Andersen J, Laerum H
Acta Psychiatr Scand. 1980 Oct;62(4):331-42. doi: 10.1111/j.1600-0447.1980.tb00619.x.
The study comprises a retrospective evaluation of case records of 220 patients admitted for the first time with psychogenic psychosis with special reference to clinical course and prognosis within a period of 13--14 years. The reliability of the diagnosis at the time of the first admission is about 60% when the evaluation is based on positive criteria for psychosis. If the psychogenic psychoses are divided into subgroups, the reliability of the diagnosis of psychogenic affective psychoses is about 30%, whereas it is over 90% for psychogenic confusional psychoses and psychogenic paranoid psychoses. If subsequent cases of other functional psychoses (manic-depressive psychosis and schizophrenia) are subtracted, the diagnostic reliability is 50% (111 of 220 cases), which represents the number of retrospectively verified psychogenic psychoses. The frequency of recurrence of psychogenic psychosis was 18% (40), corresponding to 36% of psychogenic psychoses verified by retrospective evaluation (111 of 220 cases). The recurrences were mainly homologous, as heterologous recurrences developed only among the psychogenic affective psychoses (slightly less than half of the recurrences in question). Schizophrenia developed in only 10% (23), and subsequent episodes of manic-depressive psychosis occurred in 8% (18). The stability of psychogenic psychosis on recurrence of functional psychosis was 49% expressed in relation to all subsequent cases of functional psychosis. The over-all prognosis for the psychogenic/reactive psychosis is thus good as regards subsequent mental disease. Chronic functional psychosis (schizophrenia) developed in only 10% (and in less than 20% if the prognosis is assessed on the basis of the reliability of the diagnosis at the time of the first admission (about 60%)). However, in the group of psychogenic/reactive psychoses as a whole an overmortality of 100% was observed in the course of the 14 years, highest in the younger age groups.
该研究对220例首次因心因性精神病入院的患者病例记录进行了回顾性评估，特别关注了13至14年期间的临床病程和预后。当基于精神病的阳性标准进行评估时，首次入院时诊断的可靠性约为60%。如果将心因性精神病分为亚组，心因性情感性精神病诊断的可靠性约为30%，而心因性混淆性精神病和心因性偏执性精神病的诊断可靠性超过90%。如果减去其他功能性精神病（躁狂抑郁症和精神分裂症）的后续病例，诊断可靠性为50%（220例中的111例），这代表了回顾性验证的心因性精神病的数量。心因性精神病的复发频率为18%（40例），相当于回顾性评估验证的心因性精神病的36%（220例中的111例）。复发主要是同源性的，因为异源性复发仅在心因性情感性精神病中出现（略少于所讨论复发的一半）。仅10%（23例）发展为精神分裂症，8%（18例）出现了躁狂抑郁症的后续发作。与所有后续功能性精神病病例相关，心因性精神病在功能性精神病复发时的稳定性为49%。因此，就后续精神疾病而言，心因性/反应性精神病的总体预后良好。仅10%发展为慢性功能性精神病（精神分裂症）（如果根据首次入院时诊断的可靠性（约60%）评估预后，则不到20%）。然而，在整个心因性/反应性精神病组中，在14年期间观察到100%的超额死亡率，在较年轻年龄组中最高。
