Zusammenfassung
Es bestehen wohl kaum noch Zweifel darüber, daß sowohl jahrzehntelang bewährte als auch neuentwickelte Neuroleptika effektiv in der Behandlung produktiv psychotischer bzw. positiver Symptome wie Wahn, formale Denkstörungen oder Halluzinationen sind. Deren Wirksamkeit auf die „negativen Symptome“ oder in anderer Diktion „Minussymptomatik“ ist jedoch nach wie vor umstritten. Die Unterscheidung zwischen positiver und negativer Symptomatik wurde 1884 von H. Jackson in Verbindung mit einem hierarchisch strukturierten Modell zerebraler Funktionen geprägt. Jackson interpretierte die positive Symptomatik als eine „Zerformung“ normaler Funktionen, wohingegen Jackson die Negativsymptomatik, den „Verlust“ normaler Funktionen, als direkte Folge morphologischer Veränderungen mesenzephaler Strukturen sah. Im weiteren wurde von Wing u. Brown (1970) die heute übliche dichotome Aufteilung psychopathologischer Veränderungen bei schizophrenen Patienten in positive und negative Syndrome konzeptualisiert. Dieser Ansatz wurde von Crow (1985) mit dem Modell der Typ-I- und Typ-II-Schizophrenien erweitert. Patienten, die dem Typ I angehören, weisen produktive Symptombildungen im Sinne von Wahn, Halluzinationen und Denkstörungen auf, die Crow auf eine funktionelle Hyperaktivität dopaminerger Rezeptoren in den mesolimbischen und mesokortikalen Arealen zurückführt.
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Albus, M. (1998). Bedeutung der primären Minussymptomatik bei der Therapie mit Neuroleptika. In: Bandelow, B., Rüther, E. (eds) Therapie mit klassischen und neuen Neuroleptika. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72152-6_9
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