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中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (13) : 2006 -2009. doi: 10.3877/cma.j.issn.1674-0785.2017.13.010

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综述

分裂情感性障碍诊断及治疗研究进展
李志勇1, 梁英1,()   
  1. 1. 100191 北京大学精神卫生研究所 北京大学第六医院 卫生部精神卫生学重点实验室(北京大学)
  • 收稿日期:2017-02-10 出版日期:2017-07-01
  • 通信作者: 梁英

Advances in diagnosis and treatment of schizoaffective disorder

Zhiyong Li1, Ying Liang1,()   

  1. 1. Peking University Sixth Hospital, Institute of Mental Health, Ministry of Health, Peking University, Beijing 100191, China
  • Received:2017-02-10 Published:2017-07-01
  • Corresponding author: Ying Liang
  • About author:
    Corresponding author: Liang Ying, Email:
引用本文:

李志勇, 梁英. 分裂情感性障碍诊断及治疗研究进展[J/OL]. 中华临床医师杂志(电子版), 2017, 11(13): 2006-2009.

Zhiyong Li, Ying Liang. Advances in diagnosis and treatment of schizoaffective disorder[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(13): 2006-2009.

分裂情感性障碍是同时伴有精神病性症状及情感症状的一类精神障碍。虽然精神障碍诊断与统计手册(第5版)(DSM-5)有了最新的诊断标准,但在实际临床应用中却存在诸多困惑。本文系统回顾了分裂情感性障碍的诊断演变、最新研究进展、治疗及预后评估。

Schizoaffective disorder is a kind of psychogenic co-occurrence of both psychotic and affective symptoms. Although the latest DSM-5 diagnostic criteria have been published, there are still many problems related to the clinical application of the DSM-5 diagnostic criteria. This paper reviews the evolution of the diagnosis of schizoaffective disorder as well as its latest diagnostic criteria, etiology, treatment, and prognosis evaluation.

表1 ICD-9、ICD-10、DSM-5的诊断变化
CCMD-2-R ICD-10 DSM-5
1. 符合精神分裂症和情感性精神障碍的症状标准 G1. 该障碍具有一条符合情感性精神障碍中度或重度标准 A. 在一个不间断的疾病周期中,有主要心境发作(重性抑郁或躁狂),同时存在符合精神分裂症诊断标准A的症状
2. 严重程度标准,符合以下两项:(1)社会功能显著下降。(2)自知力不全或缺乏 G2. 下列症状中必须有一条至少在两周内明确存在(这些症状精神分裂症可见,几乎完全相同) B. 在此疾病的全过程中,在缺少主要心境发作(抑郁或躁狂)的情况下,存在持续两周或更长时间的妄想或幻觉
3. 分裂性症状与情感性症状在整个病程中多同时存在,出现与消失的时间比较接近。但以分裂性症状为主要临床相的时间,必须持续两周以上 G3. G1和G2必须在疾病同一发作或至少在发作的部分时间出现。两者在临床相中必须明显 C. 在此疾病的活动期和残留期的整个病程的大部分时间内,存在符合主要心境发作诊断标准的症状
4. 说明:如果一个患者在不同发作中分别表现以分裂性症状或情感性症状为主要临床相,仍按每次发作的主要临床相做出各自的诊断 G4. 本障碍不是由于器质性精神障碍或精神活性障碍——中毒,依赖或戒断引起 D. 这种障碍不能归因于某种物质(例如,滥用的毒品、药物)的生理效应或其他躯体疾病
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