精神分裂症与其他精神病性障碍ppt课件

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‰。
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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
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.
The results of adoption studies
The rate for Schizophrenia is greater among the biological relatives of the Schizophrenia Adoptees than among the relatives of control.
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Genetics 1
精神分裂症与其他精神病性障碍
(schizophrenia and other psychotic disorders)
中南大学精神卫生研究所
The mental health institute of south-central university MD.,Ph.D.
陈晓岗
Chen Xiaogang
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
Genetics 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.
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
Epidemiology 1
Studies Method: Family studies Twin studies Adoption studies
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
The finding supports the genetic hypothesis.
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
Etiology
The results of twin studies
concordance rates among MZ pairs is higher than that among control(35-60 times)
concordance rates are about 50% for MZ and about 10% for DZ. It might be expected that some environmental factors relevant to etiology.
ቤተ መጻሕፍቲ ባይዱ
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and Hy perthermia Associated with Poisoning or and Neonatal Respiratory Care Embry ologic Development Births Obstetric Emerge ncies
Genetics 4
The risk of schizophrenia in the offspring of an unaffected twin is the same as that of an affected twin. This means that an unaffected twin has the same genetic susceptibility to developing Schizophrenia, but for some reason the susceptibility is not expressed.
The risk of both Schizophrenia and mood disorder is increased in first-degree relatives of patients with schizoaffective disorder.
The risk of bipolar illness is not increased in first-degree relatives of patients with schizophrenia.
2. Candidate gene approaches
Genes for biological mechanisms that may be involved in Schizophrenia have been localized and cloned. Using this technique, a number of genes coding for DA and 5-HT receptors have been excluded from linkage to Schizophrenia in various pedigrees（家系）.
Molecular genetic studies
Two main approaches:
1. linkage analysis
It is applied to multiply affected families(高发家系）, but no linkage markers have been clearly identified.
Genetics 2
The results of family studies:
The risk of Schizophrenia. Schizoaffective disorder, and schizotypal personality is increased in first-degree relatives of patients with Schizophrenia.
History（1）
Schneider -first rank symptoms（首级症状）
1.thought hearing (思维化声) 2. Third-person hallucinations (争论性幻听) 3. Hallucinations in the form of a commentary(评论性
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Epidemiology 2
一、 biological factors
1．genetics 2．The neurodevelopmental hypothesis 3．Changes in brain structure 4．Biochemical abnormalities
二、personality factors 三、psycho-social factors
2．掌握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
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幻听) 4. thought withdrawal or insertion (思维被夺/被插入) 5. Thought broadcasting /diffusion(思维被广播或扩散) 6. Forced feeling (强加的情感) 7. forced impulsive (强加的冲动) 8. forced behavior (强加的行为) 9. somatic passivity experience (躯体被动体验) 10. delusional perception (妄想性知觉)