Abstract
In psychological lithium research one is not only confronted with diverging findings,
very heterogenous objects and methods, but also completely different theoretical frames
of reference. Three concepts can be distinguished: lithium is considered as a chemical
substance leading to biochemical changes which are responsible 1) for the disappearance
or non-manifestation of the affective psychosis, 2) for physiological changes, and
3) for changes of so-called normal psychological functions. Within the context of
lithium induced effects on normal psychological functions different scientific aims
can be distinguished: either the relevance of psychic effects for the performance
of daily activities is considered; or special indications such as aggressiveness are
searched for; or normal psychic functions are examined as a model for psychotic processes.
Most authors have investigated psychic effects of lithium as single phenomena not
related to each other, nor to unchanged normal psychological functions. It is, however,
rather unlikely that psychotropic drug effects would not develop their own dynamics,
influencing other psychic functions. From a psychological point of view three conceptual
possibilities may be distinguished: 1) Lithium induced direct effects on psychotic
symptoms interfere with other psychotic symptoms or with non-psychotic processes.
2) Lithium-induced direct effects on normal psychic functions during the free interval
of patients or in normal volunteers interfere with other psychic functions. 3) Lithium-induced
effects on normal psychic functions are related to the prophylactic response (prophylactic
relationship). The prophylactic relationship can be interpreted in three ways according
to the chosen protocol: 1) Predictors can be obtained for the prophylactic response.
2) Psychological changes acting as condition for lithium prophylaxis may be found.
3) Factors relevant for the etiology of the psychosis may be elucidated. Such etiological
factors might be found for instance within the concept of the "typus melancholicus"
of Tellenbach. Independent of the actual findings of empirical studies a theoretical
question always arises, i.e. whether psychotic phenomena should be conceived as something
categorically different from normal psychological phenomena. This question cannot
be answered empirically, because in every description this question is always implicitly
decided. And this decision determines the possible methodological approaches towards
single phenomena or complex models. If psychopathological phenomena are conceived
as something which is not categorically different from normal psychic processes, then,
these phenomena can only be specifications of phenomena known within general psychology.
It must, then, be possible to describe them by general psychological theories, though
with those specifications distinguishing the psychopathological from the non-pathological
phenomena. Thus, the typus melancholicus and the depression would then be conceived
as specifications of normal psychic processes. A conditional relationship between
primary personality and psychosis would, then, be possible from a theoretical point
of view, because a conditional relationship requires a general substantial concept
connecting condition and what is conditioned.
Zusammenfassung
In der gegenwärtigen psychologisch interpretier baren Lithium-Forschung sind unthematisierte
heterogene Inhalte, Methoden und theoretische Bezugsrahmen erkennbar. Es werden die
aus den theoretischen Bezugsrahmen entspringenden Forschungskonzepte und bestehende
und neu entwickelte Interpretationsmöglichkeiten aufgeführt und klassifiziert. Zudem
wird die Abhängigkeit der psychologischen Theorien der Lithium-Prophylaxe und der
psychologischen Ätiogenese der Psychosen von der Begriffsmethodik und dem sachlogischen
Verhältnis der Primärpersönlichkeit zur Psychose dargestellt.
