精神分裂病における「奇異なbizarre」行動について

On Bizarre Behaviour in Schizophrenia

【抄録】　「奇異な行動」が顕著な分裂病群（奇異群）の特徴について検討した。奇異群は発病年齢が低く予後不良で，全般的重症度が高く，難治性分裂病との近接性が示唆された。症候論的には陽性症状，陰性症状，精神運動興奮など多彩な精神症状を示すが，陰性症状は相対的に重要度が低く，重篤な一級症状，奇異な思考障害を特徴とする。さらに，奇異群の特質である重篤な全般的重症度，思考解体，奇異な思考は妄想型，破瓜型，残遺型に共通して認められた。そして，症状構造は分裂病全般の特徴とされる5因子モデル，KraepelinやBleulerの中核概念に類似していることから，歴史的に形成されてきた分裂病概念の中核を体現しているといえる。

　The characteristics of a group of schizophrenics presenting obvious “bizarre behavior” (the bizarre behavior group) were investigated. These patients developed, at a relatively young age, a condition that tended to be severe, and their prognosis was poor, suggesting that the schizophrenia observed in this group of patients was close to the type called “intractable schizophrenia”. The members of this group also showed diverse behavioral symptoms, including positive and negative symptoms and psychomotor agitation. Negative symptoms seem to be of relatively small importance in this type of schizophrenia, which is characterized by severe first-rank symptoms and bizarre thinking. Furthermore, the severe condition of the patients, their disintegrated thinking and the bizarre thinking exhibited by their bizarre behavior were strongly expressd in the sub-types. i.e., paranoid, hebephrenic, and residual. The structure of their symptoms resembles that described by the five-factor model (a characterization of schizophrenia in general) and the central concepts of Kraepelin and Bleuler, suggesting that this type of schizophrenia includes the core components of the historically established concepts of schizophrenia.