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PubMed1991

Were Langfeldt's schizophreniform psychoses really affective?

Langfeldt's cases of schizophreniform psychoses were reclassified according to the ICD-9 and DSM-III-R diagnostic systems. The main purpose was to reexamine the validity of his concept of 'schizophreniform psychoses' to see whether it supported the existence of a 'third psychosis', and whether his material could be helpful in identifying good prognostic features in schizophrenia. Most of the schizophreniform psychoses turned out to be affective disorders with psychotic features. The number of other psychotic disorders was too small to facilitate a more thorough examination.

Follow-Up Studies↗
PubMed1996

Word associative production in affective versus schizophrenic psychoses.

The production of association word to stimulus words, which was found to be correlated with conceptual disorganization, as clinically measured by the Brief Psychiatric Rating Scale, was developed as a quantifiable measure of formal thought disorder. Associative word production in patients with affective psychoses (acute episodes of mania or schizoaffective disorder) was found to be higher in a statistically significant manner than in patients with acute episode of paranoid schizophrenia. The production of associative words in the two groups of acutely psychotic patients was significantly higher than in normal subjects, unipolar depressed, or residual schizophrenic patients. These quantitative differences reflected qualitative differences in the pattern of the production of word associations. Indeed, while patients with paranoid schizophrenia showed a sinusoidal-like type of oscillation in associative word production, patients with affective psychoses were characterized by exponential-like phases in associative word production. Associative word production may thus serve as a simple quantitative test for differentiating formal thought disorder in acute psychoses between patients with mania and patients with schizophrenia.

Adult↗
PubMedDate not supplied

On interrater reliability for Leonhard's classification of endogenous psychoses.

Twenty-two patients with a diagnosis of schizophrenia according to DSM-III-R and ICD-10 criteria, for whom the long-term courses of illness were all well documented, were classified by 4 independent investigators using Leonhard's classification of endogenous psychoses. With regard to the large nosological groups of cycloid psychoses (including the subtypes of anxiety-happiness psychosis, confusional psychosis and motility psychosis), of unsystematic schizophrenias (including the subtypes of affect-laden paraphrenia, cataphasia and periodic catatonia), and of systematic schizophrenias (divided into systematic catatonias, systematic paraphrenias, and hebephrenias), is was possible to reach a high level of agreement in the diagnosis, representing a Cohen kappa coefficient of 0.82 and 0.89, respectively. In only 2 out of 22 patients were discrepancies observed in the assignment to the above-mentioned groups. This clearly shows the high reliability of Leonhard's classification, which allows a differentiated diagnostic and prognostic judgement of schizophrenic psychoses according to the DSM-III-R and ICD-10.

Adult↗
PubMed2003

Diagnostic specificity and neuroanatomical validity of neurological abnormalities in first-episode psychoses.

OBJECTIVE: Neurological abnormalities are frequently seen in patients with first-episode psychotic disorders but are generally considered to be diagnostically nonspecific, neurologically nonlocalizing, and, hence, "soft." This study examined the neuroanatomical correlates and diagnostic specificity of abnormal findings on the neurological examination in first-episode schizophrenia and other psychotic disorders. METHOD: Neuroleptic-naive patients with schizophrenia (N=90) and with nonschizophrenia psychoses (N=39) and carefully matched healthy subjects (N=93) were compared on total and factor scores for a reliable subset of Neurological Evaluation Scale items. The relationship between neurological examination abnormalities and alterations in the relevant brain structures as assessed by magnetic resonance imaging was examined in a subset of subjects. RESULTS: Factor scores for repetitive motor task abnormalities were higher in both patient groups, relative to the healthy group, and did not distinguish between the patient groups. Factor scores for abnormalities in cognitively demanding and perceptual tasks were markedly higher in the schizophrenia group, relative to both comparison groups, and were not different between the nonschizophrenia psychoses group and the healthy comparison group. Higher scores for the cognitive/perceptual abnormalities factor were correlated with smaller volumes of the left heteromodal association cortex. CONCLUSIONS: Neurological signs may serve as expedient bedside measures that are potentially useful in the assessment of idiopathic psychoses, and cognitive/perceptual neurological signs may have a measure of diagnostic specificity. These findings provide neurobiological validation of abnormal findings on the neurological examination. These abnormalities may reflect discrete neuroanatomical alterations in schizophrenia and may have a localizing value.

Adult↗
PubMed2005

Personality dimensions in first-episode psychoses.

OBJECTIVE: The authors compared the patterns and specificity of premorbid personality dimensions in first-episode schizophrenia patients with those in patients with first-episode nonschizophrenia psychoses and healthy comparison subjects. METHOD: A series of 63 patients with first-episode schizophrenia and related psychotic disorders, 34 patients with first-episode nonschizophrenia psychoses, and 77 healthy comparison subjects were assessed with the Personality Disorder Evaluation, a semistructured interview schedule that measures personality dimensions. RESULTS: Cluster A as well as cluster C dimensional scores-in particular, the avoidant personality score-were higher for the schizophrenia patients, and cluster B dimensional scores were higher for the patients with nonschizophrenia psychoses. Cluster C dimensional scores, particularly the avoidant personality score, were highly intercorrelated with all cluster A dimensional scores. CONCLUSIONS: The observed association between avoidant personality and schizophrenia supports the recent literature on the comorbidity of nonspectrum personality disorders in schizophrenia. This association may be related to shared neurodevelopmentally mediated impairments in social cognition in schizophrenia and some cluster C personality dimensions.

Adult↗
PubMed2004

Excess of psychoses among the French West Indian population.

OBJECTIVE: To investigate and compare the prevalence of psychoses in the French West Indies (FWI) and in continental France. METHOD: As part of an international epidemiologic multicentre study under the authority of the World Health Organization French Collaborating Center (WHO-CC), we questioned 7257 individuals selected from the general population in France and in the FWI, using the Mini International Neuropsychiatric Interview. We compared data using the chi-square test. RESULTS: We found a significant discrepancy between the rate of psychoses at the continental French sites (1.8%) and the FWI sites (4.4%) (P < 0.0001). After homogenizing the rate of missing interviews, our results remained significant. CONCLUSIONS: Such a drastic increase in the rate of psychoses in the FWI population cannot be explained solely on the basis of either the classical migration hypothesis or other currently accepted hypotheses. More attention should be given to new parameters such as 1) the recent and significant abuse of crack cocaine and cannabis in the FWI, 2) the continued existence of magic practices in a significant portion of the French Afro-Caribbean population, and 3) the expression of mood disorders with overvalued ideation or psychotic symptomatology.

Adult↗
PubMed1975

Demographic differences in functional psychoses.

Only Scandinavian investigators have reported on demographic aspects of reactive psychoses. Data from the National Health Service, Denmark, for age at first admission, sex, and length of stay in hospital in reactive, manic-depressive and schizophrenic psychoses are analysed. Differences in sex incidence ratios, age at first admission and length of stay are evident between the three psychoses. The differences noted are considered to provide indirect evidence supporting the separate diagnostic categories.

Adolescent↗
PubMed1980

Psychose passionnelle in successive generations.

This paper describes two women. The first was admitted to hospital having suddenly, and without adequate reason, developed the idea that a senior married colleague at her workplace had fallen deeply in love with her. The second woman is her mother, who had been admitted to the same hospital twenty-two years earlier with a well systematized delusion that her husband was unfaithful. Both syndromes have been described by de Clérambault as two of the three forms of psychose passionnelle. The present report is intended to clarify the concepts of psychose passionelle and demonstrate the similarities between jealousy and erotomania. We believe these case histories describe the first reported instance of psychose passionnelle in successive generations of one family.

Adult↗
PubMed1988

Post-ictal psychoses. A clinical and phenomenological description.

Post-ictal psychoses have so far received little attention. The clinical details of 14 cases, diagnosed according to newly formulated criteria, were examined. Psychoses were usually precipitated by a run of seizures and occurred after a lucid interval. The seizures were partial complex with secondary generalisation in 11 cases. Catego analysis of the Present State Examination confirmed pleomorphic phenomenology. Follow-up details were available in all cases, for up to eight years. Psychoses tended to recur. Similarities with chronic epileptic psychosis are discussed, and a possible organic aetiology for post-ictal psychosis is proposed.

Adolescent↗
PubMed1989

The classification of functional psychoses and its implications for prognosis.

One hundred and eighty-three patients suffering from functional psychoses were diagnosed according to ICD-8, RDC, and DSM-III criteria, and the concordance rates for the diagnoses compared. The heterogeneity of the diagnosis 'schizoaffective psychosis' as defined by these systems became clear. With respect to prognosis, the DSM-III diagnosis of schizophrenia was most closely related to poor outcome. Affective psychoses and schizoaffective psychoses, as well as DSM-III 'schizophreniform disorders', demonstrated a favourable prognosis.

Adult↗
PubMed2000

Obstetric complications and affective psychoses. Two case-control studies based on structured obstetric records.

BACKGROUND: Unlike schizophrenia, little interest has been taken in the incidence of obstetric complications in affective psychoses. AIMS: To find out whether obstetric complications are more common in affective psychoses than matched controls. METHOD: Two hundred and seventeen probands with an in-patient diagnosis of affective psychosis who had been born in Scotland in 1971-74, and a further 84 born in 1975-78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth. RESULTS: Abnormal presentation of the foetus was the only complication significantly more common in the affective probands in the 1971-74 birth cohort and artificial rupture of the membranes was the only event more common in the probands in the 1975-78 cohort. Both are probably chance findings. CONCLUSION: It is unlikely that the incidence of obstetric complications is raised in people with affective psychoses of early onset.

Adolescent↗
PubMed2000

Duration of remitting psychoses with acute onset. Implications for ICD-10.

BACKGROUND: The acute and transient psychotic disorders (ATPD) in ICD-10 advanced the nosology of remitting psychoses with acute onset. But the proposed criteria for ATPD--especially in regard to duration--are tentative and need to be validated. AIMS: To evaluate: (a) the duration of remitting psychoses with acute onset; (b) the applicability of the ATPD criteria for these cases; and (c) differences in duration and ATPD diagnoses across sociocultural settings. METHOD: Data from the World Health Organization Determinants of Outcome study were used. RESULTS: The 98 cases of remitting psychoses with acute onset had a modal duration of 2-4 months, with 43% falling in this range. Mainly because of this, few met the ATPD criteria. Duration and diagnostic findings were similar across settings. CONCLUSIONS: ATPD criteria need refinement, especially in regard to duration. Further studies aimed at early detection and assessment of onset and duration of these disorders are needed.

Acute Disease↗
PubMed1996

Mortality among patients with non-affective functional psychoses in a metropolitan area of south-eastern Brazil.

High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of non-affective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge.

Adolescent↗
PubMed1998

Iatrogenic Psychoses.

Iatrogenic psychoses can cause disability, worsen previous disability, and render clinical management extraordinarily difficult. In certain cases, psychosis precedes more severe and overt toxicity, which can lead to encephalopathy or coma. This article offers an overview of iatrogenic (ie, treatment-induced) psychoses. "Pure" psychoses (ie, without confusion or mood disturbance) are emphasized. Shortcomings of available data are highlighted. The epidemiology, definition, diagnosis, differential diagnoses, risk factors, and course are discussed. Therapeutic measures include discontinuation or decreasing the dose of the suspected medication and the administration of neuroleptics, antimanics, and antidepressants. Other general principles of clinical management are given. A brief review of etiopathogenic mechanisms is offered and areas for future research are emphasized.

Journal Article↗
PubMed1976

[Genetics of psychoses under a new aspect].

To analyze the biological pathways of the genetical activity in psychoses is growing more and more to an important goal. The research in this field should be started on the assumption of a multifactorial hereditary system controlling the somatic base of mental illness in a specific way as can be argued from twin and family studies. Screening the present data, there is strong evidence that the metabolism of affective psychoses is characterized by quantitative deviations only concerning the 5-hydroxytryptamine and norepinephrine turnover particularly. The biochemical findings in schizophrenic psychoses are suspicious for qualitative abnormities too. There are some indications of toxic products in the catecholamine metabolism and of antibodies against brain substances. All these disturbances could be caused by structural gene mutants or by mutations of the genetical regulatory system changing the sensitivity for the environmental stimulus. The simultaneous investigation of simple inherited serum groups is described as a useful tool for biological marking of the responsible genotypes.

Environmental Exposure↗
PubMed1979

[Psychoses and borderline cases in puberty and adolescence and their importance in criminal law (author's transl)].

Juvenile psychoses are on the whole rare, at any rate rarer than psychoses in adults. The former commonly used conception of the disease, hebephrenia, as a pubertal form of schizophrenia has largely lost its significance. The cardinal symptoms are delusions and disordered mental processes in addition to anxiety and states of excitement. The particular importance of this disease lies in the individual experience of this disturbance of the reference environment which is an existential threat to a newly formed personality and its relation to the environment. The difficulty in classifying it among the psychoses on the one hand and as a neurosis on the other has produced a term "borderline" for it, characterized by an infantile incompatibility with positive and negative tendencies in himself and in reference persons and through the lack of a stable reality of reference.

Adolescent↗
PubMed1979

[The course of functional psychoses (author's transl)].

Functional psychoses correspond to a universal reduction of mental and intellectual function which, fundamentally reversible and unspecific, appear as sequelae of disturbances of cerebral function. They are the most common psychoses in medical practice and in hospitals. With the Syndrome Short Test and Functional Psychosis Scale B we now have a mutually equilibrated test system for the measurement of the whole range of severity of functional psychoses. With these two psychopathometric methods a relatively differentiated investigation of cross section and course can be performed, for example in arriving at a diagnosis, checking medical measures, monitoring the effect of drugs and in the prognosis of a disease.

Adult↗
PubMed1992

[Transient psychogenic psychoses in servicemen].

To specify the clinical picture, criteria for differential diagnosis and for medicolegal estimation of transitory psychogenic psychoses, 26 servicemen admitted irresponsible in respect to the actions committed in a state of psychosis were examined. Responsible servicemen who committed crimes in a state of physiological affect (n-26) or at the moment of acute situational personality reactions (n-26) were examined as reference groups. It has been established that transitory psychogenic psychoses occurred in servicemen with a definite personality and mental disposition (inhibited pathocharacteristic features and phenomena of residual organic brain injury) in a chronic (from 3 to 12 months) psychotraumatizing situation of permanent ill treatment and humiliation, causing long sleep deprivation. 3 stages were distinguished in the development of psychosis: stage I (preneurotic) was partial mental disadaptation; stage II (neurotic) involved further development of the phenomena of partial disadaptation and was characterized by well-defined asthenoneurotic and depressive dysphoric syndromes and not infrequently by syndromes of autistic aggressive fantasies; stage III was complete mental disadaptation marked only by transitory psychoses. The latter stage was short-lived (commonly lasting several hours), characterized by psychotic depth and by unmarked phenomena of agitated depression and pathological interpretations. Psychogenic psychosis that occurred in the presence of the above symptoms manifested, as a rule, by a depressive raptus with severe psychomotor excitation, vital melancholy, fragmentary hyperquantivalent depressive delirium, and phenomena of deep depersonalization and derealization.

Adaptation, Psychological↗