Bron B
Schweiz Arch Neurol Neurochir Psychiatr. 1976;119(1):73-95.
Among the psychotic symptoms in juvenile drug-consumers one can find autonomous, i.e. drug-independent developments, whose connection with the drug-abuse is to be assessed in differing ways. A beginning psychosis can be modified in its actual symptoms by drug-consumption. On the other hand one must consider the manifestation of a latent psychosis or purely symptomatic psychosis, which, in its symptoms, can hardly be distinguished from schizophrenia. Finally drug-induced personality-changes can develop together with secondary psychotic symptoms. Psychotic symptoms are determined and influenced in a varying degree by drugs. Both after short drug-consumption and after a longer drug-anamnesis with polytoxicomanic symptoms psychotic syndromes can be discovered. Even the initial psychotic symptoms can hint at an adverse development and a bad prognosis. Sometimes the drug-experiences conceal the autonomous development of the psychosis, which, as a rule, shows predominantly schizophrenic symptoms. In addition to a quick change of the actual symptoms, acute states of confusion and depressive-suicidal syndromes, flash-back and horror-trip phenomena, closely connected with the psychotic experience, and a schizophrenic colouring of affective psychoses can be found as frequently drug-induced modifications of the psychotic symptoms. Furthermore one finds an increase of symptoms and of the psychotic episodes in the case of psychoses of the schizophrenic variety which have already begun. Grave personality changes with psychotic symptoms after chronic drug-abuse can cause differential-diagnostic difficulties.
在青少年吸毒者的精神病症状中,可以发现一些自主出现的症状,即与吸毒无关的症状发展情况,其与药物滥用之间的关联需以不同方式进行评估。初期精神病的实际症状可能会因吸毒而改变。另一方面,必须考虑潜在精神病或纯粹症状性精神病的表现,其症状很难与精神分裂症区分开来。最后,药物引起的人格变化可能与继发性精神病症状同时出现。精神病症状在不同程度上由药物决定和影响。无论是短期吸毒后还是有多种药物成瘾症状的长期吸毒史后,都可能发现精神病综合征。即使是初期的精神病症状也可能暗示病情发展不利和预后不良。有时,吸毒经历会掩盖精神病的自主发展,这种自主发展通常主要表现为精神分裂症症状。除了实际症状迅速变化外,还经常能发现与精神病体验密切相关的急性意识模糊状态和抑郁自杀综合征、闪回和恐怖之旅现象,以及情感性精神病的精神分裂症色彩,这些都是药物引起的精神病症状改变。此外,在已经开始的精神分裂症类型的精神病病例中,症状和精神病发作会增加。长期吸毒后出现伴有精神病症状的严重人格变化会导致鉴别诊断困难。