精神病障碍的克雷佩林二分法 120 周年
120th Anniversary of the Kraepelinian Dichotomy of Psychiatric Disorders.
机构信息
Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572, Poznan, Poland.
Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland.
出版信息
Curr Psychiatry Rep. 2019 Jul 1;21(8):65. doi: 10.1007/s11920-019-1048-6.
Abstract
PURPOSE OF REVIEW
Emil Kraepelin, in 1899, proposed a dichotomy of psychiatric disorders into "dementia praecox," further called schizophrenia, and "manisch-depressives Irresein," now conceptualized as a bipolar disorder. The purpose of the review is to show both similarities and differences between disorders involved in this dichotomy, speaking for and against the idea.
RECENT FINDINGS
On the molecular genetic side, there are data for both a genetic overlap and genetic differences between these two illnesses. Among pharmacological treatment, lithium, valproates, and carbamazepine present evidence for Kraepelinian dichotomy while atypical antipsychotics speak against this. The recent results for similarities and differences in the immune system, cognitive functions, and neurodevelopmental mechanisms have also been presented and discussed. As of 2019, the Kraepelinian dichotomy has been still partly valid although the results of recent clinical, neurobiological, and pharmacological studies provided a large number of data for an intermediate space between schizophrenia and bipolar disorder.
摘要
目的综述
Emil Kraepelin 在 1899 年提出将精神障碍分为“早发性痴呆”，即现在所说的精神分裂症，和“躁狂抑郁性精神病”，现在被概念化为双相情感障碍。本文的目的是展示这两种二分法疾病之间的相似之处和不同之处，支持和反对这一观点。
最近的发现
在分子遗传学方面，这两种疾病之间存在遗传重叠和遗传差异的证据。在药物治疗方面，锂、丙戊酸盐和卡马西平对 Kraepelin 二分法有证据支持，而非典型抗精神病药则反对这一观点。最近还提出并讨论了免疫系统、认知功能和神经发育机制的相似性和差异。截至 2019 年，Kraepelin 二分法仍然部分有效，尽管最近的临床、神经生物学和药理学研究结果提供了大量介于精神分裂症和双相情感障碍之间的中间空间的数据。
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