The Modern Concept of Schizophrenia

This is a report of a phenomenological and descriptive study of forty-four patients seen early in their first hospitalization for schizophrenia. Most patients had a prodromal phase (median duration 30 months) during which the commonest symptoms were decreased drive and dysphoria. Symptomatology was often similar to that of a reactive depression; there was no instance resembling endogenous depression. A prodromal triad of deterioration in school or work performance, schizoid withdrawal and anergia was identified and this may have some diagnostic use. Twelve of the fifteen patients who exhibited this triad had also experienced disturbed flow of thought. Some patients experienced increased sexual drive, usually towards the end of the prodromal phase or in early overt psychosis. Some also reported regular fluctuations in symptomatology; these cycles, usually of a few good days and a few bad days, occurred in the prodromal phase and/or early overt psychosis. The transition to manifest psychosis was usually quite abrupt. An oneirophrenic experience, termed a ‘complex state”, was common either at the beginning of psychosis or soon thereafter. In the ‘complex state” a number of symptoms are experienced together or in such rapid succession that separating them is artificial. Perplexity and emotional arousal, usually dysphoric, are always present, and there is invariably at least one symptom of disturbed perception or delusion. Perceptual disturbances may affect any modality and often more than one; the perceptual alterations may be simple or complex. Disturbances of visual perception were reported more frequently than might have been expected, tending to be associated with good prognosis. Motor blocking, slowing or inco-ordination may occur, and although clouding of consciousness was experienced as part of the complex state, it was not possible to document this satisfactorily. Delusions usually developed within complex states or more commonly as explanations of them, so that the concept of primary delusion may be invalid. These findings were further discussed with particular reference to the work of Conrad and Chapman.

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“…It appears that early schizophrenia is generally similar to the oneirophrenias as depicted by Meduna and McCulloch (18,19) …”

Section: Discussionsupporting

confidence: 52%

Early Schizophrenia

Varsamis

Adamson

1971

Canadian Psychiatric Association Journal

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“…Distinguishing between acute remitting psychoses (psychogenic psychosis, cycloid psychosis, one‐ iroid states, oneirophrenia, reactive psychosis, and atypical psychosis) and schizophrenia remains challenging. 78,150–156 Using WHO data, Susser and Wannderling concluded that the acute remitting psychoses differed epidemiologically from schizophrenia. 150 Current diagnostic nomenclature deals with these distinctions more successfully than earlier nosology.…”

Section: Neurodevelopmental Model Of Schizophreniamentioning

confidence: 99%

Dementia praecox to schizophrenia: The first 100 years

Adityanjee

Aderibigbe

Theodoridis

et al. 1999

Psychiatry Clin Neurosci

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The historical roots of dementia praecox and schizophrenia are described in the context of current nosology and continuing controversies surrounding this nosology. Relevant books and journal articles were reviewed. The information was obtained through computer searches and cross‐references from previously published papers. If English translations of foreign language articles were available, they were used; if not, the cross‐references were consulted. The psychoses have existed as diagnostic categories from ancient times although their names have changed. Initially, these disorders were considered diseases of the brain, a concept that was swept aside in the United States, influenced by European‐derived psychodynamic theories. American clinicians and investigators simply accepted these theories, showing little interest in testing their underlying principles. In contrast, a narrower Kraepelinian approach was adopted outside the United States, and attempts were made to refine its nosology. Because current data supports a central nervous system aetiology for schizophrenia, the concept of dementia praecox warrants resurrection. The authors suggest abandoning the term schizophrenia in favour of the more broad and generic term dementia praecox. Replacing ‘schizophrenia’ with ‘dementia praecox’ in the 21st century will facilitate further research and help clarify the nosology of various brain disorders currently included in the schizophrenias.

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“…By w ay of illu stratio n , 3 cases m ight be w orth m entioning of p a tie n ts who were in deadly fear of im pending social ru in because of im aginary [1] expulsion from the P a rty , [2] forced enlistm ent in H itle r's police force (SS troops) during the O ccupation, and [3] th e d ea th of his m other, th e object of his affections, and his inab ility to fulfil his m any duties an d im p o rta n t task s t h a t pressed heavily on him . In addition, two women p atien ts belonging to this group laboured under a m isapprehension-owing to subjective experien ces th e y had h ad -of being th reaten ed w ith m oral ru in , th e one because the m an w ith whom she had her first sexual intercourse was her own first cousin, and the other because of a d u ltery com m it te d w ith her h u sb an d 's closest friend.…”

Section: I Pseudoschizophrenia Neuroticamentioning

confidence: 99%

“…In recent years, how ever, re p eated a tte m p ts have been m ade to isolate certain affective clinical pictures from the m anic-depres sive group, as well as to separate certain paranoid, catato n ic and hebephrenic pictures from the dom ain of schizophrenia.Thus in 1945 M eduna [3] tried to isolate from th e v ast collec tion of schizophrenia a sep arate group, w hich lie nam ed oneiro phrenia. Its clinical pictu re, according to M eduna, is characterized by an acute clouding of consciousness and oneiric confusion of m ind often com bined w ith depersonalization and derealization.…”

mentioning

confidence: 99%

Pseudoschizophrenic Syndrome

N¹

1965

Eur Neurol

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The Modern Concept of Schizophrenia

Cited by 20 publications

References 2 publications

Early Schizophrenia

Early Schizophrenia

Dementia praecox to schizophrenia: The first 100 years

Pseudoschizophrenic Syndrome

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