Zec R F
Department of Psychiatry, Southern Illinois University School of Medicine, Springfield 62794-9230, USA.
Eur Arch Psychiatry Clin Neurosci. 1995;245(4-5):216-23. doi: 10.1007/BF02191800.
Emil Kraepelin was the first to identify schizophrenia as a distinct disease in 1896. The purpose of this paper is to rediscover and reexamine the neuropsychology of schizophrenia according to Kraepelin. Kraepelin thought that the "dementia" of dementia praecox was primarily a disorder of volition, rather than one of intellect. "Volition" or "will" referred to the ability to make conscious decisions and to carry them out. By quoting relevant passages in his classic textbook, Dementia Praecox and Paraphrenia, the case is made that Kraepelin's detailed description of volitional deficits in patients with dementia praecox clearly documents impairments in executive functioning in schizophrenia patients during the preneuroleptic era. To a large extent, these deficits may be responsible for the "dementia" of dementia praecox and the "chronicity" of chronic schizophrenia. If this hypothesis is correct, the long-range prognosis of patients with schizophrenia may be considerably improved by treatment programs designed to facilitate executive functioning.
1896年，埃米尔·克雷佩林首次将精神分裂症确认为一种独特的疾病。本文旨在根据克雷佩林的观点重新发现并重新审视精神分裂症的神经心理学。克雷佩林认为，早发性痴呆的“痴呆”主要是意志障碍，而非智力障碍。“意志”或“意愿”指的是做出有意识决定并付诸实施的能力。通过引用他的经典教科书《早发性痴呆和类偏执狂》中的相关段落，有证据表明，克雷佩林对早发性痴呆患者意志缺陷的详细描述清楚地记录了在神经阻滞剂时代之前精神分裂症患者执行功能的损害。在很大程度上，这些缺陷可能是早发性痴呆的“痴呆”和慢性精神分裂症“慢性化”的原因。如果这一假设正确，那么通过旨在促进执行功能的治疗方案，精神分裂症患者的远期预后可能会得到显著改善。
