Lecrubier Y
INSERM U 302, Hôpital La Salpêtrière, Paris.
Encephale. 1997 Apr;23 Spec No 2:39-43.
There is no clinical sign, cognitive impairment or physiological abnormality pathognomic for schizophrenia. Aetiological factors and neurophysiological abnormalities appear to be heterogeneous. On the other hand, among the three symptomatic dimensions (negative, positive and disorganized), specific negative symptoms may present as early signs in childhood, may exist as essential signs marking disease onset, may be stable during disease progression, may predict an unfavourable long-term outcome, may have a significant genetic component in affected families, and may, be linked to neurological abnormalities when present. Of these symptoms, anhedonia and motivational disorders are the most stable and have the greatest predictive value. They may reflect a vulnerability common to the schizophrenic spectrum and account for the subsequent development of other symptomatic dimensions; this may be observed even when multiple aetiological factors are involved. In relation to their mechanism of action, the therapeutic effects of neuroleptics are consistent with this hypothesis.
精神分裂症没有特异性的临床体征、认知障碍或生理异常。病因因素和神经生理异常似乎具有异质性。另一方面，在三个症状维度（阴性、阳性和紊乱性）中，特定的阴性症状可能在儿童期就表现为早期症状，可能作为标志疾病发作的基本症状存在，在疾病进展过程中可能保持稳定，可能预示不良的长期预后，在受影响的家庭中可能有显著的遗传成分，并且在出现时可能与神经学异常有关。在这些症状中，快感缺失和动机障碍最为稳定，具有最大的预测价值。它们可能反映了精神分裂症谱系共有的易感性，并解释了其他症状维度的后续发展；即使涉及多种病因因素，也可能观察到这种情况。关于其作用机制，抗精神病药物的治疗效果与这一假设一致。
