Kendler Kenneth S
Virginia Institute of Psychiatric and Behavioral Genetics, and Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, Virginia.
J Nerv Ment Dis. 2023 Mar 1;211(3):169-173. doi: 10.1097/NMD.0000000000001588. Epub 2022 Sep 11.
Edward Spitzka, a prominent New York-based alienist, who spent 3 years in Germany studying psychiatry, published a textbook in 1883-the same year as the first edition of Kraepelin's textbook-that contained detailed descriptions of all the seven psychiatric syndromes that formed the basis of Kraepelin's nosologic synthesis: mania, melancholia, katatonia, secondary deteriorations, hebephrenia, circular insanity, and monomania. A study of this text provides us with a "before" picture-a view of the canvas of psychiatric diagnostic categories-from which Kraepelin worked. Studying what Spitzka's diagnostic categories contain and what they are missing highlights the key steps Kraepelin took in the development of his nosologic synthesis. For example, Spitzka does not describe a commonality in symptoms or outcome in katatonia, hebephrenia, and the move severely ill delusional monomaniacs, nor did he link together mania, melancholia, and circular insanity, but instead comments on wide differences in outcome among these three syndromes.
爱德华·斯皮茨卡是一位杰出的纽约精神病医生，他曾在德国花了三年时间研究精神病学，并于1883年出版了一本教科书——同年克雷佩林的教科书第一版问世——其中详细描述了构成克雷佩林疾病分类综合基础的所有七种精神综合征：躁狂症、忧郁症、紧张症、继发性衰退、青春期痴呆、循环性精神病和偏执狂。对这段文本的研究为我们提供了一幅“之前”的画面——一幅克雷佩林进行研究的精神诊断类别的图景。研究斯皮茨卡的诊断类别包含哪些内容以及缺少哪些内容，凸显了克雷佩林在其疾病分类综合发展过程中所采取的关键步骤。例如，斯皮茨卡没有描述紧张症、青春期痴呆以及病情更严重的妄想性偏执狂患者在症状或预后方面的共性，他也没有将躁狂症、忧郁症和循环性精神病联系在一起，而是评论了这三种综合征在预后方面的巨大差异。
