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Cycloid Psychoses—Endogenous Psychoses which are neither Schizophrenic nor Manic-Depressive^*

Humboldt University, Berlin

^* Lecture given at the Royal Edinburgh Hospital for Nervous and Mental Disorders on 27 June, 1960, at the invitation of Dr. T. A. Munro. The author wishes to thank Dr. Frank Fish, Senior Lecturer, Department of Psychological Medicine, University of Edinburgh, for the translation.

ABSTRACT

A group of acute recoverable psychoses is described, which, in the opinion of the author, are neither manic-depressive nor schizophrenic. These cycloid psychoses can be classified into three subgroups—motility psychosis, confusion psychosis and anxiety-elation psychosis. They are all bipolar illnesses in that two contrasting clinical states may occur at different times. In motility psychosis hyperkinesia and akinesia occur but there is no admixture of hyperkinetic and akinetic features as in periodic catatonia. The hyperkinetic movements are reactive and expressive and are carried out in the usual smooth manner. Confusion psychosis is characterized by incoherent thinking. In the excited phase there is pressure of talk and misidentification while in the inhibited phase there is retardation or even stupor associated with ideas of reference and significance. States of anxiety and of elation occur in anxiety elation psychosis. In the states of anxiety ideas of reference occur while in the elated states expansive ideas occur and usually there is a desire to make others happy. The three subgroups are not sharply delimited from each other, so that over lapping clinical pictures occur. These psychoses are associated with a good prognosis. Sometimes it is difficult to differentiate them from schizophrenia. In that case the schizophrenic illness belongs to the author's non-systematic group, i.e., periodic catatonia, schizophasia and affect laden paraphrenia, which has a better prognosis than the systematic group of schizophrenia.