精神分裂症与分裂情感性障碍的核心特征与治疗

Core symptoms and treatments of schizophrenia and schizoaffective disorder

精神分裂症是一种严重的精神障碍,在普通人群中的患病率为0.5%~1.0%,在住院患者中,其比例更高。由于精神分裂症的不同亚型在治疗上并无区别,并且容易给临床诊断造成混乱,因此,DSM-5去除了精神分裂症的亚型。分裂情感性障碍的患病率约为精神分裂症的一半。其症状相当于既有精神分裂症的A组症状,同时又有心境症状,例如重性抑郁或躁狂。诊断此障碍必须符合两个关键标准:(1)在半数以上的病程中,除了存在精神分裂症诊断标准A的症状以外,还伴有重性抑郁发作或躁狂发作;(2)在没有心境发作至少2周(抑郁或躁狂)的情况下,存在持续的妄想或幻觉,即证明这些精神病性症状并非由心境发作所致。

Schizophrenia is a serious mental disorder with a 0.5% -1.0% morbidity rate in the general population and a higher proportion in hospitalized patients.DSM-5 removes subtypes of schizophrenia because of the different subtypes of schizophrenia do not differ in treatment outcome and are prone to cause confusion in the diagnosis of clinicians.Schizoaffective disorder has half the morbidity rate of schizophrenia.This disorder has schizophrenia group A symptoms with a mood disorder component,such as severe depressionor mania.The diagnosis of this disorder must meet two key criterias.First,in addition to schizophrenia group A symptoms,patients also experience mood disorder symptoms,such as depression or manic episodes.Second,in the absence of a mood disorder symptoms for at least two weeks （ depression or mania）,there is a continuing delusions or hallucinations that prove these psychotic symptoms are not caused by mood problems.