Letuka Mohlalefi C, Morar Tejil
Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Psychiatry, Sterkfontein Hospital, Krugersdorp, South Africa.
S Afr J Psychiatr. 2023 Sep 29;29:2081. doi: 10.4102/sajpsychiatry.v29i0.2081. eCollection 2023.
The case report depicts the complex interplay between mental and physical illness and contests the notion of mind-body dualism in medicine. It emphasises the importance of holistic management of patients and the misnomer of schizophrenia as a purely mental illness.
Mr S is a 35-year-old male who presented to a South African specialist psychiatric hospital via the forensic system. He had multiple physical symptoms involving the abdominal, haematological, dermatological and neurological systems, in addition to an eight year duration of untreated psychosis with a marked decline in cognition and functioning.
An extensive medical examination during his admission excluded conditions such as early onset dementia, Huntington's disease, pellagra, Wilson's disease, autoimmune encephalitis and substance-related complications. A definitive diagnosis of schizophrenia was made, and both physical and psychiatric symptoms responded well to the administration of an antipsychotic resulting in an eventual discharge from the hospital.
Mind-body dualism can result in a delayed diagnosis of schizophrenia and subsequent increased duration of untreated psychosis and other complications.
This case emphasises the flaws of mind-body dualism, and the interplay of mental and physical illness.
该病例报告描述了精神疾病与躯体疾病之间复杂的相互作用，并对医学中身心二元论的观念提出了质疑。它强调了对患者进行整体管理的重要性，以及将精神分裂症单纯视为精神疾病这种错误的称谓。
S先生是一名35岁男性，通过法医系统被送至南非一家专业精神病医院。他除了有长达八年未经治疗的精神病，认知和功能显著下降外，还有涉及腹部、血液、皮肤和神经系统的多种躯体症状。
入院期间进行的全面医学检查排除了早发性痴呆、亨廷顿舞蹈症、糙皮病、威尔逊氏病、自身免疫性脑炎及物质相关并发症等疾病。最终确诊为精神分裂症，使用抗精神病药物后，躯体和精神症状均有良好反应，患者最终出院。
身心二元论可能导致精神分裂症的诊断延迟，进而使未经治疗的精神病病程延长及引发其他并发症。
本病例强调了身心二元论的缺陷以及精神疾病与躯体疾病的相互作用。
