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从波兰精神病学史看:paragnomen。

From the history of Polish psychiatry: paragnomen.

机构信息

III Klinika Psychiatryczna IPiN w Warszawie.

出版信息

Psychiatr Pol. 2020 Dec 31;54(6):1255-1261. doi: 10.12740/PP/109763.

Abstract

We present the case of a 27-year-old male patient who - without any apparent reason - jumped out of the window located at the 7th floor of the building, which resulted in severe injuries of internal organs. That shocking and inexplicable event became reason of many hospitalizations. He was hospitalized in the intensive care and rehabilitation units for months. He denied any suicidal ideation and was unable to give any reasonable justification for his jump. He was diagnosed with moderate depression and he was treated with antidepressants. Subsequently, psychotic symptoms appeared and he was hospitalized in psychiatric wards, where the diagnosis of schizophrenia was taken into account. He received antipsychotic treatment. At discharge, acute polymorphic disorder similar to schizophrenia was diagnosed. That act appears as "action against expectation" (actio praeter expectationem) - paragnomen - a concept announced by the Polish psychiatrist, Eugeniusz Brzezicki, in the 1950s. This case illustrates that an unfounded, unjustified by any meaningful reason and sudden event which led to several severe body injuries might be considered as a sign of the psychotic disorder development but does not have to necessarily result in the diagnosis of schizophrenia, as suggested by Eugeniusz Brzezicki, who was the author of the term 'paragnomen'.

摘要

我们呈现了一个 27 岁男性患者的案例,他无缘无故地从位于 7 楼的建筑物窗户跳下,导致严重的内脏损伤。这一惊心动魄、无法解释的事件成为他多次住院的原因。他在重症监护病房和康复病房住院数月。他否认有任何自杀意念,也无法对他的跳楼行为给出任何合理的解释。他被诊断为中度抑郁症,并接受了抗抑郁治疗。随后出现了精神病症状,他被收入精神科病房,考虑到精神分裂症的诊断。他接受了抗精神病治疗。出院时,诊断为类似精神分裂症的急性多形性障碍。这种行为被称为“意外行为”(actio praeter expectationem)——副名——这是波兰精神病学家尤金纽斯·布雷齐茨基(Eugeniusz Brzezicki)在 20 世纪 50 年代提出的概念。这个案例表明,无缘无故、没有任何有意义的理由、突然发生的事件,导致严重的身体伤害,可能被视为精神障碍发展的迹象,但不一定会导致精神分裂症的诊断,正如尤金纽斯·布雷齐茨基(Eugeniusz Brzezicki)所提出的那样,他是“副名”一词的作者。

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