, , , , , , DSM-III (1980), , . () (/, , ) , (, ).
, . , . ( ) 75% , , ; . , , . , , , , .
, DSM-III , , . , , . . DSM . : DSM-IV 6 1 -10, . (. 35.1.1 35.1.2).
|
|
35.1.1. -10 DSM-IV ( -9-)
-10 | DSM-IV ( -9-) |
F20 | 295 |
F20.0 | 295.30 |
F20.1 | 295.10 |
F20.2 | 295.20 |
F20.3 | 295.90 |
F20.5 | 295.60 |
F20.6 | |
F21 | 301.22 |
F22 | 297.1 |
F23 | |
F23.0 | |
F23.1 | |
F23.2 | 295.40 |
295.8 | |
F25 | 295.70 |
F25.0 , | |
F25.1 , | |
F25.2 , |
35.1.2. -10 ( , . . Dilling et al., 1994, S. 85, 86) DSM-IV ( , . American Psychiatric Association, 1996, S. 340, 341)
-10 | DSM-IV | |
1. , , () 2. , , ; 3. , ; , - 4. , , , (, ) 5. , , , 6. , ; 7. , , , , 8. , , , , ; , | 1. 2. A3. (, ) 4. 5. , . . , . : , , , | |
. 1-4 ( ) . 5-8 | , , | |
6 ( ); 1 | ||
- : , - : , - | : , |
|
|
, , . . . DSM-IV (, ) - , (, , ). , (Clark, Watson & Reynolds, 1995). (Epidemiologic Catchment Area Study) 91% (, 47% ) (Smith & Hucker, 1994). , , , . , , .
, . . . , DSM-IV -10, , : 1) , , 2) 3) . ; (McGlashan & Fenton, 1991).
, . ( ) ( ). , ( , ) (Andreasen, Arndt, Alliger, Miller & Flaum, 1995) (. . 35.1.3).
|
|
35.1.3. - (Varimax-Rotation)
() | 0,83 | 0,13 | 0,17 |
0,82 | 0,18 | 0,11 | |
0,81 | -0,11 | 0,04 | |
0,06 | 0,80 | -0,11 | |
-0,05 | 0,75 | 0,27 | |
0,43 | 0,60 | 0,25 | |
0,07 | 0,18 | 0,82 | |
0,17 | 0,01 | 0,75 | |
28% | 21% | 18% |
. 243 (Scale for the Assessment of Negative Symptoms, SANS) (Scale for the Assessment of Positive Symptoms, SAPS) ( Andreasen et al., 1995).
, , , . , , , . . . , , . (Paranoid-Depressivitats-Skala, PDS). , .
(. 35.1.4). . , (. 35.1.1). , , , , (Disability Schedule, DAS), ( : Jung, Krumm, Biehl, Maurer & Bauer-Schubart, 1989), DSM (Global Assessment of Functioning Scale, GAF). . (, AMDP, BPRS). - , (Present State Examination, PSE;Wing, Cooper & Sartorius, 1982). , (, , , Composite International Diagnostic Interview, CIDI, DSM-III-R Structured Clinical Interview for DSM-III-R, SCID)(Wittchen & Unland, 1991). , , , . . . , , , .
|
|
35.1.4. () ()
(BPRS, Brief Psychiatric Rating Scale) () (Lukoff et al., 1987) | , , 5 | 18 , |
(NOSIE, Nurses Observation Scale for Inpatient Evaluation) () (Honigfeld et al., 1996) | 7 | 30 , |
(SANS, Scale for the Assessment of Negative Symptoms) (, C) (Dieterle et al., 1986) | - 5 ( , , , , ) | (30 ) |
(PANSS, Positive and Negative Syndrome Scale) () (Kay et al., 1987) | , | 7 (30 ) |
(PD-S, Paranoid-Depressivitats-Skala) () (v. Zerssen, 1976) | : 1) - , 2) , 3) | 43 |
(InSka, IntentionalitatsSkala) () (Mundt et al., 1985) | 60 , | |
(FBF, Frankfurter Beschwerde-Fragebogen) (C) (Süllwold, 1991) | ( ) 10 | (98 ) |
35.1.1. (Positive and Negative Syndrome Scale PANSS; Kay et al. 1987, 1988, 1990)
,
Positive and Negative Syndrome Scale PANSS (Kay et al. 1987, 1988, 1990)
,
- , 7 . 30 ( 1-7:1 = , 2 = , 3 = , 4 = ... 7 = ).
- (7 ): , , , , , /, .
- (7 ): , , , , , , .
|
|
- (16 ): , , , , , , , .
- 1 ,
-- (3): , , , ;
-- (5): , , ;
-- (7): , .
- : : 0,73, 0,83, 0,79. 6 : 0,80, 0,68, 0,60; 24 : 0,24, -0,13, -0,18.
- : :
/ (Scale for Assessing Positive Symptoms); SAPS: 0,77.
/ (Scale for Assessing Negative Symptoms); SANS: 0,77.
/ (Clinical Global Impressions Scale; CGI); 0,52.
---
American Psychiatric Association. (1996). Diagnostisches und statistisches Manual psychischer Störungen - DSM-IV (Deutsche Bearbeitung und Einleitung: Saß, H., Wittchen, H. U., Zaudig, M.). Göttingen: Hogrefe.
Andreasen, N. C., Arndt, S., Alliger, R., Miller, D. & Flaum, M. (1995). Symptoms of schizophrenia: Methods, meanings, and mechanisms. Archives of General Psychiatry, 52, 341-351.
Clark, L. A., Watson, D. & Reynolds, S. (1995). Diagnosis and classification of psychopathology: Challenges to the current system and future directions. Annual Review of Psychology, 46, 121-153.
Dieterle, D. M., Albus, M. I., Eben, E., Ackenheil, M. & Rockstroh, W. (1986). Preliminary experiences and results with the Munich version of the Andreasen Scale. Pharmacopsychiatry, 19, 96-100.
Dilling, H., Mombour, W., Schmidt, M. H. & Schulte-Markwort, E. (Hrsg.).(1994). Internationale Klassifikation psychischer Störungen ICD-10 Kapitel V (F). Forschungskriterien. Bern: Huber.
Honigfeld, G., Gillis, R. D. & Klett, C. J. (1996). NOSIE-Nurses Observation Scale for Inpatient Evaluation. In CIPS (Hrsg.), Internationale Skalen für Psychiatrie (4. Aufl.). Göttingen: Hogrefe.
Jung, E., Krumm, B., Biehl, H., Maurer, K. & Bauer-Schubart, C. (1989). DAS-Mannheimer Skalen zur Einschätzung sozialer Behinderung. Weinheim: Beltz.
Kay, S. R. (1990). Significance of the positive-negative distinction in schizophrenia. Schizophrenia Bulletin, 16, 635-652.
Kay, S. R., Fiszbein, A. & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261-275.
Kay, S. R., Opler, L. A. & Lindenmayer, J. P. (1988). Reliability and validity of the Positive and Negative Syndrome Scale for schizophrenics. Psychiatry Research, 23, 99-110.
Lukoff, D., Nuechterlein, K. H. & Ventura, J. (1987). Manual for expanded Brief Psychiatrie Rating Scales (BPRS). Schizophrenia Bulletin, 12, 594-602.
McGlashan, T. H. & Fenton, W. S. (1991). Classical subtypes for schizophrenia: Literature review for DSM-IV. Schizophrenia Bulletin, 17, 609-632.
Mundt, Ch., Fiedler, P., Pracht, B. & Rettig, R. (1985). InSKa (Intentionalitäts Skala) - ein neues psycho-pathometrisches Instrument zur quantitativen Erfassung der schizophrenen Residualsymptomatik. Nervenarzt, 56, 146-149.
Smith, J. & Hucker, S. (1994). Schizophrenia and substance abuse. British Journal of Psychiatry, 165, 13-21.
Süllwold, L. (1991). Manual zum Frankfurter Beschwerde-Fragebogen (FBF). Berlin: Springer.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1982). Die Erfassung und Klassifikation psychiatrischer Symptome. Weinheim: Beltz.
Wittchen, H. U. & Unland, H. (1991). Neue Ansätze zur Symptomerfassung und Diagnosestellung nach ICD-10 und DSM-III-R: Strukturierte und standardisierte Interviews. Zeitschrift für Klinische Psychologie, 20, 321-342.
Zerssen, D. V. (1976). Klinische Selbstbeurteilungs-Skala aus dem Münchner Psychiatrischen Informations-System: Paranoid-Depressivitäts-Skalen. Weinheim: Beltz.
35.2. :
,
. , , . , 70- , (WHO Collaborative Study on Determinants of Outcome of Severe Mental Disorders)(Jablensky, Sartorius, Ernberg et al., 1992). , , , . , , , . , , . , , 10/100 000.
, , . : , , . : . , , . ( ): 25 62%, 47% (Häfner, 1995).
? , . , , , , . .
(. 10). . , . , , , , , , . , 1920 1987 (. McGue & Gottesmann, 1989). , (48% 46%) , , , , 13%.
, . , . 50%. - ? , .
, . , , . (. Kendler & Diehl, 1993), , , , , . , (Tienari, 1991) , . . , , , , , , . , , , , .
, . , , 50%. , , , .
. , . . . ; . - ; , (. Cannon & Marco, 1994).
, . , , . , , (. Gattaz, Kohlmeyer & Gasser, 1991). , , , . , .
, , . , . , . , , . , , , , . - , , (Häfner, 1995). - .
, , , . , , ; . , , , .
. , , (. Straube & Oades, 1992). (Broadbent) 1958 , . , . , , , . , , . . , , (Harris, Benedict und Leek, 1990) . , () () . , . . , , , . . , , , , , (High Risk). , (Continuos Performance Test). (Cornblatt & Keilp, 1994). : , , . , , , (. Rist & Cohen, 1991).
- . (assoziativen Netzwerke). , 30- , - , . , . , . (lexical decision tasks). , , , , , -. . . , , , . , , (. Spitzer, 1993).
, . , , . . , , , . : , , , . . , .