[The psychopathology of delusion, the principle of psychonomy and biological theory of delusion]

Abstract

The psychopathology of the delusional experiences of schizophrenic patients is analyzed on the basis of a sample of 119 drug-naive patients and 502 patients of the Bonn-Schizophrenia-Study. The phenomenology, the forms and themes of delusion, the delusional certainty, the impact on behaviour ("Realitätsbedeutung"), the levels of development of delusional perception and the meaning of the psychological working-up of the primordial delusional experiences ("Wahnarbeit") are described. The structure-dynamic and the 'gestalt'-psychological approaches of Janzarik and Kisker try to derive the phenomenon of delusional psychoses from the psychonomy of the emotional connections, as far as they cannot be explained as immediate symptoms of a somatic illness. [7]. The present study also shows that subjective experiences of schizophrenic patients, suffering from delusions, largely develop psychonomically according to the rules of the psychic motivational dynamic, and that the share of the comprehensible working-up and assimilation with regard to the "schizophrenic end-phenomena" [16] has been considered too little by the traditional psychiatry. But, there are in the view of the basic symptom concept, especially in process active stages, hints at a higher share of the somatic component as to the structure of delusional syndromes. Looking at the processes, determined by the psychic causality on the one side, and at the boundaries of "genetic understanding" [39] in the delusional psychosis on the other side, we tried to answer the question to what extent the delusional psychosis can be understood according to the "principle of psychonomy" [5,6], and, in what respect it seems to be "apsychonomic" and thereby presumably somatically founded. The inquiry yields starting points for a biological hypothesis of delusion, compatible with a multidimensional conception, that reveals understandable connections between delusion and biography and shows the reach of the "principle of psychonomy".