Dörr Zegers O, Cid Araneda A
Facultad de Medicina División Sur, Universidad de Chile.
Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1992 May-Jun;20(3):120-9.
First, the author makes reference to the psycho pathological and nosological questions associated with paranoid and schizophrenia-like psychoses in epilepsy and in particular to the non resolved problem of a distinction between these epileptic syndromes and the ones of schizophrenia. Starting from a phenomenological analysis of basic existential structures such as encounter or interpersonality, temporality and spatiality in a typical case of paranoid psychosis in epilepsy, the author tries to establish formal criteria which allow to distinguish these psychoses from schizophrenia. Thus it could be demonstrated that the structure of the encounter in the psychotic epileptic is quite conserved, both in what refers to the real and the delusional partner. His spatiality is characterized by the phenomenon of narrowness and his temporality by harassment, being necessary to underline the fact that, unlike what happens in schizophrenia, in the paranoid psychoses of epilepsy the space maintains its unity and the time its continuity. We could summarize the substantive difference between both types of paranoid psychoses with the following words: in paranoid syndromes in epilepsy what occurs is a change of state "within the world", while in schizophrenia it is a rather a modification of the "being-in-the world" itself or, with other words, it deals with a going out from the world constituted as community.
首先,作者提及了与癫痫性偏执和类精神分裂症性精神病相关的精神病理学和疾病分类学问题,尤其提到了区分这些癫痫综合征与精神分裂症综合征这一尚未解决的问题。从对癫痫性偏执性精神病典型病例中诸如相遇或人际性、时间性和空间性等基本生存结构的现象学分析出发,作者试图确立能够将这些精神病与精神分裂症区分开来的形式标准。由此可以证明,癫痫性精神病患者的相遇结构在涉及真实和妄想对象方面都相当保守。其空间性的特征是狭窄现象,时间性的特征是困扰,必须强调的是,与精神分裂症不同,在癫痫性偏执性精神病中,空间保持其统一性,时间保持其连续性。我们可以用以下的话来总结这两种偏执性精神病之间的实质性差异:在癫痫性偏执综合征中发生的是“在世界之内”的状态变化,而在精神分裂症中则是“在世存在”本身的一种改变,或者换句话说,它涉及从作为共同体构成的世界中脱离。