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[精神分裂症的概念性症状与指示性症状]

[Conceptual vs. indexical symptomatologies of schizophrenia].

作者信息

Kim Y

机构信息

National Institute of Mental Health, National Center of Neurology and Psychiatry of Japan.

出版信息

Seishin Shinkeigaku Zasshi. 1992;94(8):711-37.

PMID:1438599
Abstract

We discussed the difference of conceptual and indexical symptomatologies of schizophrenia through critics upon the theory of Eugen Bleuler, the diagnostic schema of Kurt Schneider and several recent theories of negative symptoms of schizophrenia. The notion of the group of schizophrenia of Bleuler, which is a descriptive expression of the phenomenon originally grasped in the inter-human relationships, is of conceptual value but confusing when used indexically for the definition of the illness. In the diagnostic concept of Schizophrenia by Schneider, although he explicitly sought for indexical value without any conceptual prejudice, Jaspers' notion of the psychoses defined by understandability is implicitly included. Schizophrenia is regarded as a form of psychosis which is, following Jaspers, a synonym of madness. Since then, the value of Schneider's 1st rank symptoms has been generally acknowledged and they have contributed to the development of operational diagnostic criteria of schizophrenia. However, the general neglect of unproductive symptoms has caused a new stream of operational symptomatology, namely negative symptoms. This stream includes not only biological researches but also ideological investigations of the essential disturbance of schizophrenia, which have been totally ignored in the operational symptomatology. The discussion of negative symptoms of schizophrenia is complexed because it contains both indexical and conceptual symptomatologies: this very complexity also contains the possibility of the integration of these two apparently distant methods.

摘要

我们通过对尤金·布洛伊勒理论、库尔特·施耐德的诊断模式以及近期几种精神分裂症阴性症状理论的批判,探讨了精神分裂症概念性症状与指示性症状的差异。布洛伊勒的精神分裂症群组概念,它是对最初在人际关系中所把握现象的一种描述性表达,具有概念价值,但在用于疾病定义的指示性用法时却令人困惑。在施耐德的精神分裂症诊断概念中,尽管他明确寻求指示性价值且没有任何概念性偏见,但其中隐含着雅斯贝尔斯关于由可理解性定义的精神病的概念。精神分裂症被视为一种精神病形式,按照雅斯贝尔斯的说法,它是疯狂的同义词。从那时起,施耐德一级症状的价值得到了普遍认可,它们为精神分裂症操作性诊断标准的发展做出了贡献。然而,对无生产性症状的普遍忽视引发了一种新的操作性症状学潮流,即阴性症状。这一潮流不仅包括生物学研究,还包括对精神分裂症本质性障碍的思想性探究,而这些在操作性症状学中完全被忽视了。精神分裂症阴性症状的讨论很复杂,因为它既包含指示性症状也包含概念性症状:这种复杂性本身也包含了整合这两种明显不同方法的可能性。

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