Cycloid Psychosis

Abstract

What clinical feature has been associated with cycloid psychosis? A. Frequently occurring sleep disturbances. B. Acute stress. C. Disorganized thought. D. Prodromal symptoms."Ms. A," a 27-year-old Army captain with 5 years of service, was on her third overseas combat deployment in less than 4 years when she developed psychosis characterized by sudden onset of paranoia, sense of failure, delusional guilt, withdrawal from those around her, difficulty articulating, and an initial inability to sleep. Her commander stated that her previous level of functioning was very high and that she had been a top-performing soldier. The onset of this psychosis was sudden and was not associated with energy disturbance or mood disturbance, and it was independent of any change in stressors (the severe stress of the combat setting was relatively constant). She was initially treated for heat exhaustion, but when the symptoms did not resolve, she was started on olanzapine (5 mg/day) and then switched to risperidone (2 mg/day). She was evacuated to Europe, where she recovered within 1 week on a psychiatric ward and was diagnosed as having brief psychotic disorder. She was subsequently evacuated to a psychiatric ward in the United States, and, 3 weeks later, to her home base for further observation and outpatient care. After a 4-month observation period during which her risperidone dosage was gradually tapered and discontinued, she was returned to duty and able to resume her deployment on no medications. However, within 3 months of returning to the combat zone, the same symptoms recurred. Again, there were minimal mood symptoms and no hallucinations. She was again evacuated to Europe, recovered within a week, and was subsequently evacuated to the United States, where she was hospitalized for observation. She was treated with aripiprazole (30 mg/day), and tapered off within 3 months. She was honorably retired and released from the military and joined the civilian workforce 7 months after her return from overseas.Ms. A experienced a recurrence 1 year later (9 months after being tapered off her medication) with similar AUTHOR AND ARTICLE INFORMATION

A neuropsychological study on Leonhard’s nosological system

“…The latter is also reinforced when we reanalysed only bipolar patients without cycloid psychosis, since we achieved nearly identical significant results to those shown in Table 2. Some authors disagree with combining these groups because of the recurrent nature of non-affective episodes in cycloid psychosis [65] and because of possible different underlying aetiological and neurophysiological mechanisms [66,67] but results from our group and others have reported commonalities between bipolar and cycloid psychosis findings [68][69][70][71].…”

Does a Lack of Awareness of Cycloid Psychosis Hamper Adequate Treatment for Patients Suffering From This Disorder? A Case Report

“…Cycloid psychosis as defined by the criteria of Perris is not rare: In a Swedish register study, the 1-year incidence for first admission with cycloid psychosis was 5.0 per 100,000 inhabitants in women and 3.6 per 100,000 inhabitants in men within the age range 15-50 years (17). Across epidemiological studies, and similar to what has been reported for ATPD (18), female preponderance has been a consistent feature (19). The impact of ATPD is significant, mortality rates are excessive and similar to those for bipolar disorder and schizophrenia (20).…”

“…The condition has a sudden onset with a rapid change from a state of health to a full-blown psychotic condition within a few hours or at the most a few days. affective disorder (19). However, other studies also suggest neurobiological differences between cycloid psychosis, bipolar disorder and schizophrenia (24)(25)(26)(27).…”

“…However, other studies also suggest neurobiological differences between cycloid psychosis, bipolar disorder and schizophrenia (24)(25)(26)(27). In clinical routine, patients presenting with cycloid psychosis would be most likely assigned to DSM-5's unspecified psychosis category or brief psychotic disorders (19). The reason for choosing those soft categories is the cross-sectional plethora of diverse symptoms, including non-typical psychotic and affective symptoms, symptoms of confusion and other phenomena of motility, such as catatonic symptoms.…”

COVID-19 related Psychotic Disorder: Symptomatology in Infected and Uninfected Patients

“…This is true for COVID-19 patients with either neurological or psychotic symptoms [3,20,24,66]. In cyclops psychosis, patients have episodic psychosis with complete and rapid recovery between episodes, and in DSM-5 cyclops psychosis, patients have brief or unspecified psychotic disorders [80]. In NMDARA encephalitis, autoantibodies that block the glutamate NMDA type receptor are found in serum and CSF, and the blockade can lead to hallucinations [81] and some symptoms of schizophrenia [82].…”