伴强迫症状的精神分裂症误诊原因分析
Analysis of the Causes of Misdiagnosis of Schizophrenia with Obsessive-compulsive Symptoms
高明秀 1庄宁 1王瑞超 1付华斌 1赵会懂2
作者信息
- 1. 050082 石家庄,中国人民解放军联勤保障部队第九八〇医院精神心理科
- 2. 050082 石家庄,中国人民解放军联勤保障部队第九八〇医院医学信息数据室
- 折叠
摘要
目的 探讨伴强迫症状的精神分裂症的临床特点及误诊原因.方法 回顾性分析2021 年1 月至2023年1 月伴强迫症状的精神分裂症4 例的临床资料.结果 4 例以强迫症状为主诉,病史10 个月～9 年,均以强迫为首发症状,均误诊为强迫障碍.2 例为继发性强迫,属于精神病性症状的延续症状,2 例为原发性强迫.误诊时间 10 个月～9 年.依据国际疾病分类第十一次修订本相关标准修正诊断为精神分裂症,1 例给予抗精神病及抗抑郁治疗,3例经抗精神病药物配合多参数无抽搐电休克治疗,2～3 个月后好转,阳性精神病性症状及强迫症状基本消失,残存部分阴性症状.结论 伴强迫症状的精神分裂症病情复杂、社会功能差、认知功能损害严重,误诊率高,预后较差.
Abstract
Objective To investigate the clinical characteristics and causes of misdiagnosis of schizophrenia with obsessive-compulsive symptoms.Methods The clinical data of 4 patients with schizophrenia complicated with obsessive-compulsive symptoms admitted from January 2021 to January 2023 were retrospectively analyzed.Results Four patients pres-ented with obsessive-compulsive symptoms as the main complaint,with a history of 10 months to 9 years,and obsessive-compulsive symptoms as the initial symptom.All were misdiagnosed as obsessive-compulsive disorder.Among them,2 pa-tients had secondary compulsion,which was a continuation of psychotic symptoms,and 2 patients had primary compulsion.The misdiagnosis lasted from 10 months to 9 years.According to the relevant criteria of the 11th revision of the International Classification of Diseases(ICD-11),the diagnosis of schizophrenia was revised.One case was given antipsychotic and antide-pressant treatment,and 3 patients were treated with antipsychotic drugs combined with multi-parameter non-convulsive electro-convulsive therapy.After 2 to 3 months,the positive psychotic symptoms and compulsive symptoms basically disappeared,and some negative symptoms remained.Conclusion Schizophrenia with obsessive-compulsive symptoms is complex,with poor social function,severe cognitive impairment,high misdiagnosis rate,and poor prognosis.
关键词
伴强迫症状的精神分裂症/误诊/强迫障碍/强迫观念行为/反强迫/精神病性症状/治疗/预后Key words
Schizophrenia with obsessive-compulsive symptoms/Misdiagnosis/Obsessive-compulsive disorder/Ob-sessive behavior/Counter-obsessive-compulsive/Psychotic symptoms/Treatment/Prognosis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据