伴精神病性症状情感性精神障碍的随访观察

目的　探讨伴精神病性症状的情感性精神障碍（ Ｐ Ａ Ｄ） 的预后。方法　对６５ 例 Ｐ Ａ Ｄ 及６９ 例不伴精神病性症状的情感性精神障碍（ Ｎ Ｐ Ａ Ｄ） 进行３ ～６ 年随访，调查其再入院及转归情况。并比较其在人口学特征、疾病表现等方面的异同。结果　４６ ．６７ ％的躁狂症，４４ ％ 的抑郁症及５２ ．１７ ％ 的双相情感障碍都伴发精神病性症状。 Ｐ Ａ Ｄ 与 Ｎ Ｐ Ａ Ｄ 在人口统计学，疾病对目前生活、工作的影响等方面无显著差异。有１８ ．９ ％ 的 Ｐ Ａ Ｄ 再入院诊断改变为精神分裂症，它们有如下特征：起病年龄较小，平均住院日较长，再入院次数较多，伴与情感不一致的妄想症状较多。结论　 Ｐ Ａ Ｄ 是一种常见疾病。 Ｐ Ａ Ｄ 与 Ｎ Ｐ Ａ Ｄ 在预后上无显著差异。有１８ ．９ ％ 的 Ｐ Ａ Ｄ 再入院诊断改变为精神分裂症。

A follow up study of psychotic affective disorder.

Objective To evaluate the prognosis of psychotic affective disorder (PAD). Methods 65 PAD and 69 nonpsychotic affective disorder (NPAD) were followed up for 3 6 years after their discharge. Their demographic features, general clinical characteristics, relapse and change of diagnosis were compared. Results 46.67% of the manic patients, 44 00% of the depressive patients and 52.17% bipolar patients were accompanied with psychotic symptoms. There was no difference in demographic features and clinical characteristics between PAD and NPAD. The patients with younger age, longer hospitalization time, more relapse after discharge and accompanied with mood incongruent delusions, had a higher possibility of receiving a diagnosis of schizophrenia. Conclusions The prevalence of PAD is high. There is no significant difference in the prognosis between PAD and NPAD. 18.9%of the PAD can shift their diagnosis into schizophrenia on re admission.