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《“精神分裂症反应”——20年后的随访研究(作者译)》

[The 'schizophrenic reaction'--a follow-up study after 20 years (author's transl)].

作者信息

Scharfetter C, Nüsperli M, Hurwitz E

出版信息

Arch Psychiatr Nervenkr (1970). 1979 Apr 12;226(4):347-68. doi: 10.1007/BF00342247.

Abstract

The concept of schizophrenic reaction was introduced in 1920 by Popper for single schizophrenic manifestations of short duration and full recovery, occurring after a traumatic experience. Of the 29 probands with a primary diagnosis of schizophrenic reaction when recruited for study by Rohr (report published 1961), 28 were reevaluated 20 years later. Nineteen subjects now had a clear-cut schizophrenic symptomatology (ICD 295); 16 with, and three without, remaining symptoms and/or relapse. The other nine were now diagnosed under nosologic categories other than ICD 295. Of these subjects, four were symptom free and had suffered no relapse. The study did not reveal criteria suggesting a distinguishable nosologic category 'schizophrenic reaction' with reference to a schizophrenic syndrome of acute or subacute onset after a brief traumatic event (without remaining symptoms and/or relapse). Such probands did not differ from the schizophrenic group in any of the following criteria: psychopathology, heredity data (diagnosis of relatives was undertaken without reference to the respective index cases), time of onset, duration of psychopathologic manifestation, length of hospitalization, period without remaining symptoms or relapse, and frequency and type of traumatic experiences. The two groups with schizophrenic symptomatology (ICD 295) are genetically characterized by the fact that their first-degree relatives had an incidence of schizophrenia of 8.3 +/- 2.6%. On the other hand, no certain cases of schizophrenia were found among such relatives of subjects in other diagnostic groups. The results do not support the concept of schizophrenic reaction.

摘要

1920年,波普尔提出了精神分裂症反应的概念,用于描述在创伤经历后出现的、持续时间短且能完全康复的单一精神分裂症表现。在罗尔于1961年发表报告时招募进行研究的29名初步诊断为精神分裂症反应的先证者中,20年后对其中28人进行了重新评估。现在有19名受试者有明确的精神分裂症症状(国际疾病分类295);其中16人有残留症状和/或复发,3人没有。另外9人现在被诊断为国际疾病分类295以外的其他疾病类别。在这些受试者中,4人无症状且未复发。该研究未发现任何标准表明存在一个可区分的疾病类别“精神分裂症反应”,该类别是指在短暂创伤事件后急性或亚急性起病的精神分裂症综合征(无残留症状和/或复发)。这些先证者在以下任何标准方面与精神分裂症组均无差异:精神病理学、遗传数据(对亲属的诊断不参考各自的索引病例)、发病时间、精神病理表现的持续时间、住院时间、无残留症状或复发的时期,以及创伤经历的频率和类型。有精神分裂症症状(国际疾病分类295)的两组在遗传特征上表现为其一级亲属的精神分裂症发病率为8.3±2.6%。另一方面,在其他诊断组受试者的此类亲属中未发现确诊的精神分裂症病例。研究结果不支持精神分裂症反应的概念。

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