Nickl-Jockschat T, Steiner J, Hirjak D, Hasan A
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Magdeburg, Germany.
Nervenarzt. 2025 Sep 4. doi: 10.1007/s00115-025-01861-3.
The classification of psychotic disorders has undergone a variety of changes. Since Karl Ludwig Kahlbaum's (Kahlbaum 1874) first descriptions of catatonic states and Emil Kraepelin's (Kraepelin 1883) nosological classification of psychotic syndromes in the second half of the nineteenth century, the diagnostic criteria for these disorders have been repeatedly modified, significantly impacting clinical practice. Eugen Bleuler (Bleuler 1911) coined the term "schizophrenia", emphasizing the disturbances in thinking, feeling and acting that he had observed. With the introduction of the 11th version of the International Classification of Diseases (ICD-11), several significant changes to the diagnostic criteria were introduced. First-line symptoms according to Schneider lost importance. The subtypes (e.g., paranoid, hebephrenic and catatonic schizophrenia) were also omitted and symptom and progression classifiers have been introduced instead. Finally, catatonia is now defined as an independent diagnostic entity, while in ICD-10 it was still assigned to schizophrenia under the code F20.2. This recognizes catatonia's independent, cross-diagnostic nature. Due to these symptom and progression classifiers, the ICD-11 now takes a more a hybrid categorical and dimensional approach to the diagnosis than the previous version.
精神障碍的分类经历了多种变化。自卡尔·路德维希·卡尔鲍姆(Karl Ludwig Kahlbaum,1874年)首次描述紧张症状态以及埃米尔·克雷佩林(Emil Kraepelin,1883年)在19世纪下半叶对精神综合征进行疾病分类以来,这些障碍的诊断标准不断修改,对临床实践产生了重大影响。尤金·布洛伊勒(Eugen Bleuler,1911年)创造了“精神分裂症”一词,强调了他所观察到的思维、情感和行为方面的紊乱。随着《国际疾病分类》第11版(ICD - 11)的推出,诊断标准引入了几项重大变化。施奈德提出的一线症状不再重要。亚型(如偏执型、青春型和紧张型精神分裂症)也被省略,取而代之的是引入了症状和病程分类器。最后,紧张症现在被定义为一个独立的诊断实体,而在ICD - 10中,它仍被归类于精神分裂症,编码为F20.2。这认识到了紧张症独立的、跨诊断的性质。由于这些症状和病程分类器,ICD - 11现在在诊断上比前一版采用了更多的混合分类和维度方法。