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[存在症状性精神分裂症吗?]

[Does symptomatic schizophrenia exist?].

作者信息

Huber G

机构信息

Psychiatrische Klinik, Poliklinik der Universität Bonn.

出版信息

Psychiatr Neurol Med Psychol (Leipz). 1990 Jan;42(1):11-24.

PMID:2184447
Abstract

The question if there are "symptomatic schizophrenias" has been discussed since the 20s. Schizophrenic psychoses caused be definable and well known brain diseases are presented. All schizophrenic symptoms and syndromes, the first rank symptoms (K. Schneider) too, occur in somatically founded psychoses. The group of paroxysmal transition syndromes in the sense of aura prolongata (continua) and the episodic schizophrenic psychoses in psychomotor epilepsy may be a model for the schizophrenia research. Vital threatening, so-called pernicious catatonic schizophrenias are found on the basis of infectious brain diseases, sometimes only diagnosed in autopsy. Beside acute and reversible symptomatic schizophrenic psychoses there are, even if rarely, recurrent and chronic courses of symptomatic schizophrenias. That certain conditions for the developing of symptomatic schizophrenias are rarely realised, could be an explanation for their rarity. Some findings indicate that the limbic system is significant for symptomatic (and idiopathic) schizophrenic psychoses and the pre- and postpsychotic basic stages determined by dynamic and cognitive basic symptoms, which are phenomenologically very similar to aura symptoms released by stereoelectroencephalographic depth recordings (Wieser). The characteristic features of marked fluctuation, discontinuity and insteadiness of the cognitive thought, perception, psychomotor and cenesthetic phenomena do not speak against an organic brain disorder provided that the traditional process hypothesis is abandoned in favor of a neurobiochemic disorder, fluctuating on its part depending on endogenous as well as psychic-reactive factors.

摘要

自20世纪20年代以来,人们一直在讨论是否存在“症状性精神分裂症”。文中介绍了由可定义且广为人知的脑部疾病引起的精神分裂症性精神病。所有精神分裂症症状和综合征,包括一级症状(K. 施奈德提出),也都出现在躯体性基础的精神病中。从先兆延长(持续)意义上的阵发性过渡综合征以及精神运动性癫痫中的发作性精神分裂症性精神病组,可能是精神分裂症研究的一个模型。在感染性脑部疾病基础上可发现危及生命的所谓恶性紧张型精神分裂症,有时仅在尸检时才得以诊断。除了急性和可逆的症状性精神分裂症性精神病外,即使很少见,也存在症状性精神分裂症的复发和慢性病程。症状性精神分裂症发展的某些条件很少得到满足,这可能是其罕见的一个解释。一些研究结果表明,边缘系统对症状性(和特发性)精神分裂症性精神病以及由动态和认知基础症状所决定的精神病前和精神病后基础阶段具有重要意义,这些基础症状在现象学上与立体脑电图深度记录(维泽尔)所释放的先兆症状非常相似。认知思维、感知、精神运动和本体感觉现象明显波动、不连续和不一致的特征,并不排除存在器质性脑部疾病,前提是摒弃传统的病程假说,转而支持一种神经生化紊乱,这种紊乱部分取决于内源性以及心理反应性因素而波动。

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