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Classificazione, diagnosi ed ICD-10. II - Le sindromi schizofreniche

Published online by Cambridge University Press:  11 October 2011

Elisabetta Paltrinieri  and
Giovanni de Girolamo
Elisabetta Paltrinieri
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Verona
Giovanni de Girolamo*
Affiliation:
Division of Mental Health, World Health Organization, Geneva
*
Indirizzo per la corrispondenza: Dr. G. de Girolamo, Division of Mental Health, WHO, 1211 Geneva 27, Switzerland. Fax (+41)22-791.0746
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Summary

Scope - To discuss, after a description of the main attempts of classification of schizophrenic disorders made from the last century up to now, the main features of the ICD-10 classification of schizophrenia and related dis-orders. The main features of this chapter of the ICD-10 are then compared to the ICD-9 and DSM-III-R classifications. Results - The ICD-10 diagnostic criteria for schizophrenia require a duration of only 1 month (compared to the 6 month duration criterion of the DSM-III-R); positive symptoms of psychosis, in particular Schneiderian symptoms, are given more prominence than they are in the DSM-III-R. Moreover, it is foreseen the possibility of a favourable outcome of the disorder; this has been based on the results of several follow-up studies, including some major WHO multicentric studies showing a positive outcome in substantial proportion of patients. Conclusions - On the whole, ICD-10 broadens the diagnostic concept of schizophrenia in comparison to other diagnostic systems, whereas the emphasis placed on Schneiderian first-rank symptoms tends to overweight this tendency and makes the criteria for inclusion more narrow.

Riassunto

Scopo: Presentare un breve profilo storico relativo ai numerosi tentativi di classificazione dei disturbi schizofrenici succedutisi dal secolo scorso ad oggi e descrivere le principali caratteristiche della classificazione ICD-10 della schizofrenia e dei disturbi ad essa correlati, le principali novità introdotte in essa rispetto all'ICD-9 ed infine le principali similarità e differenze ravvisabili tra la classificazione della WHO ed il DSM-III-R. Risultati - Il concetto di schizofrenia si é venuto definendo attraverso i contributi di autori di rilievo storico, quali Kraepelin, Bleuler e Schneider. Nella definizione dei criteri diagnostici per la schizofrenia, I'ICD-10 ha ripreso i principali criteri schneideriani relativamente ai sintomi patognomonici per questo disturbo, mentre ha ridimensionato, rispetto al DSM-III-R, Pimportanza del criterio longitudinale kraepeliniano relativo al decorso adottando una durata minima di un mese per la diagnosi e prospettando la possibilità di una prognosi non necessariamente sfavorevole. Conclusioni - Nel complesso, nell'ICD-10 si tende ad un ampliamento del concetto di schizofrenia, rispetto ad altri sistemi diagnostici più restrittivi, mentre l'enfasi posta sui sin- tomi schneideriani controbilancia questa tendenza e restringe i criteri di inclusione.

Keywords

diagnosiclassificazioneschizofreniadiagnosisclassificationschizophrenia
Type
Articoli
Information
Epidemiology and Psychiatric Sciences , Volume 2 , Issue 2 , August 1993 , pp. 105 - 117
Copyright
Copyright © Cambridge University Press 1993

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