Matsumoto Takuya, Kato Satoshi
Department of Psychiatry, Jichi Medical University.
Seishin Shinkeigaku Zasshi. 2012;114(7):751-63.
In this paper, we reviewed the concept of "elementary phenomena", which was used by K. Jaspers and the French Lacanian school of thought for the differential diagnosis of psychosis. This concept can provide a useful index of schizophrenia (especially paranoid schizophrenia). We psychiatrists can use elementary phenomena as a qualitative index of schizophrenia, not as a quantitative index (as is used by an operational diagnosis system). For Jaspers, elementary phenomena have 5 features: (1) elementary phenomena arise primarily (not deducted by preceding psychical experience), (2) elementary phenomena arise as a non-sensical experience, (3) elementary phenomena invade the schizophrenic patient immediately, (4) elementary phenomena have an "overwhelming power" on the patient, and (5) elementary phenomena underlie psychotic symptoms in the later stage. Jaspers thought of elementary phenomena as a primary expression of his "process", which is thought to be a specific cause of endogenous psychoses. In France, Lacan inherited Jaspers' elementary phenomena. In his doctoral dissertation (1932), Lacan stressed that delusions arise "primarily". He thought that delusional interpretation is not deducted by any other preceding psychical experience, and is one of the elementary phenomena. Later, in the 1950s, Lacan aimed to "define Jaspers' process by the most radical determinants of man's relation to the signifier", and he redefined elementary phenomena as a sudden emergence of an enigmatic signifier and non-sensical power to the patient. We propose that Jaspers is one of the founders of modern descriptive psychopathology, and it is important to take note of his description.
在本文中，我们回顾了“基本现象”这一概念，卡尔·雅斯贝尔斯（K. Jaspers）以及法国拉康派思想曾用其进行精神病的鉴别诊断。这一概念可为精神分裂症（尤其是偏执型精神分裂症）提供有用的指标。我们精神科医生可将基本现象用作精神分裂症的定性指标，而非定量指标（如同操作诊断系统所使用的那样）。对雅斯贝尔斯而言，基本现象有五个特征：（1）基本现象主要是自发产生的（并非由先前的心理体验推导而来），（2）基本现象表现为一种无意义的体验，（3）基本现象即刻侵袭精神分裂症患者，（4）基本现象对患者具有“压倒性力量”，（5）基本现象是后期精神病症状的基础。雅斯贝尔斯将基本现象视为其“过程”的主要表现形式，该“过程”被认为是内源性精神病的特定病因。在法国，拉康继承了雅斯贝尔斯的基本现象。在其博士论文（1932年）中，拉康强调妄想“主要”是自发产生的。他认为妄想性解释并非由任何其他先前的心理体验推导而来，且是基本现象之一。后来，在20世纪50年代，拉康旨在“通过人类与能指关系的最根本决定因素来界定雅斯贝尔斯的过程”，并将基本现象重新定义为对患者而言神秘能指和无意义力量的突然出现。我们认为雅斯贝尔斯是现代描述性精神病理学的奠基人之一，留意他的描述很重要。
