망상장애

기본 개념

망상장애 (Delusional disorder)

진단: 1개월 이상 망상 + 환각·와해 언행 없음(있어도 경미) + 일상 기능 유지
감별: 직장·대인관계 멀쩡하고 망상만 두드러지면 망상장애(조현병은 전반적 기능 저하)
아형: 질투형(배우자 외도) / 색정형(유명인이 나를 사랑) / 피해형(독가스·도청) / 과대형 / 신체형
치료: 항정신병약물 (병식 부족으로 치료 동맹 형성이 관건), 인지행동치료 보조

DSM-5 Delusional Disorder
A. The presence of one (or more) delusions with a duration of 1 month or longer. B. Criterion A for schizophrenia has never been met. (Note: Hallucinations, if present, are not prominent and are related to the delusional theme.) C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd. D. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods. E. The disturbance is not attributable to a substance or another medical condition and is not better explained by another mental disorder Specify type: Erotomanic / Grandiose / Jealous / Persecutory / Somatic / Mixed / Unspecified. Specify if: With bizarre content.

DSM-5 Delusional Disorder

A. The presence of one (or more) delusions with a duration of 1 month or longer.
B. Criterion A for schizophrenia has never been met. (Note: Hallucinations, if present, are not prominent and are related to the delusional theme.)
C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
D. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
E. The disturbance is not attributable to a substance or another medical condition and is not better explained by another mental disorder

Specify type: Erotomanic / Grandiose / Jealous / Persecutory / Somatic / Mixed / Unspecified. Specify if: With bizarre content.

공유정신병적 장애

개념: 망상 있는 사람(원발 환자, 보통 조현병 가족)과 밀접하게 지내며 그 망상을 받아들임
- ex) 조현병 아버지와 단둘이 사는 아이가 같은 망상을 보임 + 학교에선 정상
1차 조치: 원발 환자와 분리(분리만으로 호전)
DSM-5에서는 독립 진단으로 폐지 → "달리 명시된 조현병 스펙트럼/정신병적 장애" 또는 망상장애로 분류(아래는 DSM-IV-TR 원문)

DSM-IV-TR Shared Psychotic Disorder (folie à deux)
A. A delusion develops in an individual in the context of a close relationship with another person(s) who has an already-established delusion. B. The delusion is similar in content to that of the person who already has the established delusion. C. The disturbance is not better accounted for by another psychotic disorder (e.g., schizophrenia) and is not due to the physiological effects of a substance or a general medical condition.

DSM-IV-TR Shared Psychotic Disorder (folie à deux)

A. A delusion develops in an individual in the context of a close relationship with another person(s) who has an already-established delusion.
B. The delusion is similar in content to that of the person who already has the established delusion.
C. The disturbance is not better accounted for by another psychotic disorder (e.g., schizophrenia) and is not due to the physiological effects of a substance or a general medical condition.

연습문제 6문제

0/6 완료

정신건강의학과 (new) - 망상 및 기타 정신병적 장애

기간으로 가르는 정신병 스펙트럼

정신건강의학과 (new) - 망상 및 기타 정신병적 장애

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