[Strategies of Adaption, coping reactions and attempts of self-cure in Schizophrenes]

Abstract

Though already Kraepelin started to consider coping behavior, there has not been much interest in it. Besides a summary of the literature, evidence of the study of 616 patient histories and the exploration of 94 schizophrenes is reported. Whereas often speculative interpretations of the patients' behaviour from the sight of the therapists have predominated in publications as yet, here it is preferred - with the danger of listing rationalizations - to outline defense reactions the patients themselves mention. The coping behaviour is classified in groups of symptoms: global strategies, disorders of perception, delusion, disorders of self-awareness, cognitive, affective, and motorial disorders. The discrimination of primary psychotic and "defect" symptoms, however, is often difficult. Some problems of the evaluation of coping behaviour are discussed. Defense reactions are presumably present in all schizophrenic types at least sometimes in the course of the illness. The more abrupt the disease starts, the more inadequate the coping behaviour seems to be. A further investigation of these strategies might be worth while for theoretical und therapeutical reasons.