1、精精 神神 病病 学(学(PsychiatryPsychiatry)总总 论论相关概念相关概念相关概念相关概念精神病学的主要分支精神病学的主要分支精神病学发展简史精神病学发展简史1818世纪工业革命对西欧精世纪工业革命对西欧精神病学的影响神病学的影响1785年精神病人被解开锁链现代精神病学的学科发展趋势现代精神病学的学科发展趋势精神障碍的病因精神障碍的病因精神障碍的病因精神障碍的病因Serotonin Genetics and Life StressorsSERT l genotypeamygdalaFearful faces stressorMultiple adult life stres
2、sorsChronic stressorsBrain atrophyamygdalaamygdalaamygdalaamygdalaResilient circuitSERT s genotypevulnerable circuitMDDAnxiety disorderOveractivationNormal BaselineHypoactivation症状学(症状学(signs and signs and symptoms)symptoms)u认知和认知障碍认知和认知障碍u感觉障碍(感觉障碍(sensory disturbancesensory disturbance)知觉障碍知觉障碍(di
3、sorders of perception)知觉障碍知觉障碍(disorders of disorders of perception)perception)知觉障碍知觉障碍(disorders of perception)知觉障碍知觉障碍(disorders of perception)知觉障碍知觉障碍(disorders of perception)知觉障碍知觉障碍(disorders of perception)知觉障碍知觉障碍(disorders of disorders of perception)perception)u思维和思维障碍思维和思维障碍(thinking thinkin
4、g and disorders of thought)and disorders of thought)认知活动认知活动:思维障碍n思维障碍思维障碍(disorders of thought)disorders of thought)n思维障碍思维障碍(disorders of thought)disorders of thought)u思维障碍思维障碍(disorders of thought)disorders of thought)u思维障碍思维障碍(disorders of thought)disorders of thought)u思维障碍思维障碍(disorders of thou
5、ght)disorders of thought)认知活动认知活动:思维障碍u思维内容障碍思维内容障碍(disorders of thinking disorders of thinking content)content)u思维内容障碍思维内容障碍(disorders of disorders of thinking content)thinking content)u思维内容障碍思维内容障碍(disorders of disorders of thinking content)thinking content)u思维内容障碍思维内容障碍(disorders of disorders of
6、thinking content)thinking content)u思维内容障碍思维内容障碍(disorders of disorders of thinking content)thinking content)认知活动认知活动:注意力(attention)o主动注意:随意注意o被动注意:自觉的有预定目的的注意u注意和注意障碍注意和注意障碍(attention and attention and disorders of attention)disorders of attention)u注意障碍注意障碍(disorders of disorders of attention)attent
7、ion)认知活动认知活动:记忆力u记忆及记忆障碍记忆及记忆障碍(memory and memory and disorders of memory)disorders of memory)u记忆障碍(记忆障碍(disorders of memorydisorders of memory)u定向力定向力(orientation)orientation)u自知力自知力(insight)insight)认知活动认知活动:智能(intelligence)o痴呆(dementia)o假性痴呆(Ganser 综合症):近似回答,如1+1=11o童样痴呆(puerilism)u智能和智能障碍智能和智能障碍(
8、intelligence and intelligence and disorders of intelligence)disorders of intelligence)u痴呆(痴呆(dementia)dementia)的分类的分类痴呆(痴呆(dementia)dementia)情感活动情感活动情感和情感障碍(情感和情感障碍(emotion and emotion and emotion disorders)emotion disorders)u情感和情感障碍(情感和情感障碍(emotion and emotion and emotion disorders)emotion disorder
9、s)u情感和情感障碍(情感和情感障碍(emotion and emotion and emotion disorders)emotion disorders)意志活动意志活动o精神运动性兴奋o协调/不协调:躁狂性、青春性、紧张性、器质性o精神运动性抑制o木僵(stupor):紧张性、心因性、抑郁性、器质性木僵o怪异、冲动、自杀、自伤行为意志、行为和意志、行为障碍意志、行为和意志、行为障碍 u意志、行为和意志、行为障碍意志、行为和意志、行为障碍u运动和行为障碍运动和行为障碍u运动和行为障碍运动和行为障碍u运动和行为障碍运动和行为障碍u意识和意识障碍意识和意识障碍 意识和意识障碍意识和意识障碍u环
10、境意识障碍环境意识障碍u自我意识障碍自我意识障碍 u常见的精神症状综合征常见的精神症状综合征u常见的精神症状综合征常见的精神症状综合征精神问诊Mental InterviewThe Science of Observation问诊三步曲问诊三步曲The A.R.T of Interviewing问诊技巧问诊技巧Specific interviewing techniques-1问诊技巧问诊技巧Specific interviewing techniques-2问诊技巧问诊技巧Specific interviewing techniques-3总结总结Technique summarynEmpathynRespectntrust oAlliance附:常用精神障碍分类系统附:常用精神障碍分类系统ICD-10 CLASSIFICATIONCCMD-3CCMD-3精神障碍的诊断分类精神障碍的诊断分类