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[震颤谵妄的主要因素及症状复合体,因素及群组分析研究]

[Principle factors and symptom complexes in delirium tremens, factor and a group analytic study].

作者信息

Bühler K E, Holzbach E

出版信息

Arch Psychiatr Nervenkr (1970). 1982;232(5):451-61. doi: 10.1007/BF00345600.

Abstract

Before treatment 80 unselected patients suffering from delirium tremens were examined with regard to 13 psychopathological criteria. For the data a matrix of correlation was computed and it was factor analyzed according to the principal-component method. In consideration of the course of the value-curve two factors were interpreted. The result, however, is an undetailed classification. In addition to that, the data were cluster-analyzed according Ward. The results of the multivariate statistical analysis admit the assumption of two great, though heterogenous groups of symptoms (hallucination/vigilance). Factor I comprises the symptoms, disorder of orientation and consciousness, sweating, agitation and tremor on its positive pole, the duration of the delirant state on its negative pole. Factor II combines paranoid-hallucinatory symptoms, fearful affects and suggestibility on its positive pole, while on its negative, there are happy affect and grand-mal seizures. The bipolarity of this factor and additional diagnoses show that paranoid-hallucinatory symptoms without disorder of consciousness and grand-mal seizures mutually exclude each other. From this a differential therapy treating patients suffering from paranoid-hallucinatory symptoms with neuroleptics (e.g. Haloperidol) can be deduced, while the danger of grand-mal seizures has to be considered when disorders of consciousness appear.

摘要

治疗前,对80例未经挑选的震颤谵妄患者依据13项精神病理学标准进行了检查。针对这些数据计算了相关矩阵,并根据主成分法进行了因子分析。考虑到值曲线的走势,解读出了两个因子。然而,结果是一种不够细致的分类。除此之外,还根据沃德法对数据进行了聚类分析。多变量统计分析的结果支持存在两个主要的、尽管异质性的症状组(幻觉/警觉性)这一假设。因子I在其正极包含定向和意识障碍、出汗、激越和震颤等症状,在其负极包含谵妄状态的持续时间。因子II在其正极合并了偏执性幻觉症状、恐惧情绪和暗示性,而在其负极则有欣快情绪和癫痫大发作。该因子的双极性及其他诊断表明,无意识障碍的偏执性幻觉症状和癫痫大发作相互排斥。由此可以推断出一种用抗精神病药(如氟哌啶醇)治疗有偏执性幻觉症状患者的差异疗法,而当出现意识障碍时必须考虑癫痫大发作的风险。

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