Attar-Lévy D, Bergerioux L, Fidelle G, Brillaud D, Lôo H
Service Hospitalo-Universitaire de Santé Mentale et de Thérapeutique, Paris.
Ann Med Psychol (Paris). 1994 Aug-Sep;152(7):470-4; discussion 474-5.
Since the last decade of the nineteenth century, psychiatric nosology has been dominated by Kraepelin's binary system: the notion that the distinction between manic-depressive illness and schizophrenia identifies two separate diseases with differing symptom patterns and outcomes. However, Kraepelin recognised that intermediate states, as exemplified by Kasanin's concept of "schizoaffective" illness are common. In contrast to Kraepelin's separation of manic-depressive illness from schizophrenia, the concept of a continuum of psychosis implies that there are gradations of illness between unipolar depressive, through bipolar affective and schizoaffective illness, to schizophrenia. This concept is strongly supported by the majority of family studies. Moreover, no simple clinical demarcations of affective from schizophrenic illnesses can be made. The family findings are compatible with the hypothesis that the same gene or genes contribute to susceptibility to both schizophrenia and affective disorder: a single locus that may be variable between generations, and that is represented by homologous loci on the X and Y chromosomes.
自19世纪最后十年以来，精神病分类学一直由克雷佩林的二元系统主导：即躁狂抑郁症和精神分裂症之间的区别确定了两种具有不同症状模式和转归的独立疾病的观念。然而，克雷佩林认识到，以卡沙宁的“分裂情感性”疾病概念为例的中间状态很常见。与克雷佩林将躁狂抑郁症与精神分裂症分开不同，精神病连续统的概念意味着从单相抑郁、双相情感障碍和分裂情感性疾病到精神分裂症之间存在疾病的渐变。这一概念得到了大多数家族研究的有力支持。此外，无法对情感性疾病和精神分裂症进行简单的临床区分。家族研究结果与以下假设相符：即相同的一个或多个基因促成了对精神分裂症和情感障碍的易感性，这是一个可能在几代人之间可变的单一基因座，并且由X和Y染色体上的同源基因座代表。
