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[古斯塔夫·施佩希特(1905年)和赫尔曼·保罗·尼切(1910年)对成人注意力缺陷多动障碍(ADHD)的临床描述及分类思考]

[Adult attention deficit hyperactivity disorder (ADHD) in the clinical descriptions and classificatory reflections of Gustav Specht (1905) and Hermann Paul Nitsche (1910)].

作者信息

Steinberg Holger, Strauß Maria

机构信息

Forschungsstelle für die Geschichte der Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland.

ADHS-Sprechstunde, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland.

出版信息

Nervenarzt. 2022 Jul;93(7):735-741. doi: 10.1007/s00115-021-01233-7. Epub 2021 Nov 24.

Abstract

The notion that the adult form of attention deficit hyperactivity disorder (ADHD) is not a construct of modern psychiatry is increasingly prevailing. Looking into the history of psychiatry can make an enlightening contribution here. Guided by this aim and specifically following literature referred to by Emil Kraepelin (1856-1926), we analyzed the content of one study each by Gustav Specht (1860-1940) and the later Nazi psychiatrist Hermann Paul Nitsche (1876-1948) from 1905 and 1910, respectively, on the topic of chronic mania. Our investigation concluded that in their case studies both authors described people who would today be diagnosed as suffering from adult ADHD as the clinical descriptions reveal core symptoms of this entity as defined by modern classifications. They also mentioned currently discussed research questions. Both authors expressed their dissatisfaction with the classificatory situation of these patients at the time. Specht even postulated a "completely independent mental illness" that he called "chronic mania", under which he classified all the patients suffering from today's adult ADHD. He also pointed out that this diagnosis was not widely recognized at the time by psychiatrists as a full-fledged form of illness but used more as a diagnosis to avoid the embarrassment of not having one. Nitsche saw the "chronic manic states" as he called them as a "clinical peculiarity" but assigned them to the large group of "manic depressive insanity", which could only be more finely differentiated in the future.

摘要

注意力缺陷多动障碍(ADHD)的成人形式并非现代精神病学的概念这一观点越来越普遍。回顾精神病学的历史在此能做出具有启发性的贡献。受此目标指引,并特别参考了埃米尔·克雷佩林(1856 - 1926)所提及的文献,我们分别分析了古斯塔夫·施佩希特(1860 - 1940)在1905年以及后来的纳粹精神病学家赫尔曼·保罗·尼切(1876 - 1948)在1910年关于慢性躁狂症主题的一项研究内容。我们的调查得出结论,在他们的案例研究中,两位作者所描述的人如今会被诊断为患有成人ADHD,因为临床描述揭示了现代分类所定义的该病症的核心症状。他们还提到了当前讨论的研究问题。两位作者都表达了对当时这些患者分类情况的不满。施佩希特甚至假设了一种他称之为“完全独立的精神疾病”的“慢性躁狂症”,他将所有如今患有成人ADHD的患者都归类于此。他还指出,当时这种诊断并未被精神病学家广泛认可为一种成熟的疾病形式,更多地是被用作一种诊断以避免没有诊断的尴尬。尼切将他所谓的“慢性躁狂状态”视为一种“临床特殊性”,但将它们归入“躁狂抑郁症”这一大类,而这在未来只能进行更细致的区分。

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Adult attention-deficit hyperactivity disorder: key conceptual issues.成人注意力缺陷多动障碍:关键概念问题
Lancet Psychiatry. 2016 Jun;3(6):568-78. doi: 10.1016/S2215-0366(16)30032-3. Epub 2016 May 13.

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