Schizophrene Verläufe: Eine Strukturdynamische Interpretation
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über die Wichtigkeit der Verlaufsbetrachtung für die Schizophrenieforschung braucht kein Wort verloren zu werden; eher ist die Seltenheit von Verlaufsunter- suchungen bemerkenswert. Die nosologische Intention, mit der solche Untersuchungen von KAHLBAUM, HECKER, KRAEPELIN unternommen worden waren, ist von KLEIST, LEONHARD und ihren Schülern bis in die Gegenwart festgehalten worden. Im übrigen hat sich die nosologische Betrachtungsweise in eine typologische verwandelt. Seit LANGFELDT und M. BLEuLER sind daneben klinisch-statistische Arbeiten zunehmend in den Vordergrund getreten. Die von LANGFELDT begründete Unterscheidung zwi- schen Schizophrenien und schizophreniformen Psychosen, das prognostische Anliegen und die pragmatische Grundeinstellung bestimmen bis zur Gegenwart eine Reihe von Verlaufsuntersuchungen vorwiegend skandinavischer (AcHTE, RETTERsT0L u. a. ), da- neben auch angloamerikanischer Autoren. Die Untersuchungen ARNOLDs, die die Symptomverbandslehre C. SCHNEIDERS fortführen, stehen ihnen durch die symptoma- tologische Orientierung nahe. Soweit aus den letzten Jahren klinische Verlaufsstudien vorliegen, beschränken sie sich auf einen bestimmten Typus wie die Schizophrenia simplex (CORNU), auf die paranoischen Syndrome (BERNER), das höhere Lebensalter (e. MÜLLER, KLAGES, SCHIMMELPENNING), auf defektuöse Syndrome (HUBER) oder besonders gutartige "Emotionspsychosen " (LABHARDT). Verlaufsuntersuchungen, die den gesamten Bereich des Schizophrenen einschlie en würden, gehen über die Kräfte eines einzelnen. Wird schlie lich nicht nach Verläufen im klinischen Sinne sondern nach einer Verlaufsgestalt gefragt, in deren Modifikationen die konkreten Verläufe erscheinen, so bleibt das Ganze im Blick, doch die Einzelheiten treten zurück und die statistische Vergleichbarkeit der klinischen Daten geht verloren. Der in diesem Sinne als Typus gesehene Verlauf wird in monographischen Studien von WYRSCH, CONRAD, KISKER behandelt.
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