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Reviewing the results of the observation of 72 patients suffering from endogenic psychoses during a period of 11 years the author tries to demonstrate the advantages of a basis-near, i.e. near to the places of living and employment, therapy for psychically sick persons. The necessity of long-term therapy is emphasized.
The author suggests that a chronoepidemiological approach and the method of phasic-spatial analysis should be used a sa main orientation and tool of the study into the causes and conditions of a mass character of endogenic psychoses. This method involves a wide range of temporal, spatial, quantitative, qualitative, empirical and theoretical epidemiological parameters of the disease. The method makes it possible to elucidate different forms of cause-and-effect relationships of synchronous and diachronous nature. The efficacy of the method was assessed in a retrospective study of schizophrenic patients in the city of Andizhan. This study revealed an action of an unknown factor in the early ontogenesis of patients. On the basis of phasograms of the distribution of schizophrenia a conclusion is drawn that the unknown factor has a physical nature and cyclically varying force characteristics with a period of about 10 years.
The effectiveness of electroconvulsive treatment (ECT) was studied in 80 patients with attacks of affective and schizoaffective structure and resistance or intolerance to psychopharmacotherapy. The best therapeutic effect was observed in patients with attack-like endogenous psychoses, including manic and expansive paraphrenic syndromes. The effectiveness of ECT was related to the peculiarities of attacks and their duration.
The article presents new, specified results of the use of finlepsin (carbamazepine) for the secondary prophylaxis in patients with endogenic affective psychoses. The data have emanated from a 5-year observation of the course of therapy of 73 patients. A positive effect was observed in 83% of cases, including 27.7% of cases with complete disappearance of circulation. No significant differences in the drug efficacy have been found in patients with manic-depressive psychosis versus schizophrenia. Yet, in most of the schizophrenics the phases have disappeared, while patients with manic-depressive psychosis have presented only partial improvement. The authors recommend that doses at the initial stages of treatment be increased in a gradual manner. Variants of a positive therapeutic time-course are described. They have also determined a period of time (3.5-4 months) after which the continuation of the therapy should be considered inadvisable in case of no favourable effect.
Distribution of HLA antigens of A and B loci was studied in 200 schizophrenics, 77 patients with manic-depressive psychosis of different forms, and in 350 healthy individuals. The findings included a significant elevation in the levels of the B7 antigen in both groups of patients, of antigen B12 in individuals with paroxysmal schizophrenia as well as a decrease in the concentrations of antigen B35 in recurrent schizophrenia. Patients with monopolar manic-depressive psychosis showed increased content of antigen B14 and decreased levels of antigen B5. The data obtained confirm heterogeneity of endogenic psychoses with regard to this sign.
The results of a clinico-statistical study of 483 patients with depressive syndromes in the framework of affective and schizoaffective psychoses demonstrated a wide range of depressive conditions. In the absence of specific nosological types of depression there was, however, a certain predilection of the syndromal distribution in the nosological framework, in some clinical, psychopathological features, even in structural similar depressions, depending upon the character of the development of the pathological process and its dynamics.
The provisional definitions presented in this report are the first step of an empirical investigation initiated to establish operational definitions for schizophrenia and other non-affective psychoses of classical French nosology. They are the result of French clinicians' agreement on the identification of particular syndromes as distinct mental disorders.
The present report presents the final results of an empirical investigation initiated to establish operational definitions for schizophrenia and other non-affective psychoses of classical French nosology. For each category, the authors provide diagnostic criteria and algorithms. In addition, they propose a decision tree for the differential diagnosis of psychotic features included in the French classification of mental disorders.
An assessment of the efficacy and tolerability of zuclopenthixol dihydrochloride tablets in the treatment of acute psychotic episodes was undertaken in 63 patients in an open multi-centre study. Most patients prior to entering the study had received other neuroleptic drugs, but with inadequate effect. During the 10-week study, the dosage of zuclopenthixol dihydrochloride tablets could be adjusted to obtain optimum clinical benefit. The majority of patients received 20 to 75 mg daily (range 10 to 150 mg daily) at the start of the study and later, for most of those patients successfully treated, the dosage was 20 to 55 mg daily. Assessments before and during treatment utilized the BPRS and CGI rating scales and a check-list of side-effects. A successful response to treatment was achieved in 70% of 50 patients with schizophrenia or schizophreniform psychoses and in 69% of 13 patients with mania or hypomania. Almost half (30) of the patients studied had a successful response within 4 weeks of starting treatment and some after only 1 week of treatment. All patients but 1 had either no side-effects or side-effects not overtly affecting performance.
Using clinical, biographic and social parameters the authors analyzed the results of long-term observation on a group of patients (n = 450) with epilepsy accompanied by psychotic disturbances. Prognostic signs of a favourable variant included the predominance of homogeneous attacks and an affective structure of psychotic disorders. In cases with a moderately severe variant paroxysmal manifestations were presented by an array of temporal and unfolded convulsive forms. Psychotic disorders of the hallucinatory-delirious type serve as signs of a late exacerbation of the epileptic process. An unfavourable variant was characterized by polymorphic attacks with predominance of postural and psychomotor components, frequent states of decompensation, an increase in signs of epileptic dementia and a wide spectrum of psychotic disturbances, ranging from overworship ideas to affective-delirious and catatonic-delirious psychoses.
The authors sum up the most important basic principles of diagnostics and genetics of the schizophrenic psychoses from the viewpoint of genetic counseling for the practising psychiatrist and medical geneticist. Regarding genetic counselling strategy, in addition to nosological considerations, they stress the importance of socio-cultural and social psychological factors and of the emotional atmosphere in the family, which should all be taken into account together. Because of the special situation of schizophrenic (and in general, psychiatric) patients and their families, they regard it as advisable to set up a separate psychiatric genetic counselling service.
The author present, for pediatristist of primary care of health, a alarm factors, in the psychic evolution of children will can develop a child psychoses. The author in two groups has classified them: major signs and minors signs, he was giving a characteristics and patterns for to be valuated.
The paper demonstrates that the nosological classification of psychoses associated with pregnancy, menstruation, etc., under conditions of approximately equivalent description of syndromes, has been treated quite variously, according to the prevalent attitude, in the last hundred years. The concept of puerperal psychosis has been used to denote a psychopathological syndrome connected with pregnancy, birth, and confinement. After a relapse, nosological classification is possible.
The authors refer to the biochemical investigation of the occurrence and metabolism of essential fatty acids in the CNS and to significant differences in results between those obtained in animal experiments and those involving human beings, taking into account hypotheses that have not yet met with general acceptance. Discussed is the possible connection between eicosanic acid and schizophrenia, notably Horrobin's hypothesis of PGE1 deficiency in schizophrenic patients. The probability of a pathogenetic connection between changes in the metabolism of fatty acids and the occurrence of endogenous psychoses is assumed.
Subject of the report is methodics for a circadian analysis in case of psychotical diseases. Acquisition and filing of psychopathological phenomenona is effected by means of Strukturiertes Psychopathologisches Erfassungssystem (SPES) and other self-or outside-rating-scales. The diurnal variation of body-temperature is taken as physiological reference function. The results of the analysis, which show an internal rhythmic desynchronization in case of phasic as well as in case of non-phasic psychoses, are given by way of exemplary instances.
An analysis of certain regularities in drug pathomorphosis of psychoses in the form of transitions from psychotical states to pseudoneurotic showed a slowing in their progression, changes in the syndrome structure, an increase in the amount of incomplete or reduced conditions. This circumstance prompted reconsideration of some routine therapeutic approaches. The main recommendations include restriction of neuroleptics, expansion of the diagnosis of depressions, the use of methods of intensive psychopharmacology in combination with active rehabilitation, as well as introduction of new forms of organizational aid.
301 first-admitted hospitalized patients with paranoid psychoses have been studied by Retterstøl over a period of 5-18 years. Common Scandinavian diagnostic procedures were used. About 200 are still alive, and these subjects are at present being interviewed semistructurally by Opjordsmoen using a modification of SADS-L, and making a total follow-up period of 22-37 years. The diagnoses are confirmed according to ICD-9, RDC, DSM-III and some specific groups of delusional disorders (DD) operationalized by Winokur and Kendler. All interviews have been carried out non-blind to the diagnoses which will make a bias possible. However, in paranoid cases, it is an advantage for establishing contact and a conductive atmosphere to know something about the patient beforehand. Based upon our own experiences and reviewing the literature, we point to some important methodological aspects regarding follow-up studies in delusional persons. The suspiciousness, misinterpretation, dissimulation, rationalization and convincing argumentation seen in many paranoid cases, call for a skilled investigator and a clinical approach. However, operational criteria, new diagnostic concepts and standard procedures for follow-up interviewing and outcome assessments will make comparison for international readers easier.
The results of clinical and epidemiological study of 2 groups of patients (n-982) with reactive psychoses manifested in 1950-1971 showed that one of the most important causes of the pathomorphosis of psychogenic conditions noted in the second decade was socially induced changes in the premorbid background of these patients. The nature and orientation of the action of concrete factors of the pathomorphosis are disclosed.