Marneros A, Deister A, Rohde A
Psychiatrische Universitäts-Klinik Bonn.
Nervenarzt. 1991 Nov;62(11):676-81.
The long-term outcome of 355 patients with affective, schizoaffective and schizophrenic disorders was evaluated after long duration of the illness (mean more than 25 years). All patients were personally interviewed using operational instruments (PSE, WHO/DAS, WHO/PIRS, GAS, Huber's Psychopathological Criteria). By application of descriptive methods, integrating operationally estimated findings with clinically-impressively estimated "interactional atmosphere", we defined eight types of phenomenological constellations of persistent alterations ("residual-types") of functional disorders: "depletion syndrome", "apathetic-paranoid syndrome (resp. apathetic-hallucinatory syndrome)", "adynamic-deficient syndrome", "chronic psychosis", "structural deformation", "asthenic insufficiency syndrome", "chronic subdepressive syndrome", and "chronic hyperthymic syndrome". It was found a different distribution of persistent alterations in affective and schizophrenic disorders while schizoaffective disorders occupied a position in-between. The differences in the phenomenology of persistent alterations are interpreted as the result of differing biological and psychological processes. It was also found that the phenomenology of persistent alterations is related to the degree of disability.
对355例患有情感障碍、分裂情感性障碍和精神分裂症的患者在病程较长(平均超过25年)后进行了长期预后评估。所有患者均使用操作性工具(PSE、WHO/DAS、WHO/PIRS、GAS、胡贝尔精神病理学标准)进行个人访谈。通过应用描述性方法,将操作性评估结果与临床印象深刻的“互动氛围”评估相结合,我们定义了功能障碍持续性改变(“残留类型”)的八种现象学星座类型:“耗竭综合征”、“淡漠-偏执综合征(或淡漠-幻觉综合征)”、“动力不足-缺陷综合征”、“慢性精神病”、“结构变形”、“虚弱不足综合征”、“慢性亚抑郁综合征”和“慢性情感高涨综合征”。研究发现,情感障碍和精神分裂症中持续性改变的分布不同,而分裂情感性障碍则处于两者之间的位置。持续性改变现象学的差异被解释为不同生物学和心理过程的结果。还发现,持续性改变的现象学与残疾程度有关。