Gross G
Bereich Verlaufspsychiatrie, Universitäts-Nervenklinik Bonn (Venusberg).
Fortschr Neurol Psychiatr. 2001 Sep;69 Suppl 2:S95-100. doi: 10.1055/s-2001-16538.
Since 1911, when E. Bleuler thought of the so-called latent schizophrenia as the most frequent type of schizophrenia, but most seldom diagnosed as such, the question, whether there exist abortive forms of schizophrenia, was discussed again and again; so in 1932 by Mayer-Gross, who devoted to the uncharacteristic onset of schizophrenia a special chapter, in 1938 by Stern (so-called borderline neuroses) und in 1949 by Hoch and Polatin (pseudoneurotic schizophrenias). Since the 50s Huber had described by means of follow-up studies the uncharacteristic basic stages occurring long before the onset and after remission of the florid symptomatology, in 1957 the cenesthetic schizophrenia and in 1961 and 1966 the asthenic or pure defect of schizophrenia, which he also counts to the subclinical syndromes or formes frustes of endogenous psychoses just as the endogenous juvenile-asthenic failure syndromes, the larvate schizophrenia, the endogenous obsessive-compulsive disorder and the circumscribed cenesthopathy. The recognition of these subthreshold stages and types of the schizophrenia spectrum, which cannot be diagnosed by valid diagnostic criteria for schizophrenia, is the presupposition for an adequate therapy. The patients complain about subjectively experienced mainly dynamic, affective, cognitive (thought, perception and action disturbances), cenesthetic and vegetative basic symptoms, can be registered and documented by the Bonn Scale BSABS. We will deal with symptomatology, course and therapy of the mentioned sublinical syndromes. The psychopharmacological treatment is chosen according to the psychopathological cross-section picture and will be continued until improvement or remission of the symptomatology and after stepwise reduction stopped. If dynamic and affective basic symptoms predominate, we prefer antidepressants (e. g. amitriptyline-type or the newer SSRIs), in case of prevailing cognitive and cenethetic basic symptoms neuroleptics, today mainly atypical ones. In the past also classical neuroleptics, e. g. haloperidol, fluphenazine or pimozide in low dosage of or low potent drugs as thioridazine or perazine have proved to be worthwhile.
自1911年E. 布鲁勒认为所谓的潜在精神分裂症是最常见的精神分裂症类型，但很少被如此诊断以来，关于是否存在精神分裂症的顿挫型这一问题被反复讨论；1932年梅耶 - 格罗斯对此进行了讨论，他专门为精神分裂症不典型的起病情况写了一章，1938年斯特恩（所谓的边缘性神经症）以及1949年霍赫和波拉廷（假神经症性精神分裂症）也进行了讨论。自20世纪50年代以来，胡贝尔通过随访研究描述了在明显症状学出现之前很久以及缓解之后出现的不典型基础阶段，1957年描述了体感性精神分裂症，1961年和1966年描述了精神分裂症的虚弱型或单纯缺陷型，他也将其归入亚临床综合征或内源性精神病的顿挫型，就像内源性青少年虚弱型衰竭综合征、隐性精神分裂症、内源性强迫症和局限性体感障碍一样。认识到这些精神分裂症谱系中无法通过有效的精神分裂症诊断标准进行诊断的阈下阶段和类型，是进行充分治疗的前提。患者主诉主要是主观体验到的动态、情感、认知（思维、感知和行动障碍）、体感和植物神经基本症状，这些可通过波恩量表BSABS进行记录和存档。我们将探讨上述亚临床综合征的症状学、病程和治疗方法。精神药物治疗根据精神病理学横断面情况进行选择，并持续到症状改善或缓解，然后在逐步减量后停药。如果动态和情感基本症状占主导，我们首选抗抑郁药（如阿米替林类或更新的选择性5-羟色胺再摄取抑制剂），如果主要是认知和体感基本症状占主导，则选用抗精神病药，如今主要是非典型抗精神病药。过去，经典抗精神病药，如低剂量的氟哌啶醇、氟奋乃静或匹莫齐特，或低效药物如硫利达嗪或奋乃静也已证明是有效的。
