Fritze Friederike, Ehrt U, Brieger P
Klinik und Poliklinik für Psychiatrie und Psychotherapie der Martin-Luther-Universität Halle-Wittenberg, Germany.
Fortschr Neurol Psychiatr. 2002 Mar;70(3):117-25. doi: 10.1055/s-2002-20530.
The article reviews the conceptual history of "hyperthymia". Since K. W. Stark had used this term in the early 19(th) century, it has developed in two different directions: (1) to delineate a psychopathological syndrome and (2) to define a type of personality disorder (psychopathy). As Kurt Schneider's personality disorder (psychopathy) concept was easily understood and highly practicable, it became influential during the 20(th) century. Earlier before, psychiatrists such as E. Mendel, C. Wernicke and C. G. Jung had described entities such as "chronic mania", "hypomania" or "sanguinic degeneration", which were rather similar to each other. We analyze the historical development of such concepts. Emil Kraepelin was highly influential, as he introduced "constitutional excitation" into a broad concept of manic-depressive illness and saw it as a very mild form. After Kraepelin such spectrum concept was first forgotten. Only in recent years these historical considerations were confirmed by empirical observations, although a separate hyperthymic disorder is neither part of DSM-IV nor ICD-10. The concept of a hyperthymic temperament or a hyperthymic personality is a trait-marker and should be differentiated from hypomania as a state-marker. Nowadays, the importance of hyperthymia is not so much one of a disorder requiring treatment; rather the concept has interesting genetic, diagnostic and conceptual consequences.
本文回顾了“情感高涨”的概念史。自19世纪初K. W. 斯塔克使用该术语以来,它朝着两个不同方向发展:(1)描绘一种精神病理综合征;(2)定义一种人格障碍(精神变态)类型。由于库尔特·施奈德的人格障碍(精神变态)概念易于理解且实用性强,在20世纪颇具影响力。在此之前,E. 门德尔、C. 韦尼克和C. G. 荣格等精神病学家曾描述过“慢性躁狂”“轻躁狂”或“血质退化”等实体,它们彼此颇为相似。我们分析了这些概念的历史发展。埃米尔·克雷佩林极具影响力,因为他将“体质性兴奋”引入了广泛的躁狂抑郁症概念,并视其为一种非常轻微的形式。在克雷佩林之后,这种谱系概念最初被遗忘了。直到近年来,这些历史考量才得到实证观察的证实,尽管单独的情感高涨障碍既不属于《精神疾病诊断与统计手册》第四版(DSM-IV),也不属于《国际疾病分类》第十版(ICD-10)。情感高涨气质或情感高涨人格的概念是一种特质标记,应与作为状态标记的轻躁狂相区分。如今,情感高涨的重要性与其说是一种需要治疗的疾病,不如说这个概念在遗传学、诊断学和概念方面有着有趣的影响。