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从幻觉到妄想:类精神病体验及其影响的叙述性综述

From hallucinations to delusions: A narrative review of psychotic-like experiences and their implications.

作者信息

Logoń Katarzyna, Świrkosz Gabriela J, Kowalski Krzysztof

机构信息

Students' Scientific Group at the Faculty of Psychiatry, Wroclaw Medical University, Poland.

Department of Psychiatry, Wroclaw Medical University, Poland.

出版信息

Adv Clin Exp Med. 2025 Feb;34(2):283-294. doi: 10.17219/acem/186815.

Abstract

Psychotic-like experiences (PLEs) refer to sub-threshold hallucinations and delusions observed in both clinical samples and the general population. Psychotic-like experiences have far-reaching implications for an individual's coping strategies and daily functioning. They are associated with both psychotic and non-psychotic disorders. This article presents a comprehensive review of the current literature on PLEs, incorporating a detailed exploration of the definition, prevalence, risk factors, functional impairments, and comorbid psychiatric disorders. Medline/PubMed and Embase were searched to establish and identify the literature. A total of 108 studies met our inclusion criteria. The genetic and biochemical backgrounds of PLEs are discussed, focusing on gene polymorphisms, changes in brain gyrification and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Psychological factors, such as trauma exposure, emotion regulation difficulties, cognitive biases, and attachment issues, were thoroughly examined, especially in terms of their impact on the emergence of PLEs. Here, we show how important the clinical aspects of developmental PLEs are, underlining the significance of an increased risk of self-harm and suicidal behaviors in those individuals and the comorbidity of psychiatric disorders in enabling clinicians to discern specific areas to observe. Although there is limited evidence on effective protocols for PLE management, various treatment approaches are explained. Despite increased research on PLEs in recent years, further investigation is needed to fully understand the nature of PLEs and to optimize therapeutic strategies. This article consolidates the current knowledge by synthesizing information on PLEs, including risk factors, comorbidities, treatments, and their impact on individual's lives.

摘要

类精神病性体验(PLEs)是指在临床样本和普通人群中观察到的阈下幻觉和妄想。类精神病性体验对个体的应对策略和日常功能有着深远影响。它们与精神病性和非精神病性障碍均相关。本文对当前关于类精神病性体验的文献进行了全面综述,详细探讨了其定义、患病率、危险因素、功能损害以及共病的精神障碍。通过检索Medline/PubMed和Embase来查找和确定文献。共有108项研究符合我们的纳入标准。文中讨论了类精神病性体验的遗传和生化背景,重点关注基因多态性、脑回化变化以及下丘脑 - 垂体 - 肾上腺(HPA)轴功能障碍。对心理因素,如创伤暴露、情绪调节困难、认知偏差和依恋问题进行了深入研究,尤其探讨了它们对类精神病性体验出现的影响。在此,我们展示了发育性类精神病性体验临床方面的重要性,强调了这些个体自我伤害和自杀行为风险增加以及精神障碍共病在使临床医生能够识别特定观察领域方面的意义。尽管关于类精神病性体验管理的有效方案证据有限,但文中解释了各种治疗方法。尽管近年来对类精神病性体验的研究有所增加,但仍需要进一步研究以全面了解其本质并优化治疗策略。本文通过综合关于类精神病性体验的信息,包括危险因素、共病情况、治疗方法及其对个体生活的影响,巩固了当前的知识。

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