Hypobaria and Biomedical Physiology Service, Department of Physiological Sciences II, University of Barcelona-Bellvitge University Campus, Barcelona, Spain.
Department for Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II (Psychosomatic Medicine), Medical University Innsbruck, Innsbruck, Austria.
Wilderness Environ Med. 2023 Dec;34(4):549-552. doi: 10.1016/j.wem.2023.07.004. Epub 2023 Aug 22.
Psychotic symptoms can occur at high altitude. However, most reports are in the mountaineering literature and lack a clear medical assessment and interpretation. Here we report an episode of isolated high-altitude psychosis. It consisted of a "third person" phenomenon involving 2 sensory modalities: somesthetic (felt presence) and visual (the light of 2 flashlights) hallucinations. This episode occurred in a highly experienced climber when he was at an altitude of approximately 7500 m while descending at dusk from the summit of Gasherbrum I (8068 m). The symptoms lasted approximately 3 h and had fully resolved on reaching high camp (7150 m). No other physical or mental symptoms were reported. In addition to hypoxia, a number of other risk factors could have contributed to the occurrence of psychosis in this climber. These included sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, feeling of isolation, and perceived danger. The climber has participated in many extreme altitude expeditions, and neither before nor since this episode has the climber experienced psychotic symptoms.
高原地区可能出现精神症状。然而，大多数报道见于登山文献，缺乏明确的医学评估和解释。本报告描述了 1 例孤立性高原精神障碍。该患者出现“第三人称”现象，涉及 2 种感觉模式：体感（感觉到存在）和视觉（2 把手电筒的光）幻觉。该事件发生在一名经验丰富的登山者身上，他在黄昏时从 8068 米高的加舒布鲁姆 I 峰山顶下撤至约 7500 米处时出现症状。症状持续约 3 小时，到达高海拔营地（7150 米）时完全缓解。未报告其他身体或精神症状。除了缺氧，许多其他危险因素也可能导致该登山者出现精神障碍。这些因素包括睡眠剥夺、疲惫、脱水、电解质紊乱、可视度降低、孤立感和感知危险。该登山者曾参加过多次极高山探险，在此次事件发生之前和之后，该登山者均未出现精神症状。
