médicale, hôpital Saint-Antoine, 75012, Paris, France.
Presse Med. 2019 Jun;48(6):609-624. doi: 10.1016/j.lpm.2019.04.017. Epub 2019 May 28.
The purpose of this article is to describe complex psychiatric disorders, to recall "minimal classical" explorations in psychiatry, to describe the concept of "complex psychiatric disorders" and to propose a systematized method of exploration. Some organic diseases are well known for their links with psychiatric disorders (manic syndrome and hyperthyroidism, depressive syndrome and corticotropic insufficiency, anxiety disorder and heart disease, etc.). Many other neurological, autoimmune, metabolic, paraneoplastic or endocrine pathologies can have essentially psycho-behavioral manifestations before being neurological or systemic. A large number of factors (nutritional, toxic, immunological, etc.), often ignored, influence the links between organicity and psychiatric pathologies. It is necessary to optimize the medical management of these patients in whom the psychiatric diagnosis masks a curable organo-psychiatric cause.
本文的目的是描述复杂的精神障碍，回顾精神病学中“最低限度经典”的探索，描述“复杂精神障碍”的概念，并提出一种系统化的探索方法。一些器质性疾病因其与精神障碍的关联而广为人知（躁狂综合征与甲状腺功能亢进、抑郁综合征与促肾上腺皮质激素不足、焦虑症与心脏病等）。许多其他神经、自身免疫、代谢、副肿瘤或内分泌疾病在出现神经或全身症状之前，可能主要表现为心理行为症状。大量常被忽视的因素（营养、毒性、免疫等）影响着器质性与精神疾病之间的联系。对于那些精神诊断掩盖了可治愈的器官性精神病因的患者，优化其医疗管理很有必要。
