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[一例作为甲基苯丙胺滥用后残留症状的动机缺乏综合征病例]

[A case of amotivational syndrome as a residual symptom after methamphetamine abuse].

作者信息

Ashizawa T, Saito T, Yamamoto M, Shichinohe S, Ishikawa H, Maeda H, Toki S, Ozawa H, Watanabe M, Takahata N

机构信息

Department of Neuropsychiatry, School of Medicine, Sapporo Medecal University, Japan.

出版信息

Nihon Arukoru Yakubutsu Igakkai Zasshi. 1996 Oct;31(5):451-61.

PMID:8940805
Abstract

We had a case of psychiatric evidence who was homeless and exhibited severe abulia and autism on detention for assault and battery. It was thought that his past history of chronic methamphetamine abuse and his familial history played some part in his showing such symptoms. His mother was alcohol dependent. He was an ACOA (adult child of alcoholics), which might have led to his chronic abuse of methamphetamine. On the other hand, it is well-known fact that the amotivational syndrome induced by marijuana abuse is typified by a diminution of ambition, productivity, and motivation. However, it has been contended that amotivational syndrome is induced not only by marijuana but also by amphetamine and its analogs, cocaine and volatile solvents. Since we positively support this view, we diagnosed the case as amotivational syndrome after long-term methamphetamine abuse. This was also a rare criminal case of amotivational state without hallucinations and delusions after methamphetamine abuse. We suggested that the crime committed in this case was closely related to crime induced by economic problems in residual states of schizophrenic offenders. This could be a case of both ACOA and methamphetamine dependence. There were unresolved alcohol- and drug-related problems in this case. Therefore, careful early intervention in a crisis, cooperation with the authorities and the institutions concerned, and comprehensive rehabilitation should be employed to resolve such alcohol- and drug-related problems.

摘要

我们有一个涉及精神科证据的案例,该患者无家可归,因袭击和殴打他人被拘留时表现出严重的意志缺失和自闭症症状。据认为,他过去长期滥用甲基苯丙胺的病史以及家族病史在他出现此类症状中起到了一定作用。他的母亲有酒精依赖问题。他是一名“酗酒者成年子女”(ACOA),这可能导致了他长期滥用甲基苯丙胺。另一方面,众所周知,大麻滥用诱发的动机缺乏综合征的典型表现是抱负、生产力和动力的减退。然而,有人认为动机缺乏综合征不仅由大麻诱发,也可由苯丙胺及其类似物、可卡因和挥发性溶剂诱发。由于我们积极支持这一观点,在长期滥用甲基苯丙胺后,我们将该病例诊断为动机缺乏综合征。这也是一例罕见的甲基苯丙胺滥用后无幻觉和妄想的动机缺乏状态的刑事案件。我们认为该病例中的犯罪与精神分裂症罪犯残留状态下因经济问题诱发的犯罪密切相关。这可能是一个既属于“酗酒者成年子女”又存在甲基苯丙胺依赖的案例。该病例中存在未解决的酒精和药物相关问题。因此,应在危机中进行仔细的早期干预,与相关当局和机构合作,并开展全面康复,以解决此类酒精和药物相关问题。

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