The significance of special mental tests for diagnosis and prognosis in schizophrenia
The significance of special mental tests for diagnosis and prognosis in schizophrenia
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DOI：
10.1176/ajp.96.3.575
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发表时间：
1939-01-01
影响因子：
17.7
通讯作者：
Goldstein, K
中科院分区：
文献类型：
--
作者：
Goldstein, K
用胰岛素和其他类似的躯体治疗方法治疗精神分裂症，很容易使人们对精神分裂症的心理学研究失去兴趣。然而，有几个原因应该促使我们不要忽视心理调查。虽然这些治疗方法取得了相当大的效果，但我们不能忽视这样一个事实，即我们对这些结果是否持久知之甚少。此外，我们不知道心理治疗是否应该与躯体治疗一起发挥重要作用。心理调查需要特别考虑的另一个原因。躯体治疗当然不是在所有情况下都有帮助，我们无法预测哪些情况会或不会得到帮助。事实表明，疾病的持续时间并不是治疗改善机会的可靠指标。人们通常倾向于将持续时间作为这样的指标;然而，临床数据不能支持这样的假设。有些情况下，即使在长期患病后也会自发恢复，而在其他情况下，典型的精神分裂症终末状态可能在短期急性发作后发展。也许有一天，我们会发现躯体的迹象，使我们能够决定哪些病例预后不良或良好;化学研究特别可能成为这一目的的工具。在任何情况下，心理调查都是有帮助的。一些特殊的检查告诉我们，精神分裂症患者有一种明确的精神变化特征。然而，并非所有临床诊断为精神分裂症的患者都表现出这种变化。到目前为止，我们还不能在临床上区分那些显示这种变化的病例和那些不显示这种变化的病例。结果表明，通过心理调查可以区分疾病的类型
The treatment of schizophrenics with insulin and other similar somatic methods is apt to push into the background all interest in the psychological investigation of schizophrenia. There are several reasons, however, which should induce us not to neglect the psychological investigation. Although these treatments have yielded considerable results, we cannot overlook the fact that we know very little as to whether or not these results will be permanent. Furthermore, we do not know whether or not psychotherapy should play an important role alongside somatic treatment. There is another reason why psychological investigation demands special consideration. The somatic treatment certainly does not help in all cases, and we cannot predict which cases will or will not be helped. The facts show that the duration of the disease is not a reliable indicator as to the chances of improvement by that treatment. One is often inclined to take duration as such an indicator; however, the clinical data cannot support such an assumption. There are cases where spontaneous recoveries occur even after an illness of long standing, while in other cases the typical schizophrenic end-state might develop after a short acute attack. Perhaps one day we shall find somatic signs which will enable us to decide which cases have a bad or a good prognosis; chemical research particularly may become instrumental for this purpose. In any event, psychological investigations can be of assistance. Examinations with specific tests have taught us that there is a definite mental change characteristic of schizophrenic patients. However, not all patients with the clinical diagnosis of schizophrenia show this change. Thus far we are not able to differentiate clinically those cases which show this change and those which do not. The findings suggest that by means of psychological investigation types of the disease can be distinguished