Leube Dirk, Whitney Carin, Kircher Tilo
Department of Psychiatry, RWTH Aachen University, Pauwelsstrasse 30, Aachen, Germany.
Eur Arch Psychiatry Clin Neurosci. 2008 Nov;258 Suppl 5:22-7. doi: 10.1007/s00406-008-5017-z.
Ego-disturbances (passivity phenomena) and formal thought disorder are two hallmark symptoms of schizophrenia. Formal thought disorder has been highlighted already very early by Eugen Bleuler in his concept of basic symptoms (Grundsymptome). In contrast ego-disturbances (Ich-Störungen) or passivity phenomena have been declared as core symptoms of schizophrenia by Kurt Schneider in his concept of first-rank symptoms (Erstrangsymptome) that influenced the whole concept of schizophrenia until today (ICD10; DSM IV). We present new neuroimaging and cognitive neuropsychological results that help to explain what brain and cognitive functions may be involved in the emergence of these symptoms. Questions on cognitive and neural correlates of notions such as self-awareness, self-consciousness, introspective perspective or subjective experiences have re-emerged as topics of great interest in the scientific community. Employing new neuroscientific methods such as functional brain imaging, advances into thus far unexplored territory of mind-brain relationships have been made. These findings give new impulses for the search on the neural basis of psychopathological symptoms. We will review neuroscientific data and models on the pathogenesis of two of the core symptoms of schizophrenia, i.e. passivity phenomena and formal thought disorder.
自我障碍（被动现象）和形式思维障碍是精神分裂症的两个标志性症状。形式思维障碍在早期就已被尤金·布洛伊勒在其基本症状（Grundsymptome）概念中着重强调。相比之下，自我障碍（Ich-Störungen）或被动现象被库尔特·施耐德在其一级症状（Erstrangsymptome）概念中认定为精神分裂症的核心症状，这一概念至今仍影响着整个精神分裂症的概念（ICD10；DSM-IV）。我们展示了新的神经影像学和认知神经心理学结果，这些结果有助于解释这些症状的出现可能涉及哪些大脑和认知功能。诸如自我意识、自我觉察、内省视角或主观体验等概念的认知和神经关联问题，再次成为科学界极为关注的话题。运用功能性脑成像等新的神经科学方法，在迄今尚未探索的脑-心关系领域取得了进展。这些发现为探寻精神病理症状的神经基础提供了新的动力。我们将回顾关于精神分裂症两个核心症状即被动现象和形式思维障碍发病机制的神经科学数据和模型。
