Greene Talya
Institute of Psychiatry, King's College London, Department of Psychological Medicine, UK.
Hist Psychiatry. 2007 Sep;18(71 Pt 3):361-79. doi: 10.1177/0957154X07078977.
Emil Kraepelin's view that psychotic disorders are naturally-occurring disease entities, and that dementia praecox and manic-depressive psychosis represent two different diseases, has been hugely influential on classificatory systems for psychosis. Corresponding to the Kraepelinian dichotomy, those systems generally differentiated schizophrenia from affective psychosis. This paper examines the debate that took place between 1980 and 2000 regarding this differentiation. During the 1980s, the scientific reliability of the diagnostic criteria was challenged. In the 1990s there were significant critiques of the validity of the Kraepelinian dichotomy. Yet the dichotomy has not been formally abandoned, and the discussion continues to the present day. This paper suggests that before psychiatry can abandon the Kraepelinian dichotomy, a new model for conceptualizing and describing psychotic symptoms may be required.
埃米尔·克雷佩林认为精神障碍是自然发生的疾病实体，早发性痴呆和躁狂抑郁症代表两种不同的疾病，这一观点对精神病分类系统产生了巨大影响。与克雷佩林的二分法相对应，这些系统通常将精神分裂症与情感性精神病区分开来。本文审视了1980年至2000年间围绕这种区分展开的争论。在20世纪80年代，诊断标准的科学可靠性受到了挑战。在20世纪90年代，人们对克雷佩林二分法的有效性提出了重大批评。然而，这种二分法尚未被正式摒弃，相关讨论一直持续到今天。本文认为，在精神病学能够摒弃克雷佩林二分法之前，可能需要一个新的模型来概念化和描述精神病症状。
