精神病学
神经症
张亚林
Zhang Ya-lin M.D & Ph.D
History 历史沿革
W.Cullen , 1769 H.Bernheim, 1884
S.Freud
The Modern View for Neuroses
五个共同特征
1. The stress is related to the onset of neuroses
广泛性焦虑症
Treatment
1. drugs 药物 2. relaxation training 放松训练
Obsessive-compulsive neurosis
强迫症
Clinical picture
1. obsessive thoughts 强迫观念 2. obsessive mood 强迫情绪 3. obsessive impulses & behavior
3. psychophysiological symptoms
心理生理症状: 失眠/疼痛/食欲/性欲
Treatment
1. drugs: valium 2. psychotherapyl picture 1. somatic disorder: 躯体障碍 motor disorder , sensory disorder 2. psychological disorder: 精神障碍 amnesia, fugue, identity disorder
教学相长《礼记﹒学记》
疑病症
Clinical picture pain---head, lower lumbar region worries about “medical students’ illness”
“医学生病”
Treatment
?
Neurasthenia
神经衰弱
Clinical picture
1. mental and physical fatigue 心身疲劳 2. irritability 易激惹/烦恼/紧张
Treatment 治疗 1. behavior therapy 2. drugs 药物
行为疗法
Anxiety neurosis 焦虑症
Clinical picture
1. feeling of anxiety 焦虑的体验 2. physical symptoms 运动/植物神经症状 Panic attack 惊恐发作 Generalized anxiety disorder
id
原我
ego
自我
superego
超我
Etiology?/Theories!
相关学说
Behavior theories
stress-response
行为科学理论
刺激-反应
Cognitive theories 认知学说
S C R
认知
Phobia
恐惧症
Clinical picture 临床表现 1. agoraphobia 广场恐惧 2. simple phobia 单一恐惧 3. social phobia 社交恐惧
强迫冲动/行为
Personality features
人格特征
scrupulousness 小心多虑, rigidity 严谨规矩僵化, perfectionism 追求完美, insecurity 不安全感 Treatment 1. drugs； 2. behavior therapy
Hypochondriasis
遗忘 神游 多重人格
Personality features suggestion, self-centred, dramatization, fantasy
暗示性 自我中心 戏剧性 幻想
Treatment
induced therapy 诱导疗法
Men learn while they teach
无相应的器质病变;
4. The social function is normal on the whole
社会功能相对完好;
5. The neurotic patients do not lose insight
自知力充分.
The Classification of Neuroses
分类
Phobia 恐惧症 Anxiety disorder 焦虑症 Obsessive-compulsive disorder Hypochondriasis 疑病症 Neurasthenia 神经衰弱 Hysteria 癔症 Other 其他
发病与心理因素相关；
2. The personality is an importance although it is not grossly abnormal
个性特征突出；
The Modern View for Neuroses 五个共同特征
3. Neuroses are not caused by any kind of organic brain disorders
强迫症
The epidemiology
患病率
22.21%0
Etiology?/Theories!
相关学说
Psychoanalytic theories 精神分析学说

unconsciousness
潜意识
dream
梦
wrong
错误
neurotic symptoms
神经症症状
人格构成

personality structure