Saito T, Sekito Y, Ikeda N, Taniguchi E, Kadowaki I, Ashizawa T
Department of Occupational Therapy, School of Health Science, Sapporo Medical University, Japan.
Nihon Arukoru Yakubutsu Igakkai Zasshi. 1996 Oct;31(5):475-82.
A case (male, 27 years old) with chronic thinner intoxication, whose mental condition was reexamined in accord with a court order, is reported. He had been sniffing thinner from age 12 to 27. Since the age of 17, he experienced visual and auditory hallucinations without sniffing thinner. He had no family history of schizophrenia. The psychiatric examination revealed that he had positive symptoms of schizophrenia, especially the first rank symptoms, such as auditory hallucinations (i.e. voices commenting and voices arguing), experience of influence (withdrawal of thought, thought insertion and influence of thought) and delusional perception, but did not show negative symptoms (i.e. blunting thought). Furthermore, he could maintain good emotional contact with others. Hallucinations, which appeared in acute intoxication with thinner, were second rank symptoms, different from those observed in the sober period when he was not under the influence of the thinner. Judging from above facts it was difficult to diagnose this case as schizophrenia or the flashback phenomenon of thinner dependence. Although the disease concept of volatile solvent psychosis has not been clearly established, this case may suggest that the first rank symptoms are important manifestations of volatile solvent psychosis.
报告了一例（27岁男性）慢性稀料中毒病例，其精神状况根据法庭命令进行了重新检查。他从12岁到27岁一直在吸食稀料。自17岁起，他在未吸食稀料时也出现了视觉和听觉幻觉。他没有精神分裂症家族史。精神检查发现他有精神分裂症的阳性症状，尤其是一级症状，如幻听（即评论性幻听和争论性幻听）、被影响体验（思维被夺、思维插入和思维被影响）以及妄想性知觉，但未表现出阴性症状（即思维迟缓）。此外，他能与他人保持良好的情感交流。在急性稀料中毒时出现的幻觉属于二级症状，与他在未受稀料影响的清醒期所观察到的幻觉不同。从上述事实判断，很难将此病例诊断为精神分裂症或稀料依赖的闪回现象。尽管挥发性溶剂性精神病的疾病概念尚未明确确立，但该病例可能提示一级症状是挥发性溶剂性精神病的重要表现。
