Lepoutre Thomas, Madeira Manoel L, Guerin Nicolas
Department of Clinical Psychology, Aix-Marseille University LPCLS (EA 3278)Marseille, France.
Institute of Psychology, Federal University of Rio Grande do SulPorto Alegre, Brazil.
Front Psychol. 2017 Sep 15;8:1564. doi: 10.3389/fpsyg.2017.01564. eCollection 2017.
This article seeks to reopen a major question raised by the Lacanian nosology of the psychoses, by looking closely at Lacan's formulations of what he never ceased referring to as "paranoia". While almost all classification systems of modern psychiatry, such as the ICD-10 and the DSM-5, have abandoned the specific category of paranoia, Lacan always viewed paranoia as a major category of "functional psychosis". He held that paranoia was a qualitatively different disorder than schizophrenia, and considered it to be the principal or exemplary form of psychosis. Furthermore, in the middle period of his work, Lacan thought of paranoia in much broader terms than those of the definition proposed by Kraepelin, which he revisited, point by point, developing his theory of Freud's concept of "" or foreclosure; the latter became the focal diagnostic criterion in his nosographic construction. Lacan's privileging of and evolving theoretical views on paranoia provide a structural approach to what he called the "resistant nucleus" of psychosis; his work serves as a counterpoint to the more descriptive neo-Kraepelinian approach of contemporary psychiatric nosology.
本文旨在重新探讨拉康精神病学分类法所引发的一个重大问题，通过仔细审视拉康对他一直称之为“偏执狂”的阐述。虽然现代精神病学的几乎所有分类系统，如国际疾病分类第十版（ICD - 10）和精神疾病诊断与统计手册第五版（DSM - 5），都摒弃了偏执狂这一特定类别，但拉康始终将偏执狂视为“功能性精神病”的一个主要类别。他认为偏执狂是一种在性质上与精神分裂症不同的病症，并将其视为精神病的主要或典型形式。此外，在其研究工作的中期，拉康对偏执狂的思考远比克雷佩林提出的定义更为宽泛，他逐点重新审视了该定义，并发展了他关于弗洛伊德“或排除”概念的理论；后者成为了他分类学构建中的核心诊断标准。拉康对偏执狂的重视及其不断演变的理论观点，为他所谓的精神病“抵抗核心”提供了一种结构性方法；他的著作与当代精神病学分类学中更具描述性的新克雷佩林学派方法形成了对比。
