Janzarik W
Psychiatrische Universitätsklinik Heidelberg.
Nervenarzt. 2003 Jan;74(1):3-11. doi: 10.1007/s00115-002-1348-6.
The term "psychosis," first used by Canstatt and then by von Feuchtersleben, originally meant "psychic neurosis," one of several forms of one disease group. The term was taken up by Flemming and introduced among other typical indications such as psychic disturbance, psychic disease, mind disease, and madness around 1875 in the German-speaking world."Psychosis" was understood from the beginning as a cerebral pathology which found its expression in psychic symptomatology. The broadest interpretation of the concept of psychosis prior to the turn of the nineteenth to the twentieth centuries has today been reduced to the modern differentiations of psychopathologies and neuroses. Since then, no consensus has been reached on the extent of the concept of psychosis.We have remained at the "persistent unclarity" described by H. Kindt. Contemporary diagnostic systems have done without the concept of psychosis. The indication "psychotic" which has taken its place and is based primarily on characteristically schizophrenic phenomena is also unclear. Independently of the unsolved problem of differentiation, there remains the question of psychotic qualities which are understandable on biologic and psychopathologic levels at the same time and which combine biologic, interpretative, and descriptive elements, uniting them in the field of biologic and clinical psychiatry.
“精神病”一词最早由坎施塔特使用，后被冯·费希特莱本采用，最初意为“精神神经症”，是某一疾病组的几种形式之一。该词被弗莱明采用，并于1875年左右在德语世界引入，用于诸如精神障碍、精神疾病、心智疾病和疯狂等其他典型指征之中。“精神病”从一开始就被理解为一种在精神症状学中得以表现的大脑病理学。在19世纪末到20世纪初之前，对精神病概念最宽泛的解释如今已简化为现代精神病理学和神经症的区分。从那时起，关于精神病概念的范围就一直没有达成共识。我们仍处于H. 金特所描述的“持续的不清晰”状态。当代诊断系统已经不再使用精神病这一概念。取而代之的“精神病性的”指征主要基于典型的精神分裂症现象，其也并不明确。抛开尚未解决的区分问题不谈，同时在生物学和精神病理学层面上都能理解的精神病特质问题依然存在，这些特质将生物学、解释性和描述性元素结合在一起，在生物精神病学和临床精神病学领域将它们统一起来。
