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Course of atypical psychoses]
Authors:G Hofmann  J Grünberger  H Hofmann
Abstract:An attempt was made to classify the atypical psychoses according to cross-sectional psychopathological criteria. We were able to separate two groups from a group of benign schizophrenics. The latter served more as a comparison group and were in every way similar to the nuclear group, except for a better social prognosis. Group C (atypical manic depressive illnesses) which was closer to manic depressive illness than the other two groups, differs from it by thought disorders and delusional experiences. In the further course of the illness, after a few schizophrenic symptoms had appeared once or repeatedly during the acute stage, the typical features of manic depressive illness came more and more to the fore. In group A (mixed psychotic syndrome) manic depressive and schizophrenic symptom complexes appeared for quite some time during the acute stage with approximately equal clarity and significance. In the further course, during which manic depressive phases as well as schizophrenic thrusts can make their appearances, one can often see the development of a 'hypomanic defect'. Systematised delusions, as well as grimacing and circumstantiality, can also persist frequently. On the whole, however, it is difficult to recognize the defect states from their original state once the illness has settled down. A classification of the atypical psychoses and their differentiation from typical manic depressive illness or nuclear schizophrenia is necessary, at least, because of the worse, respectively better, social prognosis of the atypical psychoses. This investigation should be continued further by using as control groups bi- and unipolar affective psychoses and nuclear schizophrenics with a severe course. The subgroups of the atypical psychoses will be used to evaluate different long-term therapies in a further study.
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