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Die retrospektive Erfassung der Negativsymptomatik im Frühverlauf der Schizophrenie

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Zusammenfassung

Seit Beginn der 80er Jahre beschäftigt das Thema Negativsymptomatik die Schizophrenieforschung in beträchtlichem Maße. Ausgehend von Andreasens frühen Skalenentwicklungen (SANS (4) und SAPS (5)) und Crows Typ I/II-Schizophrenie (20–25) erzielten sogenannte Dichotomiemodelle der Schizophrenie einen hohen Grad an Akzeptanz. Der Crow’sche Typ I ist gekennzeichnet durch positive Symptomatik, Ansprechen auf Neuroleptika, Reversibilität der Symptome und einen günstigen Verlauf, die Typ II-Schizophrenie durch Negativsymptomatik, weitgehende Behandlungsresistenz gegenüber herkömmlichen Neuroleptika und Irreversibilität mit chronischem Verlauf. Den Syndromen liegen nach Crow unterschiedliche pathologische Prozesse zugrunde: der Typ I-Schizophrenie eine Störung der Dopaminrezeptoren (16, 17), der Typ II-Schizophrenie wahrscheinlich ein Zellverlust mit bleibenden Strukturveränderungen des Gehirns (44, 45, 8, 73, 25, 74). Doch hat sich heute aufgrund einer großen Zahl der Arbeiten zur Reduktion des Symptomspektrums auf wenige Grunddimensionen oder Symptomklassen bzw. -typen mittels statistischer Verfahren, meistens Faktoren- oder Hauptkomponentenanalysen (58, 61 48, 56, 57, 13, 27, 11, 70, 28), der Latent Class Analyse (54), der multidimensionalen Skalierung (69, 72) oder des Facettenmodells (82, 79) die Sichtweise durchgesetzt, daß die Dichotomisierung in ein positives und ein negatives Syndrom nicht ausreicht, um die Fülle der Symptomatik angemessen reduzieren zu können.

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  1. Zentralinstitut für Seelische Gesundheit J5, D-68159, Mannheim, Deutschland

    Dr. K. Maurer & Prof. Dr. Dr. Drs. h.c. H. Häfner

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Maurer, K., Häfner, H. (1997). Die retrospektive Erfassung der Negativsymptomatik im Frühverlauf der Schizophrenie. In: Gerbaldo, H. (eds) Negativsymptomatik. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-22212-6_2

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