摘要:

Although reactive (psychogenic) psychoses have no doubt occurred throughout the history of mankind, it is only during the last century that the corresponding concept has been defined, beginning with Summer’s definition of the term ‘psychogenic’ and Jaspers’ distinctions between ‘reaction’ and ‘process’, and between ‘neurosis’ and ‘psychosis’, respectively. A change in Kurt Schneider’s nosological concepts induced the majority of German-speaking psychiatrists to avoid the concept of psychogenic psychoses. The very varying use of the concept of reactive psychoses in different countries is described and discussed, with special regard to implications for psychiatric epidemiology.

ISSN:0254-4962    

DOI:10.1159/000284480

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The diagnosis of reactive psychosis is more commonly used in Denmark and Norway, where 50 and 40%, respectively, of first-admitted patients with functional psychoses will be diagnosed as having a reactive psychosis. The predictive validity of the concept is discussed. The concept has to be better operationalized and limited in the future.

ISSN:0254-4962    

DOI:10.1159/000284481

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Reactive psychoses are relatively often diagnosed in Norway, although they are not operationalized in any classificatory system and the reliability may be questioned. The aim of this study was to define a group of reactive paranoid psychoses and compare its long-term outcome to the group of nonreactive paranoid psychoses and to paranoid schizophrenia. Approximately 200 out of 301 delusional subjects earlier studied by Retterstöl have recently been interviewed semistructurally, making a total follow-up period of 22–38 years. Diagnoses at discharge have been assessed retrospectively before the present interview, with a polydiagnostic approach. Based upon Kendler’s criteria of delusional disorder and influenced by Jaspers, the concept of reactive delusional disorder has been operationalized. Results from the first 125 interviews show 31 cases of Kendler’s delusional disorder, of which 16 are diagnosed as reactive delusional disorder. Outcome in this group is most favorable, and especially good outcome is found in acute reactive delusional disorder.

ISSN:0254-4962    

DOI:10.1159/000284482

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The problems of reactive psychoses are discussed from the following perspectives: terminology, prevalence, psychogenesis and trauma, predisposition and vulnerability, as well as outcome. Four definitions of reactive psychoses, which are used in Scandinavia, are presented and discussed. Each of them is beset with problems. The authors argues that the term ‘reactive psychoses’ should be limited to those functional psychoses which are not typically schizophrenic, manic-depressive or paranoid.

ISSN:0254-4962    

DOI:10.1159/000284483

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Although the Scandinavian concept of reactive psychoses relates to K. Jaspers and although Kretschmer described the prototype of a psychosis of psychogenic/reactive origin (Der sensitive Beziehungswahn), the concept is not so commonly used in German-speaking countries. Important reasons for this refusal may be (1) the sharp distinction between psychosis (which may be explained but not understood) and understandable reactions, which was stressed in rather influential German psychiatric schools in the middle of the century, and (2) the aim of stressing psychological understanding in a broad spectrum of psychiatric illnesses in the Swiss tradition, where the demarcation of particular reactive psychoses seemed to be superfluous. The development of modern concepts stressing the multidimensionality in the etiology of the main groups of psychiatric disorders was certainly influenced by the concept of reactive psychoses but passed it.

ISSN:0254-4962    

DOI:10.1159/000284484

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Dysphoric conditions are increasingly postulated as representing independent mood disorders. However, despite much effort at clarification, their psychopathological definitions remain unclear and variable. This paper reviews some examples of these divergent definitions, most of which are based on quality of mood, as well as responsiveness to external stimuli. The paper then introduces a strategy in possible solution of the above-mentioned definition problems. Setting out from restriction of the term dysphoria to conditions of a morose, tense and irritated mood, as suggested by Snaith and Taylor, we support the opinion that dysphoria should be accepted as a third possibility of mood swing, as a psychopathological disturbance which can be well distinguished from stable and unstable mixed states.

ISSN:0254-4962    

DOI:10.1159/000284485

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Many authors have stressed the particular affective behavior in paranoid psychoses, mainly its dysphoric pattern. In 1983, Berner formulated the dysphoric axial syndrome as a third type of the endogenomorphous cyclothymic axial syndrome. In this paper two points are examined: (1) The interrelation between dysphoric and depressive and/or manic affective disorders in paranoid psychoses, cross-sectionally and longitudinally, in order to test the hypothesis of their independence, and (2) the relation of dysphoric mood disorders in paranoid psychoses to their course, again in comparison with other types of affective symptoms. The paper is based on an empirical study by Gabriel in 1978 on the phenomenology and the course of paranoid psychoses.

ISSN:0254-4962    

DOI:10.1159/000284486

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The purpose of the present study is to investigate the relationship between dysphoric states (episodes in which irritable mood is prominent and relatively persistent) and manic-depressive illness. A further purpose is to clarify the probable causal influence of chemotherapy and the social consequences concerning dysphoria. The observations carried out on 14 patients are illustrated by 2 case reports. A strong tie seems to exist between dysphoric state and manic-depressive illness, especially with respect to typical biorhythmic disturbances. Although the origin of such states is generally unknown, there are indications that neuroleptics and lithium may play a major role. Social consequences are on the whole minor, if the disturbances in mood and drive occur acutely and markedly. On the other hand, mild to moderate mood changes (especially when unaccompanied by drive changes) may lead to severe social impairment. The reason for this may be that the latter-mentioned states are misinterpreted by the entourage as personality traits rather than as expressions of an illness.

ISSN:0254-4962    

DOI:10.1159/000284487

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Dysphoric states have been of particular interest for a long time since they occur not only in patients with psycho-organic syndromes but also in those with manic-depressive disease. This paper discusses some aspects of dysphoria from the pathophysiological point of view. Data mostly derived from epileptic patients indicate the critical role the limbic system plays in the control of emotions. It is suggested that functional alterations within the limbic system and its manifold interconnections to other parts of the central nervous system are responsible for characteristic pathophysiological phenomena as, e.g., dysphoria.

ISSN:0254-4962    

DOI:10.1159/000284488

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Comparing the pattern of serotonin, 5-hydroxyindole acetic acid, 3,4-dihydroxy-phenyl acetic acid and homovanillic acid in five brain areas of one dysphoric patient to those of 3 depressed patients it seems that dysphoria biochemically is a state between depression and mania. Dynamically, dysphoria may possibly be seen as a behavioral correlate of a switch process between high and low turnover of neurotransmitters (rather high frequency in comparison to bipolar disorder with very low frequency). However, the biochemical data are obviously in agreement with psychiatric findings, i.e. that dysphoria in any case is an extremely labile state.

ISSN:0254-4962    

DOI:10.1159/000284489

出版商:S. Karger AG    

年代:1987

数据来源: Karger