bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2026-1-1106bekhterev-1321Research ArticleДИСКУССИОННЫЙ КЛУБTALKING SHOPДифференциальная диагностика идиопатических психомоторных психозов. II–СовременностьDifferential diagnosis of idiopathic psychomotor psychoses. II — Modernityhttps://orcid.org/0000-0002-1438-1890СнедковЕ. В.SnedkovE. V.

Снедков Евгений Владимирович — д.м.н., профессор, врач-психиатр 

190121, Санкт-Петербург, наб. р. Мойки, 126

St. Petersburg

esnedkov@mail.ruhttps://orcid.org/0009-0002-0491-6545ЛемешевИ. В.LemeshevI. V.

Лемешев Илья Владимирович — заведующий отделением ОПП РПС ДС, врач-психиатр; ассистент кафедры психиатрии и наркологии 

Санкт-Петербург

191015, Санкт-Петербург, ул. Кирочная, д.41 

 

St. Petersburg

ilya.lemeshev@gmail.comhttps://orcid.org/0009-0005-2827-4761КолядаА. А.KoliadaA. A.

Коляда Александр Александрович — к.м.н., врач-невролог 

Санкт-Петербург

St. Petersburg

kazak-76@mail.ruПсихиатрическая больница св. Николая ЧудотворцаРоссияSt. Nicholas Psychiatric HospitalRussian FederationПсихиатрическая больница св. Николая Чудотворца; Северо-Западный государственный медицинский университет им. И.И. МечниковаРоссияSt. Nicholas Psychiatric Hospital; North-Western State Medical University named after I.I. MechnikovRussian Federation2026020320266018997Copyright © Снедков Е.В., Лемешев И.В., Коляда А.А., 20262026Снедков Е.В., Лемешев И.В., Коляда А.А.Snedkov E.V., Lemeshev I.V., Koliada A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1321

во второй части статьи продолжен анализ принципиальных отличий патофизиологии, клиники, течения, исходов циклоидного психоза подвижности, периодической кататонии и персистирующих кататоний. Показано, что диагностические указания, содержащиеся в международных классификациях болезней 10-го и 11-го пересмотров, препятствуют их надлежащей дифференциации. Подмена клинической феноменологии «операциональными критериями», механистическое объединение любых психомоторных аномалий в конструкт кататонии обусловливает искажение базовых понятий и низкую продуктивность научных исследований в данной области. По мнению авторов, необходим возврат к общепринятой во всех клинических дисциплинах феноменологической диагностике. Перспективной основой для практического применения и дальнейших исследований может послужить систематика психомоторных психозов, разработанная школой Вернике-Клайста-Леонхарда.

The second part of the article continues the analysis of the fundamental differences between the pathophysiology, clinic, course, and outcomes of cycloid motility psychosis, periodic catatonia, and persistent catatonia. It is evident that the diagnostic criteria outlined in the International Classifications of Diseases in their 10th and 11th editions hinder their accurate distinction. The substitution of «operational criteria» for clinical phenomenology, the mechanistic unification of any psychomotor abnormalities into a construct of catatonia, leads to a distortion of basic concepts and low productivity of scientific research in this field. According to the authors, a return to the generally accepted phenomenological diagnosis in all clinical disciplines is necessary. The systematics of psychomotor psychoses developed by the Wernicke-Kleist-Leonhard school can serve as a promising basis for practical application and further research.

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The authors declare that there are no conflicts of interest present.