Psychosis.
Psychosis.
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DOI：
10.1212/01.con.0000466662.89908.e7
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发表时间：
2015-06-01
期刊：
影响因子：
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通讯作者：
Arciniegas, David B
中科院分区：
文献类型：
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作者：
Arciniegas, David B
综述目的：精神病是许多精神病学、神经发育、神经学和医学疾病的一种常见的功能紊乱症状，也是神经学和精神病学实践中评估和治疗的重要目标。这篇综述的目的是定义精神病，传达《精神疾病诊断和统计手册》第五版(DSM-5)中描述的原发精神障碍分类和标准的最新变化，并总结当前评估和管理原发和继发精神疾病的循证方法。研究结果：DSM-5对原发精神障碍的分类和标准强调这些疾病是沿着谱系发生的，分裂样(人格)障碍和精神分裂症分别定义了其轻度和严重的终点。精神病也被确定为这些障碍中神经精神障碍的几个维度之一，其他包括异常精神运动行为、阴性症状、认知障碍和情绪障碍。这种维度的方法认为幻觉和妄想是由于神经系统服从感知和信息处理而产生的，从而使用于描述和研究原发性精神障碍中此类症状的神经生物学框架与用于研究与其他神经疾病相关的精神病的神经生物学框架保持一致。总结：本文为执业神经科医生提供当前诊断、评估和治疗原发性和继发性精神病的最新方法。
PURPOSE OF REVIEW: Psychosis is a common and functionally disruptive symptom of many psychiatric, neurodevelopmental, neurologic, and medical conditions and an important target of evaluation and treatment in neurologic and psychiatric practice. The purpose of this review is to define psychosis, communicate recent changes to the classification of and criteria for primary psychotic disorders described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and summarize current evidence-based approaches to the evaluation and management of primary and secondary psychoses.RECENT FINDINGS: The DSM-5 classification of and criteria for primary psychotic disorders emphasize that these conditions occur along a spectrum, with schizoid (personality) disorder and schizophrenia defining its mild and severe ends, respectively. Psychosis is also identified as only one of several dimensions of neuropsychiatric disturbance in these disorders, with others encompassing abnormal psychomotor behaviors, negative symptoms, cognitive impairments, and emotional disturbances. This dimensional approach regards hallucinations and delusions as arising from neural systems subserving perception and information processing, thereby aligning the neurobiological framework used to describe and study such symptoms in primary psychotic disorders with those used to study psychosis associated with other neurologic conditions.SUMMARY: This article provides practicing neurologists with updates on current approaches to the diagnosis, evaluation, and treatment of primary and secondary psychoses.