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PubMed1990

[Clinico-pathogenetic aspects of pathologic premorbid conditions in alcoholic psychoses].

A study was made of the pattern of the clinicopathogenetic correlation of the pathological premorbid condition and alcoholic psychoses in 689 patients. Three degrees of the pathogenicity of the pathological ground and a respective grouping of alcoholic psychoses were distinguished. For correlation analysis purposes 4 most informative factors and 12 parameters mirroring the main tendencies of the pathogenesis of alcoholic psychoses were also distinguished. A regularity was discovered, according to which each of the 4 factors produces a different effect on the clinicopathogenetic mechanisms and formation of the varieties of alcoholic psychoses. The author puts forward a rationale for increased proneness of patients suffering from alcoholism with the pathological premorbid condition to the development of alcoholic psychoses.

Adolescent↗
PubMed1989

[Alcohol consumption and alcoholic psychoses].

The course of alcoholic psychoses was juxtaposed to that of alcoholic beverages purchase in Moscow during 1984-1986. Antialcoholic measures since June, 1985, sharply decreased the number of psychoses to 33.1% of the 1984 level. Their distribution within a month has changed. The alcoholic beverages purchase in 1986 was 61.7% of that in 1984. The number of alcoholic psychoses displayed a strong correlation with the purchase level (r = +0.90). Regression analysis showed that beverages purchase reduction to 28% of the 1984 level would fully abolish the alcoholic psychoses in Moscow. The conclusion was that the alcoholic psychoses can serve as a reliable index of the effectiveness of anti-alcoholic measures.

Alcoholic Beverages↗
PubMed1987

[Patterns in the recurrence and transformation of alcoholic psychoses developing against a pathologic background (clinico-statistical study)].

A clinical and statistical study has covered 689 patients with alcoholic psychoses developing against the pathologic background. The study of the correlation between the form of attacks and the type of the disease course has demonstrated some highly probable variants of relapse development and transformation of the clinical forms of alcoholic psychoses in subsequent bouts. Two variants of the course of alcoholic psychoses have been identified. In the first variant psychoses show no tendency to recur and transform while the second one is associated with their relapses and transformation. These findings make it possible to infer that the presence of pathologic background is a factor of risk and to outline on this basis the measures to prevent the development and relapse of alcoholic psychoses.

Alcohol Withdrawal Delirium↗
PubMed1978

[Syndromokinesis of alcoholic psychoses (according to the results of a clinico-epidemiologic survey)].

A clinico-epidemiological study was made of 446 patients who suffered from alcoholic psychoses during 1946--1970. An analysis of the quantitative and qualitative modification of the syndromes, the regularities in their dynamics demonstrated that the transformation of the symptomatology to a large extent depend upon the type of development of the alcoholic psychoses. Transitory psychoses are more frequently replaced by psychopathy-like personality changes. In a remittent development, repeated psychoses are characterized, as a rule, by a delirium or hallucinosis. Following a delirium there are typical acute verbal hallucinosis. During relapses there is an increasing amount of atypical symptoms. In patients with mixed and especially a continuous development of the psychoses, the pathokinesis of syndromes proceeds on the level of profound psychopathological disorders. As a result there may be either schizoform and crude organic clinical pictures and eventually there is a deep organic symptomatology (pseudoparalysis), or against the background of crude alcoholic personality changes, after lucid periods, there may be acute psychotic conditions.

Hallucinations↗
PubMed1975

Reactive psychoses. A family study.

Reactive, or psychogenic, psychoses have been given the most attention in the literature by Scandinavian investigators. We defined diagnostic criteria for reactive psychoses emphasizing differences with manic-depressive psychoses and schizophrenia. Forty Danish probands were selected and family history data was obtained by personal interview and record review. In order to compare our results with other investigations, we age corrected family history data. Siblings of reactive probands were found to have significantly more reactive psychoses than siblings of manic-depressives or schizophrenics, and significantly less schizophrenia than siblings of schizophrenics. Although there was some genetic overlap with manic-depressive psychosis, we believe that the findings are sufficiently distinct to warrant the separate diagnostic category of reactive psychoses.

Adolescent↗
PubMed1995

Schizoaffective psychoses: genetical clues to classification.

The diagnostic classification of schizoaffective psychoses has varied much since Kasanin introduced the concept in 1933. The various classifications have agreed that schizoaffective psychoses present a combination of schizophreniform and affective symptoms, but the diagnostic criteria differ as to the number, quality, and time sequence of the symptoms even in recent classifications like RDC, DSM-III-R, and ICD-10. The classifications are syndromatical, and the etiology of the schizoaffective psychoses is still undetermined apart from evidence for a strong genetic factor. Results from family, twin, and adoption studies are divergent, but all the same, support a separate classification of broadly defined schizoaffective psychoses as possibly being phenotypical variations or expressions of genetic interforms between schizophrenia and affective psychoses.

Bipolar Disorder↗
PubMed1997

The epidemiology of functional psychoses of late onset.

For the functional psychoses of late life, epidemiological information comes from two sources: studies of persons who have reached psychiatric services; and surveys of elderly persons sampled from the general population. A conspectus of published data from both sources leads to the following conclusions: States phenomenologically similar to those found in clinics do occur in the community in non-trivial numbers. There is no notable divergence in the information obtained from clinical series and from population-based surveys. These states are more common in women, they become more common with increasing age and are sometimes associated with decline in cognitive performance or with degenerative changes in the brain revealed by neuroimaging. Genetic factors appear to be less important than in early-onset psychoses but remain ill-defined, and the roles of social isolation and disorders of personality have not yet been sufficiently elucidated. Both clinical and community-based studies have found an association with sensory impairment. The community-based data suggest that paranoid symptoms may be detectable at subclinical level, and an association between them and cognitive impairment is demonstrable in individuals who are not diagnosable cases either of psychosis or of dementia. Differences exist between late-onset paranoid psychoses and affective psychoses in symptomatology and response to treatment. These observations confirm the importance of the late-onset psychoses for research directed towards uncovering the origins of psychotic symptoms in any age group.

Age of Onset↗
PubMed2006

[Cycloid psychoses as atypical manic-depressive disorders. Results of a family study].

BACKGROUND: Whereas a growing body of evidence suggests that cycloid psychoses have to be separated from schizophrenic psychoses, their relations to bipolar affective disorder are less clear. PATIENTS AND METHODS: In a controlled family study, we recruited 46 patients with cycloid psychosis (CP), 33 with manic-depressive illness (MDI), and 27 controls. Three hundred fifty-six of 389 living first-degree relatives were personally examined by experienced psychiatrists blinded to the diagnosis of the index proband. RESULTS: The relatives of CP patients showed significantly lower morbidity risk of functional psychoses than relatives of patients with MDI in Kaplan-Meier life table calculation. The morbidity risk for functional psychoses in relatives of patients with CP did not differ significantly from that in relatives of controls. CONCLUSION: These results suggest that CP are etiologically different from bipolar affective psychoses and cannot be integrated into the spectrum of bipolar affective disorders. The findings provide further evidence for a nosological independence of CP.

Adult↗
PubMed2000

[Differential diagnosis, course and outcome of postpartum psychoses. A catamnestic investigation].

In a polydiagnostic study, a systematically recruited collective of 34 women with a first-episode postpartum psychosis was reexamined after a period of 6-26 years (averaging 12.6 years) in order to establish lifetime-diagnoses according to ICD-10 and Leonhard's classification, and to determine course and outcome. According to ICD-10, unipolar depressive disorders (32%) and acute polymorphous psychotic disorders (28%) represented the most frequent diagnoses. Applying Leonhard's classification revealed a marked predominance of cycloid psychoses (62%) with the subform of motility psychosis being the most frequent diagnosis (38%). Schizophrenias occurred rarely according to both classifications. Investigating the long-term course, we found in 59% multiphasic disorders. The mean number of episodes per patient was 2.5 (range 2-6) with a mean duration of 9.8 weeks (SD = 5.2). 6 patients (18%) had undergone a monophasic course, in 4 cases (12%) the course was not determinable. 17 women (50%) had 19 further deliveries during the follow-up period. The frequency of relapses in connection with a further delivery was 47%. Administering the Strauss-Carpenter-Outcome-Scale revealed a favourable outcome with a mean value of 14.1 (SD = 2.83) for our total sample. Only 4 patients (12%) had never recovered fully since the onset of the illness. Our findings suggest that cycloid psychoses, in particular motility psychoses, account for the majority of postpartum psychoses, and do not support the hypothesis of a nosological independence of postpartum psychoses. They provide further evidence of a favourable prognosis of severe postpartum psychiatric disorder despite a relatively high rate of non-puerperal and especially puerperal relapses.

Adult↗
PubMed2005

Evidence for unaltered brain electrical topography during prefrontal response control in cycloid psychoses.

OBJECTIVE: Prefrontal structures such as the anterior cingulate cortex (ACC) play a decisive role in processes of action monitoring and response control, functions often impaired in schizophrenia. Patients with cycloid psychoses exhibit some characteristic neurophysiological features not indicative of the cerebral hypofrontality observed in schizophrenia. This study aimed at examining if cycloid psychoses-unlike schizophrenias-involve a normal brain-electrical topography during a task demanding prefrontal response control. METHODS: Thirty-seven patients with cycloid psychoses and 37 healthy controls were investigated electrophysiologically while performing a Continuous Performance Test (CPT). Topographical analyses were conducted to individually quantify the Nogo-anteriorisation (NGA) as a neurophysiological index of prefrontal response control. RESULTS: The patients exhibited an unaltered topography with a mean NGA not significantly different from the controls. They did, however, differ from the control group regarding their Global Field Power (GFP), with a significantly reduced GFP (p<0.001) and decreased latencies (p<0.01) during Nogo trials. On a behavioral level, patients exhibited prolonged reaction times and an increased rate of omission errors. CONCLUSIONS: The investigated patients showed an activation of specific (presumably frontal) brain areas during Nogo trials, resulting in a frontalisation of the brain-electrical field comparable to the control group. However, the strength of this activation was apparently reduced. The patients' unaltered topographical pattern contrasts with previous findings in schizophrenic patients and supports the hypothesis that cycloid psychoses entail less severe prefrontal deficits than schizophrenias, which might be an indication of different biological backgrounds for both groups of endogenous psychoses.

Adult↗
PubMed2004

Hippocampus and amygdala volumes in schizophrenia and other psychoses in the Northern Finland 1966 birth cohort.

Structural brain differences have been reported in many studies with schizophrenia, but few have involved a general population birth cohort. We investigated differences in volume, shape and laterality of hippocampus and amygdala in patients with schizophrenia, all psychoses and comparison subjects within a large general birth cohort sample, and explored effects of family history of psychosis, perinatal risk and age-at-onset of illness. All subjects with psychosis from the Northern Finland 1966 birth cohort were invited to a survey including MRI scan of the brain, conducted in 1999-2001. Comparison subjects not known to have psychosis were randomly selected from the same cohort. Volumes of hippocampus and amygdala were measured in 56 subjects with DSM-III-R schizophrenia, 26 patients with other psychoses and 104 comparison subjects. Small hippocampal volume reductions in schizophrenia (2%) and all psychoses (3%) were not significant when adjusted for total brain volume. The shape of hippocampus in schizophrenia did not differ significantly from comparison subjects. Right hippocampus and amygdala were significantly larger than the left in all groups. Mean amygdala volume in schizophrenia or all psychoses did not differ from comparison subjects. Patients with family history of psychosis had larger hippocampus than patients without. Neither perinatal risk nor age-at-onset of illness had any effect on hippocampal or amygdala volumes. Small hippocampal volume reduction in schizophrenia and all psychoses was not disproportionate to reduced whole brain volume in this population-based sample. Perinatal events that have been suggested as of etiological importance in structural pathology of psychosis had no effect.

Adult↗
PubMed2002

The Kraepelinian dichotomy: preliminary results of a 15-year follow-up study on functional psychoses: focus on negative symptoms.

In a 15-year follow-up study, we used a comparative approach to assess course and outcome for all functional psychoses. The presented results focus on negative symptoms and refer to a sample of 76 patients with schizophrenia, 38 patients with a schizoaffective disorder and 32 patients with an affective disorder according to ICD-9. These patients were assessed at their first psychiatric hospitalization and 15 years later. In summary, the findings indicate that the course and outcome of schizophrenia is less favorable than that of affective and schizoaffective disorders. Negative symptoms occurred in all functional psychoses, but were more frequent and prominent in the schizophrenic group than in the other two diagnostic groups at any time of assessment. Narrower concepts of negative symptoms, conceptualized as the deficit syndrome, seem to be specific for schizophrenia and appear quite rarely in patients with affective psychoses. Overall, our study supports Kraepelin's original hypothesis that bifurcated the psychoses into the affective psychoses and schizophrenia, whereby the latter have a more deleterious long-term course and outcome.

Adult↗
PubMed1992

[Importance of calcium ions and calcium antagonists in affective psychoses].

Apart from the eminent changes in the neurotransmitter systems of the central nervous system, a disturbance of the calcium ion concentration may be of significance in the pathophysiology of affective psychoses. The present paper deals with the contribution of calcium ions in the generation of affective psychoses and discusses the calcium antagonism as a new strategy in the treatment of the disease. The following topics will be described: 1. Disturbances of calcium metabolism in affective psychoses, 2. a comparison of lithium and carbamazepine effects, 3. clinical studies with organic calcium channel blockers in affective psychoses and 4. the role of calcium ions in affective psychoses.

Affective Disorders, Psychotic↗
PubMed1983

[Classification of schizophrenic psychoses].

There is a substantial need, based on the heuristic principle, to arrive at a valid classification of schizophrenic psychoses. According to the modern theory of science bases on critical rationalism, nosological classifications in psychiatry are regarded as "useful" conventions requiring precise operational definitions. There are several methods of classification, typological classifications having gained widest acceptance in nosology. The multiaxial classification approach allows to document separately data from different levels of data collection, such as symptomatological, etiological, psychosocial and family data, as well as personality factors. However, it is always necessary to render any classification empirically valid by verifying it by means of empirically observed data. In this review, some frequently used classifications of schizophrenic psychoses are evaluated regarding their "usefulness". Usefulness of a classification is assumed if its sub-grouping of data on one level of data collection is validated by data from another level, or if there is sufficient evidence that this classification can generate hypotheses which lend themselves to empirical testing. The traditional sub-classification of schizophrenias into hebephrenic, paranoid, catatonic, and simple forms lacks clear rules for allocating patients to one of the sub-groups; moreover, these sub-groups have not proved reliable. Some authors have tried to classify schizophrenic psychoses via the course of the illness. Methodological difficulties are considerable, and hence most of these classification still await validation. On the other hand, the course of premorbid personality development has been shown to be very important for the sub-grouping of schizophrenics: Good vs. poor premorbid adaptation dichotomy has been validated by prognostic and psychophysiological studies, by therapy response and by family data. Any distinction between acute and chronic types is bound to be of rather questionable value. Symptom criteria have also been proposed for differentiating between schizophrenic psychoses. Paranoid vs. nonparanoid dichotomy has been supported by several biochemical, psychophysiological, familial and therapy response studies. There is a great deal of evidence from prognostic and genetic studies that the presence of a valid sub-group of schizophrenic psychoses. Sub-grouping schizophrenics according to narrowly defined symptom criteria such as Schneider's first-rank symptoms and Langfeldt's, Feighner's and Spitzer's research symptom criteria is of limited value for a valid sub-classification. An approach to classification based on the distinction between the predominance of positive vs. negative schizophrenic symptomatology is of heuristic usefulness in that it generates biochemical and pathophysiological hypotheses which can be tested empirically.

Acute Disease↗
PubMed1983

The genetics of delusional psychoses.

In a genetic study of the first-degree relatives of 77 patients with delusional (paranoid) psychoses, the morbidity risks for schizophrenia, affective disorders, and atypical psychoses were evaluated using ICD-9 criteria. The prevalence of schizophrenia was 3.10 percent (4.12 percent with age correction to 40 years and 4.94 percent with age correction to age 60), which is higher than in investigations of paranoid psychoses, but lower than in studies of paranoid schizophrenia. The prevalence figure for affective disorders (age-corrected 3.04 percent for unipolar plus bipolar patients) is also intermediate to those for relatives of paranoid schizophrenics and paranoid psychotics. When the 77 index delusional patients were subdivided into axial syndromes (endogenomorphic-schizophrenic, endogenomorphic-cyclothymic, and organomorphic axial syndromes), two very homogeneous subgroups emerged. The endogenomorphic-schizophrenic subgroup showed high rates of schizophrenic secondary cases, whereas the endogenomorphic-cyclothymic subgroup showed high rates of affectively disordered secondary cases. The third organomorphic subgroup showed a high prevalence of atypical psychoses among first-degree relatives. Thirty-seven of the 77 index patients could not be assigned to any axial syndrome; their first-degree relatives had an increased prevalence of schizophrenia, but affective disorders were no more frequent than in the normal population. These data suggest that the heterogeneous group of paranoid psychoses can be meaningfully subdivided by use of axial syndromes which are viewed as representing "basic" disturbances underlying delusional symptomatology.

Adolescent↗
PubMed1975

Bilateral inheritance as evidence for polygenicity in functional psychoses.

Among 1,678 functional psychoses followed up, 35 had parents, uncles, aunts or grandparents with 2 or more cases diagnosed as schizophrenic psychoses, or 2 or more secondary relatives diagnosed as non-schizophrenic psychoses. Comparisons of unilateral and bilateral inheritance suggest that the schizophrenic and endogenous affective psychoses have polygenic transmission, while this is not the case for reactive psychoses.

Bipolar Disorder↗
PubMed1983

On the reason, why psychiatry in 80 years could not integrate schizo-affective psychoses. Can it now?

Schizo-affective psychoses are neither schizophrenias nor affective psychoses. What makes them particular are the pathological changes in emotions. As has already been pointed out by Wernicke in 1900, virtually all changes in the patient's psychopathology are dependent on the actual degree of anxiety or other pathological emotions. But neither emotion nor even anxiety has ever been part of any psychiatric semiology. Although emotional psychoses--a term we would prefer instead of schizo-affective psychoses--are easy to diagnose, if the psychiatrist takes into consideration the pathology of emotions which we outline here, it seems unlikely that psychiatry is now more able to integrate these psychoses than it was 80 years ago. This can be put down to language problems, but there are also historical, symptomatical, methodological, and systematic reasons for it.

Affective Disorders, Psychotic↗
PubMed1983

Long-term prognosis and course of schizo-affective, schizophreniform, and cycloid psychoses.

From the Bonn study including 502 patients followed up an average 22.4 years after onset of schizophrenic disease diagnosed according to the criteria of K. Schneider, we selected 113 cases of schizo-affective, schizophreniform, and cycloid psychoses in accordance to the definitions given by Kasanin, Retterstøl, Angst, and Leonhard. These psychoses have a better prognosis than the whole sample: characteristic residues are seen more rarely, complete remissions and noncharacteristic residues more frequently. This group of psychoses differs from the whole sample in the hereditary taint, too: the morbidity risk with affective psychoses and with schizophrenic psychoses in first- and second-degree relatives is higher than in the total sample of the Bonn study. In spite of the better prognosis and other differences described in the paper, we believe that these results do not justify the classification of schizo-affective and related disorders as an independent disease group. Between these different subtypes of schizophrenia only a differential typology and not a differential diagnostic is possible.

Bipolar Disorder↗