One operation cures three people; effect of prefrontal leukotomy on a case of folie à deux et demie.
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First, the author makes reference to the psycho pathological and nosological questions associated with paranoid and schizophrenia-like psychoses in epilepsy and in particular to the non resolved problem of a distinction between these epileptic syndromes and the ones of schizophrenia. Starting from a phenomenological analysis of basic existential structures such as encounter or interpersonality, temporality and spatiality in a typical case of paranoid psychosis in epilepsy, the author tries to establish formal criteria which allow to distinguish these psychoses from schizophrenia. Thus it could be demonstrated that the structure of the encounter in the psychotic epileptic is quite conserved, both in what refers to the real and the delusional partner. His spatiality is characterized by the phenomenon of narrowness and his temporality by harassment, being necessary to underline the fact that, unlike what happens in schizophrenia, in the paranoid psychoses of epilepsy the space maintains its unity and the time its continuity. We could summarize the substantive difference between both types of paranoid psychoses with the following words: in paranoid syndromes in epilepsy what occurs is a change of state "within the world", while in schizophrenia it is a rather a modification of the "being-in-the world" itself or, with other words, it deals with a going out from the world constituted as community.
We wished to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia and the prevalences of dysfunction among functionally psychotic and normal individuals. Therefore, we investigated pursuit tracking in a large sample of psychotic patients, normal subjects, and first-degree relatives (N = 482). Patients were recruited as part of an epidemiological study of first-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2 1/2-year period. Patients received diagnoses of schizophrenia, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The distribution of tracking performance was bimodal for the schizophrenic patients and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to schizophrenic patients and their relatives and occurred infrequently in other psychotic patients and normal subjects.
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A young male presented both Capgras syndrome and Folie à Deux. Both of his parents shared the same delusions with the patient. A dynamic explanation is provided for the simultaneous occurrence of both syndromes. The case report and the management of this patient may be of interest to clinicians.
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The authors examined 29 patients with endogenous psychosis (incl. 25 suffering from paranoid schizophrenia and four suffering from bipolar psychosis diagnosed according to DSM III criteria) with the aim to reveal the relationship of hitherto little studied HLA-DR antigens and the psychotic disease. Moreover, the passesed in the group also the ration of HLA-A, B, C antigens. In patients with paranoid schizophrenia and in all patients they found a higher incidence of HLA-DR2 antigens and a lower incidence of HLA-DRw6 and DR7. A statistically significant result was obtained only for HLA-DR2, and only before correction of p. The corrected p value (for the number of antigens) was no longer significant. This finding may serve as a stimulus to resolve the relationship of HLA-DR antigens and schizophrenia in a larger number of patients and in a greater number of departments.
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