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統合失調症はどんな病気?


自分はひょっとして統合失調症ではないかと相談を受けることがあります。私は医師でないので必ず精神科を受診されることをお勧めします。なんとなく足が病院に向かない方がたまにおられます。 自己判断は危険だとおもいますが参考になればと思い一部掲載します。

これは国際的な統合失調症の診断基準だそうです。ただしこれのみで自己判定して確定するのは危険ですので迷った時などは直ちに精神科を受診されれば良いと思います。国際的な診断基準は英語で表記されています。あくまでも参考ですのでご注意ください。

私が下手に訳すと誤解や問題が生じますので原文のままです。(かなり不親切ですみません。)他のサイトで多分上手い翻訳文があるはずです。

ICD-10とDSM-IVを検索してみてください。

Diagnostic criteria for schizophrenia according to the ICD-10 classification of mental and behavioral disorders.

1) thought echo, thought insertion or withdrawal, and thought broadcasting;

2) delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions, or sensations; delusional perception;

3) hallucinatory voices giving a running commentary on the patient's behavior, or discussing the patient among themselves, or other types of hallucinatory voices coming from some part of the body;

4) persistent delusions of other kinds that are Culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and abilities (e.g., being able to control the Weather, or being in communication with aliens from another World);

5) persistent hallucinations in any modality, when accompanied either by fleeting or half formed delusions without clear affective content, or by persistent over valued ideas, or when occurring every day for weeks or months on end;

6) breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech, or neologisms;

7) catatonic behavior, such as excitement, posturing or waxy flexibility, negativism, mutism, and stupor;

8) "negative" symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance, it must be clear that these are not due to depression or to neuroleptic medication,

9) a significant and consistent change in the overall quality of some aspects of personal behavior, manifested as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.

Diagnostic guidelines

One Very clear symptom (and usually two if less clear-cut) from any of the groups listed as (1) to (4) above, or symptoms from at least two of the groups listed as (5) to (8), should have been clearly present for most of the time during a period of 1 month or more. Symptoms from group (9) applies only to the diagnosis of simple Schizophrenia, and a duration of at least 1 year is required. The diagnosis of Schizophrenia should not be made in the presence of overt brain disease, during states of drug intoxication or withdrawal, or in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedated the affective disturbance.

Diagnostic criteria for schizophrenia according to DSM-IV

A. Delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence) grossly disorganized or catatonic behavior, negative symptoms (e.g., affective flattening, alogia, avolition)

B. Social or Occupational dysfunction for a significant portion of the time since onset

C. Continuous signs of the disturbance persisting for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A and may include periods of prodromal or residual symptoms.

D. Schizoaffective and mood disorders should be ruled out.

E. The disturbance should not be due to the direct physiological effects of a substance or a general medical Condition.

F. In case of a history of Autistic Disorder or another Pervasive Developmental Disorder, the diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month (or less if successfully treated).

Diagnostic guidelines: One symptom will satisfy Criterion A if delusions are bizarre or auditory hallucinations Consist of running Commentary on the person's behavior or thoughts. Otherwise, at least two should be present for a significant portion of time during a 1-month period (or less if Successfully treated). All Criteria A-F are required for the diagnosis.

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