Wettig J
Klinik für Psychiatrie und Psychotherapie Eichberg, Eltville am Rhein.
MMW Fortschr Med. 2001 May 28;143 Suppl 2:67-70.
The dual diagnosis schizophrenia and addiction represents a combination of an endogenous psychosis and an addictive condition in the sense of abuse of or dependence on psychotropic substances. Before this diagnosis is established, schizophreniform organic psychoses must be distinguished from primary schizophrenia. Since the psychopathological differentiation is often not quite unequivocal, a search must be made for treatable underlying disorders. Here, help is afforded by the patient's history obtained on the basis of the reports of relatives and friends, physical neurologic examinations, and various laboratory, radiologic, electrophysiologic and neuropsychologic methods. In the daily clinical situation, a series of characteristic leading symptoms help clarify the differential diagnosis. The starting point for treatment is the patient's personal view of the problem, and his subjective state of health. Goals to be aimed at include integrative therapeutic approaches propagating the interaction of pharmacotherapy, psychotherapy and sociotherapy.
精神分裂症与成瘾的双重诊断意味着一种内源性精神病与一种成瘾状况的结合，这种成瘾状况表现为对精神活性物质的滥用或依赖。在确立这一诊断之前，必须将精神分裂症样器质性精神病与原发性精神分裂症区分开来。由于精神病理学上的鉴别往往并非十分明确，因此必须寻找可治疗的潜在病症。在此，可根据亲属和朋友的报告、体格神经学检查以及各种实验室、放射学、电生理学和神经心理学方法获取的患者病史提供帮助。在日常临床情况下，一系列特征性的主要症状有助于明确鉴别诊断。治疗的出发点是患者对问题的个人看法及其主观健康状况。治疗目标包括推广药物治疗、心理治疗和社会治疗相互作用的综合治疗方法。
