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夏科教授《周二讲座》中的创伤性癔症性神经衰弱

Traumatic Hystero-Neurasthenia in Professor Charcot's Leçons du Mardi.

作者信息

Yrondi Antoine, Taib Simon, Dupuch Laetitia, Schmitt Laurent, Very Etienne, Birmes Philippe

机构信息

Service de Psychiatrie et de Psychologie Médicale de l'adulte, Centre Expert Dépression Résistante FondaMental, CHU Toulouse.

Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS.

出版信息

J Nerv Ment Dis. 2019 Sep;207(9):799-804. doi: 10.1097/NMD.0000000000001093.

Abstract

At the end of the 19th century, several authors became interested in the physical and psychological symptoms resulting from traumatic life events. Oppenheim presented 42 detailed clinical observations. He suggested the term "traumatic neurosis." Charcot, who was interested in male hysteria, published over 20 cases of traumatic hysteria between 1878 and 1893. The symptoms were considered to have a dynamic or functional origin. The role of horror and terror during the trauma was emphasized. However, Charcot opposed the idea of traumatic neuroses as specific syndromes as he considered them to be only an etiological form of hystero-neurasthenia. In The Tuesday Lessons (Les Leçons du Mardi), he presents several observations. They are surprising when compared with the current criteria for posttraumatic stress disorder (PTSD). Although he had rejected this new entity, a hundred years before the appearance of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Charcot described most of the symptoms mentioned for a diagnosis of PTSD such as intrusion (reliving the trauma, nightmares, and severe emotional distress), avoidance, negative changes in thinking and mood (negative thoughts, lack of interest, etc.), arousal, and reactivity (trouble sleeping, trouble concentrating, being easily startled or frightened, irritability, etc.).

摘要

19世纪末,几位作者开始关注创伤性生活事件所导致的身体和心理症状。奥本海姆展示了42例详细的临床观察病例。他提出了“创伤性神经症”这一术语。对男性癔症感兴趣的夏科,在1878年至1893年间发表了20多例创伤性癔症病例。这些症状被认为具有动态或功能性起源。人们强调了创伤期间恐惧和惊恐的作用。然而,夏科反对将创伤性神经症视为特定综合征的观点,因为他认为它们只是癔症性神经衰弱的一种病因形式。在《星期二课程》中,他展示了一些观察结果。与当前创伤后应激障碍(PTSD)的标准相比,这些结果令人惊讶。尽管他拒绝承认这个新的病症,但在《精神疾病诊断与统计手册》第三版修订本出现的一百年前,夏科就描述了诊断PTSD所提及的大多数症状,如侵入(重温创伤、噩梦和严重情绪困扰)、回避、思维和情绪的消极变化(消极想法、缺乏兴趣等)、觉醒和反应性(睡眠困难、注意力不集中、容易受到惊吓或恐惧、易怒等)。

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