ABSTRACT
Schizo-affective psychoses lead more often to reintegration of the paranoid-hallucinatory pattern than schizophrenic psychoses. The author interprets schizo-affective psychoses in the light of his systematic psychopathology and concludes that excitation is intensified in comparison with cyclothymia. Ego destruction is more serious, but paranoid manifestations decrease in the course and emotional syndromes become more pronounced. Prognosis depends on the intensity of therapeutic efforts in the sense of psychopharmacological and supportive therapies and is not prestabilized.
Subject(s)
Psychotic Disorders/diagnosis , Bipolar Disorder/diagnosis , Cyclothymic Disorder/diagnosis , Diagnosis, Differential , Humans , Paranoid Disorders/diagnosis , Psychotic Disorders/psychology , Schizophrenia/diagnosisABSTRACT
Total CK and CK-MB (by the inhibition test, Merck-1-CK-MB) were measured in 33 patients which had to be admitted to the department of psychiatry due to acute withdrawal symptoms (predelirium, delirium) caused by chronic alcohol abuse. The results were evaluated together with the routinely performed laboratory determinations as well as clinical examination and morphologic investigations (ECG, X-ray examination of the thorax, EEG, CT). The results show that the CK-MB/total CK relationship represents also in these patients the most reliable parameter to discriminate elevated total CK values. In no but one case a substantial CK-BB release from the central nervous system could be demonstrated by the inhibition test. In 83% of the patients with elevated total CK activities it was possible to exclude an affection of the heart muscle (CK-MB portion below 6%). The CK-MB/total CK-quotient was clearly superior to the total CK/GOT relationship, by which a myocardial affection could be excluded in less than 40%. In four patients the CK-MB portion was above the critical decision limit of 6%: three obtained between 6% and 7%, one even 17%. The results suggest that the CK-MB/total CK-quotient may represent the most sensitive and reliable parameter of myocardial affection in patients with an alcohol intoxication and/or a delirium tremens.
Subject(s)
Alcohol Withdrawal Delirium/diagnosis , Clinical Enzyme Tests , Creatine Kinase/blood , Psychoses, Alcoholic/diagnosis , Acute Disease , Adult , Alcohol Withdrawal Delirium/enzymology , Diagnosis, Differential , Female , Humans , Isoenzymes , Male , Middle Aged , Psychiatric Status Rating Scales , Substance Withdrawal Syndrome/diagnosisABSTRACT
In endogenous depression a neurasthenic syndrome is partially included. In 100 male cases whose diagnoses merely stated "endogenous depression" without further remarks like "neurotic traits" or "reactive influences", we found in 48 cases a clear neurasthenic syndrome. It is suggested that these symptoms often lead to the diagnosis of endogenous depression. Pharmacotherapy is partially directed to the neurasthenic condition. Hereditary factors may play a part in the unability of the later endogenous depressive to relax.
