Schepank H
Psychosomatischen Klinik des Zentralinstituts für Seelische Gesundheit Mannheim.
Z Psychosom Med Psychoanal. 1991;37(4):375-88.
Being able to look ahead, being able to make a correct prediction of events and developments has been of great interest to mankind since biblical times and with good reason. Due to his profession one expects from a doctor that he can make a prognosis. In the realm of psychogenic illnesses or of healthy persons certain barriers arise because of the lacking epidemiologic knowledge. We had to overcome these barriers in our cohort study conducted in Mannheim: In a random sample of 600 adults from a mostly healthy population, after conducting thorough psychoanalytic interviews a prognostic judgment was given for each person regarding the further course of psychic health or psychogenic illness (diagnosed for 26% of the persons). The spontaneous course and the accuracy of the prognosis was reexamined after three years. The quota of accuracy as well as occurring problems and considerations and a case oriented analysis of the prognostic misjudgements are discussed.
自圣经时代以来,能够展望未来、对事件和发展做出正确预测就一直引起人类的极大兴趣,这是有充分理由的。由于医生的职业,人们期望他能够做出预后诊断。在心理疾病领域或健康人群中,由于缺乏流行病学知识,会出现某些障碍。在我们于曼海姆进行的队列研究中,我们不得不克服这些障碍:在一个主要为健康人群的600名成年人随机样本中,在进行了全面的精神分析访谈后,对每个人的心理健康或心理疾病(26%的人被诊断患有心理疾病)的未来病程做出了预后判断。三年后重新检查了预后的自然病程和准确性。讨论了准确性的配额以及出现的问题和考虑因素,并对预后错误判断进行了个案分析。