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PubMed1981

[Clinical pathomorphosis of alcoholic psychoses according to the results of an epidemiologic study].

In order to detect the pathomorphosis of alcoholic psychoses appearing in recent years, 2 populations of patients were analysed: a population detected in 1946--1960 and 1961--1970. The structure of initial psychotic states and the syndromological conditions of the recent population is characterized by a reduction of chronic syndromological forms and an increase in the amount of acute psychotic states. In transient and partially relapsing psychoses, there is an increase of cases with acute verbal hallucinations and reduction of delirious forms. In mixed and continuous psychoses, there is a drop in the amount of paranoial syndromes with overvalued and delusional ideas of jealousy. In the prevalence of different types of alcoholic psychoses, a statistically significant increase is seen only in transient forms.

Acute Disease↗
PubMed2004

A longitudinal study of premorbid IQ Score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses.

CONTEXT: Longitudinal studies indicate that a lower IQ score increases risk of schizophrenia. Preliminary evidence suggests there is no such effect for nonpsychotic bipolar disorder. To our knowledge, there are no prior population-based, longitudinal studies of premorbid IQ score and risk of developing severe depression requiring hospital admission. OBJECTIVES: To investigate the association between premorbid IQ score and risk of developing schizophrenia, other nonaffective psychoses, bipolar disorder, and severe depression and to investigate effects of confounding and examine possible causal pathways by which IQ may alter these risks. DESIGN: Historical cohort study, using record linkage for hospital admissions during a 27-year follow-up period. SETTING: Survey of Swedish conscripts (1969-1970). PARTICIPANTS: Population-based sample of 50,087 male subjects. Data were available on IQ score at conscription and on other social and psychological characteristics. MAIN OUTCOME MEASURES: International Classification of Diseases, Eighth Revision or Ninth Revision diagnoses of schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. RESULTS: There was no association between premorbid IQ score and risk of bipolar disorder. Lower IQ was associated with increased risk of schizophrenia, severe depression, and other nonaffective psychoses. Risk of schizophrenia was increased in subjects with average IQ compared with those with high scores, indicating that risk is spread across the whole IQ range. CONCLUSIONS: Lower IQ score was associated with increased risk for schizophrenia, severe depression, and other nonaffective psychoses, but not bipolar disorder. This finding indicates that at least some aspects of the neurodevelopmental etiology of bipolar disorder may differ from these other disorders.

Adolescent↗
PubMed1983

Genetic disorders presenting as "schizophrenia". Karl Bonhoeffer's early view of the psychoses in the light of medical genetics.

There is overwhelming empirical evidence for the influence of genetic factors in the etiology of schizophrenic psychoses. An appreciable and still increasing number of exogenous factors have been known for decades that are capable of inducing psychoses that present as "schizophrenia" or are more or less similar to it. In this article, genetic disorders--chromosomal abnormalities and Mendelian diseases--are summarized that may be associated with such psychoses. These disorders frequently but not necessarily exhibit additional physical symptoms. Although the majority of schizophrenic psychoses can so far not be explained by exogenous factors or well-defined genetic disorders, the proportion of these etiologies among all cases may be higher than presumed so far, because they evade detection. Data from the literature are discussed in the light of Karl Bonhoeffer's early concept of exogenous reaction types and modern medical genetics.

Diagnosis, Differential↗
PubMed1982

Prognosis of periodic bipolar manic depressive and schizo-affective psychoses. A comparison of two studies.

Aspects of the course of manic depressive and schizo-affective psychoses with high recurrence (the patient must have suffered from at least three episodes) are measured by length of episodes, intervals, and cycles. Differences between two patient samples from Switzerland and Poland, and differences between the two diagnostic groups are analyzed taking into account some independent variables such as sex, marital state, age at onset, precipitation, and symptomatology. Bipolar and schizo-affective psychoses show similar patterns of course: early onset, high relapse rate, high number of episodes, and short intervals. Compared to schizo-affective psychoses bipolar psychoses tend to have a higher frequency of episodes per year, shorter intervals, and the length of episodes is longer. Multivariate analysis shows very few correlations of independent variables with aspects of the course. On the whole the differences between the diagnostic groups are much smaller than between the two centers. The Polish and Swiss patient samples differ in course considerably. The patients from Zurich show longer episodes, intervals, and cycles, therefore, the frequency of episodes per year is lower in Zurich. Only a smaller part of the variance can be explained by differences in psychopathology (the Polish patients are more manic and more paranoid). There remain unexplained qualitative differences between the two centers which show how difficult it is to compare scientific results from different sources.

Adult↗
PubMed1982

Aspects of the course of bipolar manic-depressive, schizo-affective, and paranoid schizophrenic psychoses.

The study deals with the course of three diagnostic groups, namely 50 bipolar manic-depressive, 50 bipolar and manic schizo-affective, and 50 recurrent paranoid psychoses. The patients course was observed over 14-17 years, at least 5 years prospectively. The study concentrates mainly on the prognosis based on the symptomatology observed during the first episode, the stability of the symptoms over several episodes, the residual symptomatology, and the degree of remission during the intervals. Bipolar and schizo-affective psychoses show a similar periodicity. The study further reveals that the periodicity of schizo-affective disorders is mainly linked with the affective symptoms of this disorder. Qualitatively the residual symptoms of bipolar and schizo-affective psychoses differ. Bipolar and phasic paranoid psychoses are quite different with regard to their periodicity and their symptomatology during the episodes and during the intervals.

Adult↗
PubMed2002

[Clinical aspects of puerperal psychoses. Review with 3 case examples].

Psychic disturbances in the post-partum period are divided into the postpartum blues, postpartum depression, and postpartum psychoses. The latter are severe endogenous psychoses which mostly fulfill the diagnostic criteria for cycloid psychoses according to Leonhard. Based on three case reports, characteristic symptoms, the phasic clinical course with remissions, and distinct etiological, therapeutic, and forensic aspects of cycloid psychoses in the post-partum period are discussed. The high relapse rate of approximately 50% in patients at risk requires intensive psychiatric care in the peripartal period. In particular, the possibility of a prophylactic treatment of patients at risk with lithium immediately after delivery is emphasized. However, this sophisticated therapeutic strategy requires close cooperation between gynecologists and psychiatrists.

Adult↗
PubMed1999

Absence of a subgroup of chronic schizophrenia in monozygotic twins. Consequences for considerations on the pathogenesis of schizophrenic psychoses.

In the region of Lower Franconia, Germany, all twins born after 1930 and hospitalized for a schizophrenia spectrum psychosis were ascertained in a systematic twin study comprising 22 monozygotic (MZ) and 25 dizygotic (DZ) pairs. One aim of the study was to compare concordance rates between MZ and DZ pairs with regard to various diagnostic classifications. Two experienced psychiatrists independently classified the probands according to DSM-III-R, ICD-10, and Leonhard's classification. Schizophrenic psychoses were found among MZ and DZ pairs in equal proportions according to DSM-III-R and ICD-10 criteria. In contrast, when Leonhard's classification was applied it became apparent that systematic schizophrenias, which represent the core group of schizophrenias in Leonhard's nosology, were completely lacking among the 34 ill MZ twins. Among the 30 ill DZ twins, 6 suffered from a systematic schizophrenia (p < 0.01). Unsystematic schizophrenias and cycloid psychoses occurred among MZ twins at a frequency of 58.8% and 41.2%, respectively. In the course of his own twin-investigations, Leonhard also observed an absence of systematic schizophrenias in MZ twins, although his twins were not systematically ascertained. This striking finding requires an explanation regarding its significance for the etiology of chronic schizophrenic psychoses. In view of the absence of other conclusive theories, one speculative explanatory model is that specific psychosocial factors, i.e., a lack of communication during childhood, may result in distinct biological damage to functional brain systems and, thus, may play a role in the pathogenesis of these psychoses.

Adult↗
PubMed2001

Major psychoses symptomatology: factor analysis of 2241 psychotic subjects.

Current nosography classifies major psychoses as separate disorders, but their symptomatological presentation during illness episodes largely overlaps and diagnoses may change during a lifetime. Few analyses of major psychoses symptomatology have been performed so far because of the large number of subjects needed to obtain stable factors. The purpose of this study was, therefore, to identify the symptomatologic structure common to major psychoses based on lifetime symptoms. Two thousand and forty-one inpatients affected by schizophrenic (n=1008), bipolar (n=563), major depressive (n=352), delusional (n=108) and psychotic not otherwise specified disorder (n=210) were rated for lifetime symptoms using the Operational Criteria Checklist for Psychotic Illness (OPCRIT) and included in a factorial analysis. Four factors were obtained, the first consisted of excitement symptoms, the second comprised psychotic features (delusions and hallucinations), the third comprised depression and the fourth disorganization. When scored by the OPCRIT checklist, major psychoses symptomatology is composed of excitement, depressive, delusion and disorganization symptoms.

Adult↗
PubMed2002

Cycloid psychoses -- from clinical concepts to biological foundations.

The modern concept of cycloid psychoses is primarily based upon the clinical delineation of their phenotypes according to Leonhard. By settling the dilemma of Kraepelinean "atypical psychoses", their description may be considered one of the major achievements of clinical psychiatry in the last century. In particular, this had been facilitated by the work of Wernicke and Kleist. Albeit not yet generally recognized, cycloid psychoses have already stimulated great efforts of research yielding remarkable results. In this article, we elucidate the concept of cycloid psychoses and present recent findings pertaining to their putative biological foundations. Finally, future perspectives for the field of biological psychiatry are proposed fostering the heuristics of Leonhard's nosology.

Brain↗
PubMedDate not supplied

Convergence of American and Scandinavian diagnoses of functional psychoses.

One hundred ninety-nine case summaries of a consecutive sample of functional psychoses, which had been classified by Odegård, were diagnosed independently using DSM-III-R criteria by four experienced psychiatrists. Odegård's classification and DSM-III-R showed high concordance for schizophrenia and affective psychoses. Odegård's concept of reactive psychoses had high concordance with atypical psychoses in DSM-III-R. These findings imply that the results of genetic and follow-up studies from Scandinavia might be relevant for these diagnostic categories in DSM-III-R.

Affective Disorders, Psychotic↗
PubMed2001

Early developmental milestones in adult schizophrenia and other psychoses. A 31-year follow-up of the Northern Finland 1966 Birth Cohort.

Delayed childhood development may precede adult psychoses. We tested this hypothesis in a large, general population birth cohort (n=12058) followed to age 31 years. The ages at which individuals learned to stand, walk, speak, and became potty-trained (bowel control) and dry (bladder control), were recorded at a 1-year examination. Psychiatric outcome was ascertained through linkage to a national hospital discharge register. Cumulative incidence of DSM-III-R schizophrenia, other psychoses and non-psychotic disorders were stratified according to the timing of milestones and compared within the cohort using internal standardization. 100 cases of DSM-III-R schizophrenia, 55 other psychoses, and 315 non-psychotic disorders were identified. The ages at learning to stand, walk and become potty-trained were each related to subsequent incidence of schizophrenia and other psychoses. Compared with the whole cohort, earlier milestones reduced, and later milestones increased, the risk in a linear manner. These developmental effects were not seen for non-psychotic outcomes. The findings support hypotheses regarding psychosis as having a developmental dimension with precursors apparent in early life.

Adolescent↗
PubMed2004

Validity of the family history method for diagnosing schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders in first-degree relatives of schizophrenia probands.

This study examined the validity of the family history method for diagnosing schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders in first-degree relatives of schizophrenia probands. This is the first large-scale study that examined the validity of the family history method for diagnosing DSM-III-R personality disorders. The best estimate DSM-III-R diagnoses of 264 first-degree relatives of 117 adult-onset schizophrenia probands based on direct structured diagnostic interviews, family history interview, and medical records were compared to Family History Research Diagnostic Criteria (FH-RDC) diagnoses based on the NIMH Relative Psychiatric History Interview and to family history Structured Clinical Interview for DSM-III-R: Personality Disorders (SCID-II) diagnoses based on the SCID-II adapted to a third person format. Diagnoses of relatives were made blind to proband diagnostic status. The median sensitivity for schizophrenia and the related psychoses was 29% (range 0-50%), the median specificity 99% (range 98-100%), and the median positive predictive value (PPV) 67% (range 20-80%). The median sensitivity for the personality diagnoses was 25% (range 14-71%), the median specificity 100% (range 99-100%), and the median PPV 100% (range 67-100%). The family history method has low sensitivity but has excellent specificity and PPV for schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders. The kappa coefficient for the family history method was moderately good for the psychoses (0.598) and for paranoid and schizotypal personality disorder (0.576). Using the family history method, the validity of making schizophrenia-related personality disorder diagnoses was comparable to that of making psychotic disorder diagnoses.

Adolescent↗
PubMed2002

Serotonin transporter gene (5-HTTLPR) and major psychoses.

Serotoninergic neurotransmitter systems have been implicated in the pathogenesis of major psychoses. A functional polymorphism (5-HTTLPR) in the upstream regulatory region of the gene (SLC6A4) has been associated with a number of psychiatric disturbances, but conflicting replication followed. The aim of this study was to investigate the possibility that the 5-HTTLPR might be associated with major psychoses. One thousand, eight hundred and twenty inpatients (789 bipolars, 667 major depressives, 66 delusionals, 261 schizophrenics, 37 psychotics not otherwise specified-NOS) and 457 control subjects were included in this study. A subsample of 1235 patients (523 bipolars, 359 major depressives, 259 schizophrenics, 66 delusionals, 28 psychotic NOS) were evaluated for lifetime psychotic symptomatology using the Operational Criteria for Psychotic illness (OPCRIT) checklist. The subjects were also typed for 5-HTTLPR variants using PCR techniques. 5-HTTLPR allele frequencies were not significantly different between controls and bipolars, major depressives, schizophrenics, delusionals and psychotic NOS; genotype analysis also did not show any association. The analysis of symptomatology did not show significant differences. Consideration of possible stratification factors such as sex and age of onset did not significantly influence results. 5-HTTLPR variants are not therefore a liability factor for major psychoses or for major psychoses symptomatology.

Adult↗
PubMed1998

Electroencephalographic findings in functional psychoses: state or trait indicators?

The clinical significance of electroencephalographic (EEG) changes in patients with functional psychoses is not yet clearly defined, particularly whether these changes are state indicators or trait indicators. In the present review, the EEG abnormalities in schizophrenia are discussed. In early EEG studies of schizophrenics, the various specific EEG patterns were suggested to be trait indicators, but those findings were not confirmed. The EEG patterns of some patients with catatonic schizophrenia, especially periodic catatonia, were thought to be episode or state indicators, and some of the patients diagnosed as having atypical psychoses in Japan were suggested to show state indicator EEG findings. As the computerized and spectral analyses of EEG have advanced, the contradictory findings of EEG in schizophrenia have been reported, interpreted as 'hyperstable' or 'hypernormal' EEG findings and 'hypofrontal' EEG findings (slow waves in the frontal region). However, no conclusion can be made as to whether these EEG findings are state or trait indicators. On the borderland of functional psychoses, the behavioral changes in temporal lobe epilepsy were described as a trait indicator, and the psychotic states in non-convulsive generalized status epilepticus and acute confusional states were suggested to be state indicators. Further studies of EEG abnormalities in schizophrenia are necessary from multi-dimensional perspectives, including in comparison with the symptomatic psychoses.

Catatonia↗
PubMed1991

[The hyperarousal hypothesis: new aspects of a neurophysiologic concept of endogenous psychoses].

The hyperarousal hypothesis has been developed as a concept of the major psychoses on the basis of neurophysiological findings on the function of the reticular formation. An enduring hyperactivity of the ascending reticular activation system is assumed to be characteristical for the major psychoses. Recently, studies on the habituation of auditory evoked potential components provided new evidence supporting the hyperarousal hypothesis. Thus, by means of the auditory evoked potential investigation an electrophysiological assessment of the hyperarousal state in patients with major psychoses has become feasible. These findings may have important implications for the research on the major psychoses and may find clinical applications.

Arousal↗
PubMed1990

[Distribution of serum haptoglobin groups in affective psychoses--more than a genetic marker indication?].

The haptoglobin serum group 2-2 has a preponderance in affective psychoses (p less than 0.0005). This genetic marker trait is extended on unipolar depressions (p less than 0.005) and cycloid psychoses (p less than 0.0005). In addition, it must be assumed that the serum levels of albumin (p less than 0.0001), ceruloplasmin (p less than 0.0001) and haptoglobin (p less than 0.0001) are increased in affective disorders. Besides, the transferrin serum values are decreased in cycloid psychoses (p less than 0.001). As ascertained in a supplementary study, Hp 2-2 is associated within the normal range of variation with the highest albumin serum levels already in healthy controls when compared with Hp 1-1 (p less than 0.05) and Hp 2-1 (p less than 0.001). Even after including the extreme variants, the Hp 2-2 sera display more albumin values above 40.8 g/l than the Hp 2-1 specimens and the summarized samples of Hp 1-1 and Hp 2-1 (p less than 0.02). Furthermore the Hp 2-2 sera exhibit higher ceruloplasmin levels than the samples of Hp 1-1 (p less than 0.01) and Hp 2-1 (p less than 0.005). These differences are persisting too in the same trend after including extreme high ceruloplasmin values (p less than 0.05 and p less than 0.005 respectively). Obviously there are several possibilities for Hp 2-2 to operate on the biological background of affective psychoses as a risk factor. The findings are interpreted with reference to the actual data concerning the activities of the haptoglobin genes and proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Disorders, Psychotic↗
PubMed1986

[Psychoses of physical origin--traditional interpretation and DSM III nomenclature].

Classification of organic psychoses according to the revised version of DSM III and in accordance with the terminology used in traditional German psychopathology, are compared. In DSM III, organic Psychoses are presented as a heterogeneous group divided into psychoses of known or suspected origin and in psychoses of unknown aetiology. Relevant differences in the use of diagnostic terms such as delir are noticeable, whereas known syndromes such as Korsakoff's syndrome (Korsakoff's psychosis or alcoholic psychosis) are not considered and incorporated into larger categories in DSM nomenclature.

Dementia↗
PubMed2005

Inverse relation between clinical distractibility and Stroop interference in functional psychoses.

INTRODUCTION: Many patients with psychotic disorders appear distractible. Some theories propose that distractibility causes psychotic symptoms, others propose the reverse. We tested these theories by assessing relations between psychotic symptoms, Stroop interference, and clinical distractibility in patients with schizophrenia or affective psychoses. METHODS: We rated clinical distractibility in patients with acute schizophrenia or affective psychoses and measured their Stroop interference in a single trial colour-naming task. RESULTS: Clinical distractibility related inversely to Stroop interference. Stroop interference was small in drug-naive patients with schizophrenia, but normal in those receiving treatment. Patients with affective psychoses showed the opposite pattern. CONCLUSIONS: The abnormality of attention that clinicians rate as "distractibility" is probably the opposite-attentional capture. Abnormal attention neither results from nor causes psychotic symptoms. Rather, it is an independent correlate of pathophysiology in functional psychoses that merits assessment and treatment in its own right.

Journal Article↗