Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Schizophr Res. 2024 Jan;263:151-159. doi: 10.1016/j.schres.2022.10.006. Epub 2022 Nov 3.
Catatonia is featured by complex symptoms combining motor, affective and behavioral phenomena as well as by its syndrome character with trans-diagnostic occurrence. It paradigmatically shows the limits of current forms of psychopathology like affective and cognitive approaches with respect to both clinical symptoms and brain mechanisms. We therefore suggest Spatiotemporal Psychopathology (STPP) which, as recently introduced, is here developed further following the latest findings in both clinical psychiatry and neuroscience. STPP is characterized by two core features: (i) an experience-based approach that accounts for symptoms primarily in terms of first-person experience of time-space as distinct from third-person observation of specific functions and related behavior; (ii) an integrated brain-mind approach where the brain's neural topography and dynamic, e.g., inner time and space, are shared by the mind's mental topography and dynamic, e.g., time-space experience, as their "common currency". We demonstrate how these two features can well account for both symptom complexity and trans-diagnostic nature of catatonia. In conclusion, catatonia can serve as paradigmatic example for the need to develop a more comprehensive psychopathological approach in psychiatry. This is provided by STPP that allows integrating subjective experience, clinical symptoms and the brain's neural activity in terms of their inner space-time, e.g., topography and dynamic.
紧张症的特点是复杂的症状，结合运动、情感和行为现象，以及其综合征特征，具有跨诊断发生。它范例性地展示了当前形式的精神病理学的局限性，如情感和认知方法，无论是在临床症状还是大脑机制方面。因此，我们建议使用时空精神病理学（STPP），正如最近介绍的那样，在临床精神病学和神经科学的最新发现的基础上，我们进一步发展了这一理论。STPP 的特点是两个核心特征：（i）基于经验的方法，主要根据时间-空间的第一人称经验来解释症状，而不是根据第三人称观察到的特定功能和相关行为；（ii）大脑-思维的综合方法，其中大脑的神经拓扑结构和动态，例如内在时间和空间，与思维的心理拓扑结构和动态，例如时间-空间体验，共享作为它们的“共同货币”。我们展示了这两个特征如何能够很好地解释紧张症的症状复杂性和跨诊断性质。总之，紧张症可以作为发展更全面的精神病理学方法在精神病学中的必要性的范例。这是由 STPP 提供的，它允许在其内在的时空，例如拓扑结构和动态方面，整合主观经验、临床症状和大脑的神经活动。
