Dubertret C, Gorwood P, Adès J
Hôpital Louis Mourier, Service de Psychiatrie, Colombes.
Encephale. 1997 May-Jun;23(3):157-67.
The distinction between schizophrenia and chronic delusion syndromes (such as paraphrenia, late-paraphrenia and "Psychose Hallucinatoire Chronique") is currently used in France, although there is no international criteria (ICD 10 or DSM IV) for chronic delusion syndromes. It is thus worth analysing the literature in order to compare the differences between late-onset schizophrenia and "Psychose Hallucinatoire Chronique", and the similarities between young-onset schizophrenia and chronic delusion syndromes. Clinical investigations clearly differentiate "Psychose Hallucinatoire Chronique" and late-onset-schizophrenia from young-onset schizophrenia because they have more delusion and hallucinatory symptoms, less negative symptoms, better evolution, and better sensitivity to antipsychotic drugs. Epidemiological data show that "Psychose Hallucinatoire Chronique" and late-onset schizophrenia have both a different sex-ratio (around 7 women for 1 man) than young-onset schizophrenia (nearly 1 woman for 1 man), and that in "Psychose Hallucinatoire Chronique" and in late-onset schizophrenia, social withdrawal is frequently observed before onset of the disorder. Lastly, putative risk factors may be shared by "Psychose Hallucinatoire Chronique" and late-onset schizophrenia, and may isolate them from young-onset schizophrenia, for example regarding the oestradiol hypothesis (oestradiol enhance dopamine efficacy and delay the onset of delusion disorders), the impact of sensory handicaps (which may be clinically and experimentally associated with hallucinations), or the role of genetic and familial factors (with a familial concentration intermediate between the familial concentration of schizophrenia of schizophrenic proband, and the familial concentration of schizophrenia of control probands). In accordance with this review of the literature, the authors conclude that the absence of specific criteria for late-onset schizophrenia and/or "Psychose Hallucinatoire Chronique" In international diagnostic manual risk to counter the facility to detect specific risk factors involved in the pathogenesis of schizophrenia.
目前法国采用了精神分裂症与慢性妄想综合征（如偏执狂、晚发性偏执狂和“慢性幻觉性精神病”）之间的区分，尽管慢性妄想综合征尚无国际标准（国际疾病分类第10版或精神疾病诊断与统计手册第四版）。因此，分析文献以比较晚发性精神分裂症与“慢性幻觉性精神病”之间的差异，以及早发性精神分裂症与慢性妄想综合征之间的相似性是很有必要的。临床研究清楚地将“慢性幻觉性精神病”和晚发性精神分裂症与早发性精神分裂症区分开来，因为它们有更多的妄想和幻觉症状、更少的阴性症状、更好的病情发展以及对抗精神病药物更高的敏感性。流行病学数据表明，“慢性幻觉性精神病”和晚发性精神分裂症的性别比（约为7名女性对1名男性）与早发性精神分裂症（近1名女性对1名男性）不同，并且在“慢性幻觉性精神病”和晚发性精神分裂症中，在疾病发作前经常观察到社交退缩。最后，“慢性幻觉性精神病”和晚发性精神分裂症可能有共同的假定风险因素，并且可能将它们与早发性精神分裂症区分开来，例如关于雌二醇假说（雌二醇增强多巴胺效能并延迟妄想障碍的发作）、感觉障碍的影响（在临床和实验上可能与幻觉相关），或遗传和家族因素的作用（家族聚集程度介于精神分裂症先证者的精神分裂症家族聚集程度和对照先证者的精神分裂症家族聚集程度之间）。根据对文献的这一综述，作者得出结论，国际诊断手册中缺乏针对晚发性精神分裂症和/或“慢性幻觉性精神病”的特定标准，这有可能不利于发现精神分裂症发病机制中涉及的特定风险因素。
