Moskalewicz Marcin, Kordel Piotr, Brejwo Agnieszka, Schwartz Michael A, Gozé Tudi
Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznan, Poland.
Faculty of Philosophy, University of Warsaw, Warsaw, Poland.
Front Psychiatry. 2021 Mar 5;12:642322. doi: 10.3389/fpsyt.2021.642322. eCollection 2021.
The psychopathological notion of the Praecox Feeling (PF) refers to an experience of strangeness and bizarreness that arises in a clinician during contact with a patient with schizophrenia. There is evidence that psychiatrists take advantage of this feeling in their diagnostic decisions despite the domination of an operationalized diagnostic approach. The article presents the results of a survey assessing the self-reported prevalence of the PF among psychiatrists in Poland and compares them with data from West Germany (1962), USA (1989), and France (2017) based on the same survey. The study finds a consistent prevalence of reported feelings suggestive of the diagnosis of schizophrenia among psychiatrists of different cultural backgrounds and times. These feelings are independent of variables such as attitude toward schizophrenia, professional orientation, and professional experience and are considered reliable, even if not the most reliable, by the psychiatrists who have them. The study also finds that intersubjective phenomena, such as problematic affective attunement, gestures, and body language, are considered core to these feelings by the psychiatrists. The evidence confirms that psychiatrists' feelings about patients with schizophrenia are considered diagnostically relevant and calls for more deeply investigating the nature and diagnostic significance of these feelings. The article concludes with some speculations regarding the possible benefits of recognizing the PF in facilitating a psychotherapeutic encounter with psychotic patients.
早发性情感（PF）的精神病理学概念是指临床医生在接触精神分裂症患者时产生的一种陌生和怪异的体验。有证据表明，尽管存在一种可操作的诊断方法占主导地位的情况，但精神科医生在诊断决策中仍会利用这种感觉。本文介绍了一项调查结果，该调查评估了波兰精神科医生自我报告的PF患病率，并将其与基于相同调查的西德（1962年）、美国（1989年）和法国（2017年）的数据进行了比较。研究发现，不同文化背景和时代的精神科医生中，报告的提示精神分裂症诊断的感觉患病率一致。这些感觉与对精神分裂症的态度、专业方向和专业经验等变量无关，并且有这些感觉的精神科医生认为它们是可靠的，即使不是最可靠的。研究还发现，精神科医生认为主体间现象，如情感协调问题、手势和肢体语言，是这些感觉的核心。证据证实，精神科医生对精神分裂症患者的感觉被认为与诊断相关，并呼吁更深入地研究这些感觉的本质和诊断意义。文章最后对认识PF在促进与精神病患者的心理治疗接触中可能带来的益处进行了一些推测。
