摘要:

The term ‘atypical psychosis’ coined by Mitsuda in 1942 describes a group of psychosis that show similarities to schizophrenia as well as manic-depressive diseases. It is controversial whether it refers to a uniform group of diseases exposing typical characteristics. According to Leonhard a typical uniform group of cycloid psychoses can be contrasted with a group of atypical schizophrenias. The position of the so-called atypical psychoses in the sense of a nosological position within the classification systems of different psychiatric schools will be analyzed and discus

ISSN:0254-4962    

DOI:10.1159/000284668

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The validity of the current systems of classification of endogenous psychoses has not yet been unambiguously demonstrated using the criterion of prognosis. An alternative to these systems may be seen in the Leonhard classification of endogenous psychoses. In a catamnestic study, 93% of the initial diagnoses and prognoses made between 1969 and 1973 could be confirmed in 1986.

ISSN:0254-4962    

DOI:10.1159/000284669

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

On the basis of 30 years of cowork with Leonhard it is attempted to enlighten the theoretical background of his classification of endogenous psychoses. Inspired by the conceptions of Wernicke and Kleist he explained the differentiation of symptomatology by the model of system diseases applying this in completing and improving the psychopathological classification. His ideas about the origin of a differentiated vulnerability of brain structures are very similar to the doctrine of pathoclisis of Vogt, although Leonhard did not use this term.

ISSN:0254-4962    

DOI:10.1159/000284670

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Leonhard was largely influenced, during his years at the Frankfurt Mental Hospital, by the Wernicke follower Karl Kleist (1879–1960). Kleist was a representative of brain pathology. His psychopathological concepts, which he developed using the evaluation of brain injuries, look very modern. He tried to attribute different symptoms to definite functional centers and regulatory loops. His theory of the ‘autonomous psychic syndromes’, his categories of psychomotor activity, his concepts of cycloid psychoses and schizophrenic subgroups are described. The author emphasizes that the differentiation between unipolar and bipolar affective psychoses is based on the team work of Kleist, Edda Neele and Leonhard. Because of Kleist’s great contribution to the classification of psychoses, it would be more correct to use the term ‘Kleist-Leonhard classificatio

ISSN:0254-4962    

DOI:10.1159/000284671

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Carl Wernicke derived his theory of the pathomechanism of mental illness of his theories on aphasia. For this reason Jaspers [ 1 ] accused him of mythologizing the brain. On the other hand, however, Jaspers does admit that Wernicke has produced one of the most important works on psychology and says that a serious study of this work is something that no researcher can do without. Now, through the influence of modern biological psychiatry, the psychiatry of Wernicke and his school is once more gaining in significance.

ISSN:0254-4962    

DOI:10.1159/000284672

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

In this paper the author highlights the importance that the classificatory work carried out by Leonhard has had for recent international developments in the classification of mental disorders. In particular, the diagnostic relevance of a distinction between bipolar and unipolar affective disorders and the separation of the cycloid psychotic disorders from other major psychoses is underscored.

ISSN:0254-4962    

DOI:10.1159/000284673

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Leonhard conceived a hierarchical classification system for endogenous psychoses consisting of a small number of vast, clinically heterogenous main categories. These are subdivided into more homogenous and narrower subcategories: Bipolar affective psychoses, cycloid psychoses and unsystematic schizophrenias are subcategories of a main category of psychopathologically polymorphic, episodic bipolar psychoses. Common features of these related forms of psychoses are syndrome lability, bipolarity and switching. Rapid cycling is a course complication in bipolar affective psychoses as well as in cycloid psychoses and in nonsystematic schizophrenias. Empirically established ideal types of idiopathic psychoses are the foundation of psychiatric classification systems, not only in Leonhard’s classification, but also in others. In the description of the features of diagnostic categories based on psychotic ideal types, Leonhard accounted for the low degree of diagnostic specificity of isolated symptoms in so far as he recognised that in bipolar affective psychoses, in cycloid psychoses and in unsystematic schizophrenias intra-episodic syndrome-dynamical features are of greater diagnostic importance. The phenomenon of intra- and interepisodic syndrome lability as a dynamic feature finds its strongest expression in the switch processe

ISSN:0254-4962    

DOI:10.1159/000284674

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Psychiatric diagnoses in endogenous psychoses are still largely based on clinical psychopathology. Despite intensive efforts including progress to more reliability in classification, no definite and causally relevant biological abnormalities have been identified so far. This failure might be due to the present standard classification systems like DSM or ICD being too crude to allow the distinction of homogeneous nosological entities. The classification developed by K. Leonhard offers a more subtle alternative. In order to facilitate the handling of this system and in the interest of reliability, an algorithm for computer-assisted diagnostic decision making based on similarities to Leonhard’s ideal types is presente

ISSN:0254-4962    

DOI:10.1159/000284675

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The DCR Budapest-Nashville was developed by adopting a differentiated concept of the ‘full disease entity’. The so-called small disease entity is a preliminary stage in the search for more complicated disease entities. In its present form, the DCR is a diagnostic method for identifying small disease entities in the spectrum of reactive (i.e. psychogenic) and functional (i.e. endogenous) psychoses. The nosological concept of the DCR can be characterized by thirteen paradigms: (1) a nonkraepelinian clinical classificatory system given by Leonhard; (2) the index-psychosis paradigm as opposed to the end-state paradigm; (3) conceptual differentiation of the disease entities as opposed both to the full disease entity paradigm and to the only-one-psychosis (or no disease entity) paradigm, respectively; (4) an aristotelian distinction between content (meaning) and form as opposed to the paradigm of ideas; (5) three-aspect approach to the psychopathological phenomena instead of choosing only one or two of the aspects of experience, of the behavior and of the achievement as special paradigm; (6) gestalt paradigm specified in different ways, as completing the associationist paradigm; (7) structural paradigm, especially concerning the delusions; (8) method of understanding in contrast to the method of causal explanation in distinguishing reactive (i.e psychogenic) psychoses from functional (i.e. endogenous) psychoses; (9) behavioral symptoms overrule experiential symptoms in the decision-tree process concerning schizophrenias; (10) erosive psychotic phenomena (‘minus symptoms’) overrule productive phenomena (‘plus symptoms’) in the decision-tree process concerning hebephrenias in the group of systematic schizophrenias; (11) three-dimensional (polarity, rhythmicity, deterioration) assessment of course of illness; (12) sociological paradigm in reformulation of types of ‘defect’; (13) psychosis paradigm concerning the operationalization of applicability of DCR to patients. Some empirical investigations are mentioned concerning the vali

ISSN:0254-4962    

DOI:10.1159/000284676

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Introduction of therapeutically effective psychotropic drugs focused attention on the heterogeneity of psychiatric populations within the traditional diagnostic categories of psychiatric disorders. Recognition that valid diagnostic concepts are essential for progress in the biology and pharmacotherapy of psychaitric disorders resulted in a revival of interest in psychiatric nosology with a special emphasis on Leonhard’s classification of ‘endogenous psychoses’. Of particular importance for psychopharmacolgoy in Leonhard’s system is the recognition of two distinctive populations within the schizophrenic disorders, i.e., ‘unsystematic schizophrenias’ and ‘systematic schizophrenias’; three distinctive populations within the bipolar disorders, i.e., ‘manic-depressive illness,’ ‘cycloid psychoses’ and ‘unsystematic schizophrenias’; and two distinctive populations within depressive disorders, i.e., ‘unipolar depression’ and ‘bipolar depression’. In this paper supporting data for Leonhard’s classification of

ISSN:0254-4962    

DOI:10.1159/000284677

出版商:S. Karger AG    

年代:1990

数据来源: Karger