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Nervenheilkunde 2014; 33(09): 591-598
DOI: 10.1055/s-0038-1627722
Psychopathologie
Schattauer GmbH

Psychopathologie und Verlaufsforschung

Pychopathology, course and outcome studies
R. Bottlender
1   Klinik für Psychiatrie und Psychotherapie des Klinikums Lüdenscheid
2   Ruhr Universität Bochum
› Author Affiliations
Further Information

Publication History

eingegangen am: 20 April 2014

angenommen am: 05 May 2014

Publication Date:
24 January 2018 (online)

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Zusammenfassung

Psychopathologie und Verlaufsforschung sind traditionell eng miteinander verbunden. Historisch bestand ein zentrales Ziel der Verlaufsforschung in der Validierung der auf der klinisch-psychopathologischen Querschnittssymptomatik basierenden, kategorialen Klassifikationen von bestimmten Patientenpopulationen. Die Ätiopathogenese der so gefundenen Zustands-Verlaufs-Einheiten sollte biologisch entschlüsselt werden. Jedoch fanden sich weder einheitliche Verlaufstypen noch konnte die Ätiopathogenese der meisten psychiatrischen Erkrankungen aufgeklärt werden. Auch die durch operationalisierte Diagnosemanuale erhöhte Reliabilität psychiatrischer Diagnosen änderte an diesem Umstand nichts. Die mit der globalen Einführung operationalisierter Diagnosemanuale einhergehende Dekonstruktion psychiatrischer und psychopathologischer Schulen hinterließ ein Theoriendefizit, welches, solange die biologische Ursachenaufklärung psychischer Erkrankungen in greifbarer Nähe schien, hinnehmbar war, nun aber überwunden werden muss. Funktionale und theoretische Psychopathologie oder die Entwicklungspsychopathologie bieten vielversprechende Ansätze, die durch integrative Forschungsansätze weiterentwickelt werden müssen. Die konzeptuellen Rahmenbedingungen hierfür können z. B. aus der Systemtheorie oder der Theorie zu komplexen adaptiven Systemen abgeleitet werden.

Summary

Psychopathology, course and outcome studies are traditionally closely connected with each other. From an historical perspective a major purpose of course and outcome studies can be seen in the validation of nosological concepts based on descriptive psychopathology. In a second step, etiopathogenesis of those nosological concepts were to be deciphered. Unfortunately however, so far neither the nosological concepts have been validated nor has the etiopathogenesis been explained. This situation has not been changed by an improved reliability of operationalized diagnoses either. The global introduction of operationalized diagnostic systems led to a deconstruction of psychiatric and psychopathological schools and traditions and left psychiatry with a theoretical deficit which was tenable as long as there was hope for an early uncovering of the biological causes of mental illnesses. However, in the current situation this theoretical deficit needs to be overcome. In that respect, functional and theoretical psychopathology as well as developmental psychopathology are promising new approaches which should be further developed by an integration of other disciplines. The conceptual framework for this scientific venture can be derived from systems theory or theory of complex adaptive systems.

Schlüsselwörter

Psychopathologie - Verlaufsstudien - Ätiopathogenese - Systemtheorie

Keywords

Psychopathology - course and outcome studies - etiopathogenesis - systems theory
 

  • Literatur

  • 1 Andreasen NC. DSM and the death of phenomenology in America: an example of unintended consequences. Schizophrenia Bulletin 2007; 33 (01) 108-112.
    PubMedGoogle Scholar
  • 2 Nordgaard J, Arnfred SM, Handest P, Parnas J. The diagnostic status of first-rank symptoms. Schizophrenia Bulletin 2008; 34 (01) 137-54.
    PubMedGoogle Scholar
  • 3 van Os J. Are psychiatric diagnoses of psychosis scientific and useful? The case of schizophrenia. Journal of Mental Health 2010; 19 (04) 305-17.
    CrossrefPubMedGoogle Scholar
  • 4 Bottlender R, Wegner U, Wittmann J, Strauss A, Möller HJ. Phänomenologie des Verlaufs schizophrener Erkrankungen: Ergebnisse aus der Münchner 15-Jahres-Verlaufsstudie funktioneller Psychosen. In: Psychopathologie im Längsschnitt. Soyka M. et al. (Hrsg.). Hamburg: ecomed Verlag; 2003: 113-26.
    Google Scholar
  • 5 Hegarty JD, Baldessarini RJ, Tohen M, Waternaux C, Oepen G. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry 1994; 151 (10) 1409-16.
    CrossrefPubMedGoogle Scholar
  • 6 McGlashan TH. A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophr Bull 1988; 14: 573-585.
    Google Scholar
  • 7 Möller HJ, von Zerssen D. Course and outcome of schizophrenia. In: Hirsch SR, Weinberger DR 1995; 107-27.
    Google Scholar
  • 8 Riecher-Rössler A, Rössler W. The course of schizophrenic psychoses: what do we really know? A selective review from an epidemiological perspective. Eur Arch Psychiatry Clin Neurosci 1998; 248: 189-202.
    CrossrefPubMedGoogle Scholar
  • 9 Goldberg JF, Garno JL, Harrow M. Long-term remission and recovery in bipolar disorder: A review. Current Psychiatry Reports 2005; 07 (06) 456-61.
    CrossrefPubMedGoogle Scholar
  • 10 Craddock N, Owen MJ. The beginning of the end for the Kraepelinian dichotomy. BJP 2005; 186: 364-6.
    CrossrefPubMedGoogle Scholar
  • 11 Berrettini W. Evidence for shared susceptibility in bipolar disorder and schizophrenia. American Journal of Medical Genetics 2003; 123: 59-64.
    Google Scholar
  • 12 Kendler KS, Neale MC, Walsh D. Evaluating the spectrum concept of schizophrenia in the Roscommon Family Study. Am J Psychiatry 1995; 152 (05) 749-54.
    CrossrefPubMedGoogle Scholar
  • 13 Stromgren E. The concept of schizophrenia: the conflict between nosological and symptomatological aspects. J Psychiatr Res 1992; 26 (04) 237-46.
    CrossrefPubMedGoogle Scholar
  • 14 Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977; 196 (4286): 129-36.
    CrossrefPubMedGoogle Scholar
  • 15 Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry 1980; 137: 535-544.
    CrossrefPubMedGoogle Scholar
  • 16 The World health report. 2001 Mental health: new understanding, new hope. https://extranet.who.int/iris/restricted/bitstream/10665/42390/1/WHR_2001.pdf
    PubMedGoogle Scholar
  • 17 Watt DC, Katz K, Shepherd M. The natural history of schizophrenia: a 5-year prospective followup of a representative sample of schizophrenics by means of a standardized clinical and social assessment. Psychol Med 1983; 13 (03) 663-70.
    CrossrefPubMedGoogle Scholar
  • 18 Bleuler. Die schizophrenen Geistesstörungen im Lichte langjähriger Kranken- und Familiengeschichten. Stuttgart: Thieme; 1972
    Google Scholar
  • 19 Harding CM, Brooks GW, Ashikaga T, Strauss JS, Breier A. The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. Am J Psychiatry 1987; 144 (06) 718-26.
    CrossrefPubMedGoogle Scholar
  • 20 Bottlender R, Strauß A, Möller HJ. Methodische Probleme der Prädiktorforschung. In: Methodik von Verlaufs- und Therapiestudien in Psychiatrie und Psychotherapie. Engel, Maier, Möller (Hrsg.). Göttingen: Hogrefe Verlag; 2000: 151-158.
    Google Scholar
  • 21 Hubschmid T, Ciompi L. Prädiktoren des Schizophrenieverlaufs – eine Literaturübersicht. Fortschr Neurol Psychiatr 1990; 58 (10) 359-66.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Max MMarshall, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association Between Duration of Untreated Psychosis and Outcome in Cohorts of First-Episode Patients. Arch Gen Psychiatry 2005; 62: 975-983.
    CrossrefPubMedGoogle Scholar
  • 23 Bottlender R, Strauss A, Möller HJ. Impact of duration of symptoms prior to first hospitalization on acute outcome in 998 schizophrenic patients. Schizophr Res 2000; 44 (02) 145-50.
    CrossrefPubMedGoogle Scholar
  • 24 Bottlender R, Sato T, Jäger M, Strauss A, Möller HJ. The Impact of the Duration of Untreated Psychosis prior to First psychiatric Admission on the 15-years Outcome in Schizophrenia. Schizophr Res 2003; 62 (1–2): 37-44.
    CrossrefPubMedGoogle Scholar
  • 25 Bottlender R, Möller HJ. The Impact of the Duration of Untreated Psychosis (DUP) on the Shortand Longterm Outcome in Schizophrenia. Curr Opin in Psychiatry 2003; 16 (Suppl. 02) 39-43.
    Google Scholar
  • 26 Edwards J, Maude D, McGorry PD, Harrigan SM, Coks JT. Prolonged recovery in first-episode psychosis. Br J Psychiatry 1998; 172 Suppl. 33: 107-116.
    Google Scholar
  • 27 Haas GL, Garratt LS, Sweeney JA. Delay to first antipsychotic medication in schizophrenia: impact on symptomatology and clinical course of illness. J Psychiatr Res 1998; 32 (3–4): 151-9.
    CrossrefPubMedGoogle Scholar
  • 28 Black K, Peters L, Rui Q, Milliken H, Whitehorn D, Kopala LC. Duration of untreated psychosis predicts treatment outcome in an early psychosis program. Schizophr Res 2001; 47 (2–3): 215-22.
    CrossrefPubMedGoogle Scholar
  • 29 Larsen TK, Moe LC, Vibe-Hansen L, Johannessen JO. Premorbid functioning versus duration of untreated psychosis in 1 year outcome in first-episode psychosis. Schizophr Res 2000; 45 (1–2): 1-9.
    CrossrefPubMedGoogle Scholar
  • 30 Carbone S, Harrigan S, McGorry PD, Curry C, Elkins K. Duration of untreated psychosis and 12-month outcome in first-episode psychosis: the impact of treatment approach. Acta Psychiatr Scand 1999; 100 (02) 96-104.
    CrossrefPubMedGoogle Scholar
  • 31 McGorry PD, Edwards J, Mihalopoulos C, Harrigan SM, Jackson HJ. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull 1996; 22 (02) 305-26.
    CrossrefPubMedGoogle Scholar
  • 32 Amminger GP, Edwards J, Brewer WJ, Harrigan S, McGorry PD. Duration of untreated psychosis and cognitive deterioration in first-episode schizophrenia. Schizophr Res 2002; 54 (03) 223-30.
    CrossrefPubMedGoogle Scholar
  • 33 Scully PJ, Coakley G, Kinsella A, Waddington JL. Psychopathology executive (frontal) and general cognitive impairment in relation to duration of initially untreated versus subsequently treated psychosis in chronic schizophrenia. Psychol Med 1997; 27: 1303-1310.
    CrossrefPubMedGoogle Scholar
  • 34 Perkins DO, Gu H, Boteva K, Lieberman JA. Relationship Between Duration of Untreated Psychosis and Outcome in First-Episode Schizophrenia: A Critical Review and Meta-Analysis. Am J Psychiatry 2005; 162: 1785-804.
    CrossrefPubMedGoogle Scholar
  • 35 Meehl PE. Schizotaxia, schizotypy, schizophrenia. American Psychologist 1962; 17 (12) 827-38.
    CrossrefGoogle Scholar
  • 36 Gross G, Huber G, Klosterkötter J, Linz M. Bonner Skala für die Bestimmung von Basissymptomen (BSABS). Berlin: Springer Verlag; 1987
    Google Scholar
  • 37 Schultze-Lutter F, Klosterkötter J. Schizophrenia Prediction Instrument, Adult Version (SPI–A). Universität Köln; 2004
    Google Scholar
  • 38 Häfner H, Löffler W, Maurer K, Riecher-Rössler A, Stein A. IRAOS: Interview für die retrospektive Erfassung des Erkrankungsbeginns und -verlaufs bei Schizophrenie und anderen Psychosen. Bern: Verlag Hans Huber; 1999
    Google Scholar
  • 39 Maurer K. et al. Le développement de l’inventaire de dépistage ERIraos: Un outil global d’appreciation du risque d’évolution psychotique. Psychiatrie, Sciences Humaines, Neurosciences 2005; III (Suppl. 01) 29-41.
    Google Scholar
  • 40 Chapman LJ, Chapman PJ. Scales for rating psychotic or psychotic like experiences as continua. Schizophr Bull 1980; 06: 476-89.
    CrossrefGoogle Scholar
  • 41 Yung AR, Phillips L, McGorry P, Ward J, Donovan K, Thompson K. The comprehensive assessment of at-risk mental states (CAARMS). Melbourne: University of Melbourne, Department of Psychiatry, Australia; 2000
    Google Scholar
  • 42 Miller TJ, McGlashan TH, Rosen JL, Somjee L, Marchovich PJ, Stein K, Woods SW. Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002; 159: 863-5.
    CrossrefPubMedGoogle Scholar
  • 43 Cicchetti D. The Emergence of Developmental Psychopathology. Child Development 1984; 55 (01) 1-7.
    CrossrefPubMedGoogle Scholar
  • 44 Sameroff AJ. Developmental systems and psychopathology. Development and Psychopathology 2000; 03: 297-312.
    Google Scholar
  • 45 Taylor MA, Vaidya NA. Descriptive psychoapthology. The signs and symptoms of behavioral disorders. Cambridge: Cambridge University Press; 2009
    Google Scholar
  • 46 Fulford B, Morris K, Sadler J, Stanghellini G. Nature and narrative. An introduction to the new philosophy of psychiatry. Oxford: University Press; 2003
    Google Scholar
  • 47 Radden J. Philosophy of psychiatry. Oxford: University Press; 2004
    Google Scholar
  • 48 Cox MJ, Mills-Koonce R, Propper C, Gariépy JL. Systems theory and cascades in developmental psychopathology. Dev Psychopathol 2010; 22 (03) 497-506.
    CrossrefPubMedGoogle Scholar
  • 49 Sturmberg JP, Martin CM. Diagnosis–the limiting focus of taxonomy. J Eval Clin Pract. 2014 in press.
    PubMedGoogle Scholar
  • 50 Brüne M. et al. The crisis of psychiatry – insights and prospects from evolutionary theory. World Psychiatry 2012; 11 (01) 55-7.
    CrossrefPubMedGoogle Scholar
  • 51 Häfner H. et al. Das Rätsel Schizophrenie: eine Krankheit wird entschlüsselt. München: C. H. Beck; 2000
    Google Scholar