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PubMedDate not supplied

Paranoia and dysphoria: historical developments, current concepts.

Regarding diagnostic criteria for paranoia (delusional disorder) today psychiatry usually refers to Kraepelin, suggesting that this diagnostic category has existed more or less unchanged since the end of the 19th century. But, reviewing German literature on this topic, one can find a lively discussion with regard to definition, development and course. In this context, the position of affective symptomatology - especially dysphoria with its various meanings - is of major interest. This paper aims at clarifying some definitory questions and at recalling the 'old' paranoia dispute which is worth rediscovering as a stimulation for modern classification and clinical practice.

Anger↗
PubMed1983

EEG vigilance profile as a supplement of psychiatric data.

A vigilance measurement based on EEG spectra was employed to supplement the clinical data. In an experimental situation when the patient was left undisturbed after a standard stimulation, four typical patterns were observed. Besides the normal profile, a 'somnolent pattern' with pronounced vigilance decrease and an 'unquiet pattern' with high variance could be seen in treated and in untreated schizophrenic patients, respectively. A combination of both characteristics occurred in depressive patients with symptoms such as agitation, tension, and hypochondria. The outcome of treatment was predictable in the patients with a 'mixed pattern', while the drug effect was unpredictable in other patients with the same diagnosis.

Adult↗
PubMed1994

Case study of monosymptomatic delusion of unpleasant body odor with structural frontal abnormality.

We report a 63-year-old man with a monosymptomatic delusion of unpleasant body odor contracted at the age of 61 years, who believed that his body reeked of some type of paint. He had symmetrical atrophy in the bilateral frontal lobes of unknown etiology on MRI. Further, quantitative rCBF measurement with SPECT brain scan using 99mTc-HMPAO showed relative hypoperfusion localized in the bilateral frontal lobes. EEG, neurological and neuropsychological tests were all normal, including the WAIS-R and Wechsler Memory Scale tests. However, he showed poor results on the Wisconsin Card Sorting test, presumably on account of frontal dysfunction, attaining only two categories with frequent perseverative errors. Although it is undetermined whether the illness in this case can be classified as organic delusional syndrome or paranoid disorder according to DSM-III-R criteria, these results imply that delusions are associated with frontal lobe abnormality.

Atrophy↗
PubMed1984

Course and outcome of delusional psychoses.

The authors reinvestigated 84 out of a sample of 90 patients with delusional psychoses after an interval of 6-9 years. The results of the follow-up showed a pattern of episodic versus chronic course which compares to follow-up studies on classically diagnosed schizophrenias. The authors found evidence for their hypothesis concerning the nosological heterogeneity of this group of psychoses and propose a syndromatological classification apart from the delusional symptomatology itself. What they call background symptomatology was divided into axial syndromes. The authors feel that this results in subgroups that are more homogeneous for course and outcome than the usual classification systems.

Adolescent↗
PubMed1984

Heterogeneity of delusional syndromes: diagnostic criteria and course prognosis.

In addition to genetic findings and treatment response, the course prognosis is also meant to be a possible validating criterion for diagnosis and diagnostic systems. In our study we used the polydiagnostic approach (i.e. the simultaneous application of various criteria for diagnosing a given disorder to one and the same population) to test the ability of several diagnostic systems to create homogeneous groups regarding the course (episodic/chronic). We applied Schneider's FRS, ICD-9, DSM-III, Spitzer's RDC and the Vienna Research Criteria to 90 patients with the diagnosis of delusional syndrome (aside from any nosological classification), who underwent 6-9 years of follow-up. At the index examination, schizophrenia was most frequently diagnosed with Schneider's FRS, which apparently encompasses a very heterogeneous group of patients regarding psychopathology and course. Diagnostic systems which allowed the diagnosis of affective disorders despite the presence of mood-incongruent delusional symptomatology (DSM-III, RDC, Vienna Criteria) or offered the diagnosis of schizoaffective disorder (DSM-III, RDC) succeeded in separating subgroups with an episodic course on a statistically significant level. In ICD-9 this significance appeared only after exclusion of the schizoaffective cases from the group of schizophrenias. Our data thus uphold the old rule of thumb that affective symptomatology apparently has a very high prognostic value regarding the course of the illness and is in this respect superior to productive symptomatology (such as delusions and hallucinations), still taken to be pathognomonic for schizophrenia by some of the diagnostic criteria under study. This aspect warrants further investigation and should be taken into account in the development and improvement of diagnostic manuals (e.g. ICD-10, DSM-IV).

Adolescent↗
PubMed1985

Types of complaints in psychiatric and internal medical patients.

A follow-up study was made in groups of female neurotic, depressive, periodic catatonic, hypertonic, hyperthyreotic patients and normal control subjects using self-rating questionnaires to assess disposition, depressivity, neuroticism and subclinical symptoms. The subclinical symptoms scale (Sub-S) was elaborated on the basis of Huber's pure defect. We found that the experience (Sub-Exp) and behavior characteristics (Sub-Be) of the Sub-S form two separate subconstructs. The Sub-Exp belongs to the neuroticism factor and the Sub-Be can be evaluated as a subclinical appearance of manifest psychopathological behavior symptoms. The 'general disposition' construct is divided into subconstructs and shows contextual variants. It is proposed to use different methods for assessing it in the different problem areas simultaneously.

Adolescent↗