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[青春型精神分裂症——一种可行的精神病理学概念?]

[Hebephrenia - a viable psychopathological construct?].

作者信息

Jäger M, Becker T, Wigand M E

机构信息

Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Kempten, Akademisches Lehrkrankenhaus, Universität Ulm, Robert-Weixler-Str. 46, 87439, Kempten, Deutschland.

Klinik für Psychiatrie und Psychotherapie II, Universität Ulm, Günzburg, Deutschland.

出版信息

Nervenarzt. 2018 Jan;89(1):18-26. doi: 10.1007/s00115-017-0366-3.

Abstract

Ewald Hecker was the first psychiatrist to describe the disease entity of hebephrenia in some detail, focusing mainly on disturbances of affect. Later Emil Kraepelin and Eugen Bleuler saw hebephrenia as a subtype of dementia praecox or schizophrenia. Willy Mayer-Gross and Karl Leonhard characterized hebephrenia with highly differentiated psychopathological descriptions, whereas this construct only played a minor role in the works of Klaus Conrad and Kurt Schneider. The International Classification of Diseases (ICD-10) lists hebephrenia as a subtype of schizophrenia but in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no subtypes of schizophrenia are mentioned and the concept of hebephrenia is thus lost. Hebephrenia can be seen as an ideal type describing a psychopathological course pattern. This construct can be useful to conceptualize a group of disorders of affect which otherwise escape description, especially since these psychopathological alterations of affect are difficult to operationalize. To have a viable concept of these disorders is relevant for the prognosis and therapy planning. If the concept of hebephrenia is abolished, important psychopathological knowledge might be lost for future generations of psychiatrists.

摘要

埃瓦尔德·黑克尔是首位较为详细地描述青春型精神分裂症疾病实体的精神科医生,主要关注情感障碍。后来,埃米尔·克雷佩林和尤金·布洛伊勒将青春型精神分裂症视为早发性痴呆或精神分裂症的一个亚型。威利·迈耶-格罗斯和卡尔·莱昂哈德用高度分化的精神病理学描述对青春型精神分裂症进行了特征描述,而这一概念在克劳斯·康拉德和库尔特·施奈德的著作中仅起次要作用。《国际疾病分类》(ICD - 10)将青春型精神分裂症列为精神分裂症的一个亚型,但在《精神疾病诊断与统计手册》(DSM - 5)中未提及精神分裂症的亚型,青春型精神分裂症的概念因此消失。青春型精神分裂症可被视为一种描述精神病理病程模式的理想类型。这一概念有助于对一组情感障碍进行概念化,否则这些情感障碍难以描述,特别是因为这些情感的精神病理改变难以操作化。拥有这些障碍的可行概念对于预后和治疗规划至关重要。如果青春型精神分裂症的概念被摒弃,重要的精神病理学知识可能会为后世精神科医生所遗失。

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