Leonhard-Klassifikation endogener Psychosen - erste biologische Befunde und differentialtherapeutische Erwägungen

Lanczik, M.; Fritze, Jürgen

doi:10.1055/s-2007-999149

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…In diesem Zusammenhang seien zunächst zahlreiche Arbeiten aus der Würzburger Universitätsklinik erwähnt, die um die Jahrtausendwende entstanden. Diese verfolgten das Ziel, die Konzepte Leonhards durch empirische Untersuchungen zu validieren [30,31,32]. So wurden hier die psychopathologischen Krankheitsbeschreibungen Leonhards zum Ausgangspunkt für Untersuchungen zum Verlauf und zur Ätiopathogenese gewählt.…”

Section: Wissenschaftstheoretische üBerlegungenunclassified

“…So sprach er sich dagegen aus, die zykloiden Psychosen dauerhaft im Sinne einer Rezidivprophylaxe antipsychotisch zu behandeln. Auch gibt es Hinweise, dass Antipsychotika bei den systematischen Schizophrenien im Gegensatz zu den unsystematischen Schizophrenien deutlich weniger wirksam sind, so dass hier trotz Symptompersistenz eine möglichst sparsame Dosierung empfohlen wird [30]. Auch wenn man diese Ansichten nicht teilt, so erscheinen die hier angestellten Überlegungen in Hinblick auf neuere Daten zu möglichen langfristigen Nebenwirkungen der Antipsychotika [43] und zum möglichen Schaden einer Dauerbehandlung bei Patienten mit remittierten Psychosen [44] heute zumindest wieder diskussionswürdig.…”

Section: Wissenschaftstheoretische üBerlegungenunclassified

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Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie

Jäger

2018

Fortschr Neurol Psychiatr

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Historically, the Wernicke-Kleist-Leonhard School represents a countermovement to psychopathology as described by Karl Jaspers and Kurt Schneider. The School aimed to interlink psychopathological and neurobiological aspects. Starting from the model of different functional neuronal systems, each of which can be disturbed in the sense of a hypofunction, hyperfunction, or parafunction, it developed a comprehensive phenomenology of psychopathological symptoms and syndromes that finally culminated in Karl Leonhard's course descriptions. This school of thought can provide important impulses even today. Thus, on the one hand, the neurobiological models can serve as the basis for additional research projects and on the other hand, the psychopathological descriptions of disorders can perhaps also be interpreted in the sense of typological constructs that can contribute to pragmatic clinical decisionmaking.

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Section: Wissenschaftstheoretische üBerlegungenunclassified

Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie

Jäger

2018

Fortschr Neurol Psychiatr

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“…Überraschend fand sich in einer kürzlich veröffentlichten Vergleichsuntersuchung [43] Zusammenfassend läßt sich feststellen, daß es bisher eine ganze Reihe von klinischen Befunden und Forschungsergebnissen gibt, die auf den hohen klinischen und wissenschaftlichen Stellenwert des Konzepts der zykloiden Psychosen hinweisen. Einige vermutlich auf die mangelnde Differenzierung der klinischen Bilder zurückgehende Inkonsistenzen in den Ergebnissen der biologisch-psychiatrischen Forschung könnten sich unter Zugrundelegung der Leonhardschen Aufteilung der endogenen Psychosen aufldären lassen [25].…”

Section: Diagnostische Kriterienunclassified

Das Konzept der zykloiden Psychosen

Pfuhlmann¹

1998

Fortschr Neurol Psychiatr

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Karl Leonhard developed the concept of cycloid psychoses by further elaborating previous findings of Carl Wernicke and Karl Kleist. A phasic alternating and recurrent as well as remittent course without residual states and a bipolar and polymorphous symptomatology are main features of cycloid psychoses. The symptom constellations are typical in a manner that, in most cases, allows establishing a diagnosis solely by carefully examining a cross-section of the clinical syndromes. 3 sub-forms are differentiated. Anxiety-happiness psychosis is characterised by extreme affective alterations with paranoid anxiety on the one hand and ecstasy with feelings of elation on the other. Formal thought disorder with incoherence, mainly as "incoherence of thematic choice", on the excited pole and perplexedness on the inhibited pole are the central elements of confusion psychosis. Motility psychosis shows hyperkinesis or akinesis of a purely psychomotor nature affecting predominantly expressive and reactive motions as main features. A description of Leonhard's highly operationalised diagnostic criteria for each sub-form of cycloid psychoses is followed by an account of the clinical significance of the concept of cycloid psychoses. Furthermore, important findings of recent research are summarised. The findings point to the fact that cycloid psychoses represent a nosological entity that can be clearly separated from schizophrenic as well as from affective psychoses. Schizophreniform, schizoaffective or acute transient psychotic disorders are also not identical with cycloid psychoses. According to the criteria of DSM-IV or ICD-10, cycloid psychoses are spread over a broad spectrum of heterogeneous diagnoses, thus hampering the recognition of the clinical and scientific importance of this homogeneous group of psychoses.

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Absence of a subgroup of chronic schizophrenia in monozygotic twins. Consequences for considerations on the pathogenesis of schizophrenic psychoses

Pfuhlmann¹,

Franzek²,

Beckmann³

1999

European Archives of Psychiatry and Clinical Neuroscience

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In the region of Lower Franconia, Germany, all twins born after 1930 and hospitalized for a schizophrenia spectrum psychosis were ascertained in a systematic twin study comprising 22 monozygotic (MZ) and 25 dizygotic (DZ) pairs. One aim of the study was to compare concordance rates between MZ and DZ pairs with regard to various diagnostic classifications. Two experienced psychiatrists independently classified the probands according to DSM-III-R, ICD-10, and Leonhard's classification. Schizophrenic psychoses were found among MZ and DZ pairs in equal proportions according to DSM-III-R and ICD-10 criteria. In contrast, when Leonhard's classification was applied it became apparent that systematic schizophrenias, which represent the core group of schizophrenias in Leonhard's nosology, were completely lacking among the 34 ill MZ twins. Among the 30 ill DZ twins, 6 suffered from a systematic schizophrenia (p < 0.01). Unsystematic schizophrenias and cycloid psychoses occurred among MZ twins at a frequency of 58.8% and 41.2%, respectively. In the course of his own twin-investigations, Leonhard also observed an absence of systematic schizophrenias in MZ twins, although his twins were not systematically ascertained. This striking finding requires an explanation regarding its significance for the etiology of chronic schizophrenic psychoses. In view of the absence of other conclusive theories, one speculative explanatory model is that specific psychosocial factors, i.e., a lack of communication during childhood, may result in distinct biological damage to functional brain systems and, thus, may play a role in the pathogenesis of these psychoses.

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Leonhard-Klassifikation endogener Psychosen - erste biologische Befunde und differentialtherapeutische Erwägungen

Cited by 5 publications

References 9 publications

Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie

Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie

Das Konzept der zykloiden Psychosen

Absence of a subgroup of chronic schizophrenia in monozygotic twins. Consequences for considerations on the pathogenesis of schizophrenic psychoses

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