精神分裂症的阴性症状

"Negative"并不意味着“坏的but...

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The negative symptoms include symptoms where there is a decrease or a loss in a mental function compared to normal functioning.

精神分裂症的负面症状是什么??

  1. 观察到的情绪反应降低(临床术语:限制性影响)。值得注意的是,这种症状是根据对患者行为的观察而诊断的,而不是根据报告的主观情绪缺乏。受影响的患者可能会报告情感,但他们没有表现出来。
  2. 报告的情绪反应降低(临床术语:情绪范围降低)。病人几乎感觉不到任何情绪。
  3. 言语生成减少(临床术语:言语贫乏)。There is little spontaneous speech.The patient tends to answer most questions with a monosyllabic"yes"or"no".At times there is a delay in getting the words out or there are long time gaps separating sentences or even words within a sentence.Speech delays due to the patient paying attention to hallucinated voices or visions or simply being disorganized should be differentiated from poverty of speech.
  4. 利息减少。Apathy is a common symptom of分裂症.The patient appears indifferent,即使是基本活动(美容和卫生)也缺乏兴趣。There is a pervasive lack of enthusiasm coupled with a striking lack of concern for both minor and major matters (e.g.,what is to eat,how the bills will get paid,当家人不再需要帮助时会发生什么)。
  1. Decreased sense of purpose.患者很难讨论参与活动或项目的意义或价值。It might be difficult to get the patient to articulate short and long term goals and plans.
  2. Decreased desire to socialize (clinical term: decreased social drive).当然,这可能是更普遍缺乏兴趣的结果。然而,some patients show a distinct lack of interest in being social while they might continue to be interested in a variety of other activities.病人可能有他最喜欢的电视节目,which he enjoys and follows,但当被问到为什么他把所有的时间都花在自己身上时,他说他不关心别人的陪伴。值得注意的是,选择孤立是因为感觉偏执或是因为命令独处的声音,应该区别于社会驱动力下降(可以想象,the patient would choose to spend time with others provided they stop harassing him).

什么导致了负面症状??

It is not clear.While some studies reported the deficit schizophrenia run in families,对于阴性症状或缺陷型精神分裂症没有已知的遗传关联。Interestingly,while winter birth increases the risk for schizophrenia,夏季出生的精神分裂症患者出现阴性症状的风险更高。

What Is the Course and Prognosis for Negative Symptoms??

与对照组相比,治疗阴性症状的疗程似乎更持久。阳性症状.People with deficit schizophrenia have a poorer response to treatment,social and occupational functioning,与无缺陷精神分裂症患者相比,总体生活质量更高。

由于阴性症状表明功能缺陷,它们也被称为缺陷症状。然而,缺陷型精神分裂症不是缺陷或负性症状的同义词。

Often times,patients with schizophrenia might have one negative symptom in addition to the more commonly observed positive symptoms.有时,一些治疗精神分裂症的药物,如第一代或典型抗精神病药,可能有负面影响,如兴趣下降或情绪反应下降。因为这些症状是由药物引起的,它们叫第二的阴性症状。也,在精神分裂症的过程中,阴性症状可能会反复出现。

Deficit schizophrenia is diagnosed when patients have:

1。六种阴性症状中至少有两种。

2。这些症状持续存在——意味着它们至少存在一年,患者甚至在临床稳定期间也会经历这些症状。

三。这些症状是主要的。主要的意思是不是由于其他原因(见上文-次要的负面症状)。

抗精神病药

抗精神病药are effective in treating negative symptoms that are第二的to positive symptoms.For example,patients can be socially isolated due to paranoid beliefs or voices commanding them not to leave their home.In such cases,抗精神病药物对偏执和幻听有效,也会改善社会关系。Unmedicated patients experiencing positive symptoms with secondary negative symptoms should start a neuroleptic;如果已经治疗过,可能需要增加剂量,或者,if the medication is deemed ineffective,a switch to an alternative medication is recommended.

对阳性症状有效第一代/典型抗精神病药有许多神经方面的不良反应,such as parkinsonism,这会增加继发性阴性症状。当接受典型抗精神病药物治疗的患者出现退缩和减慢,这可能是他们的抗精神病药物的副作用。If that is the case,可以降低药物剂量,或者可能需要将药物更改为second generation/atypicalantipsychotic.

抑郁,with secondary lack of interest and motivation,can be treated with an antidepressant.

Neither first generation/typical antipsychotics or second generation/atypical antipsychotics improve初级的以及持续的阴性症状。

Psycho-social interventions with a focus on the social disconnection play an important role in the treatment of persistent negative symptoms.

支持疗法提供了一个陪伴的机会,where the patient is offered non-judgmental validation,常识建议,以及保证。

行为疗法教会患者认识和参与能够提高生活质量的行为和活动。社会技能培训是一种特殊的行为疗法,在这种疗法中,患者被教导如何表达情感和需求,问问题,控制他们的声音,身体和面部表情。

Cognitive therapyaims to train the patient to question and correct patterns of thoughts that result in overwhelming feelings.

Psycho-education for patients and families is helpful in decreasing stigma and improve opportunities for ongoing social engagement.

As medications efficacy is limited,最好将药物与心理社会干预相结合。

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