Klosterkötter J
Klinik für Psychiatrie und Psychotherapie, Universität zu Köln.
Fortschr Neurol Psychiatr. 1998 Mar;66(3):133-43. doi: 10.1055/s-2007-995248.
Starting from the original concept of "dementia praecox", in this article, the ICD 10 and DSM-IV revisions of their respective definitions of schizophrenia are made more transparent and evaluative in regards to their development. For the ICD 10 definition, the schizophrenia concept of K. Schneider and its characteristic orientation towards diagnostic validity had a pre-eminent impact, whereas in DSM-IV the authors intended to follow the schizophrenia concept of E. Bleuler and thereby aimed at placing greater emphasis on the negative symptomatology. However, the results of the revision of schizophrenic disorders of this diagnostic system surprisingly leaned again towards the concept of K. Schneider. With regard to own findings on the diagnostic validity of positive and negative symptoms, it is shown that this result is justified in accordance with the present state of the art in schizophrenia research. In addition, the article deals with the definitions of schizotype features, prodromal and residual symptoms in these new diagnostic systems and critically evaluates these elements. To sum up it is clear that the recent definitions are based on the German psychopathological tradition on the one hand and the empirical findings of the last centuries on the other. Taking the latter into account, this might lead to a new understanding of schizophrenic disorders in the future.
从“早发性痴呆”的最初概念出发,本文对国际疾病分类第10版(ICD - 10)和《精神疾病诊断与统计手册》第四版(DSM - IV)中各自对精神分裂症的定义修订进行了更清晰的阐述,并对其发展进行了评估。对于ICD - 10的定义,K. 施奈德的精神分裂症概念及其对诊断效度的独特取向产生了突出影响,而在DSM - IV中,作者旨在遵循E. 布鲁勒的精神分裂症概念,从而更加强调阴性症状学。然而,该诊断系统中精神分裂症障碍修订的结果却令人惊讶地再次倾向于K. 施奈德的概念。关于自身对阳性和阴性症状诊断效度的研究结果表明,根据精神分裂症研究的当前技术水平,这一结果是合理的。此外,本文还探讨了这些新诊断系统中分裂型特征、前驱症状和残留症状的定义,并对这些要素进行了批判性评估。总之,很明显,最近的定义一方面基于德国精神病理学传统,另一方面基于过去几个世纪的实证研究结果。考虑到后者,这可能会在未来带来对精神分裂症障碍的新认识。