Lefebvre P, Crombez J C
Can J Psychiatry. 1980 Jun;25(4):319-24. doi: 10.1177/070674378002500408.
After kidney transplantation patients experience an initial period of euphoria which is usually followed by a phase of disillusionment and depression. At this point the "one day at a time syndrome" appears as an attitude of adaptation and defense. It is proposed that there are two dynamically and prognostically different varieties of this syndrome: A first type represents a regressive megalomanic defense whereby depressive anxiety concerning the rejection of the part-self represented by the graft is conscious but depressive anxiety concerning the eventual death of the whole self is omnipotently denied. This variety of the syndrome is related to a more negative prognosis both psychologically and somatically. The second type of the "one day at a time syndrome" is a progressive hypomanic defense whereby depressive anxiety concerning the rejection of the part-self represented by the graft is present and conscious but relative and does not preclude the conscious depressive anxiety concerning the eventual death of the whole self, which once acknowledged can gradually be mastered, permitting the pursuit of as pleasurable a life as possible. This variety of the syndrome is prognostically more favourable both physically and psychologically.
肾移植后，患者会经历一段初期的欣快感，随后通常会进入幻想破灭和抑郁阶段。此时，“过好每一天综合征”作为一种适应和防御态度出现。本文提出，该综合征有两种在动态变化和预后方面截然不同的类型：第一种类型表现为退行性夸大狂防御，即对移植所代表的部分自我被排斥的抑郁焦虑是有意识的，但对整个自我最终死亡的抑郁焦虑却被全能地否认。这种综合征在心理和躯体方面都与更消极的预后相关。第二种类型的“过好每一天综合征”是一种进行性轻躁狂防御，即对移植所代表的部分自我被排斥的抑郁焦虑存在且有意识，但这种焦虑是相对的，并不排除对整个自我最终死亡的有意识抑郁焦虑，一旦认识到这一点，就可以逐渐掌控，从而尽可能追求愉快的生活。这种综合征在身体和心理方面的预后都更为有利。
