摘要
目的:以病迹学的研究范式考察徐渭的精神行为表现,尝试作出诊断。方法:收集整理徐渭的诗文、书信、亲友记载等传记资料,通过多方参照、情理推测等甄别出精神症状,进行精神病理分析,经过分析得出诊断意见。结果:徐渭病史特点包括:发作时病情严重,狂乱失态,乃至自杀、杀人;至少有四次明确的发作,发作间期社会功能可恢复到几乎正常,也有"时病时止"的状态;有大量丰富的跨度二十余年的"祟兆"症状,其中有说明的全部为错视或幻视,而且内容生动;有长期饮酒史;对自身症状和发病经过有着清醒的认识,做了详细的记录;除了发病期,其余时间均保持良好的创作能力,即使在晚年狂放不羁的状态下仍佳作迭出,社会交往能力基本良好。结论:对徐渭的精神障碍的诊断存在争议,需考虑的诊断包括双相情感障碍、人格障碍、精神分裂症等,而笔者所支持的诊断是癫痫所致精神障碍和酒精使用障碍。
Objective:To investigate the mental state of Xu Wei with the paradigm of pathography,and try to make a diagnosis.Methods:By collecting and sorting out Xu Wei’s biographical materials such as his poems,letters,and records of friends,the authors identified mental symptoms and carried out psychopathological analysis via multi-aspect references and reasonable speculation.Diagnostic opinions were obtained through discussion.Results:The characteristics of Xu Wei’s medical history are as follows:Xu Wei suffered from severe insanity,and he committed suicide and homicide when he was in the attack of disease.At least there were 4 explicit disease episodes.During the period of disease episodes,social functioning could return to almost normal,and there was a state of intermittent episodes.He had plenty of visual disorders,that were all illusion or hallucination,lasting for more than 20 years,and the content of which was vivid.He had a long history of alcohol use.He had a sober understanding of his symptoms and the course of the episodes,and made a detailed record of them.Apart from the period of illness,he maintained good artistic creativity and social skills.He continued to produce good work in his later years.Conclusions:The diagnosis of Xu Wei’s mental disorder is still controversial.Bipolar disorder,personality disorder,schizophrenia,etc.,are also needed to be considered.The diagnoses supported by the authors are epilepsy-induced mental disorder and alcohol-related disorders.
作者
陈智民
吴彦
钱竹书
王祖承
CHEN Zhimin;WU Yan;QIAN Zhushu;WANG Zucheng(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)
出处
《心理学通讯》
2021年第2期128-132,共5页
Psychological Communications
关键词
徐渭
精神障碍
病迹学
癫痫
酒精
Xu Wei
mental disorder
pathography
epilepsy
alcohol
