Huber G, Gross G
Recenti Prog Med. 1989 Dec;80(12):646-52.
This paper presents the psychiatric aspects of the concept of basic symptoms (BS), especially history, actual position and tendencies of development of the doctrine of BS, phenomenology and clinical picture of basic stages, the Bonn Scale for the assessment of dynamic and cognitive basic deficiencies (BSABS) and the importance of this concept for early diagnosis, therapy, prevention and rehabilitation. The patients experience and communicate the BS as deficiencies and are able to cope with, adapt and compensate for them. The BS were termed as basic symptoms because they represent the basis of the productive-psychotic symptomatology. Follow-up studies of cases with the suspicion diagnosis "prodrome of schizophrenia" based on BSABS rating, revealed that the subgroup passing over in schizophrenic psychoses after an average of 6.3 years showed significantly higher scores of cognitive BS at the time of index investigation. It now seems possible to impede increase of cognitive BS already present in prepsychotic prodromal states before reaching the threshold of transition into productive-psychotic symptomatology. Long-term development is more favorable if therapy commences as early as possible including the prepsychotic basic stages and also taking into consideration BS which were, until now, disregarded in DSM-III. Summarizing our findings of the last 30 years we suggest that the BS-concept may be an approach to overcome the dichotomy of negative and positive psychopathology in schizophrenia.
本文介绍了基本症状（BS）概念的精神科方面内容，尤其是基本症状学说的历史、现状及发展趋势，基本阶段的现象学和临床表现，用于评估动态和认知基本缺陷的波恩量表（BSABS），以及这一概念在早期诊断、治疗、预防和康复中的重要性。患者体验并将基本症状视为缺陷，且能够应对、适应和补偿这些缺陷。基本症状被称为基本症状是因为它们代表了产生性精神病症状学的基础。基于BSABS评分对疑似“精神分裂症前驱期”病例的随访研究表明，平均6.3年后发展为精神分裂症性精神病的亚组在索引调查时认知基本症状得分显著更高。现在看来，有可能在达到向产生性精神病症状学转变的阈值之前，阻止已经存在于精神病前前驱状态的认知基本症状增加。如果尽早开始治疗，包括精神病前的基本阶段，并考虑到目前在《精神疾病诊断与统计手册》第三版（DSM-III）中被忽视的基本症状，长期发展会更有利。总结我们过去30年的研究结果，我们认为基本症状概念可能是一种克服精神分裂症中阴性和阳性精神病理学二分法的方法。
