‫‪1‬‬ ‫ﺭﻭﺍﻧﮕﺴﯿﺨﺘﮕﯽ‬

‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‬

‫‪Cloth embroidered by a patient diagnosed with schizophrenia‬‬

‫]‪[1‬‬ ‫ﺁﯼﺳﯽﺩﯼ‪۱۰-‬‬
‫‪20F‬‬

‫]‪[2‬‬ ‫ﺁﯼﺳﯽﺩﯼ‪۹-‬‬
‫‪295‬‬

‫]‪[3‬‬ ‫ﺍُﻣﯿﻢ‬
‫‪181500‬‬

‫]‪[4‬‬ ‫ﺩﺍﺩﮔﺎﻥ ﺑﯿﻤﺎﺭﯼﻫﺎ‬

‫‪11890‬‬

‫]‪[5‬‬ ‫ﻣﺪﻻﯾﻦ ﭘﻼﺱ‬

‫‪000928‬‬

‫]‪[7‬‬ ‫]‪[6‬‬ ‫ﺍﯼﻣﺪﯾﺴﯿﻦ‬

‫‪emerg/520‬‬ ‫‪med/2072‬‬

‫]‪[8‬‬ ‫ﺳﻤﭗ‬
‫‪F03.700.750‬‬

‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‪ ،‬ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽﻭﺷﯿﺰﻭﻓﺮﻧﯽ )ﺑﻪ ﺍﻧﮕﻠﯿﺴﯽ‪ (Schizophrenia :‬ﯾﺎ ﺫﻫﻦ ﺧﯿﻠﯽ ﺑﺎﺯ ‪ ،‬ﯾﮏ ﺑﯿﻤﺎﺭﯼ ﺭﻭﺍﻧﯽ ﺑﺎ ﻣﻨﺸﺎء ﻧﺎﻣﺸﺨّﺺ ﻭ ﻋﻼﯾﻢ ﻣﺘﻐﯿّﺮ‬
‫ﻣﯽﺑﺎﺷﺪ ﮐﻪ ﺍﺻﻄﻼﺡ ﺁﻥ ﺗﻮﺳﻂ ﯾﻮﺟﯿﻦ ﺑﻠﻮﻟﺮ ﺍﺯ ﺗﺮﮐﯿﺐ ﺩﻭ ﻭﺍﮊﻩٔ ﯾﻮﻧﺎﻧﯽ ‪) shizein‬ﺩﻭ ﻧﯿﻢ ﮐﺮﺩﻥ‪ ،‬ﮔﺴﺴﺘﻦ‪ (σχίζειν :‬ﻭ ‪) phrenos‬ﻓﮑﺮ‪ ،‬ﺍﻧﺪﯾﺸﻪ‪(φρήν :‬‬
‫ﻭﺿﻊ ﺷﺪﻩ ﺍﺳﺖ‪ .‬ﻣﺸﺨﺼﻪٔ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﻋﺪﻡ ﺗﻮﺍﻧﺎﯾﯽ ﺩﺭﮎ ﻭ ﯾﺎ ﺑﯿﺎﻥ ﻭﺍﻗﻌﯿﺖ ﺍﺳﺖ‪ .‬ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺩﺍﺭﺍﯼ ﻋﻮﺍﺭﺿﯽ ﻫﻤﭽﻮﻥ ﻋﺪﻡ ﺍﺭﺗﺒﺎﻁ ﻣﻨﻄﻘﯽ ﺩﺭ ﺭﻓﺘﺎﺭ ﻭ ﮔﻔﺘﺎﺭ‪ ،‬ﺍﻧﺰﻭﺍ‬
‫ﻭ ﮔﻮﺷﻪ ﻧﺸﯿﻨﯽ ﺑﯿﺶ ﺍﺯ ﺣﺪ ﻭ ﻫﺬﯾﺎﻥ ﻭ ﺗﻮﻫﻢ ﺍﺳﺖ‪ .‬ﺗﺸﺨﯿﺺ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺑﺎ ﻣﺼﺎﺣﺒﻪ ﺑﺎ ﺑﯿﻤﺎﺭ ﻭ ﻣﺸﺎﻫﺪﻩ ﺭﻓﺘﺎﺭ ﺍﻭ ﻣﯿﺴﺮ ﻣﯽﺷﻮﺩ‪ .‬ﻧﺘﺎﯾﺞ ﯾﮏ ﺗﺤﻘﯿﻖ ﺩﺭ ﻣﺠﻠﻪ ﻧﯿﭽﺮ‬
‫ﺍﯾﻨﭽﻨﯿﻦ ﻣﻨﺘﺸﺮ ﺷﺪﻩ ﺍﺳﺖ ﮐﻪ ﺑﺮ ﺍﺳﺎﺱ ﮔﻔﺘﻪ ﻫﺎﯼ ﺩﮐﺘﺮ ﮐﺎﺭﯼ ﺍﺳﺘﯿﻮﻧﺴﻦ ﮐﻪ ﺭﻫﺒﺮﯼ ﺍﯾﻦ ﮔﺮﻭﻩ ﺗﺤﻘﯿﻖ ﺭﺍ ﺑﺮ ﻋﻬﺪﻩ ﺩﺍﺭﺩ‪ ،‬ﺳﻦ ﭘﺪﺭ ﺑﺮﺍﯼ ﺳﻼﻣﺖ ﮐﻮﺩﮎ ﺗﻌﯿﯿﻦ‬
‫ﮐﻨﻨﺪﻩ ﺗﺮ ﻭ ﻣﻮﺛﺮﺗﺮ ﺍﺯ ﺳﻦ ﻣﺎﺩﺭ ﺍﺳﺖ‪ .‬ﺑﻪ ﮔﻔﺘﻪ ﺩﮐﺘﺮ ﺍﺳﺘﯿﻮﻧﺴﻦ‪ ،‬ﺟﺎﻣﻌﻪ ﻧﺴﺒﺖ ﺑﻪ ﺳﻦ ﻣﺎﺩﺭ ﺣﺴﺎﺱ ﺗﺮ ﺍﺯ ﺳﻦ ﭘﺪﺭ ﺍﺳﺖ ﺍﻣﺎ ﺑﻪ ﻏﯿﺮ ﺍﺯ ﺳﻨﺪﺭﻭﻡ ﺩﺍﻭﻥ‪ ،‬ﺑﻪ ﻧﻈﺮ ﻣﯽ‬
‫]‪[9‬‬
‫ﺭﺳﺪ ﮐﻪ ﺍﺧﺘﻼﻻﺗﯽ ﭼﻮﻥ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﻭ ﺍﻭﺗﯿﺴﻢ ﺗﺤﺖ ﺗﺎﺛﯿﺮ ﺳﻦ ﭘﺪﺭ ﻫﺴﺘﻨﺪ ﻧﻪ ﻣﺎﺩﺭ‪.‬‬
‫‪2‬‬ ‫ﺭﻭﺍﻧﮕﺴﯿﺨﺘﮕﯽ‬

‫ﻋﻼﺋﻢ ﺑﯿﻤﺎﺭﯼ‬
‫ﻋﻼﯾﻢ ﻭ ﻧﺸﺎﻧﻪﻫﺎﯼ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﺷﺎﻣﻞ ﻣﺠﻤﻮﻋﻪﻫﺎﯾﯽ ﺍﺯ ﻋﻼﯾﻢ ﺍﺳﺖ]‪:[10‬‬
‫•‬ ‫ﻧﺸﺎﻧﻪﻫﺎﯼ ﻣﺜﺒﺖ‪:‬ﻋﻼﺋﻢ ﻣﺜﺒﺖ‪» ،‬ﻓﺰﻭﻧﯽﻫﺎﯼ ﺁﺳﯿﺐﺷﻨﺎﺳﺎﻧﻪ« ﻫﺴﺘﻨﺪ‪ ،‬ﻭ ﯾﺎ ﺭﻓﺘﺎﺭﻫﺎﯼ‬
‫ﻏﺮﯾﺒﯽ ﮐﻪ ﺑﻪ ﺭﻓﺘﺎﺭﻫﺎﯼ ﻋﺎﺩﯼ ﻓﺮﺩ ﺑﯿﻤﺎﺭ ﺍﻓﺰﻭﺩﻩ ﻣﯽﺷﻮﻧﺪ‪ .‬ﻫﺬﯾﺎﻥﻫﺎ‪ ،‬ﺗﻔﮑﺮ ﻭ ﮔﻔﺘﺎﺭ ﺍﺯ ﻫﻢ‬
‫ﮔﺴﯿﺨﺘﻪ‪ ،‬ﺍﺩﺭﺍﮐﺎﺕ ﺗﺸﺪﯾﺪ ﺷﺪﻩ ﻭ ﺗﻮﻫﻢﻫﺎ‪ ،‬ﻭ ﻭﺍﮐﻨﺶﻫﺎﯼ ﻧﺎﺑﺠﺎ ﺍﺯ ﺟﻤﻠﻪ ﻋﻼﺋﻢ ﻣﻌﻤﻮﻝ ﺩﺭ‬
‫ﺍﯾﻦ ﺑﯿﻤﺎﺭﺍﻥ ﻫﺴﺘﻨﺪ‪ [11].‬ﺗﻮﻫﻢ ﻣﻌﻤﻮﻻً ﺷﻨﯿﺪﺍﺭﯼ ﯾﺎ ﺩﯾﺪﺍﺭﯼ ﺍﺳﺖ ﻭﻟﯽ ﻣﯽﺗﻮﺍﻧﺪ ﺩﺭ‬
‫ﺗﻤﺎﻣﯽ ﺣﻮﺍﺱ ﺩﯾﺪﻩ ﺷﻮﺩ‪.‬‬
‫•‬ ‫ﻧﺸﺎﻧﻪﻫﺎﯼ ﻣﻨﻔﯽ‪:‬ﻋﻼﺋﻢ ﻣﻨﻔﯽ »ﮐﻤﺒﻮﺩﻫﺎﯼ ﺁﺳﯿﺐﺷﻨﺎﺳﺎﻧﻪ« ﺷﺨﺼﯿﺘﯽ ﻫﺴﺘﻨﺪ ﮐﻪ‬
‫ﺷﺨﺺ ﺑﯿﻤﺎﺭ ﻓﺎﻗﺪ ﺁﻧﻬﺎﺳﺖ‪ .‬ﻓﻘﺮ ﺩﺭ ﮔﻔﺘﺎﺭ‪ ،‬ﻭﺍﮐﻨﺶﻫﺎﯼ ﮐﻨﺪ ﻭ ﺳﻄﺤﯽ‪ ،‬ﺍﺯ ﺩﺳﺖ ﺩﺍﺩﻥ‬
‫ﺍﺭﺍﺩﻩ‪ ،‬ﻭ ﮔﺮﯾﺨﺘﻦ ﺍﺯ ﺍﺟﺘﻤﺎﻉ ﻧﺸﺎﻧﻪﻫﺎﯼ ﻫﺴﺘﻨﺪ ﮐﻪ ﻣﻌﻤﻮﻻً ﺩﺭ ﺍﯾﻦ ﺑﯿﻤﺎﺭﺍﻥ ﺩﯾﺪﻩ ﻣﯽﺷﻮﻧﺪ‪.‬‬
‫]‪[12‬‬
‫ﭼﻨﯿﻦ ﮐﻤﺒﻮﺩﻫﺎﯾﯽ ﺯﻧﺪﮔﯽ ﻭ ﻓﻌﺎﻟﯿﺖﻫﺎﯼ ﻓﺮﺩ ﺭﺍ ﺑﻪ ﺷﺪﺕ ﺗﺤﺖ ﺗﺎﺛﯿﺮ ﻗﺮﺍﺭ ﻣﯽﺩﻫﻨﺪ‪.‬‬
‫ﻫﻤﭽﻨﯿﻦ ﻋﺪﻡ ﺑﺮﻭﺯ ﻋﻮﺍﻃﻒ‪ ،‬ﻋﺪﻡ ﻟﺬﺕ ﺍﺯ ﺯﻧﺪﮔﯽ ﺍﺯ ﻋﻼﯾﻢ ﻣﻨﻔﯽ ﺑﯿﻤﺎﺭﯼ ﺍﺳﺖ‪.‬‬
‫•‬ ‫ﺍﻓﺴﺮﺩﮔﯽ‪ :‬ﺑﺮﻭﺯ ﺍﻓﺴﺮﺩﮔﯽ ﺩﺭ ﺑﯿﻤﺎﺭﺍﻥ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﻪ ﺑﺎﻻﺳﺖ ﻭ ﻣﯽﺗﻮﺍﻧﺪ ﺑﺴﯿﺎﺭ ﺷﺪﯾﺪ‬
‫ﺑﺎﺷﺪ‪ .‬ﻣﻌﻤﻮﻻً ﺍﯾﻦ ﺍﻓﺴﺮﺩﮔﯽ ﺑﻪ ﺁﻧﺘﯽ ﺳﺎﯾﮑﻮﺗﯿﮑﻬﺎﯼ ﺁﺗﯿﭙﯿﮏ ﭘﺎﺳﺦ ﻣﯽﺩﻫﺪ‪.‬‬
‫•‬ ‫ﺍﺧﺘﻼﻻﺕ ﺷﻨﺎﺧﺘﯽ‪:‬ﺍﻓﺮﺍﺩ ﻣﺒﺘﻼ ﺩﭼﺎﺭ ﺍﺧﺘﻼﻻﺕ ﺷﻨﺎﺧﺘﯽ ﻧﯿﺰ ﻣﯽﺷﻮﻧﺪ ﺷﺎﻣﻞ ﺍﺧﺘﻼﻝ‬
‫ﺩﺭ ﺗﻮﺟﻪ‪ ،‬ﺣﺎﻓﻈﻪ ﻭ ﻋﻤﻠﮑﺮﺩﻫﺎﯼ ﺍﺭﺍﺩﯼ‪ .‬ﺍﯾﻦ ﺍﺧﺘﻼﻻﺕ ﻧﯿﺰ ﺑﺎ ﺩﺍﺭﻭﻫﺎﯼ ﺁﻧﺘﯽ ﺳﺎﯾﮑﻮﺗﯿﮏ‬
‫ﯾﻮﺟﯿﻦ ﺑﻠﻮﻟﺮ ﺭﻭﺍﻧﭙﺰﺷﮏ ﺳﻮﯾﯿﺴﯽ ﻭﺍﮊﻩٔ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﺭﺍ ﻭﺿﻊ ﮐﺮﺩ‬ ‫ﺁﺗﯿﭙﯿﮏ ﺩﺭﻣﺎﻥ ﻣﯽﺷﻮﻧﺪ‪.‬‬
‫•‬ ‫ﺳﺎﯾﺮ ﺍﺧﺘﻼﻻﺕ‪:‬ﺍﻓﺮﺍﺩ ﻣﺒﺘﻼ ﺑﻪ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﮔﺎﻩ ﻧﺸﺎﻧﻪﻫﺎﯼ ﺭﻭﺍﻧﯽ ﺣﺮﮐﺘﯽ ﻧﯿﺰ ﺑﺮﻭﺯ‬
‫ﻣﯽﺩﻫﻨﺪ‪ ،‬ﻣﺜﻞ ﺣﺮﮐﺎﺕ ﻋﺠﯿﺐ‪ ،‬ﺷﮑﻠﮏﻫﺎﯼ ﺗﮑﺮﺍﺭﯼ‪ ،‬ﻭ ﮊﺳﺖﻫﺎﯼ ﻧﺎﻣﻌﻤﻮﻝ‪ .‬ﺑﻪ ﻧﻈﺮ ﻣﯽﺭﺳﺪ ﮐﻪ ﺍﯾﻦ ﮊﺳﺖﻫﺎﯼ ﻏﯿﺮﻋﺎﺩﯼ ﻣﻌﻤﻮﻻ ﻧﻮﻋﯽ ﻣﻨﻈﻮﺭ ﺷﺨﺼﯽ ﺑﺮﺍﯼ‬
‫]‪[13‬‬
‫ﻓﺮﺩ ﺑﯿﻤﺎﺭ ﺩﺍﺭﻧﺪ‪ ،‬ﻣﺜﻞ ﻧﻮﻋﯽ ﺁﯾﯿﻦ ﯾﺎ ﺟﺎﺩﻭ‪.‬‬

‫ﺍﻧﻮﺍﻉ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‬
‫ﺑﺮ ﺍﺳﺎﺱ ﺗﻘﺴﯿﻢ ﺑﻨﺪﯼ ‪ DSM-IV‬ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﭘﻨﺞ ﺯﯾﺮ ﻣﺠﻤﻮﻋﻪ ﺩﺍﺭﺩ‪:‬‬
‫‪ 1.‬ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﭘﺎﺭﺍﻧﻮﺋﯿﺪ )‪:(Paranoid‬ﺩﺭ ﺍﯾﻦ ﻧﻮﻉ ﻓﺮﺩ ﺑﺎ ﯾﮏ ﯾﺎ ﺩﻭ ﺗﻮﻫﻢ ﻭ ﻫﺬﯾﺎﻥ ﺩﺭﮔﯿﺮ ﺍﺳﺖ ﻭﻟﯽ ﺩﭼﺎﺭ ﺑﻪ ﻫﻢ ﺭﯾﺨﺘﮕﯽ ﺗﻔﮑﺮ ﻭ ﺭﻓﺘﺎﺭ‪ ،‬ﺭﻓﺘﺎﺭ ﮐﺎﺗﺎﺗﻮﻧﯿﮏ ﻭ‬
‫ﯾﺎ ﻓﻘﺪﺍﻥ ﻋﻮﺍﻃﻒ ﻧﯿﺴﺖ‪.‬‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﺑﻪ ﻫﻢ ﺭﯾﺨﺘﻪ )‪ :(Disorganized‬ﻣﺸﺨﺼﻪ ﺁﻥ ﺭﻓﺘﺎﺭ‪ ،‬ﻓﮑﺮ ﯾﺎ ﮔﻔﺘﺎﺭ ﺩﺭ ﻫﻢ ﺭﯾﺨﺘﻪ ﻭ ﺑﺪﻭﻥ ﺑﺮﻭﺯ ﻋﻮﺍﻃﻒ )‪ (flat affect‬ﯾﺎ ﻋﻮﺍﻃﻒ ﻧﺎﻣﻨﺎﺳﺐ‬ ‫‪2.‬‬
‫ﺍﺳﺖ‪.‬‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﮐﺎﺗﺎﺗﻮﻧﯽ )‪ :(Catatonic‬ﺩﺭ ﺍﯾﻦ ﻧﻮﻉ ﻓﺮﺩ ﻣﯽﺗﻮﺍﻧﺪ ﺩﭼﺎﺭ ﻧﺎﺗﻮﺍﻧﯽ ﺣﺮﮐﺘﯽ‪ ،‬ﺣﺮﮐﺎﺕ ﺯﯾﺎﺩﻩ ﺍﺯ ﺣﺪ‪ ،‬ﻧﮕﺎﺗﯿﻮﯾﺴﻢ ﺍﻓﺮﺍﻃﯽ ﯾﺎ ﻣﺎﺕ ﺷﺪﻥ‪ ،‬ﺣﺎﻟﺖ‬ ‫‪3.‬‬
‫ﮔﯿﺮﯼﻫﺎﯼ ﻋﺠﯿﺐ )‪ (Bizzare posturing‬ﻭ ﺗﮑﺮﺍﺭ ﻭ ﺗﻘﻠﯿﺪ)‪ (Echopraxia‬ﺣﺮﮐﺎﺕ ﺑﺎﺷﺪ‪.‬‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﺍﻓﺘﺮﺍﻕ ﺩﺍﺩﻩ ﻧﺸﺪﻩ )‪ :(Undifferentiated‬ﺩﺭ ﺍﯾﻦ ﻧﻮﻉ ﻓﺮﺩ ﻣﻌﯿﺎﺭ ﺗﺸﺨﯿﺼﯽ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺭﺍ ﺩﺍﺭﺩ ﻭﻟﯽ ﺩﺭ ﻫﯿﭻ ﯾﮏ ﺍﺯ ﺳﻪ ﮔﺮﻭﻩ ﻓﻮﻕ ﻗﺮﺍﺭ‬ ‫‪4.‬‬
‫ﻧﻤﯽﮔﯿﺮﺩ‪.‬‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﺑﺎﻗﯽﻣﺎﻧﺪﻩ )‪ :(Residual‬ﮐﻪ ﺩﺭ ﺍﯾﻦ ﺣﺎﻟﺖ ﻋﻼﯾﻢ ﻣﺜﺒﺖ ﺷﺪﺕ ﮐﻤﯽ ﺩﺍﺭﻧﺪ‪.‬‬ ‫‪5.‬‬
‫]‪[14‬‬
‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﻫﯿﻔﺮﻧﯿﮏ )‪:(Hebephrenic‬ﮐﻪ ﺑﺎ ﺭﻓﺘﺎﺭ ﺍﺑﻠﻬﺎﻧﻪ ﻭ ﺑﯽ ﻫﺪﻑ ﻭ ﭘﺮ ﮔﻮﯾﯽ ﻣﺸﺨﺺ ﻣﯽ ﺷﻮﺩ‪.‬‬ ‫‪6.‬‬
‫‪3‬‬ ‫ﺭﻭﺍﻧﮕﺴﯿﺨﺘﮕﯽ‬

‫ﺳﺒﺐ ﺷﻨﺎﺳﯽ ﺭﻭﺍﻥ ﮔﺴﯿﺨﺘﮕﯽ‬

‫ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﯾﮏ ﺑﯿﻤﺎﺭﯼ ﭼﻨﺪﻋﺎﻣﻠﯽ ﺍﺳﺖ ﻭ ﻣﺠﻤﻮﻋﻪ ﺍﯼ ﺍﺯ ﻋﻮﺍﻣﻞ ﺯﯾﺴﺖ ﺷﻨﺎﺧﺘﯽ ﻭ ﺭﻓﺘﺎﺭﯼ ﺩﺭ‬
‫ﺑﺮﻭﺯ ﺁﻥ ﻣﻮﺛﺮ ﻫﺴﺘﻨﺪ‪.‬‬

‫• ﮊﻧﺘﯿﮏ‪ :‬ﺷﻮﺍﻫﺪﯼ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﮐﻪ ﻧﺸﺎﻥ ﺍﺯ ﻧﻘﺶ ﮊﻧﺘﯿﮏ ﺩﺭ ﺑﺮﻭﺯ ﺑﯿﻤﺎﺭﯼ ﺩﺍﺭﻧﺪ‪ .‬ﺑﯿﻤﺎﺭﯼ ﺩﺭ ‪۵۰‬‬
‫ﺩﺭﺻﺪ ﺩﻭﻗﻠﻮﻫﺎﯼ ﺗﮏ ﺗﺨﻤﯽ ﺑﺮﻭﺯ ﻣﺸﺘﺮﮎ ﺩﺍﺭﺩ‪ .‬ﺍﮔﺮ ﻫﺮ ﺩﻭ ﭘﺪﺭ ﻭ ﻣﺎﺩﺭ ﻣﺒﺘﻼ ﺑﺎﺷﻨﺪ ‪ ۴۰‬ﺩﺭﺻﺪ‬
‫ﺍﺣﺘﻤﺎﻝ ﺍﺑﺘﻼ ﻭﺟﻮﺩ ﺩﺍﺭﻧﺪ ﻭ ﺩﺭ ﺩﻭ ﻗﻠﻮﻫﺎﯼ ﺩﯼﺯﺍﯾﮕﻮﺕ ‪ ۱۰‬ﺩﺭﺻﺪ ﺍﺑﺘﻼﯼ ﻫﻤﺰﻣﺎﻥ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪.‬‬
‫• ﻧﻈﺮﯾﻪ ﻧﻮﺭﻭﺷﯿﻤﯿﺎﯾﯽ )ﻧﻘﺶ ﺩﻭﭘﺎﻣﯿﻦ( ﻓﻌﺎﻟﯿﺖ ﺯﯾﺎﺩﻩ ﺩﺭ ﻣﺴﯿﺮ ﺩﻭﭘﺎﻣﯿﻨﯽ ﻣﺰﻭﻟﯿﻤﺒﯿﮏ ﺭﺍ ﺑﺎﻋﺚ‬
‫ﺍﯾﺠﺎﺩ ﻋﻼﯾﻢ ﻣﺜﺒﺖ ﺑﯿﻤﺎﺭﯼ )ﺗﻮﻫﻢ‪ ،‬ﻫﺬﯾﺎﻥ‪ ،‬ﺭﻓﺘﺎﺭ ﻭ ﮔﻔﺘﺎﺭ ﺑﻪ ﻫﻢ ﺭﯾﺨﺘﻪ ﻭ ﺁﮊﯾﺘﺎﺳﯿﻮﻥ( ﺩﺍﻧﺴﺘﻪ‬
‫ﺍﻧﺪ‪ .‬ﻣﺸﺎﻫﺪﻩ ﺷﺪﻩ ﮐﻪ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺩﺍﺭﻭﻫﺎﯾﯽ ﮐﻪ ﺑﺮﺍﯼ ﺩﺭﻣﺎﻥ ﺍﯾﻦ ﺑﯿﻤﺎﺭﺍﻥ ﺑﻪ ﮐﺎﺭ ﻣﯽﺭﻭﺩ ﻭ‬
‫ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﺩﻭﭘﺎﻣﯿﻦ ﻣﯽﺷﻮﻧﺪ ﻭ ﻣﻨﺠﺮ ﺑﻪ ﮐﺎﻫﺶ ﻋﻼﯾﻢ ﻣﺜﺒﺖ ﺑﯿﻤﺎﺭﯼ ﻣﯽﺷﻮﻧﺪ‪ .‬ﺍﻟﯿﮕﻮ‬
‫ﺩﻧﺪﺭﻭﺳﯿﺖﻫﺎ ﻣﻬﻢﺗﺮﯾﻦ ﺳﻠﻮﻝﻫﺎﯼ ﻋﺎﻣﻞ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﻫﺴﺘﻨﺪ‪ .‬ﺩﺭﺍﻟﯿﮕﻮ ﺩﻧﺪﺭﻭﺳﯿﺘﻬﺎﯼ ﺍﻓﺮﺍﺩ‬
‫ﻣﺒﺘﻼ ﺑﻪ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‪ ،‬ﺣﺪﺍﻗﻞ ‪ ۱۵‬ﮊﻥ ﺩﺭﺳﺖ ﻋﻤﻞ ﻧﻤﯽﮐﻨﺪ‪ .‬ﻣﺸﺨﺺ ﺷﺪﻩﺍﺳﺖ ﮐﻪ ﮊﻥ‬
‫ﺭﺳﭙﺘﻮﺭﻫﺎﯼ ﺩﻭﭘﺎﻣﯿﻦ ‪ ۲D‬ﻭ‪) ۳D‬ﯾﻌﻨﯽ ‪ ۲DRD‬ﻭ‪(DRD3‬ﻭ ﻫﻤﭽﻨﯿﻦ ﮊﻥ ﺗﯿﺮﻭﺯﯾﻦ‬
‫ﺗﺼﻮﯾﺮ ﭘﺖ ﺍﺳﮑﻦ ﺍﺯ ﯾﮏ ﺑﯿﻤﺎﺭ ﺭﻭﺍﻥ ﮔﺴﯿﺨﺘﻪ‬ ‫ﻫﯿﺪﺭﻭﮐﺴﯿﻼﺯ ﺑﺎ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﺍﺭﺗﺒﺎﻁ ﺩﺍﺭﺩ‪ .‬ﺁﻧﺰﯾﻢ ﺗﯿﺮﻭﺯﯾﻦ ﻫﯿﺪﺭﻭﮐﺴﯿﻼﺯ‪ ،‬ﺗﯿﺮﻭﺯﯾﻦ ﺭﺍ ﺑﻪ ﺩﯼ‬
‫ﻫﯿﺪﺭﻭﮐﺴﯽ ﻓﻨﯿﻞ ﺁﻻﻧﯿﻦ ﮐﻪ ﭘﯿﺶ ﺳﺎﺯ ﺩﻭﭘﺎﻣﯿﻦ ﺍﺳﺖ ﺗﺒﺪﯾﻞ ﻣﯽﮐﻨﺪ‪ .‬ﻫﻤﭽﻨﯿﻦ ﮊﻥ‬
‫ﺭﺳﭙﺘﻮﺭﻫﯿﺴﺘﺎﻣﯿﻦ ‪ (HRH2) ،۲H‬ﺑﻪﻋﻨﻮﺍﻥ ﯾﮑﯽ ﺍﺯ ﮐﺎﻧﺪﯾﺪﻫﺎﯼ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﻣﺤﺴﻮﺏ ﺷﺪﻩﺍﺳﺖ‪ .‬ﯾﮑﯽ ﺩﯾﮕﺮ ﺍﺯ ﮊﻧﻬﺎﯾﯽ ﮐﻪ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺷﻨﺎﺳﺎﯾﯽ‬
‫ﺷﺪﻩﺍﺳﺖ ﮊﻥ ‪ ۷CHRNA‬ﺍﺳﺖ ﮐﻪ ﺯﯾﺮﻭﺍﺣﺪ ﺁﻟﻔﺎ ﯾﮑﯽ ﺍﺯ ﺭﺳﭙﺘﻮﺭﻫﺎﯼ ﺍﺳﯿﺪ ﻧﯿﮑﻮﺗﯿﻨﯿﮏ‪ ،‬ﺭﺍ ﮐﺪ ﻣﯽﮐﻨﺪ‪.‬ﮊﻥ ﮐﺪ ﮐﻨﻨﺪﻩ ﯾﮑﯽ ﺍﺯ ﺭﺳﭙﺘﻮﺭﻫﺎﯼ‬
‫ﺳﺮﻭﺗﻮﻧﯿﻦ)‪ (HTR2A‬ﻧﯿﺰ ﺍﺯ ﺩﯾﮕﺮ ﮊﻧﻬﺎﯾﯽ ﺍﺳﺖ ﮐﻪ ﺑﺎ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﭘﯿﻮﺳﺘﮕﯽ ﺩﺍﺭﺩ‪ .‬ﺑﺎﻧﮕﺎﻫﯽ ﺑﻪ ﺍﻧﺒﻮﻩ ﮊﻧﻬﺎﯼ ﮐﺎﻧﺪﯾﺪ ﺑﺮﺍﯼ ﺑﯿﻤﺎﺭﯼ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‪ ،‬ﺩﺭﻣﯽ‬
‫ﯾﺎﺑﯿﻢ ﮐﻪ ﺍﻏﻠﺐ ﺍﯾﻦ ﮊﻧﻬﺎ‪ ،‬ﺩﺭ ﺍﺭﺗﺒﺎﻁ ﺑﺎ ﻧﻮﺭﻭﺗﺮﺍﺗﻨﺴﻤﯿﺘﺮﻫﺎ ﻣﯽﺑﺎﺷﻨﺪ‪ .‬ﺑﺮﺧﯽ ﺍﺭ ﺍﯾﻦ ﮊﻧﻬﺎ ﺭﺳﭙﺘﻮﺭﻫﺎﯼ ﻧﻮﺭﻭﺗﺮﺍﻧﺴﻤﯿﺘﺮﻫﺎ ﺭﺍ ﮐﺪ ﻣﯽﮐﻨﻨﺪ ﻭ ﺑﺮﺧﯽ ﺩﯾﮕﺮ ﺩﺭ ﺳﻨﺘﺰ ﺁﻧﻬﺎ‬
‫ﻧﻘﺶ ﺩﺍﺭﻧﺪ‪.‬‬

‫• ﻧﻮﺭﻭﺁﻧﺎﺗﻮﻣﯽ‪ :‬ﺩﺭ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺍﻓﺰﺍﯾﺶ ﻋﻤﻠﮑﺮﺩ ﻟﻮﺏﻫﺎﯼ ﻓﺮﻭﻧﺘﺎﻝ ﻭ ﻋﺪﻡ ﺗﻘﺎﺭﻥ ﻋﻤﻠﮑﺮﺩﯼ ﺳﯿﺴﺘﻢ ﻟﯿﻤﺒﮏ ‪ /‬ﺗﻤﭙﻮﺭﺍﻝ‬
‫• ﻧﻮﺭﻭﺍﻧﺪﻭﮐﺮﯾﻦ‪ :‬ﺑﻌﻀﯽ ﻫﻮﺭﻣﻮﻧﻬﺎ ﺩﺭ ﺑﺮﻭﺯ ﺑﯿﻤﺎﺭﯼ ﻣﻮﺛﺮ ﺗﺸﺨﯿﺺ ﺩﺍﺩﻩ ﺷﺪﻩﺍﻧﺪ‪.‬‬
‫• ﻋﻮﺍﻣﻞ ﻓﺼﻠﯽ ﻫﻤﭽﻮﻥ ﺗﻮﻟﺪ ﺩﺭ ﺯﻣﺴﺘﺎﻥ‪ ،‬ﻋﻔﻮﻧﺘﻬﺎﯼ ﻭﯾﺮﻭﺳﯽ ﻗﺒﻞ ﺍﺯ ﺗﻮﻟﺪ ﻭ ﺗﻔﺎﻭﺗﻬﺎﯼ ﺟﻐﺮﺍﻓﯿﺎﯾﯽ ﻧﯿﺰ ﺩﺭ ﺑﺮﻭﺯ ﺑﯿﻤﺎﺭ ﺗﺎﺛﯿﺮ ﺩﺍﺭﻧﺪ‪.‬‬

‫ﭘﯿﺸﯿﻨﻪ‬
‫ﻋﻼﯾﻢ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺩﺭ ﮔﺬﺷﺘﻪﻫﺎﯼ ﺩﻭﺭ ﻧﯿﺰ ﺷﻨﺎﺧﺘﻪ ﺷﺪﻩ ﺑﻮﺩ‪ .‬ﻭﻟﯽ ﭘﯿﺸﯿﻨﯿﺎﻥ ﺗﻌﺒﯿﺮﻫﺎﯼ ﺍﺳﻄﻮﺭﻩﺍﯼ ﺑﺮﺍﯼ ﺁﻥ ﺩﺍﺷﺘﻨﺪ‪ .‬ﺩﺭ ﮔﺬﺷﺘﻪ ﺑﻪ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ))ﺟﻨﻮﻥ‬
‫ﺟﻮﺍﻧﯽ(( ﻣﯽﮔﻔﺘﻨﺪ ﮐﻪ ﺍﻣﺮﻭﺯﻩ ﭼﻨﺪﺍﻥ ﻣﻮﺭﺩ ﭘﺴﻨﺪ ﺭﻭﺍﻥﭘﺰﺷﮑﺎﻥ ﻭ ﺭﻭﺍﻥﺷﻨﺎﺳﺎﻥ ﻧﯿﺴﺖ‪ [16][15].‬ﭘﯿﺸﯿﻨﯿﺎﻥ ﻣﯽﮔﻔﺘﻨﺪ ﺩﯾﻮﺍﻧﻪ ﮐﺴﯽ ﺍﺳﺖ ﮐﻪ ﺩﯾﻮ ﺭﺍ ﻣﯽﺑﯿﻨﺪ ﻭ‬
‫ﻣﺠﻨﻮﻥ ﮐﺴﯽ ﺍﺳﺖ ﮐﻪ ﺟﻦ ﺭﺍ ﻣﯽﺑﯿﻨﺪ‪ .‬ﺍﯾﻦ ﻫﻤﺎﻥ ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﺍﺳﺖ‪ .‬ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ ﻧﻮﻋﯽ ﺍﺯ ﺑﯿﻤﺎﺭﯼ ﺍﺳﺖ ﮐﻪ ﺑﯿﻤﺎﺭ ﻣﻮﺟﻮﺩﯼ ﺭﺍ ﻣﯽﺑﯿﻨﺪ ﮐﻪ ﺩﯾﮕﺮﺍﻥ‬
‫ﻧﻤﯽﺑﯿﻨﻨﺪ ﻭ ﻣﺮﺩﻡ ﺑﻪ ﺍﯾﻦ ﺩﻟﯿﻞ ﮐﻪ ﺁﻥ ﻣﻮﺟﻮﺩ ﻣﻮﺭﺩ ﺍﺩﻋﺎ ﺭﺍ ﻧﻤﯽﺑﯿﻨﻨﺪ ﺑﻪ ﻓﺮﺩﯼ ﮐﻪ ﺁﻥ ﻣﻮﺟﻮﺩ ﺭﺍ ﻣﯽﺑﯿﻨﺪ ﻣﺠﻨﻮﻥ ﯾﺎ ﺩﯾﻮﺍﻧﻪ ﻣﯽﮔﻮﯾﻨﺪ‪ .‬ﺑﻪ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺩﺭ ﻗﺪﯾﻢ‬
‫ﺩﯾﻮﺍﻧﮕﯽ ﯾﺎ ﺟﻦ ﺯﺩﮔﯽ ﯾﺎ ﺁﻝ ﺯﺩﮔﯽ ﻣﯽﮔﻔﺘﻨﺪ‪.‬‬
‫ﺩﺭ ﻗﺮﻥ ﻧﻮﺯﺩﻫﻢ ﭘﺰﺷﮑﺎﻥ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺭﺍ ﺑﻪ ﻋﻨﻮﺍﻥ ﺟﻨﻮﻥ ﻭ ﺩﯾﻮﺍﻧﮕﯽ ﻣﺤﺾ ﻣﯽﺍﻧﮕﺎﺷﺘﻨﺪ ﻭ ﺩﺭ ﺍﻭﺳﻂ ﻫﻤﯿﻦ ﻗﺮﻥ ﺑﻨﺪﯾﮑﺖ ﺍﻭﮔﻮﺳﺘﻦ ﻣﻮﺭﻝ ﺑﺮﺍﯼ ﺍﻭﻟﯿﻦ ﺑﺎﺭ ﺑﻪ ﺗﻮﺻﯿﻒ‬
‫ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺩﺭ ﮐﺘﺎﺏ ﺧﻮﺩ ﭘﺮﺩﺍﺧﺖ ﻭ ﺍﺯ ﺁﻥ ﺑﻪ ﻋﻨﻮﺍﻥ »ﺗﻮﻗﻒ ﻧﺎﮔﻬﺎﻧﯽ ﺗﻤﺎﻡ ﻗﻮﺍﯼ ﺭﻭﺣﯽ« ﯾﺎﺩ ﮐﺮﺩ‪ .‬ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺩﺭ ﺁﻥ ﺯﻣﺎﻥ ﺍﻏﻠﺐ ﺩﺭ ﺩﺳﺘﻪ ﻫﯿﺴﺘﺮﯼ ﺑﻪ ﺷﻤﺎﺭ‬
‫]‪[17‬‬
‫ﻣﯽﺭﻓﺖ ﻭ ﺑﻪ ﺁﻥ ﻫﯿﺴﺘﺮﯼ ﮔﯿﺞ ﻭ ﻣﻨﮓ ﻣﯽﮔﻔﺘﻨﺪ‪.‬‬
‫ﺩﺭ ﺍﻭﺍﺧﺮ ﻗﺮﻥ ﻧﻮﻧﺰﺩﻫﻢ ﺍﻣﯿﻞ ﮐﺮﭘﻠﯿﻦ‪ ،‬ﺭﻭﺍﻧﭙﺰﺷﮏ ﺁﻟﻤﺎﻥﯼ‪ ،‬ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﺭﺍ ﺟﻨﻮﻥ ﺯﻭﺩﺭﺱ ﻧﺎﻣﯿﺪ ﮐﻪ ﺑﻪ ﻓﺮﺍﮔﯿﺮﯼ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﻧﺰﺩ ﺟﻮﺍﻧﺎﻥ ﻭ ﻧﻮﺟﻮﺍﻧﺎﻥ ﺑﺎﺯ ﻣﯽﮔﺸﺖ‪.‬‬
‫ﺩﺭ ﻧﻬﺎﯾﺖ ﯾﻮﺟﯿﻦ ﺑﻠﻮﻟﺮ‪ ،‬ﺭﻭﺍﻧﭙﺰﺷﮏ ﺳﻮﺋﯿﺴﯽ‪ ،‬ﮐﻠﻤﻪ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﺭﺍ ﺩﺭ ﺟﻬﺖ ﺩﻓﺎﻉ ﺍﺯ ﺭﻭﺍﻧﮑﺎﻭﯼ ﻓﺮﻭﯾﺪ ﺍﺑﺪﺍﻉ ﮐﺮﺩ ﻭ ﺑﻪ ﺗﻌﺮﯾﻒ ﻋﻮﺍﺭﺽ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﭘﺮﺩﺍﺧﺖ‪ .‬ﻓﺮﻭﯾﺪ‬
‫]‪[18‬‬
‫ﻟﻔﻆ ﭘﺎﺭﺍﻓﺮﻧﯽ ﺭﺍ ﺑﺮﺍﯼ ﺍﯾﻦ ﺑﯿﻤﺎﺭﯼ ﻣﻨﺎﺳﺐ ﺗﺮ ﻣﯽﺩﺍﻧﺴﺖ‪.‬‬

‫ﺗﻮﺻﯿﻒ ﻋﯿﻨﯽ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯿﺎﯼ ﺑﻪ ﻫﻢ ﺭﯾﺨﺘﻪ)‪(disorganized‬‬

‫ﯾﮏ ﺭﻭﺯ ﮐﻪ ﺩﺍﺧﻞ ﺩﻓﺘﺮ ﻣﺪﯾﺮ ﻣﺪﺭﺳﻪ ﺑﻮﺩﻡ ﺍﺗﺎﻕ ﻧﺎﮔﻬﺎﻥ ﺑﺰﺭﮒ ﺷﺪ ﻭ ﻧﻮﺭ ﺗﺮﺳﻨﺎﮐﯽ ﺑﺎ ﺳﺎﯾﻪ ﻫﺎﯼ ﻣﺠﺎﺯﯼ ﺁﻥ ﺭﺍ ﺭﻭﺷﻦ ﮐﺮﺩ‪.‬ﻫﻤﻪ ﭼﯿﺰ ﻭﺍﺿﺢ ﺻﯿﻘﻞ ﺧﻮﺭﺩﻩ ﺳﺎﺧﺘﮕﯽ‬
‫ﻭ ﺑﺴﯿﺎﺭ ﺳﻔﺖ ﺑﻮﺩ‪.‬ﻣﯿﺰ ﻫﺎ ﻭ ﺻﻨﺪﻟﯽ ﻫﺎ ﻣﺜﻞ ﯾﮏ ﺳﺮﯼ ﻣﺪﻝ ﺍﯾﻨﺠﺎ ﻭ ﺁﻧﺠﺎ ﭼﯿﺪﻩ ﺷﺪﻩ ﺑﻮﺩﻧﺪ‪.‬ﺩﺍﻧﺶ ﺁﻣﻮﺯﺍﻥ ﻭ ﻣﻌﻠﻤﺎﻥ ﻣﺜﻞ ﻋﺮﻭﺳﮏ ﻫﺎﯼ ﺧﯿﻤﻪ ﺷﺐ ﺑﺎﺯﯼ ﺷﺪﻩ‬
‫ﺑﻮﺩﻧﺪ ﮐﻪ ﺑﯽ ﺩﻟﯿﻞ ﻭ ﺑﯽ ﻫﺪﻑ ﻣﯽ ﭼﺮﺧﯿﺪﻧﺪ‪.‬ﻫﯿﭻ ﭼﯿﺰ ﻭ ﻫﯿﭻ ﮐﺲ ﺭﺍ ﻧﻤﯽ ﺷﻨﺎﺧﺘﻢ‪.‬ﮔﻮﯾﯽ ﻭﺍﻗﻌﯿﺖ ﺍﺯ ﺍﯾﻦ ﺍﺷﯿﺎ ﻭ ﺁﺩﻡ ﻫﺎ ﺭﺧﺖ ﺑﺮ ﺑﺴﺘﻪ ﺑﻮﺩ‪.‬ﻭﺣﺸﺖ ﻋﺠﯿﺒﯽ‬
‫ﻭﺟﻮﺩﻡ ﺭﺍ ﮔﺮﻓﺖ‪ .‬ﺩﺭ ﺣﺎﻟﯽ ﮐﻪ ﮔﻮﯾﯽ ﮔﻢ ﺷﺪﻩ ﺑﻮﺩﻡ ﺍﻣﯿﺪ ﺑﻪ ﮐﻤﮏ ﻧﺪﺍﺷﺘﻢ‪.‬ﺻﺪﺍﯼ ﺣﺮﻑ ﺯﺩﻥ ﺁﺩﻡ ﻫﺎ ﺭﺍ ﻣﯽ ﺷﻨﯿﺪﻡ ﻭﻟﯽ ﻣﻌﻨﺎﯼ ﮐﻠﻤﺎﺗﺸﺎﻥ ﺭﺍ ﻧﻤﯽ ﻓﻬﻤﯿﺪﻡ‪.‬ﺻﺪﺍﻫﺎ‬
‫ﺁﻫﻨﯽ ﻭ ﺑﯽ ﺭﻧﮓ ﻭ ﺳﺮﺩ ﺑﻮﺩﻧﺪ‪ .‬ﮔﺎﻫﯽ ﮐﻠﻤﻪ ﺍﯼ ﺍﺯ ﮐﻠﻤﺎﺕ ﺩﯾﮕﺮ ﺟﺪﺍ ﻣﯽ ﺷﺪ‪ .‬ﺑﻌﺪ ﺩﺭ ﺫﻫﻨﻢ ﺑﻪ ﺷﮑﻞ ﻣﺴﺨﺮﻩ ﺍﯼ ﺗﮑﺮﺍﺭ ﻣﯽ ﺷﺪ ﻭ ﻣﺜﻞ ﺳﻮﻫﺎﻥ ﺭﻭﺣﻢ ﺭﺍ ﻣﯽ ﺧﻮﺭﺩ‪.‬‬
‫]‪[20] [19‬‬
4 ‫ﺭﻭﺍﻧﮕﺴﯿﺨﺘﮕﯽ‬

‫ﭘﺎﻧﻮﯾﺲ‬

[1] http://apps.who.int/classifications/icd10/browse/2010/en#/F20[1]
[2] http://www.icd9data.com/getICD9Code.ashx?icd9=295[2]
[3] http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=181500[3]
[4] http://www.diseasesdatabase.com/ddb11890.htm[4]
[5] http://www.nlm.nih.gov/medlineplus/ency/article/000928.htm[5]
[6] http://www.emedicine.com/med/topic2072.htm[6]
[7] http://www.emedicine.com/emerg/topic520.htm#[7]
field=entry#TreeF03.700.750&term=Schizophrenia&http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?mode= [8]
[Kaplan & Sadock, Clinical Psychiatry, 2001] [9]
.Sadock, B.J., et al. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (Synopsis of Psychiatry), 10th ed] [10]
[Philadelphia, PA; Lippincott Williams & Wilkins, 2007
[11] [Comer 416]
[11]
[12] [Comer 420]
[12]
[13] [Comer 422]
[13]
[14] ‫[ﻫﻨﮓ ﭘﺰﺷﮑﯽ ﺩﮐﺘﺮ ﻣﺤﻤﺪ ﻫﻮﺷﻤﻨﺪ‬14]
‫ﻓﺮ‬
Itemid=65&id=1519&task=view&http://www.ravanpajoh.com/index.php?option=com_content (‫[ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ )ﺟﻨﻮﻥ ﺟﻮﺍﻧﯽ‬15]
http://www.tebyan.net/index.aspx?pid=100470 ‫[ ﭘﯿﺪﺍ ﻭ ﭘﻨﻬﺎﻥ ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ‬16]
[17] ۱۱۸ ‫ﻣﻮﻟﻠﯽ‬
[17]
[18] ۱۱۸ ‫ﻣﻮﻟﻠﯽ‬
[18]
p22 ۱۹۵۱sechehaye [19]
1387‫ﻣﻬﺮﺍﺩ ﻓﯿﺮﻭﺯﺑﺨﺖ‬-‫ﺟﺎﻥ ﺳﺎﻧﺘﺮﺍﮎ‬،‫ﺯﻣﯿﻨﻪ ﺭﻭﺍﻧﺸﻨﺎﺳﯽ ﺳﺎﻧﺘﺮﺍﮎ‬ [20]

‫ﻣﻨﺎﺑﻊ‬
،۸۰۵ - ۷۹۸ ،۳۶۲ ،D. et al. Oligodendrocyte dysfunction in schizophrenia and bipolar disorder. The Lancet ،Tkachev •
.(۲۰۰۳)
.th ed. New York: Worth Publishers, 2007۶ .Ronald J. Abnormal Psychology •
• ‫• ﺍﺳﮑﯿﺰﻭﻓﺮﻧﯽ ﺍﺛﺮ ﺩﮐﺘﺮ ﻋﻠﯽ ﻓﺮﺩﯼ‬
ISBN 964-312-752-4.‫ ﭼﺎﭖ ﺩﻭﻡ‬.۱۳۸۴ .‫ ﻧﺸﺮ ﻧﯽ‬.‫ ﺗﻬﺮﺍﻥ‬.‫ﻟﮑﺎﻥ‬-‫ ﻣﺒﺎﻧﯽ ﺭﻭﺍﻧﮑﺎﻭﯼ ﻓﺮﻭﯾﺪ‬.‫ ﮐﺮﺍﻣﺖ‬،‫• ﻣﻮﻟﻠﯽ‬
http://www.bbc.co.uk/persian/science/2012/08/120823_l06_science_older_dads_genetic_disorder.shtml

‫ﻣﻄﺎﻟﻌﻪٔ ﺑﯿﺸﺘﺮ‬
(http://www2.irib.ir/health/html/schisoferni.htm) ‫• ﭘﺎﯾﮕﺎﻩ ﺍﻃﻼﻉﺭﺳﺎﻧﯽ ﺻﺪﺍ ﻭ ﺳﯿﻤﺎﯼ ﺟﻤﻬﻮﺭﯼ ﺍﺳﻼﻣﯽ ﺍﯾﺮﺍﻥ‬
(http://www.pezeshk.us/?p=3139) ‫• ﭘﺎﯾﮕﺎﻩ ﭘﺰﺷﮑﺎﻥ ﺑﺪﻭﻥ ﻣﺮﺯ‬
5 ‫ﻣﻨﺎﺑﻊ ﻣﻘﺎﻟﻪﻫﺎ ﻭ ﻣﺸﺎﺭﮐﺖﻫﺎ‬

‫ﻣﻨﺎﺑﻊ ﻣﻘﺎﻟﻪﻫﺎ ﻭ ﻣﺸﺎﺭﮐﺖﻫﺎ‬

,Achaemenes, Alefbe, Ali81844, Amiraram, Aryo.Z, Ayda, Behzad.ht, Cobain, Coffeetalkh, Dilmaghanian m :‫ﻫﻤﮑﺎﺭﺍﻥ‬  http://fa.wikipedia.org/w/index.php?oldid=8681892 :‫ﻣﻨﺒﻊ‬  ‫ﺭﻭﺍﻥﮔﺴﯿﺨﺘﮕﯽ‬
,Elessar, Esteghpers, Far50had, Farzaaaad2000, Khazaei, Ladsgroup, Maziarparizade, Mohsen2165, Paiamshadi, Pejmanpejman, Pro translator, R0stam, Seamorgh, Shaahvali, Surena, Tor1714
‫ ﻭﯾﺮﺍﯾﺶﻫﺎﯼ ﻧﺎﺷﻨﺎﺱ‬11 ,‫ ﻫﻤﺎﻥ‬,‫ ﻣﺮﺗﻀﺎ‬,‫ ﻣﺎﻧﻲ‬,‫ ﻗﻠﯽ ﺯﺍﺩﮔﺎﻥ‬,‫ ﻗﺎﺻﺪﮎ ﺑﻬﺎﺭ‬,‫ ﻇﻬﯿﺮﯼ‬,‫ ﺷﻤﺎﻝ ﺑﺰﺭﮒ‬,‫ ﺳﯿﻤﺮﻍ‬,‫ ﺯﺭﺷﮏ‬,‫ ﺭﺑﻮﺳﺎﻡ‬,‫ ﺩﺍﻧﯿﻞ‬,‫ ﺑﻪﺁﻓﺮﯾﺪ‬,2010 ‫ ﺍﯾﻠﯿﺎ‬,Vussat, WiiinsIra, ÆON

‫ ﻣﺠﻮﺯﻫﺎ ﻭ ﻣﺸﺎﺭﮐﺖﻫﺎ‬،‫ﻣﻨﺎﺑﻊ ﺗﺼﻮﯾﺮ‬

Creative Commons :‫ﻣﺠﻮﺯ‬  Cloth_embroidered_by_a_schizophrenia_sufferer.jpg:‫=ﭘﺮﻭﻧﺪﻩ‬http://fa.wikipedia.org/w/index.php?title :‫ﻣﻨﺒﻊ‬  File:Cloth embroidered by a schizophrenia sufferer.jpg
cometstarmoon :‫ﻫﻤﮑﺎﺭﺍﻥ‬  Attribution 2.0
Clinique du Burghözli :‫ﻫﻤﮑﺎﺭﺍﻥ‬  Public Domain :‫ﻣﺠﻮﺯ‬  Eugen_Bleuler.jpg:‫=ﭘﺮﻭﻧﺪﻩ‬http://fa.wikipedia.org/w/index.php?title :‫ﻣﻨﺒﻊ‬  Eugen_Bleuler.jpg:‫ﭘﺮﻭﻧﺪﻩ‬
,Editor at Large, Grook Da Oger, J.delanoy :‫ﻫﻤﮑﺎﺭﺍﻥ‬  Public domain :‫ﻣﺠﻮﺯ‬  Schizophrenia_PET_scan.jpg:‫=ﭘﺮﻭﻧﺪﻩ‬http://fa.wikipedia.org/w/index.php?title :‫ﻣﻨﺒﻊ‬  Schizophrenia PET scan.jpg:‫ﭘﺮﻭﻧﺪﻩ‬
‫ ﻭﯾﺮﺍﯾﺶﻫﺎﯼ ﻧﺎﺷﻨﺎﺱ‬Monkeybait, Skagedal, Was a bee, Ö, 9

‫ﺍﺟﺎﺯﻩﻧﺎﻣﻪ‬
Creative Commons Attribution-Share Alike 3.0 Unported
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