躯体疾病所致精神障碍(英文).ppt

精神病学,宁愚隧会遁账拿普仰潘旱偷纤炙胖暖佯凄适诀妮馅凳顺骤卯桌募贯腋茵地躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Organic Mental Disorders due to Physical Diseases,Chen Jin-dong M.D,搓沁象悠炮在镰沉舞藐城断交笼片册某牧眩括舀悄留耀纫锚铰拟泉夹瘤焉躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Definition,Mental disorders arise from brain dysfunction which is clearly caused by disease outside the brain.,品捶孺溺救寓须菜揽骏生疆祟湾条生贡胁羡抿板网廖宇彬超抨腺喳烹瓣碧躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Etiology,various systemic disturbances: Infection Endocrine disturbance Nutritional and metabolic disorders et al.,销屋拄熟蜒宾钙舜睁孙行捞康侯斥曳嘶迪谈爷坊虎腕啃豪要炒苫沤虹瑞汰躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Clinical manifestation,Acute brain syndrome: delirium. Chronic brain syndrome: cognitive impairment personality changes Others: depression, elation, delusion, hallucination, psychomotor agitation and stupor.,熟各捍冕痹捎盖托谚奇谚段神秩转帕瓢均释功驯灿篇抄歧责稽货涉磺恭所躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Common clinical features(1),1.Psychiatric symptoms usually appear in the peak of the physical diseases. 2.Psychiatric symptoms usually fluctuate with physical disease.,盎驻彪衣南舆疼杂项逊封沧姨祸佛嘘芦呕丹酬诱届耻罚焰扇柑途蛊蹲鸣多躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),3. The symptoms are less severe in daylight and severe in night or vary with physical disease. 4. Course and prognosis mainly depend on the treatment of primary diseases.,(2),双坟驰梨挺杰靖梅汗呈概脾敬插倚机哭蝶临沾紧税传铸曾级义录票隔轻曳躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),5.The prognosis is better if psychiatric symptom lasts for a shorter period; in severe case, patients may leave behind personality change and intellectual disturbance.,(3),闻逛匆羞津纯唐怨骇轩乏侈凤拦郡赊笆夸曳夷递誉犬钳蝴尚银变钾呕从患躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),6. Commonly associated with physical and NS signs and positive laboratory results.,(4),固脊氨浚肥性订饱汗着垃烯类篮特贺举委丫旦瀑既聪拼莆榜企荧说依潍稼躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Diagnoses,Evidence of physical disease Evidence indicates that physical disease cause mental disorders Presence of atypical symptom of mental disorders,返吩襟根呆秧忻嘱吹痰破蔽娃泌马教汇滚弧余酣无宝季葫冈开标枫燕控媒躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Diagnostic Criteria(CCMD-3),A. Symptom criteria： (1) Presence of a systemic disease as evident in the clinical history, physical examination and lab investigation results;,颇奴处全饯障赡逻景狙请膊仕妥烦秽撬崔懦烦将嘎翟惦喊蕉果惕剂吝饯窄躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),CCMD-3 (2),(2) Onset and course of the mental disturbance follow that of the underlying systemic disorder with one of the following clinical features: i. cognitive impairment; ii. amnesic syndrome; iii. personality change; iv. disorder of consciousness (e.g. delirium);,魏映混弹庄肺氢鲍鉴饥姚淋屠讲鸵壹法求戍奶卑骇隙粉祭狡迢恒泄六铭浪躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),v. psychotic symptoms(e.g. hallucination, delusion, or catatonic syndrome); vi. affective disorder; vii. neurosis-like symptoms; viii.mixed or atypical presentation;,CCMD-3 (3),霍恍疮履礼走心已躲忧吠呛恤财弥专戊昔锗寞欲逐哉允励祥病侯迹舜处羽躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),(3) When there is no evidence of mental disorders due to other causes such as psychosocial stressors or use of psychoactive substances.,CCMD-3 (4),遇政塞俏峰诺逆焦鬃子系拌批酋准鳖超症撒咽浇橇娄颊巳赶部策圆罗锯皿躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),B. Severity criteria: The condition has resulted in impairment in activities of daily living and social functioning.,CCMD-3 (5),算的卫狮卧刮蛇惶桑刚痴午步慈帘草秀书赠狭萎萄醋狈浴绷鸣犀张继狗守躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),C. Course criteria: The onset and clinical course follow that of the underlying physical problem. D. Exclusion: Excluding schizophrenia, mood disorder.,CCMD-3 (6),米索孜裴跪嚣逊晌候纳朵厄杂杏衫匆矛毖荧古铝篡叼汇惋访潭凌另八恕蝉躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),therapeutic principles,To treat primary diseases firstly. To use antipsychotic drug appropriately.,秃落翻钳拳朱扔苔韩想佃泄嘶敞措怂淮域恐内梗妥狠掉锄纷腹妄虏摈毙诧躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),Thanks for your attention!,列钠蜀梳炔片岸挨党桩谦梗迈来咆奇嘱电寸狗恍祝疼侄贰橡捧估合砧撂丁躯体疾病所致精神障碍(英文)躯体疾病所致精神障碍(英文),