Strauss J S, Carpenter W T
Schizophr Bull. 1978;4(1):56-67. doi: 10.1093/schbul/4.1.56.
Three main ways of viewing schizophrenia exist that have different prognostic, practical, and conceptual implications. The mixed cross-sectional/longitudinal view of Kraepelin and others states essentially that there is a disease, schizophrenia, that can be identified by considering both characteristic symptoms and course. Prognosis in the disorder so defined is guarded, but because of the composite diagnostic criteria used, the characteristics most important for relating to outcome remain unknown. The second view defines schizophrenia primarily in terms of the cross-sectional symptom picture alone. It has been shown empirically that defining a disorder in this way has relatively limited prognostic implications. The third approach identifies schizophrenia in terms of several "axes," such as type of schizophrenic symptoms, their duration, the person's social relations, and his work function. These axes are viewed as relatively independent processes with somewhat different determinants, implying the need for different specific treatments. The authors believe this last view is the one most supported by currently available data.
对于精神分裂症的认识主要存在三种观点，它们在预后、实际应用及概念方面都有着不同的意义。克雷佩林等人提出的横断面/纵向混合观点认为，本质上存在一种名为精神分裂症的疾病，可通过综合考虑特征性症状和病程来识别。如此定义的该疾病预后并不乐观，不过由于采用了综合诊断标准，对于判断预后最为重要的特征仍不明确。第二种观点主要仅依据横断面症状表现来定义精神分裂症。经验表明，以这种方式定义一种疾病，其预后意义相对有限。第三种方法从几个“轴”来界定精神分裂症，比如精神分裂症症状的类型、持续时间、患者的社会关系以及工作功能。这些轴被视为相对独立的过程，其决定因素略有不同，这意味着需要不同的特定治疗方法。作者认为最后这种观点最能得到现有数据的支持。
