Data for a Comparative Account of Toxic Psychoses of Various Aetiologies

¹ Professor of Psychiatry, Novosibirsk Medical Institute, 52 Krasny Prospect, Novosibirsk 5, U.S.S.R.
² Novosibirsk Medical Institute, 52 Krasny Prospect, Novosibirsk 5, U.S.S.R.

We have investigated the clinical psychopathology of toxic psychoses of various aetiologies, and established the presence of certain disturbances common to all reactions of the exogenous type, as well as some psychological disorders that are to some extent specific for a particular type of intoxication.

The common features of all the psychoses we studied were disturbances on the basis of which it is customary to classify individual psychopathological syndromes. Disturbances of consciousness were observed in all the cases of intoxication under study.

Delirium syndromes were also observed in all cases. The specificity of toxic psychoses of various aetiologies was reflected in the time-course of the psychopathological syndrome. Atropine, astmatol and chloracyzin delirium were marked by initial stupefaction followed by the delirium syndrome. Tofranil, lead and alcohol delirium were not preceded by a stage of stupefaction.

The post-delirium stage of asthenia varied in duration and severity, depending on the toxic agent. It was most marked after lead delirium, and practically speaking absent after imipramine and alcohol delirium.

Investigations have demonstrated the specificity of both the psychopathological picture and the disturbances of autonomic function associated with various types of intoxication. Specificity is more marked when delirium syndromes due to chemically and pharmacodynamically dissimilar agents are compared (for instance, atropine and lead); the most closely related compounds produce the least distinctive pictures (atropine and astmatol). Differences in psychopathological symptoms were observed at different levels during toxic delirium syndromes—disorders of consciousness, of perception, and peculiarities of emotional reaction.

Investigation of the delirium syndromes provoked by alcohol and Tofranil in schizophrenic patients has led us to conclude that the underlying illness exerts a definite influence on the nature of the toxic delirium. This delirium was marked by features that were not characteristic of the classical delirium syndrome: the true hallucinations typical of this syndrome were accompanied by pseudo-hallucinations and by elements of psychic automatism. The degree of influence exerted by schizophrenic symptoms on the picture of delirium varied inversely with the severity of the delirium.

This article has been cited by other articles:

				R. C. W. Hall, M. K. Popkin, R. A. Devaul, L. A. Faillace, and S. K. Stickney Physical Illness Presenting as Psychiatric Disease Arch Gen Psychiatry, November 1, 1978; 35(11): 1315 - 1320. [Abstract] [PDF]