脑损伤后“强哭强笑”的表现、机制、治疗和诊断归属-单春雷.ppt

PK内容 励：患者朱xx的“强哭强笑”属于什么障碍？ 朱：属于器质性精神障碍，是脑损害导致的精神异常，不像是情绪障碍。 单：属于情绪控制障碍，可能为皮质延髓束损伤导致，不像是精神障碍。 几个术语-中西方不统一 几个术语-中西方不统一 ICD10： Emotion：情绪； Mood：心境； Affect：情感 Emotion is a mental and physiological state associated with a wide variety of feelings, thoughts, and behavior. Emotions are subjective experiences, often associated with mood, temperament, personality, and disposition. Mood is a relatively long lasting emotional state. Moods differ from simple emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event. Affect refers to the experience of feeling or emotion. Affect is a key part of the process of an organism’s interaction with stimuli. The word also refers sometimes to affect display, which is a facial, vocal, or gestural behavior that serves as an indicator of affect. (APA 2006) Mood is the emotional feeling stated by a patient, and affect is the emotional appearance of the patient. 脑损伤后“强哭强笑”的表现、机制、治疗和诊断分类 南京医科大学一附院康复医学科 单春雷 Pseudobulbar affect（PBA，假性延髓情绪） is a dramatic disorder of emotional expression and regulation characterized by uncontrollable episodes of laughing and crying that often cause embarrassment, curtailment of social activities, and reduction in quality of life. The disorder occurs in patients with brain injury caused by many types of neurological disease, including stroke, tumors, and neurodegenerative gray and white matter disorders. Although the pathophysiology is unknown, PBA may relate to release of brainstem emotional control centers from regulation by the frontal lobes. Poeck crystallized the features of PBA into four criteria. First, the episodes are inappropriate to the situation and can be precipitated by nonspecific stimuli, such as contraction of facial muscles, removal of bedcovers, or the approach of someone toward the patient. Second, there is not a close relation between the emotional expression and how the patient is feeling. Third, the epi