DSM-5-TR臨床個案實戰手冊 (2版)

《DSM-5-TR臨床個案實戰手冊》是專為精神醫療與心理健康專業人士所設計的實用指南，精選104則案例，完整呼應《DSM-5-TR》19個核心診斷主題，每則個案皆由經驗豐富的臨床醫師撰寫簡明討論，宛如「肩上的專家」，引導讀者剖析複雜症狀，並進行鑑別診斷推理。全書內容精煉，突顯資深臨床醫師如何將複雜資料有效轉化為臨床決策，啟發讀者進行積極思辨：診斷是否合理？還需哪些資訊？潛在共病、後續病程與治療考量。本書不僅更新了《DSM-5-TR》的修訂重點，更納入種族、人種及人口統計等多元面向，兼具臨床實用性與教育價值。無論是精神科醫師、心理師或相關專業學習者，都能從中獲得實戰啟發，是臨床訓練與教學的必備資源。

導言 .............................................................................................. xv 1 神經發展疾患 ................................................................................. 1 導言 ......................................................................................................... 1 CASE 1.1：關於自閉症的第二意見........................................................ 3 CASE 1.2：情緒不穩 .............................................................................. 7 CASE 1.3：學業困難 ............................................................................ 10 CASE 1.4：學校問題 ............................................................................ 14 CASE 1.5：坐立不安且分心 ................................................................. 18 2 思覺失調類群及其他精神病症 .................................................... 21 導言 ....................................................................................................... 21 CASE 2.1：情緒不穩定 ........................................................................ 24 CASE 2.2：越來越奇怪 ........................................................................ 27 CASE 2.3：靈性的幻覺 ........................................................................ 29 CASE 2.4：心靈控制 ............................................................................ 33 CASE 2.5：悲傷與精神病 ..................................................................... 36 CASE 2.6：精神病與大麻 ..................................................................... 39 CASE 2.7：跳蚤寄生 ............................................................................ 42 3 雙相情緒及其相關障礙症 ............................................................ 45 導言 ....................................................................................................... 45 CASE 3.1：情緒出現異常 ..................................................................... 48 CASE 3.2：憂鬱的循環) ...................................................................... 51 CASE 3.3：被自殺想法佔據 ................................................................. 54 CASE 3.4：偶發的憂鬱 ........................................................................ 57 CASE 3.5：易怒與悲傷 ........................................................................ 60 CASE 3.6：神已治癒我！ ..................................................................... 63 CASE 3.7：奇怪的沉默 ........................................................................ 66 CASE 3.8：產後的改變 ........................................................................ 69 CASE 3.9：憂鬱與焦慮 ........................................................................ 72 4 憂鬱症 .......................................................................................... 75 導言 ....................................................................................................... 75 CASE 4.1：心情多變與易怒 ................................................................. 78 CASE 4.2：產後低落 ............................................................................ 81 CASE 4.3：悲傷與憂鬱 ........................................................................ 83 CASE 4.4：生活失去興趣 ..................................................................... 87 CASE 4.5：絕望 .................................................................................... 89 CASE 4.6：感到失落多年 ..................................................................... 92 CASE 4.7：情緒波動 ............................................................................ 94 CASE 4.8：壓力、藥物與不開心 ......................................................... 97 CASE 4.9：喜樂不能與不安寧的睡眠 .................................................. 99 CASE 4.10：非雙相情緒障礙，但有混合特徵 .................................. 103 CASE 4.11：不知所措 ........................................................................ 106 CASE 4.12：失眠與身體抱怨 ............................................................. 109 5 焦慮症 ........................................................................................ 113 導言 ..................................................................................................... 113 CASE 5.1：恐懼與擔憂 ...................................................................... 115 CASE 5.2：恐慌 .................................................................................. 118 CASE 5.3：青少年害羞 ...................................................................... 121 CASE 5.4：害怕飛行 .......................................................................... 124 CASE 5.5：總是緊張不安 ................................................................... 126 CASE 5.6：焦慮與肝硬化 ................................................................... 128 6 強迫症及相關障礙症.................................................................. 133 導言 ..................................................................................................... 133 CASE 6.1：憂鬱 .................................................................................. 135 CASE 6.2：細菌 .................................................................................. 138 CASE 6.3：過於關注外貌 ................................................................... 141 CASE 6.4：憂鬱與焦慮 ...................................................................... 144 CASE 6.5：拔頭髮 .............................................................................. 146 7 創傷及壓力相關障礙症 .............................................................. 149 導言 ..................................................................................................... 149 CASE 7.1：危險行為 .......................................................................... 151 CASE 7.2：兩種創傷反應 ................................................................... 154 CASE 7.3：車禍) ................................................................................ 156 CASE 7.4：容易被觸發 ...................................................................... 158 CASE 7.5：壓力山大 .......................................................................... 161 CASE 7.6：肺癌 .................................................................................. 164 CASE 7.7：藥物過量 .......................................................................... 166 CASE 7.8：工作倦怠 .......................................................................... 169 8 解離症 ........................................................................................ 175 導言 ..................................................................................................... 175 CASE 8.1：悲傷且孤獨 ...................................................................... 177 CASE 8.2：感覺不真實 ...................................................................... 180 CASE 8.3：解離 .................................................................................. 183 9 身體症狀及相關障礙症 .............................................................. 187 導言 ..................................................................................................... 187 CASE 9.1：疼痛與憂鬱 ...................................................................... 190 CASE 9.2：身體抱怨 .......................................................................... 192 CASE 9.3：慢性的萊姆病 ................................................................... 195 CASE 9.4：癲癇發作 .......................................................................... 199 CASE 9.5：肚子痛 .............................................................................. 201 CASE 9.6：呼吸困難 .......................................................................... 204 10 餵食及飲食障礙症 ..................................................................... 209 導言 ..................................................................................................... 209 CASE 10.1：肚子痛 ............................................................................ 211 CASE 10.2：掉落至生長曲線下 ......................................................... 214 CASE 10.3：頭痛和疲累 .................................................................... 216 CASE 10.4：失去控制 ........................................................................ 220 CASE 10.5：體重增加 ........................................................................ 222 11 排泄障礙症 ................................................................................. 225 導言 ..................................................................................................... 225 CASE 11.1：情緒崩潰和身體症狀抱怨 .............................................. 226 12 睡醒障礙症 ................................................................................. 229 導言 ..................................................................................................... 229 CASE 12.1：無法維持睡眠 ................................................................. 231 CASE 12.2：焦慮和想睡 .................................................................... 234 CASE 12.3：想睡覺 ............................................................................ 237 CASE 12.4：感到癢、毛骨悚然和有蠕動感 ...................................... 240 13 性功能障礙 ................................................................................. 243 導言 ..................................................................................................... 243 CASE 13.1：性功能障礙 .................................................................... 245 CASE 13.2：性功能問題 .................................................................... 248 14 性別不安 .................................................................................... 251 導言 ..................................................................................................... 251 CASE 14.1：性別重置 ........................................................................ 253 15 侵擾行為、衝動控制及行為規範障礙症 ................................... 257 導言 ..................................................................................................... 257 CASE 15.1：不懂規則 ........................................................................ 259 CASE 15.2：無法住一起 .................................................................... 262 16 物質相關及成癮障礙症 .............................................................. 265 導言 ..................................................................................................... 265 CASE 16.1：酒精 ................................................................................ 266 CASE 16.2：酒精戒斷 ........................................................................ 269 CASE 16.3：成癮 ................................................................................ 271 CASE 16.4：膝蓋疼痛 ........................................................................ 274 CASE 16.5：向下沉淪的漩渦 ............................................................. 276 CASE 16.6：壓力與物質濫用 ............................................................. 280 CASE 16.7：賭博 ................................................................................ 283 17 認知類障礙症 ............................................................................. 287 導言 ..................................................................................................... 287 CASE 17.1：不悅 ................................................................................ 289 CASE 17.2：躁動與混亂 .................................................................... 292 CASE 17.3：憂鬱與戒斷 .................................................................... 294 CASE 17.4：邋遢且精力耗盡 ............................................................. 297 CASE 17.5：僵硬和健忘 .................................................................... 300 CASE 17.6：偏執與幻覺 .................................................................... 304 CASE 17.7：突然叛逆 ........................................................................ 308 18 人格障礙症 ................................................................................. 313 導言 ..................................................................................................... 313 CASE 18.1：人格衝突 ........................................................................ 316 CASE 18.2：怪異地獨處 .................................................................... 319 CASE 18.3：擔心且怪異地佔據式思考 .............................................. 322 CASE 18.4：不公平 ............................................................................ 324 CASE 18.5：脆弱和生氣 .................................................................... 327 CASE 18.6：痛苦的自殺傾向 ............................................................. 330 CASE 18.7：不滿足 ............................................................................ 333 CASE 18.8：害羞 ................................................................................ 336 CASE 18.9：缺少自信 ........................................................................ 338 CASE 18.10：關係控制 ...................................................................... 341 19 性偏好症 .................................................................................... 313 導言 ..................................................................................................... 345 CASE 19.1：施虐與被虐 .................................................................... 348 CASE 19.2：關係問題 ........................................................................ 352 CASE 19.3：性冒犯 ............................................................................ 354 CASE 19.4：一些特殊性癖好 ............................................................. 358 主題索引 .................................................................................... 363 臨床個案索引 ............................................................................. 387