Follow-up study of hysterical psychosis, reactive/psychogenic psychosis, and schizophrenia

The present study was undertaken to learn more about the longer-term course of nonaffective functional psychoses, including hysterical psychosis. A group of 48 female patients diagnosed with hysterical psychosis, nonhysterical reactive/psychogenic psychosis, and schizophrenia at their first admission were reassessed after an average follow-up period of 11.6 years. Seventy-five percent were receiving outpatient treatment; less than half were on neuroleptics, and only 35% were rehospitalized. The patients suffered from a few, mostly unspecific, symptoms and were relatively well adjusted socially. No differences were found between original diagnostic categories regarding all variables studied. Hysterical psychosis does not appear to be a special clinical entity, distinguishable from other reactive/psychogenic psychoses in the short term and from other nonaffective functional psychoses in the longer term. The symptomatology and clinical presentation of nonaffective functional psychoses at first admission do not allow any prognostic longer-term forecast, and the initial differences between individual psychoses tend to disappear over time.