[精神分裂症及精神分裂症谱系障碍中的“复杂”现象：系统学方面]
[«Verschroben»-phenomenon in schizophrenia and schizophrenia spectrum disorders: aspects of systematics].
作者信息
Smulevich A B, Romanov D V, Mukhorina A K, Atadzhikova J A
机构信息
Mental Health Research Center, Moscow, Russia; Sechenov First Moscow State Medical University, Moscow, Russia.
Mental Health Research Center, Moscow, Russia.
出版信息
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(1):5-16. doi: 10.17116/jnevro2017117115-16.
AIM
Psychopathological analysis and typological differentiation of «verschroben»-phenomenon as the full-blown syndrome of defect in schizophrenia and schizophrenia spectrum disorders.
MATERIAL AND METHODS
Fifty patients, 33 female and 17 male, mean age 44.8±8.5 years, with ICD-10 diagnosis of schizotypal disorder (F21) and residual schizophrenia (F20.5) were included in the study. Patients were examined using psychopathological and psychometric (SPQ-74) methods.
RESULTS AND CONCLUSION
There was clinical heterogeneity of the «verschroben» type defect: the differentiation of primary defect syndrome and the «second life» defect was confirmed. This typological classification is based not only on the differences in psychopathological symptoms and impaired social functioning but on the trajectory of the development of deficit syndromes related with the features of the course of endogenous disease. The typology would be useful for future studies of deficit changes in view of clinical prognosis, social context of schizophrenia spectrum disorders with negative «verschroben» type changes.
目的
对“verschroben”现象进行精神病理学分析和类型学区分，该现象为精神分裂症及精神分裂症谱系障碍中缺陷的全面综合征。
材料与方法
本研究纳入了50例患者，其中女性33例，男性17例，平均年龄44.8±8.5岁，国际疾病分类第10版（ICD - 10）诊断为分裂型障碍（F21）和残留型精神分裂症（F20.5）。采用精神病理学和心理测量学（SPQ - 74）方法对患者进行检查。
结果与结论
“verschroben”型缺陷存在临床异质性：原发性缺陷综合征和“第二人生”缺陷的区分得到证实。这种类型学分类不仅基于精神病理症状和社会功能受损的差异，还基于与内源性疾病病程特征相关的缺陷综合征发展轨迹。鉴于临床预后，该类型学对于未来研究精神分裂症谱系障碍中具有阴性“verschroben”型变化的缺陷改变及社会背景将是有用的。
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