Schizophrenia and Depression – Challenging the Paradigm of Two Separate Diseases
Schizophrenia and Depression – Challenging the Paradigm of Two Separate Diseases
复制标题
精神分裂症和抑郁症——挑战两种不同疾病的范式
DOI：
10.1007/978-94-007-0831-0_16
复制
发表时间：
2011
期刊：
影响因子：
--
通讯作者：
an der Heiden W.
中科院分区：
文献类型：
--
作者：
Häfner H;an der Heiden W.
情感症状，特别是抑郁症，在精神分裂症中的发生率很高。当与亚临床精神病症状结合发生时，它们是精神病风险的前兆。它们随时间的增加与精神病风险的增加有关，它们随着精神病风险的下降而减少。严重抑郁症的前驱期和精神分裂症的精神病前前驱期表现出大致相同的症状，但只有在精神病症状发作后才能在诊断上相互区分。在全面发展的精神分裂症过程中，抑郁情绪是最常见的症状，甚至比精神分裂症特有的阳性症状更常见。在精神病复发发作中，抑郁症状也会增加，当精神病缓解时，抑郁症状在一定程度上也会减少。15-20%的复发发作的特征是情感症状而没有精神病症状。试图确定精神病复发中的抑郁前驱症状并没有得到一致的结果。Kraepelinian模型的两个离散的疾病组没有提供一个充分的描述情感和精神病症状之间的功能关联观察整个病程。基于症状维度的精神分裂症模型似乎更接近现实，这些症状维度在功能上部分相关，并且在个体疾病中的份额不同。由于目前可用的抗精神病和抗抑郁药物和特定的心理治疗技术作用于症状维度，而不是Kraepelinian疾病的概念，精神分裂症的维度模型似乎在治疗方面更有用。
Affective symptoms, depression in particular, show high rates in schizophrenia. When occurring in combination with subclinical psychotic symptoms they are precursors of psychosis risk. Their increase over time is associated with an increase in psychosis risk and their decrease with a fall therein. The prodromal stage of severe depression and the prepsychotic prodromal stage of schizophrenia show, in the mean, more or less identical symptoms, but are diagnostically distinguishable from each other only after the onset of psychotic symptoms. In the course of full-blown schizophrenia depressive mood is the most frequent symptom, even more frequent than the positive symptoms specific to schizophrenia. In psychotic relapse episodes depressive symptoms, too, increase and to some extent also decrease when the psychosis remits. 15–20% of the relapse episodes are characterised by affective symptoms without psychotic symptoms. Attempts to identify a depressive prodrome in psychotic relapses have not yielded consistent results. The Kraepelinian model of two discrete illness groups does not provide an adequate description of the functional association between affective and psychotic symptoms observable throughout the illness course. A model of schizophrenia based on symptom dimensions, which are in part functionally related and differ in their shares in individual illness, seems to be closer to reality. Since the currently available antipsychotic and antidepressant medications and specific psychotherapeutic techniques act on symptom dimensions rather than the Kraepelinian disease concepts, a dimensional model of schizophrenia seems more useful in therapeutic respect as well.
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发表时间：
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期刊：
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影响因子：
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