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1、躯体疾病所致精神障碍英文第1页,本讲稿共18页Organic Mental Disorders due to Physical DiseasesChenJin-dongM.D第2页,本讲稿共18页DefinitionMentaldisordersarisefrombraindysfunctionwhichisclearlycausedbydiseaseoutsidethebrain.第3页,本讲稿共18页Etiologyvarioussystemicdisturbances:lInfectionlEndocrinedisturbancelNutritionalandmetabolicdisor
2、dersetal.第4页,本讲稿共18页Clinical manifestationAcutebrainsyndrome:delirium.Chronicbrainsyndrome:lcognitiveimpairmentlpersonalitychangesOthers:depression,elation,delusion,hallucination,psychomotoragitationandstupor.第5页,本讲稿共18页Common clinical features(1)1.Psychiatricsymptomsusuallyappearinthepeakofthephysi
3、caldiseases.2.Psychiatric symptoms usually fluctuatewithphysicaldisease.第6页,本讲稿共18页3.Thesymptomsarelesssevereindaylightandsevereinnightorvarywithphysicaldisease.4.Courseandprognosismainlydependonthetreatmentofprimarydiseases.(2)第7页,本讲稿共18页5.The prognosis is better if psychiatricsymptomlastsforashort
4、erperiod;inseverecase,patientsmayleavebehindpersonalitychangeandintellectualdisturbance.(3)第8页,本讲稿共18页6.CommonlyassociatedwithphysicalandNSsignsandpositivelaboratoryresults.(4)第9页,本讲稿共18页DiagnosesEvidenceofphysicaldiseaseEvidenceindicatesthatphysicaldiseasecausementaldisordersPresenceofatypicalsympt
5、omofmentaldisorders第10页,本讲稿共18页Diagnostic Criteria(CCMD-3)A.Symptomcriteria:(1)Presenceofasystemicdiseaseasevidentintheclinicalhistory,physicalexaminationandlabinvestigationresults;第11页,本讲稿共18页CCMD-3(2)(2)Onsetandcourseofthementaldisturbancefollowthatoftheunderlyingsystemicdisorderwithoneofthefollow
6、ingclinicalfeatures:i.cognitiveimpairment;ii.amnesicsyndrome;iii.personalitychange;iv.disorderofconsciousness(e.g.delirium);第12页,本讲稿共18页v.psychoticsymptoms(e.g.hallucination,delusion,orcatatonicsyndrome);vi.affectivedisorder;vii.neurosis-likesymptoms;viii.mixedoratypicalpresentation;CCMD-3(3)第13页,本讲
7、稿共18页(3)When there is no evidence of mentaldisorders due to other causes such aspsychosocialstressorsoruseofpsychoactivesubstances.CCMD-3(4)第14页,本讲稿共18页B.Severitycriteria:Theconditionhasresultedinimpairmentinactivitiesofdailylivingandsocialfunctioning.CCMD-3(5)第15页,本讲稿共18页C.Coursecriteria:Theonsetandclinicalcoursefollowthatoftheunderlyingphysicalproblem.D.Exclusion:Excludingschizophrenia,mooddisorder.CCMD-3(6)第16页,本讲稿共18页therapeutic principleslTotreatprimarydiseasesfirstly.lTouseantipsychoticdrugappropriately.第17页,本讲稿共18页Thanks for your attention!第18页,本讲稿共18页