[Recurrence of screwiness (Verschrobenheit, L. Binswanger) in chronic schizophrenia--psychopathological considerations of Mitwelt oriented screwiness ("Verschrobenheit")].
In this paper, we discuss "Verschrobenheit" of chronic schizophrenia to reconsider the recurrent deviant behavior of schizophrenics. According to Binswanger, "Verschrobenheit" is one of the fundamental disturbances of schizophrenia, characterized by morbidly thorough consistency, loss of intersubjectivity and transfiguration of the dasein like a "distorted screw" in the Mitwelt. From the viewpoint of interpersonal relationships, it manifests as a difficulty in establishing one-to-one relationships with other humans. We consider that Binswanger used the word "Verschrobenheit" to refer to 2 categories of "Verschrobenheit". The first is the behavioral aspects of screwiness without delusion, which is defined by two psychopathological features: 1) a static and morbid posture, such as an autistic attitude or unnatural position held for a long time; and 2) estrangement from the Mitwelt. The other category of "Verschrobenheit" is the behavioral aspects of screwiness with delusions. Of these aspects, the least consideration has been given to the latter. In order to discuss what screwiness means, we herein present preliminary consideration of the history of the concept of "Verschrobenheit". We report 2 cases of patients with schizophrenia who, after a certain time point following hospitalization, began to exhibit eccentric behaviors not previously observed. From examination of these cases of screwiness, and the comparison of these patients' screwiness and the former classical concepts, we determined that screwiness, has two pathological features: 1) delusional discourses confusing the surrounding people, and 2) Mitwelt-orientation.
Watanabe
Yoshihiro
Y
Department of Psychiatry, Jichi Medical School.
Kato
Satoshi
S
D000328:Adult; D001526:Behavioral Symptoms; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011599:Psychopathology; D012008:Recurrence; D012565:Schizophrenic Psychology