ABSTRACT
INTRODUCTION: The cycloid psychoses have not been included in the modern classifications-what makes scientific research difficult. The aim of the present study is to investigate the presence and specific characteristics of the cycloid psychoses in a broad sample of first psychotic episodes. METHODS: Seventy patients diagnosed with one-year first schizophrenia episode, schizophreniform disorder, or schizoaffective disorder were studied (mean age, 27.9 years old; SD±6.34). The detection of the possible cases of cycloid psychosis was done according to the Perris and Brockington operational criteria. Two groups of "cycloid" (n=11) and "non cycloid" (n=59) patients were compared according to demographic and clinical variables, and possible diagnostic variables were evaluated by the ROC curves. RESULTS: Significant differences were found between cycloid and non cycloid groups for a number of clinical variables: prodromic symptoms (p<0.001), PANSS total score (p=0.003), PANSS-P (p=0.009), PANSS-GP (p=0.001), total score for mania by EVMAC (p=0.001), and CDSS for depression (p=0.004). ROC curves were significant for PANSS-GP (AUC=0.791, p=0.002), EVMAC (AUC=0.938, p=0.001), and CDSS (AUC=0.770, p=0.005). A sensitivity/specificity study demonstrated a negative predictive value for PANSS-GP (93.88%), EVMAC (96.30%), and CDSS (93.88%). CONCLUSIONS: According to these results, cycloid psychoses might represent differentiated and well-defined clinical entity.
Subject(s)
Psychotic Disorders/diagnosis , Adolescent , Adult , Female , Humans , Male , Psychiatric Status Rating Scales , Psychotic Disorders/classification , Psychotic Disorders/psychology , Recurrence , Reproducibility of Results , Schizophrenia/classification , Schizophrenia/diagnosis , Schizophrenic Psychology , Sensitivity and Specificity , Sex Factors , Young AdultABSTRACT
La acumulación se presenta en un continuum desde la normalidad hasta un extremo patológico. Es importante distinguir entre las distintas patologías que se presentan con conductas de acumulación. El trastorno por acumulación es un subtipo de trastorno obsesivo-compulsivo caracterizado por la adquisición de objetos, la incapacidad para tirarlos y la acumulación. Los pacientes suelen desarrollar otros fenómenos obsesivos, sienten gran angustia si no acumulan, presentan un patrón cognitivo muy típico de características obsesivas y se relacionan interpersonalmente a través de los objetos. El síndrome de Diógenes se define como un abandono extremo del autocuidado, acumulación de basuras, negativa a ser ayudados y aislamiento social en pacientes de edad avanzada. Suelen presentar algún trastorno psiquiátrico y/o somático. La depresión y la demencia constituyen factores de riesgo para el autoabandono. El coleccionismo es un fenómeno normal, común en la población infantil, aunque también presente en adultos. Esta actividad suele estar organizada, guardando los objetos en lugares específicos y estructurados. Coleccionar tiene como fin organizar y jerarquizar una serie de objetos, no meramente acumularlos. Los objetos coleccionados a menudo son apreciados por otros coleccionistas, por lo que se convierten en moneda de cambio para constituir la colección
Hoarding of objects comprises a continuum from normality to extreme disease. It is important to distinguish between the different disorders that include hoarding behaviors. Compulsive hoarding is a form of obsessive-compulsive disorder (OCD) that is characterized by excessive acquisition of possessions, inability to discard possessions, and excessive clutter. Patients usually display other obsessive features, feel distress if they cannot hoard objects, show a typical cognitive pattern with obsessive features, and their interpersonal relations are mediated by objects. Diogenes syndrome is the combination of severe selfneglect, domestic squalor, social withdrawal, hoarding, and refusal of help, in elderly patients. There is high comorbidity with psychiatric/somatic disorders. Depression and dementia are risk factors for self-neglect. Collectionism is a normal phenomenon that is common in children but also found in adults. It is usually an organized activity, and the objects are kept in specific and structured places. The aim of collecting is to organize and hierarchize a series of objects, not just to hoard them. Collected objects are frequently appreciated by other collectors, and become exchanged to enlarge the collection
Subject(s)
Humans , Obsessive Behavior/complications , Obsessive-Compulsive Disorder/diagnosis , Diagnosis, Differential , Social Isolation/psychology , Self Care , Risk FactorsABSTRACT
Hoarding of objects comprises a continuum from normality to extreme disease. It is important to distinguish between the different disorders that include hoarding behaviors. Compulsive hoarding is a form of obsessive-compulsive disorder (OCD) that is characterized by excessive acquisition of possessions, inability to discard possessions, and excessive clutter. Patients usually display other obsessive features, feel distress if they cannot hoard objects, show a typical cognitive pattern with obsessive features, and their interpersonal relations are mediated by objects. Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, hoarding, and refusal of help, in elderly patients. There is high comorbidity with psychiatric/somatic disorders. Depression and dementia are risk factors for self-neglect. Collectionism is a normal phenomenon that is common in children but also found in adults. It is usually an organized activity, and the objects are kept in specific and structured places. The aim of collecting is to organize and hierarchize a series of objects, not just to hoard them. Collected objects are frequently appreciated by other collectors, and become exchanged to enlarge the collection.
Subject(s)
Food , Obsessive-Compulsive Disorder/diagnosis , Diagnosis, Differential , Humans , Obsessive-Compulsive Disorder/psychology , Severity of Illness Index , SyndromeABSTRACT
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