Schizophrenia and Other Psychotic Disorders LIU Tie-qiao 20237/16
2023/7/16 1 Schizophrenia and Other Psychotic Disorders LIU Tie-qiao
学习且标 1.掌握精神分裂症的临床表现、诊断和鉴别诊断、 治疗和预防复发策略 2.了解精神分裂症疾病的分型、预后特征 3.了解精神分裂症疾病的病因学 4.了解其它精神病性障碍的概念 20237116
2023/7/16 2 学习目标 1．掌握精神分裂症的临床表现、诊断和鉴别诊断、 治疗和预防复发策略 2．了解精神分裂症疾病的分型、预后特征 3．了解精神分裂症疾病的病因学 4. 了解其它精神病性障碍的概念
Part one Introduction 20237/16
2023/7/16 3 Part one Introduction
The definition of Schizophrenia in CCMD-3 Schizophrenia comprises a group of psychotic disorders of unknown specific etiology often presented with a gradual onset of abnormalities in perception,thought, motion and behavior since young adulthood. Consciousness is usually maintained.Intelligence is intact,but in some cases,there is some degree of cognitive impairment.The natural course of the disorder is chronic remitting but sometimes deteriorating. 20237/16
2023/7/16 4 The definition of Schizophrenia in CCMD-3 Schizophrenia comprises a group of psychotic disorders of unknown specific etiology often presented with a gradual onset of abnormalities in perception, thought, motion and behavior since young adulthood. Consciousness is usually maintained. Intelligence is intact, but in some cases, there is some degree of cognitive impairment. The natural course of the disorder is chronic remitting but sometimes deteriorating
Epidemiology (1) Prevalence Point prevalence in China (1982):4.75%(rural area 3.42%o,urban6.06%)。 Total prevalence in China(1982):5.69%0,(6.55 %0 1999). Lifetime prevalence in USA (1988)13%00 2023/7/16 5
2023/7/16 5 Epidemiology (1) Prevalence ： ◆ Point prevalence in China (1982): 4.75‰（rural area 3.42‰，urban 6.06 ‰ )。 ◆ Total prevalence in China(1982):5.69‰，(6.55 ‰ 1999)。 ◆ Lifetime prevalence in USA（1988）13‰
Epidemiology(2) Incidence ◆USA:0.43%0.69%0 ◆China:0.11%0.35%o The reasons of these reported differences may be include: ◆diagnostic criteria ◆areas methods of case finding,migration 2023/7/16 6
2023/7/16 6 Epidemiology( 2) ◼ Incidence ◆ USA: 0.43‰~0.69‰ ◆ China : 0.11‰~0.35‰ ◼ The reasons of these reported differences may be include: ◆ diagnostic criteria ◆ areas ◆ methods of case finding, migration
Epidemiology(3) Age:the age of onset in 50%of patients is 20~30 year old,over 80%of patients is 16~35year old. Gender: Schizophrenia occurs equally in men and women(in abroad) .The prevalence in men is more than women (1.6:1)in China. .The mean age of onset is about 2 to 5 years earlier in men than women. 2023/7/16
2023/7/16 7 Epidemiology( 3) ◼ Age：the age of onset in 50% of patients is 20~30 year old，over 80% of patients is 16~35year old. ◼ Gender： ◆ Schizophrenia occurs equally in men and women(in abroad) ◆ The prevalence in men is more than women (1.6:1) in China. ◆ The mean age of onset is about 2 to 5 years earlier in men than women
Outcome evaluation(multi-dimensions) Clinical outcome Social function Quality of life Living condition Family condition others 20237116
2023/7/16 8 Outcome evaluation(multi-dimensions) ◼ Clinical outcome ◼ Social function ◼ Quality of life ◼ Living condition ◼ Family condition ◼ others
History 1.Demence precoce(Morel,1857) 2.Hebephrenia(Hecker,1871) 3.Catatonia(Kzhlbaum,1874) 4.Kraepelin(1896)thought all above descriptions are different types of the same disease-dementia praecox 2023/7/16 9
2023/7/16 9 History（1） 1. Demence precoce(Morel,1857) 2. Hebephrenia(Hecker,1871) 3. Catatonia(Kzhlbaum,1874) 4. Kraepelin(1896)thought all above descriptions are different types of the same disease-dementia praecox
History (2) E.Bleuler(1911)suggested that splitting of thought and affect was the central feature of the illness-schizophrenia He found that the outcome of this illness was neither universally poor nor associated with severe dementia. M.Bleuler-4A symptoms Association disorder ·Apathy Ambivalence Autism 2023/7116 10
2023/7/16 10 History（2） E.Bleuler(1911)suggested that splitting of thought and affect was the central feature of the illness – schizophrenia He found that the outcome of this illness was neither universally poor nor associated with severe dementia. M.Bleuler- 4A symptoms： ▪ Association disorder ▪ Apathy ▪ Ambivalence ▪ Autism