精神医学65巻11号

2023年11月発行

特集 精神疾患回復の時間経過を見通す

統合失調症の経過

著者： 孫樹洛¹ 村井俊哉¹

所属機関： ¹京都大学大学院医学研究科脳病態生理学講座（精神医学）

ページ範囲：P.1481 - P.1488

抄録
　統合失調症の経過は急性期と慢性期と呼ばれる2つの段階に分けられる。統合失調症における急性期の期間は一般的に1か月〜数か月程度とされており，幻覚，妄想などを代表症状とし，病識欠如をしばしば伴い，社会機能が大幅に損なわれる。抗精神病薬による薬物療法でこれらの症状および社会機能は大幅に改善するが，その後，情動表出の減少，意欲低下などの陰性症状が目立ってくる。慢性期（安定・維持期）には，エピソード記憶，作業記憶，注意機能，遂行機能などの認知機能の障害が目立つようになり，薬物療法以外に，認知行動療法，認知リハビリテーション，個別就労支援プログラムなどの心理社会的介入が重要性を増してくる。これらの治療を，患者個人ごとに最適化することが，治療効果を最大化する上で重要となる。

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