Schizophrenia一词可以直译作

Schizophrenia

一词可以直译作“分裂的心智”，它的希腊 词根是

schizein

（撕裂）和

p hren

（心智）。

Eugen

Bl euler

于

1908

第一次提出了这 个概念，用来描述人格、思想、

记忆、知觉之间的功能分离。对精神分裂症患者而言，情 感、知觉和认知（知情意）不

是作为一个整合体来进行加工的。情感可能与知觉分离，而 知觉可能与现实分离。正如

他所说的“人格失去了完整性”人们常常混淆“精神分裂症” 和“人格分裂”，这种误

解可能是源自字面上的理解，

精神分裂 症患者可能存在幻听幻视，但他们不存在于多个

人格之间来回变换的情形。据文献记载第 一个误用的是一名诗人

T.

S.

E liot

（

1933

）。

在

抗精神病药物

发明以前 ，人们采用了胰岛素昏迷、电休克及脑外科手术等治疗

手段

.

描写诺贝尔经济学奖得主

John Forbes Nash< /p>

的电影《美丽心灵》另译成《美丽

境界》在向普通民众普及精神分 裂症知识方面起到了非常大的作用。

研究认为，

遗传

、幼年环境、

神经科学

及

心理

与社会历程是导致精神分裂症的重要因素

思维障碍

妄想

幻听

幻觉 影像在没有真正

视觉

刺激的情况下，患者便可看到一些本不存< /p>

在的

影像

，且深信不疑

< br>

幻触在没有真正

触觉

刺激的情 况下，患者感到被触摸的感觉。可以感

觉是来自

人

的触摸，也可以感觉到是来自

动物

的触摸等

What Is the History of Schizophrenia?

The term schizophrenia has only been in use since 1911. Soon before that, it was deemed a separate

mental illness in 1887 by Emil Kraepelin. Despite that relatively recent history, it has been described

throughout written history. Ancient Egyptian, Hindu, Chinese, Greek, and Roman writings described

symptoms similar to the positive symptoms of schizophrenia. During medieval times, schizophrenia, like

other illnesses, was often viewed as evidence of the sufferer being possessed by spirits or evil powers.

Who Is Affected?

Schizophrenia affects about 1% of the population, corresponding to more than 2 million people in the

United States and 100,000-200,000 newly diagnosed people every year. Other statistics about

schizophrenia include that it affects men about one and a half times more commonly than women and

that 50% of people in hospital psychiatric care have schizophrenia. Diagnosis is usually in people aged

17-35 years with the illness appearing earlier in men (in the late teens or early 20s) than in women (who

are affected in the 20s to early 30s).

How Common Is Schizophrenia in Children?

Although there have been fewer studies on schizophrenia in children compared to adults, researchers

are finding that children as young as 6 years old can be found to have all the symptoms of their adult

counterparts and continue to have those symptoms into adulthood.

Types of Schizophrenia

There are five types of schizophrenia, each based on the kind of symptoms the person has at the time of

assessment:

?

?

?

?

?

Paranoid schizophrenia

Disorganized schizophrenia

Catatonic schizophrenia

Undifferentiated schizophrenia

Residual schizophrenia

We'll take a look at each type on the following slides

?

Paranoid Schizophrenia

Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations but relatively

normal intellectual functioning and expression of affect. The delusions can often be about being

persecuted unfairly or being some other person who is famous. People with paranoid-type schizophrenia

can exhibit anger, aloofness, anxiety, and argumentativeness.

Disorganized Schizophrenia

Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or

difficult to understand, and flattening or inappropriate emotions. People with disorganized-type

schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what

they are saying or doing. Their disorganized behavior may disrupt normal activities, such as showering,

dressing, and preparing meals.

Catatonic Schizophrenia

Catatonic-type schizophrenia is characterized by disturbances of movement. People with catatonic-type

schizophrenia may keep themselves completely immobile or move all over the place. They may not say

anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is

putting these people at high risk because it impairs their ability to take care of themselves.

Undifferentiated Schizophrenia

Undifferentiated-type schizophrenia is characterized by episodes of two or more of the following

symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative

symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic type

of schizophrenia.

Residual Schizophrenia

Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia,

but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or

behavior). It may represent a transition between a full-blown episode and complete remission, or it may

continue for years without any further psychotic episodes.

What Are Causes of Schizophrenia?

There is no single cause for schizophrenia. Rather, it is the result of a complex group of genetic,

psychological, and environmental factors. Genetically, schizophrenia and bipolar disorder have much in

common, in that the two disorders share a number of the same risk genes. However, the fact is that both

illnesses also have some genetic factors that are unique. Environmentally, the risks of developing

schizophrenia can even occur before birth. For example, the risk of schizophrenia is increased in

individuals whose mother had one of certain infections during pregnancy. Difficult life circumstances

during childhood, like the early loss of a parent, parental poverty, bullying, witnessing parental violence;

emotional, sexual, or physical abuse; physical or emotional neglect; and insecure attachment have been

associated with the development of this illness.

Is Schizophrenia Hereditary?

One frequently asked question about schizophrenia is if it is hereditary. As with most other mental

disorders, schizophrenia is not directly passed from one generation to another genetically, but it is known

to run in families. Thus, the risk of illness in an identical twin of a person with schizophrenia is 40%-50%

and a child of a parent suffering from schizophrenia has a 10% chance of developing the illness.

Schizophrenia Symptoms

A person with schizophrenia may not have any outward appearance of being ill. In other cases, the

illness may be more apparent, causing changes in behavior as well as bizarre behaviors. These may

include social withdrawal, depersonalization (intense anxiety and a feeling of being unreal), loss of

appetite, loss of hygiene, delusions, hallucinations, and a sense of being controlled by outside forces. In

order to better understand schizophrenia, the concept of clusters of symptoms is often used. Thus,

people with schizophrenia can experience symptoms that may be grouped under the following categories

shown in the slides that immediately follow.

Positive (More Overtly Psychotic) Symptoms

?

?

?

?

?

Beliefs that have no basis in reality (delusions)

Hearing, seeing, feeling, smelling, or tasting things that have no basis in reality (hallucinations)

Disorganized speech

Disorganized behaviors

Catatonic behaviors

Negative (Deficit) Symptoms

?

?

?

?

Social withdrawal

Difficulty in expressing emotions

Difficulty in taking care of themselves

Inability to feel pleasure

Cognitive Symptoms

Cognitive symptoms include difficulties attending to and processing of information, in understanding the

environment, and in remembering simple tasks.

Affective (or Mood) Symptoms

The most notable affective symptom is depression, which accounts for a very high rate of attempted

suicide in people suffering from schizophrenia.