Differential diagnosis and different etiologies of monopolar and bipolar phasic psychoses

Monopolar and bipolar phasic psychoses can be differentiated not only on the course but also on the symptom pattern. This applies also to the euphoric forms which usually are still assigned to Manic-depressive illness. The differential diagnosis is presented. Aetiology is completely different in the monopolar and the bipolar phasic psychoses. Manic-depressive illness has a hereditary basic, whereas in the monopolar ("pure") forms loading is very low. Particularly few psychoses among the relatives have been found in the euphoric forms which demonstrates their independency for if they would belong to Manic-depressive illness they necessarily would show the heavy genetic loading of this bipolar illness. In the pure phasic psychoses external causes were detected when we focused on the sibships in which the probands had grown up. The euphoric patients had relatively many older siblings, the depressive ones relatively few older siblings. A similar difference was found in two cycloid psychoses. Transcultural observations as well as shifts in the incidence rate of the psychoses in our times confirmed our results. Prophylactic measures can be derived.     

Exceptional musical performance in early childhood catatonia

Many years ago the author, jointly with a psychologist, described a patient who, in spite of her alleged idiocy, showed an exceptional musical capacity. However, in the meantime the author has recognized and described early childhood catatonics and, as a consequence of this new knowledge, he has to admit an error. Even according to our then findings it would have been identifiable that, as has been confirmed now by follow-up, the patient is suffering from catatonia, starting in infancy. The high musical performance, then arousing our greatest astonishment, is now explicable, for childhood schizophrenics do not develop general mental deficiency but only specific circumscribed deficits.     

Has the cataphasic form of schizophrenia increased in modern times?

According to our investigations the incidence of cataphasia, which is a subtype of schizophrenia, has become more common in the last years and on average, has started earlier in life. As the central disorder of this illness concerns thinking perhaps there exists a relation of our finding to the rapid modern development of techniques, insofar as the cognitive function is overstrained in childhood and adolescence, when the nervous system has not matured yet. Introverted individuals seem to be at a particular risk. However, it must not be disregarded that cataphasia is an inherited illness which cannot be caused by external influences, but can only be promoted in its manifestation.     

Differential diagnosis of endogenous psychoses in relation to a symptom catalog

The paper introduces a catalog of symptoms to promote in the field of endogenous psychoses differentiated diagnosis, at the same time constituting a prognosis. Symptoms should be more minutely differentiated than is customary in psychiatric questionnaires. Manic-depressive disorders and purely phasal psychoses are distinguished solely in the clinical evaluation. Thus benign cycloid psychoses can be distinguished from malignant unsystematic schizophrenia.     

Hereditary and psychosocial causes of schizophrenia

On the basis of the examination of patients with endogenic psychosis, indications were obtained that there are forms that mainly develop on a hereditary basis, and forms determined by psychosocial causes. In unsystematic schizophrenia the chief factors are hereditary, above all in periodic catatonia. On the other hand, there are a few indications of a hereditary genesis in systematic schizophrenia although it is just these forms that are distinguished by the severity of their course. By studying twins, cases of schizophrenia in infancy, and the circumstances of brothers and sisters, strong indications of psychosocial causes of systematic schizophrenia were found. Lack of contacts in the course of development appears to the determing factor. In motility psychosis, one of the cycloid psychoses, indications were found that excessive encouragement by other children can be a cause of overstrain and thus may be detrimental. The conclusions drawn are based on concrete findings obtained in a total of 1,114 cases and are for the most part statistically significant.     

‘I Interact Therefore I Am’: The Self as a Historical Product of Dialectical Attunement

Topoi - In this article, moving from being to becoming, we construe the ‘self’ as a dynamic process rather than as a static entity. To this end we draw on dialectics and Bayesian...