编辑“思覺失調”

{{Redirect2|精神病|心理疾患|精神疾患}}
{{Redirect2|精神錯亂|3=精神病人 (過時術語)|過時的醫學及法律術語}}{{Distinguish|思覺失調症|精神官能症}}
{{NoteTA
|G1 = Medicine
}}
{{Expert needed|subject=醫學|time=2022-04-11T00:58:45+00:00}}
{{medical}}
{{Infobox medical condition
| name = 思覺失調
| synonyms = 早期精神病（Early Psychosis）
| image = Van Gogh - Starry Night - Google Art Project.jpg
| caption = [[梵高]]1889 年的「[[星夜]]」展示了因為精神病而可能出現的光線和顏色的變化<ref>{{Cite book|title=Morgue: A Life in Death|url=https://books.google.com/books?id=e7HPCgAAQBAJ&pg=PA236|publisher=St. Martin's Publishing Group|date=2016-05-17|isbn=978-1-4668-7506-7|language=en|first=Dr Vincent Di|last=Maio|first2=Ron|last2=Franscell|page=236|access-date=2022-10-11|archive-date=2023-01-14|archive-url=https://web.archive.org/web/20230114033238/https://books.google.com/books?id=e7HPCgAAQBAJ&pg=PA236|dead-url=no}}</ref><ref>{{Cite book|title=Neurological Disorders in Famous Artists|url=https://books.google.com/books?id=Glx9t1aWvzQC&pg=PA125|publisher=Karger Medical and Scientific Publishers|date=2005-01-01|isbn=978-3-8055-7914-8|language=en|first=Julien|last=Bogousslavsky|first2=François|last2=Boller|page=125|access-date=2022-10-11|archive-date=2023-01-14|archive-url=https://web.archive.org/web/20230114033221/https://books.google.com/books?id=Glx9t1aWvzQC&pg=PA125|dead-url=no}}</ref>。
| field = [[精神醫學]]
| symptoms = [[幻聽]]、[[幻覺]]、[[妄想]]<ref name="HVM001" />、語無倫次<ref name="NIH2018QA" />
| complications = [[自我傷害]]、[[自殺]]
| onset = 
| duration = 
| types = 
| causes = [[精神疾患]]、身體疾病、[[藥物濫用]]、[[睡眠不足|睡眠剝奪]]
| risks = 
| diagnosis = 
| differential = 
| prevention = 
| treatment = [[抗精神病藥]]、[[心理治療]]、[[社會支持]]
| medication = 
| prognosis = 依病因而異
| frequency = 3%
| deaths = 
}}
'''思覺失調'''（{{lang-en|Early Psychosis}}）<ref>{{Cite web |title=Smart Patient Website - Early Psychosis |url=https://www21.ha.org.hk/smartpatient/SPW/en-us/Disease-Information/Disease/?guid=efc1ca62-8742-4bd4-9554-d75b43138f77 |archive-url=https://web.archive.org/web/20221014112857/https://www21.ha.org.hk/smartpatient/SPW/en-us/Disease-Information/Disease/?guid=efc1ca62-8742-4bd4-9554-d75b43138f77 |archive-date=2022-10-14 |access-date=2022-10-12 |website=www21.ha.org.hk |dead-url=no }}</ref><ref>{{Cite web |title=Schizophrenia中文譯名由「精神分裂症」更名為「思覺失調症」的歷史軌跡。 |url=http://www.pinsoul.com/blog-zh/2015/5/27/2 |archive-url=https://web.archive.org/web/20221015040123/http://www.pinsoul.com/blog-zh/2015/5/27/2 |archive-date=2022-10-15 |access-date=2022-10-13 |website=pinsoul |language=en-US |dead-url=no }}</ref>是醫學術語<ref>{{Cite web |title=思覺失調 {{!}} 常見精神疾病 {{!}} 思健醫務中心 |url=https://www.healthymindhk.com/%E6%80%9D%E8%A6%BA%E5%A4%B1%E8%AA%BF |archive-url=https://web.archive.org/web/20221013085030/https://www.healthymindhk.com/%E6%80%9D%E8%A6%BA%E5%A4%B1%E8%AA%BF |archive-date=2022-10-13 |access-date=2022-10-12 |website=思健醫務中心 HealthyMind |language=zh |dead-url=no }}</ref><ref>{{Cite web |title=105年7月68期 - 國軍高雄總醫院-院刊內容 |url=https://802.mnd.gov.tw/ListP0003102.ShowItemListState.do?StateEvent=InitEvent&QueryRecord.ArticleId=2016-07-06%2013:26:04 }}{{Dead link}}</ref>，是[[心智]]的異常狀態，為'''精神病'''（{{lang-en|Psychosis}}）<ref>{{Cite web |title=psychosis - 精神病 |url=https://terms.naer.edu.tw/detail/3285072/?index=6 |archive-url=https://web.archive.org/web/20221016074303/https://terms.naer.edu.tw/detail/3285072/?index=6 |archive-date=2022-10-16 |access-date=2022-10-16 |website=terms.naer.edu.tw |dead-url=no }}</ref>的早期。描述一個人與現實失去聯繫<ref name="NIH2018QA">{{cite web |title=RAISE Questions and Answers |url=https://www.nimh.nih.gov/health/topics/schizophrenia/raise/raise-questions-and-answers.shtml |archive-url=https://web.archive.org/web/20191008203120/https://www.nimh.nih.gov/health/topics/schizophrenia/raise/raise-questions-and-answers.shtml |archive-date=2019-10-08 |access-date=2020-04-24 |website=NIMH |dead-url=no }}</ref>，屬於[[思覺失調症]]（{{lang-en|Schizophrenia}}）的症狀之一。但是一個人出現了思覺失調的症狀，不一定是思覺失調症。換句話說，一個人也可能在不是思覺失調症的情況下經歷思覺失調的症狀<ref>{{Cite web |date=2022-01-26 |title=Psychosis vs. Schizophrenia: Understanding the Difference |url=https://www.healthline.com/health/schizophrenia/psychosis-vs-schizophrenia |archive-url=https://web.archive.org/web/20221016161410/https://www.healthline.com/health/schizophrenia/psychosis-vs-schizophrenia |archive-date=2022-10-16 |access-date=2022-10-12 |website=Healthline |language=en |dead-url=no }}</ref>。此外，如一個人經歷思覺失調的症狀，但持續時間少於一個月，會被診斷為「短暫性／急性思覺失調」(Acute schizophrenia-like psychotic disorder)。<ref>{{Cite web|title=ICD-10 Version:2019|url=https://icd.who.int/browse10/2019/en#F23.2|access-date=2023-09-23|website=icd.who.int|archive-date=2020-03-31|archive-url=https://archive.today/20200331004754/https://icd.who.int/browse10/2019/en%23/U07.1#F23.2|dead-url=no}}</ref><ref>{{Cite web|last=Limited|first=Digital Candy Hong Kong|title=甚麼是思覺失調？|url=https://www.mind.org.hk/zh-hant/mental-health-a-to-z/%e6%80%9d%e8%a6%ba%e5%a4%b1%e8%aa%bf/%e7%94%9a%e9%ba%bc%e6%98%af%e6%80%9d%e8%a6%ba%e5%a4%b1%e8%aa%bf%ef%bc%9f/|access-date=2023-09-23|website=Mind HK|language=zh-hant|archive-date=2023-10-03|archive-url=https://web.archive.org/web/20231003081934/https://www.mind.org.hk/zh-hant/mental-health-a-to-z/%e6%80%9d%e8%a6%ba%e5%a4%b1%e8%aa%bf/%e7%94%9a%e9%ba%bc%e6%98%af%e6%80%9d%e8%a6%ba%e5%a4%b1%e8%aa%bf%ef%bc%9f/|dead-url=no}}</ref><ref>{{Cite web|last=Henderson|first=Dr Roger|date=2020-04-28|title=Everything you need to know about schizophrenia|url=http://www.netdoctor.co.uk/conditions/brain-and-nervous-system/news/a341/schizophrenia/|access-date=2023-09-23|website=Netdoctor|language=en-GB}}</ref>

思覺失調主要症狀：
*[[幻聽]]、[[幻覺]]<ref name="HVM001">{{Cite web |title=【 請使用「聽聲」取代「幻聽」，避免污名化 】 |url=https://hvmtw.blogspot.com/2022/05/blog-post_27.html |archive-url=https://web.archive.org/web/20220707075753/https://hvmtw.blogspot.com/2022/05/blog-post_27.html |archive-date=2022-07-07 |access-date=2022-10-13 |language=zh-TW |dead-url=no }}</ref> – [[聽聲者]]聽到、看到或感覺到身旁者沒有聽到、看到或感覺到的事情。
*[[妄想]] – 在現實環境中無充分的依據，且不被他人認同的強烈信念。
*其他病徵還有[[思考障礙|語無倫次]]及不合時宜的行為舉止。

<!-- Cause and treatment -->
思覺失調有許多可能的成因，包含：
*[[精神疾患]]。
*[[藥物濫用]]。
*[[睡眠不足|睡眠剝奪]]。
*某些身體疾病等情況<ref name="NIH2018QA" /><ref name="NHS2020-C">{{cite web |title=Psychosis - Causes |url=https://www.nhs.uk/conditions/psychosis/causes/ |archive-url=https://web.archive.org/web/20210126121649/https://www.nhs.uk/conditions/psychosis/causes/ |archive-date=2021-01-26 |access-date=2020-04-24 |website=NHS |dead-url=no }}</ref>。
治療包含：
*[[抗精神病藥]]。
*心理諮商。
*[[社會支持]]等<ref name="NIH2018QA" /><ref name="NHS2020-P">{{cite web |title=Psychosis |url=https://www.nhs.uk/conditions/psychosis/ |archive-url=https://web.archive.org/web/20181015043847/https://www.nhs.uk/Conditions/Psychosis/Pages/Prevention-OLD.aspx |archive-date=2018-10-15 |access-date=2020-04-24 |website=NHS |dead-url=no }}</ref>。

要診斷精神疾患，應排除其他潛在的成因<ref name="NIH2018QA" /><ref>{{Cite book|title=The Diagnosis of Psychosis|url=https://books.google.ca/books?id=wE3FXgW9gDkC&pg=PA279|publisher=Cambridge University Press|date=2011-03-31|isbn=978-1-139-49790-9|language=en|first=Rudolf N.|last=Cardinal|first2=Edward T.|last2=Bullmore|page=279}}</ref>，尤其如果出現不典型的症狀<ref name="NHS2020-P" /><ref name="Sadock2015">{{cite book|last1=Sadock|first1=Benjamin J.|title=Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry|date=2015|publisher=Wolters Kluwer|isbn=9781469883755|page=317|url=https://books.google.com.tw/books?id=IzGYBAAAQBAJ|access-date=2020-04-26|archive-date=2021-01-22|archive-url=https://web.archive.org/web/20210122003700/https://books.google.com.tw/books?id=IzGYBAAAQBAJ|dead-url=no}}</ref>。[[神经递质|神經傳導物質]][[多巴胺]]據信扮演重要角色<ref name="NHS2020-C" />。

== 定義 ==
在[[精神疾病診斷與統計手冊]]的早期版本中，定義精神病為「現實感喪失」或「自我界限消失」<ref name="Arciniegas2015">{{cite journal en |last=Arciniegas |first=David B |year=2015 |title=Psychosis |journal=Continuum (Minneap Minn) |volume=21 |pages=716}}</ref>，導致日常生活功能下降。在[[國際疾病與相關健康問題統計分類]]第九版中，則使用當時傳統的二分法，區分精神病與[[精神官能症]]，並且刻意沒有給予詳細定義。而在這兩本手冊的現今版本中，則使用狹義的定義，指須有妄想、幻覺或兩者兼具的症狀，並視思考障礙為可能出現的相關症狀。當精神病的原因是精神疾患時，稱為原發性精神症，當原因是其他醫學情況時，稱為次發性精神症<ref name="Griswold2015">{{Cite journal |last=Griswold |first=Kim S. |last2=Regno |first2=Paula a. Del |last3=Berger |first3=Roseanne C. |date=2015-06-15 |title=Recognition and Differential Diagnosis of Psychosis in Primary Care |url=https://www.aafp.org/pubs/afp/issues/2015/0615/p856.html |journal=American Family Physician |language=en-US |volume=91 |issue=12 |access-date=2022-11-13 |archive-date=2023-03-03 |archive-url=https://web.archive.org/web/20230303172217/https://www.aafp.org/pubs/afp/issues/2015/0615/p856.html |dead-url=no }}</ref>。

== 流行病學 ==
任何年齡、性別、種族、生活水準或學歷的人士都有機會患病。在美國，精神病的終生盛行率約為3%<ref name=Griswold2015/>，其中約0.21%是由一般醫學情況所引起的<ref>{{Cite journal |last=Perälä |first=Jonna |last2=Suvisaari |first2=Jaana |last3=Saarni |first3=Samuli I. |last4=Kuoppasalmi |first4=Kimmo |last5=Isometsä |first5=Erkki |last6=Pirkola |first6=Sami |last7=Partonen |first7=Timo |last8=Tuulio-Henriksson |first8=Annamari |last9=Hintikka |first9=Jukka |last10=Kieseppä |first10=Tuula |last11=Härkänen |first11=Tommi |date=2007-01-01 |title=Lifetime Prevalence of Psychotic and Bipolar I Disorders in a General Population |url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.64.1.19 |journal=Archives of General Psychiatry |language=en |volume=64 |issue=1 |doi=10.1001/archpsyc.64.1.19 |issn=0003-990X |pmid=17199051 |access-date=2022-11-13 |archive-date=2021-10-01 |archive-url=https://web.archive.org/web/20211001175524/http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.64.1.19 |dead-url=no }}</ref>。[[思覺失調症]]及第一型[[躁鬱症]]的終生盛行率則各約1%<ref>{{Cite journal |last=Merikangas |first=Kathleen R. |last2=Pato |first2=Michael |date=2009-06 |title=Recent developments in the epidemiology of bipolar disorder in adults and children: Magnitude, correlates, and future directions. |url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01152.x |journal=Clinical Psychology: Science and Practice |language=en |volume=16 |issue=2 |doi=10.1111/j.1468-2850.2009.01152.x |issn=1468-2850}}</ref>。

==病徵==
=== 妄想 === 
{{Main|妄想}}
{{quote|自古以來，瘋狂的核心特徵就是妄想。|[[卡尔·雅斯贝尔斯]], 1963, p. 93<ref name="Jaspers">{{cite book|last=Jaspers|first=Karl|name-list-format=vanc|authorlink=卡尔·雅斯贝尔斯|others=Translated by J. Hoenig and M.W. Hamilton from German|title=Allgemeine Psychopathologie (General Psychopathology)|origyear=1963|edition = Reprint|date=1997-11-27|publisher=Johns Hopkins University Press|location=Baltimore, Maryland|isbn=978-0-8018-5775-1}}</ref>}}

妄想是堅信不疑的錯誤[[信念]]，縱使有強烈相反證據也無法動搖，並且不在所屬文化中流行<ref name="Sadock2015" />。要將無法合理確認的信念視為妄想時，應特別謹慎，例如文化與宗教的領域。一群人所共同持有的信念不是妄想，例如相信[[幽浮]]的存在<ref name="Hopkins2020">{{cite web |last=Barta |first=Patrick |title=Delusions |url=https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787024/all/Delusions |archive-url=https://web.archive.org/web/20210122002626/https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787024/all/Delusions |archive-date=2021-01-22 |access-date=2020-04-24 |website=Johns Hopkins Psychiatry Guide |dead-url=no }}</ref>。妄想在思覺失調症中的盛行率至少90%，在躁鬱症中則有50%。在第五版的精神疾病診斷與統計手冊（DSM-5）中，定義怪異妄想為全然不可能的信念，不被所處文化的同儕所理解，也不是日常生活經驗所導出的體悟<ref name="DSM5">{{cite book|title=Diagnostic and Statistical Manual of Mental Disorders: DSM-5|publisher=American Psychiatric Association|year=2013}}</ref>，例如相信自己的器官已被換成別人的，還沒有留下任何疤痕。

妄想可依內容主題分為[[被害妄想]]、[[情愛妄想|愛戀妄想]]、[[自大型妄想|誇大妄想]]、[[病態性嫉妒|嫉妒妄想]]、[[軀體型妄想|身體妄想]]等。其中最常見的被害妄想，牽涉到個人相信本身被人謀害、欺騙、監視、跟蹤、下毒、惡意毀謗、騷擾或是阻礙其追隨長遠目標的情況<ref name="DSM5" />。嫉妒妄想主題是伴侶不貞。{{tsl|en|Delusional misidentification syndrome|妄想性錯認症候群}}患者的妄想主題都與人事物的身份被改變有關，例如[[卡普格拉综合征|卡普格拉症候群]]則是患者相信親友被人冒名頂替，外表一模一樣但是內在卻不同；{{tsl|en|Fregoli syndrome|佛列哥利症候群}}的患者認為不同的人皆是同一人所裝扮而成的<ref name="Arciniegas2015" />。

與妄想相對比，{{tsl|en|Overvalued idea|超價觀念}}則是不合理的執著信念，可被理解且未達堅信的程度<ref name="Arciniegas2015" />，例如在[[体象障碍|身體臆形症]]患者所認為自身外觀缺陷的念頭<ref>{{cite book|ref={{harvid | Clinical Manifestations of Psychiatric Disorders | 2017 }}|last1=Matorin|first1=Anu A|last2=Shah|first2=Asim A|last3=Ruiz|first3=Pedro|editor1-last=Sadock|editor1-first=Virginia A|editor2-last=Sadock|editor2-first=Benjamin J|editor3-last=Ruiz|editor3-first=Pedro|year=2017|title=Kaplan & Sadock's Comprehensive Textbook of Psychiatry|edition=10th|isbn=978-1-4511-0047-1|publisher=Wolters Kluwer|chapter=8 Clinical Manifestations of Psychiatric Disorders|at=THINKING DISTURBANCES, Thought Content, Disturbances in Thought Contents.}}</ref>，或者當懷疑伴侶不貞的念頭可以被相反證據所說服時，不應視為妄想<ref>{{cite book|editor1-last=Kinirons|editor1-first=Mark|title=French's Index of Differential Diagnosis, 1 An A-Z|publisher=CRC Press|isbn=9781444128703|year=2011|url=https://books.google.com.tw/books?id=qWzNBQAAQBAJ&pg=PA134|access-date=2020-04-26|archive-date=2021-01-22|archive-url=https://web.archive.org/web/20210122002542/https://books.google.com.tw/books?id=qWzNBQAAQBAJ&pg=PA134|dead-url=no}}</ref>。當錯誤信念牽涉到價值判斷時，只有當該判斷極端到不可置信時才可以被視為妄想。[[虛談症]]也不是妄想，那是指無意欺瞞的編造記憶，通常為自傳性質，講述時非常相信，但卻時常隨即忘記<ref name="Arciniegas2015" />。

=== 幻覺 ===
{{Main|幻觉}}
根據法國精神科組織之父{{tsl|fr|Jean-Étienne Esquirol|吉恩·埃斯基羅爾}}醫師的定義，幻覺為「沒有刺激來源的知覺」<ref>{{cite book|last1=Freudenreich|first1=Oliver|year=2007|title=Psychotic Disorders: A Practical Guide|isbn=9780781785433|publisher=Lippincott Williams & Wilkins}}</ref>。沒有病識感的幻覺才是精神症的症狀<ref name="Arciniegas2015" />，相對於[[偏頭痛]]預兆時所出現的視幻覺，偏頭痛病人通常知道該幻覺並非真實。幻覺可能牽涉五官中任何一個感官，以不同形式出現，可以是簡單的感受（例如光線、顏色、聲音、味道、氣味）或是複雜仔細的經驗（看見形體、聽見語音），通常具有生動且無法控制的特性<ref name="DSM5" />。其中，[[幻聽]]是最常見且顯著的一種形式，所聽到的聲音可能談及某些人，甚至是好幾個假想的角色中的對話。{{tsl|en|Lilliputian hallucinations|小人國幻覺}}使人感到東西看起來比實際的或大或小忽遠忽近，則較常出現在腦病變患者身上<ref name="Sadock Psychosis">{{cite book|last1=Lewis|first1=Stephen|last2=Escalona|first2=Rodrigo|last3=Keith|first3=Samuel|editor1-last=Sadock|editor1-first=Virginia|editor2-last=Sadock|editor2-first=Benjamin|editor3-last=Ruiz|editor3-first=Pedro|name-list-format=vanc|title=Kaplan and Sadock's Comprehensive Textbook of Psychiatry|publisher=Wolters Kluwer|chapter=Phenomenology of Schizophrenia}}</ref>。

[[錯覺]]與幻覺並不同，那是對真實刺激的錯誤解讀。[[既視感]]也非幻覺<ref name="Arciniegas2015" />。

=== 思想及言語紊亂 ===
談話內容無意義的、急迫、缺乏主題、雜亂無章、語無倫次，不切實際以致別人難以理解。

==治療==

思覺失調可用藥物治療及心理治療，藥物治療主要用作減退徵狀、由徵狀帶來的緊張、不安及困擾。家人應持續監察患者情況，小心其濫用藥物等的行為<ref name=":2">{{Cite web |title=思覺失調的症狀治療與康復 |url=http://www3.ha.org.hk/easy/chi/what04.html |archive-url=https://web.archive.org/web/20210106030125/https://www3.ha.org.hk/easy/chi/what04.html |archive-date=2021-01-06 |access-date=2012-05-09 |dead-url=no }}</ref>。

有些新的藥物及療法讓患者不一定需要入院接受治療，只需定期到門診接受評估。即使需要住院治療，其留醫時間因為新的藥物以及療法亦可以儘量縮短 。每個患者的康復過程和速度都會有名有分別；有些人可在很短的時間便可康復；而有些人需要較長的時間。在徵狀未完全受到控制前，有些患者會感到困擾和沮喪，擔心自己不能完全康復，以及不知如何去面對未來的日子。在這關鍵的時候，家人和朋友應該給予支持和鼓勵，協助他們面對難關，使他們相信疾病是可以治療的。

==病發過程==
;先兆期 
這階段難以被察覺和並不明顯。徵狀包括焦慮、失眠、思想難以集中、多疑和社交退縮。

;急性期 
這階段會有較明顯的徵狀，例如思想及言語紊亂、幻覺和妄想。

;第三階段 康復期 
患者可能因接受治療而使狀況改善，但無法恢復至原先狀態。
正性症狀通常於此一階段減輕許多，但負性症狀卻大多持續存在著。

== 病因 ==
=== 正常狀態 ===
在正常人身上偶爾也會有短暫的幻覺出現<ref name="Cardinal_2011_diagnosis_psychosis">{{Cite book|title=The diagnosis of psychosis|url=https://www.worldcat.org/oclc/671710663|publisher=Cambridge University Press|date=2011|location=Cambridge, UK|isbn=978-0-521-16484-9|oclc=671710663|first=Edward T.|last=Bullmore}}</ref>，原因如下：
* {{tsl|en|hypnopompic|剛睡醒}}或{{tsl|en|Hypnagogic|即將睡著}}時，出現的聽幻覺或視幻覺完全正常<ref name="Ohayon_et_al_1996">{{cite journal |vauthors=Ohayon MM, Priest RG, Caulet M, Guilleminault C |date=1996-10 |title=Hypnagogic and hypnopompic hallucinations: pathological phenomena? |journal=The British Journal of Psychiatry |volume=169 |issue=4 |pages=459–67 |doi=10.1192/bjp.169.4.459 |pmid=8894197}}</ref>
* [[喪慟]]時，出現離世親人的幻覺<ref name="Cardinal_2011_diagnosis_psychosis" />
* 嚴重的[[睡眠不足|睡眠剝奪]]<ref name="sleep_dep1">{{cite journal |vauthors=Sharma V, Mazmanian D |date=2003-04 |title=Sleep loss and postpartum psychosis |journal=Bipolar Disorders |volume=5 |issue=2 |pages=98–105 |doi=10.1034/j.1399-5618.2003.00015.x |pmid=12680898}}</ref><ref name="sleep_dep2">{{cite journal |vauthors=Chan-Ob T, Boonyanaruthee V |date=1999-09 |title=Meditation in association with psychosis |journal=Journal of the Medical Association of Thailand = Chotmaihet Thangphaet |volume=82 |issue=9 |pages=925–30 |pmid=10561951}}</ref><ref name="sleep_dep3">{{Cite journal |last=Devillières |first=P. |last2=Opitz |first2=M. |last3=Clervoy |first3=P. |last4=Stephany |first4=J. |date=1996-05 |title=Delusion and sleep deprivation |url=https://pubmed.ncbi.nlm.nih.gov/8767052 |journal=L'Encephale |volume=22 |issue=3 |issn=0013-7006 |pmid=8767052 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022640/https://pubmed.ncbi.nlm.nih.gov/8767052/ |dead-url=no }}</ref>
*壓力<ref>{{Cite journal |last=Gispen-de Wied |first=Christine C |date=2000-09-29 |title=Stress in schizophrenia: an integrative view |journal=European Journal of Pharmacology |series=Festschrift David de Wied |volume=405 |issue=1 |pages=375–384 |doi=10.1016/S0014-2999(00)00567-7 |issn=0014-2999 |pmid=11033342}}</ref>

=== 精神性 ===
原發性精神疾病包括<ref name="DSM5" /><ref name="ICD-10">[[世界卫生组织|World Health Organization]], [http://www.who.int/entity/classifications/icd/en/bluebook.pdf ''The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines (CDDG)''] {{Wayback|url=http://www.who.int/entity/classifications/icd/en/bluebook.pdf|date=20200519210119}}, 1992.</ref>：
* [[思覺失調症]]與{{tsl|en|schizophreniform disorder|類思覺失調症}}
* 情緒性精神疾患中，例如[[重性抑鬱疾患|鬱症]]、[[躁鬱症]]中，鬱症階段時出現被害或自責妄想與幻覺，或是在躁症發作時經歷誇大妄想
* [[分裂情感性障碍|情感思覺失調症]]，同時出現情緒障礙症發作和思覺失調症的症狀
* {{tsl|en|brief psychotic disorder|短暫精神病症}}
* [[妄想症]] 
* {{tsl|en|chronic hallucinatory psychosis|慢性幻覺性精神症}}

也可以出現在下列疾患中<ref name="Cardinal_2011_diagnosis_psychosis" />：
* [[分裂性人格障礙]]
* 某些[[人格障礙]]遭遇壓力時（包括[[偏執型人格障礙|妄想型人格障礙症]]、[[類精神分裂型人格違常|孤僻型人格障礙症]]、[[边缘性人格障碍|邊緣型人格障礙症]]）
* [[創傷後壓力症候群]]
* [[二联性精神病]]
* 有些[[强迫症]]患者
* [[解离性障碍]]<ref>{{Cite journal |last=Shibayama |first=Masatoshi |date=2011 |title=[Differential diagnosis between dissociative disorders and schizophrenia] |url=https://pubmed.ncbi.nlm.nih.gov/22117396/ |journal=Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica |volume=113 |issue=9 |issn=0033-2658 |pmid=22117396 |access-date=2022-11-13 |archive-date=2023-03-31 |archive-url=https://web.archive.org/web/20230331113944/https://pubmed.ncbi.nlm.nih.gov/22117396/ |dead-url=no }}</ref>

=== 生理性 ===
*神經紊亂
**[[腦癌]]<ref name="Brain_tumor">{{Cite journal |last=Lisanby |first=null |last2=Kohler |first2=null |last3=Swanson |first3=null |last4=Gur |first4=null |date=1998-01 |title=Psychosis Secondary to Brain Tumor |url=https://pubmed.ncbi.nlm.nih.gov/10085187/ |journal=Seminars in Clinical Neuropsychiatry |volume=3 |issue=1 |issn=1084-3612 |pmid=10085187 |access-date=2022-11-13 |archive-date=2022-11-19 |archive-url=https://web.archive.org/web/20221119001507/https://pubmed.ncbi.nlm.nih.gov/10085187/ |dead-url=no }}</ref>
**退化性癡呆症<ref name="DLB">{{Cite journal |last=McKeith |first=Ian G. |date=2002-02 |title=Dementia with Lewy bodies |url=https://www.cambridge.org/core/product/identifier/S0007125000270888/type/journal_article |journal=British Journal of Psychiatry |language=en |volume=180 |issue=2 |doi=10.1192/bjp.180.2.144 |issn=0007-1250 |pmid=11823325}}</ref>
**[[多发性硬化症]]<ref name="multiple_sclerosis">{{Cite journal |last=Rodríguez-Gómez |first=D. |last2=Gónzalez-Vázquez |first2=E. |last3=Pérez-Carral |first3=O. |date=2005-08 |title=Acute psychosis as the presenting symptom of multiple sclerosis |url=https://pubmed.ncbi.nlm.nih.gov/16075405/ |journal=Revista De Neurologia |volume=41 |issue=4 |issn=0210-0010 |pmid=16075405 |access-date=2022-11-13 |archive-date=2022-11-19 |archive-url=https://web.archive.org/web/20221119001517/https://pubmed.ncbi.nlm.nih.gov/16075405/ |dead-url=no }}</ref>
**[[结节病]]<ref name="Sarcoidosis">{{Cite journal |last=Bona |first=Joseph R. |last2=Fackler |first2=Sondralyn M. |last3=Fendley |first3=Morris J. |last4=Nemeroff |first4=Charles B. |date=1998-08 |title=Neurosarcoidosis as a Cause of Refractory Psychosis: A Complicated Case Report |url=http://psychiatryonline.org/doi/abs/10.1176/ajp.155.8.1106 |journal=American Journal of Psychiatry |language=en |volume=155 |issue=8 |doi=10.1176/ajp.155.8.1106 |issn=0002-953X |pmid=9699702}}</ref>
**[[阿茲海默症|老人癡呆症]]<ref>{{Cite journal |last=Lesser |first=Jary M. |last2=Hughes |first2=Susan |date=2006-12 |title=Psychosis-related disturbances. Psychosis, agitation, and disinhibition in Alzheimer's disease: definitions and treatment options |url=https://pubmed.ncbi.nlm.nih.gov/17184138/ |journal=Geriatrics |volume=61 |issue=12 |issn=1936-5764 |pmid=17184138 |access-date=2022-11-13 |archive-date=2022-11-19 |archive-url=https://web.archive.org/web/20221119001654/https://pubmed.ncbi.nlm.nih.gov/17184138/ |dead-url=no }}</ref>
**[[帕金森氏症|柏金遜症]]<ref name=":3">{{Cite journal |last=Goldman |first=Jennifer G. |last2=Holden |first2=Samantha |date=2014-03 |title=Treatment of Psychosis and Dementia in Parkinson’s Disease |url=http://link.springer.com/10.1007/s11940-013-0281-2 |journal=Current Treatment Options in Neurology |language=en |volume=16 |issue=3 |doi=10.1007/s11940-013-0281-2 |issn=1092-8480 |pmc=3994190 |pmid=24464490}}</ref>
**[[多巴胺]]分泌異常
*電解物質紊亂
**[[低鈣血症]]<ref name="Rossman_1956">{{Cite journal |last=Rossman |first=P. L. |last2=Vock |first2=R. M. |date=1956-09 |title=Postpartum tetany and psychosis due to hypocalcemia |url=https://pubmed.ncbi.nlm.nih.gov/13356186/ |journal=California Medicine |volume=85 |issue=3 |issn=0008-1264 |pmc=1531921 |pmid=13356186 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022641/https://pubmed.ncbi.nlm.nih.gov/13356186/ |dead-url=no }}</ref>
**[[高血鈣|高鈣血症]]<ref name="Rosenthal_et_al_1997">{{Cite journal |last=Rosenthal |first=M. |last2=Gil |first2=I. |last3=Habot |first3=B. |date=1997 |title=Primary hyperparathyroidism: neuropsychiatric manifestations and case report |url=https://pubmed.ncbi.nlm.nih.gov/9231574/ |journal=The Israel Journal of Psychiatry and Related Sciences |volume=34 |issue=2 |issn=0333-7308 |pmid=9231574 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022640/https://pubmed.ncbi.nlm.nih.gov/9231574/ |dead-url=no }}</ref>
**[[高鈉血症]]<ref name="Jana_1973">{{Cite journal |last=Jana |first=D. K. |last2=Romano-Jana |first2=L. |date=1973-10 |title=Hypernatremic psychosis in the elderly: case reports |url=https://pubmed.ncbi.nlm.nih.gov/4729012/ |journal=Journal of the American Geriatrics Society |volume=21 |issue=10 |doi=10.1111/j.1532-5415.1973.tb01212.x |issn=0002-8614 |pmid=4729012 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022640/https://pubmed.ncbi.nlm.nih.gov/4729012/ |dead-url=no }}</ref>
**[[低血鈉症]]<ref name="Haensch_et_al_1996">{{Cite journal |last=Haensch |first=C. A. |last2=Hennen |first2=G. |last3=Jörg |first3=J. |date=1996-04 |title=[Reversible exogenous psychosis in thiazide-induced hyponatremia of 97 mmol/l] |url=https://pubmed.ncbi.nlm.nih.gov/8684511/ |journal=Der Nervenarzt |volume=67 |issue=4 |issn=0028-2804 |pmid=8684511 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022645/https://pubmed.ncbi.nlm.nih.gov/8684511/ |dead-url=no }}</ref>
**[[低鉀血症|低血鉀症]]<ref name="Hafez_et_al_1984">{{Cite journal |last=Hafez |first=H. |last2=Strauss |first2=J. S. |last3=Aronson |first3=M. D. |last4=Holt |first4=C. |date=1984-06 |title=Hypokalemia-induced psychosis in a chronic schizophrenic patient |url=https://pubmed.ncbi.nlm.nih.gov/6725222/ |journal=The Journal of Clinical Psychiatry |volume=45 |issue=6 |issn=0160-6689 |pmid=6725222 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022641/https://pubmed.ncbi.nlm.nih.gov/6725222/ |dead-url=no }}</ref>
**[[低血鎂症]]<ref name="Konstantakos_2006">{{Cite journal |date=2022-07-19 |title=Hypomagnesemia: Practice Essentials, Pathophysiology, Etiology |url=https://emedicine.medscape.com/article/2038394-overview |access-date=2022-11-13 |archive-date=2019-07-24 |archive-url=https://web.archive.org/web/20190724090817/https://emedicine.medscape.com/article/2038394-overview |dead-url=no }}</ref>
**{{tsl|en|Hypermagnesemia|高血鎂症}}<ref name="Velasco_et_al_1999">{{Cite journal |last=Velasco |first=P. J. |last2=Manshadi |first2=M. |last3=Breen |first3=K. |last4=Lippmann |first4=S. |date=1999-11 |title=Psychiatric aspects of parathyroid disease |url=https://pubmed.ncbi.nlm.nih.gov/10581976/ |journal=Psychosomatics |volume=40 |issue=6 |doi=10.1016/s0033-3182(99)71186-2 |issn=0033-3182 |pmid=10581976 |access-date=2022-11-13 |archive-date=2022-11-13 |archive-url=https://web.archive.org/web/20221113022643/https://pubmed.ncbi.nlm.nih.gov/10581976/ |dead-url=no }}</ref>

== 各別地域 ==
=== 香港 ===
2001年[[香港醫院管理局]]啟動的一項專為early psychosis人士設立的服務，為消除歧視，特別創立了思覺失調這個新的中文醫學名詞<ref>{{Cite web |title=思覺失調 – 思覺基金 |url=http://www.episo.org/思覺失調/|language=zh-HK |access-date=2022-10-13 |archive-date=2022-10-13 |archive-url=https://web.archive.org/web/20221013220338/http://www.episo.org/%e6%80%9d%e8%a6%ba%e5%a4%b1%e8%aa%bf/ |dead-url=no }}</ref>。同年，香港醫院管理局也開始籌辦一個醫療服務，目的是要針對及早治療精神症患者，減輕其病情。於是一群精神科醫生計劃有策略地向大眾宣傳及教育有關思覺失調症、妄想症、躁狂抑鬱症。考慮到這些早期症狀，有可能以心理學的角度及少量鎮靜劑治療。

據2018年醫管局數字顯示，香港思覺失調患者超過4萬人<ref>{{Cite web |date=2019-07-01 |title=思覺失調患者拒絕求診 透過教練服務助其家人 |url=https://thecompanions.com.hk/zh-hant/思覺失調/家人患思覺失調拒絕求診可以怎麼辦/ |archive-url=https://web.archive.org/web/20210122003606/https://thecompanions.com.hk/zh-hant/%E6%80%9D%E8%A6%BA%E5%A4%B1%E8%AA%BF/%E5%AE%B6%E4%BA%BA%E6%82%A3%E6%80%9D%E8%A6%BA%E5%A4%B1%E8%AA%BF%E6%8B%92%E7%B5%95%E6%B1%82%E8%A8%BA%E5%8F%AF%E4%BB%A5%E6%80%8E%E9%BA%BC%E8%BE%A6/ |archive-date=2021-01-22 |accessdate=2019-08-09 |work=The Companions 匡仁心理輔導 |language=zh-hant |dead-url=no }}</ref>。

==參見==
*[[思覺敏感]]

== 参考文献 ==
{{Reflist|30em}}

== 外部連結 ==
{{Medical resources
| DiseasesDB = 
| ICD10 = {{ICD10|F|20}}-{{ICD10|F|29}}
| ICD9 = {{ICD9|290}}-{{ICD9|299}}
| ICDO = 
| OMIM = 603342
| MedlinePlus = 001553
| eMedicineSubj = 
| eMedicineTopic = 
| oMIM_mult = {{OMIM2|608923}} {{OMIM2|603175}} {{OMIM2|192430}}
| meshName = Psychotic+Disorders
| meshNumber = F03.700.675
}}

{{-}}
{{精神病學}}
{{ICD-10-F}}
{{Mood disorders}}
{{Authority Control}}

[[Category:医学]]
[[Category:精神病]]
[[Category:心理学]]
[[Category:精神病理學]]