Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-27T14:36:23.780Z Has data issue: false hasContentIssue false

Anxiety as a Primary Symptom in Cycloid Psychosis

Published online by Cambridge University Press:  07 November 2014

Abstract

Psychotic anxiety has not been systematically included in standard psychopathologic and diagnostic literature, presumably because anxiety is implicitly perceived to be an emphatically comprehensible consequence of the cognitive symptoms of psychosis. This review gives an overview of neurophysiologic studies that indicate different pathogenic mechanisms for different types of psychosis. Convergent and complementary structural and functional imaging findings, biochemical and neuropsychological data allow conjecture as to neurophysiologic-psychopathologic links in cycloid psychosis. Intriguing results suggest that in cycloid psychosis, a generalized hyperasousal related to the tonus of the noradrenergic system may be the basic disturbance causing the delusionary and perceptual psychotic distortions. The findings are specific for cycloid psychoses, which are diagnosed as polymorphous psychosis in the International Classification of Diseases and Related Health Problems, 10th Edition. Furthermore, these findings are consistent with the author's hypothesis that the emotional derailment is the primary disturbance in cycloid psychosis (anxiety-elation). In contrast, cognitive disturbances are secondary and remit after the exceptional emotional state is rebalanced.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Mental and behavioural disorders: clinical descriptions and diagnostic guidelines. In: World Health Organization. Tenth Revision of the International Classification of Diseases (ICD-10). Chapter V (F). Bern, Switzerland: Huber; 1991.Google Scholar
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Ed. Washington, DC: American Psychiatric Press; 1994.Google Scholar
3.Westphal, C. Ueber die Verrücktheit. Zeitschr f Psych. 1878;34:252.Google Scholar
4.Magnan, V. Leçons cliniques sur les maladies mentales. 2nd Ed. Paris: Bataille; 1893.Google Scholar
5.Wimmer, A. Psykogene Sindsygdomsformer. In: Sankt Hans Hospitals 100-års-jubilaeumsskrift. Coppenhagen: Gad; 1916:85216.Google Scholar
6.Leonhard, K. In: Robins, E, ed. The Classification of Endogenous Psychoses. Fifth ed. New York, NY: Irvington Publishers Inc; 1979.Google Scholar
7.Heidrich, A, Strik, WK. Auditory P300 topography and neuropsychological test performance: evidence for left hemispheric dysfunction in schizophrenia. Biol Psychiatry. 1997;41:327335.Google Scholar
8.Ford, JM, White, PM, Csernansky, JG, et al.ERPs in schizophrenia: effects of antipsychotic medication. Biol Psychiatry. 1994;36:153170.CrossRefGoogle ScholarPubMed
9.Strik, WK, Fallgatter, AJ, Brandeis, D, et al.Three dimensional tomography of event-related potentials during response inhibition: evidence for phasic frontal lobe activation. Electroencephalogr Clin Neurophysiol. 1998;108:406413.CrossRefGoogle ScholarPubMed
10.Halgren, E, Stapleton, JM, Smith, M, et al.Generators of the human scalp P3(s). In: Cracco, Q, Bodis-Wollner, I, eds. Evoked Potentials. New York, NY: Alan Liss Publishers; 1986:269284.Google Scholar
11.Linden, DE, Prvulovic, D, Formisano, E, et al.The functional neuroanatomy of target detection: an fMRI study of visual and auditory oddball tasks. Cereb Cortex. 1999;9:815823.CrossRefGoogle ScholarPubMed
12.Morstyn, R, Duffy, FH, McCarley, RW. Altered P300-topography in schizophrenia. Arch Gen Psychiatry. 1983;40:729734.CrossRefGoogle ScholarPubMed
13.Strik, WK, Dierks, T, Franzek, E, et al.P300 asymmetries in schizophrenia revisited with reference-independent methods. Psychiatr Res. 1994;55:153166.CrossRefGoogle ScholarPubMed
14.McCarley, RW, Shenton, ME, O'Donnel, BF, et al.Auditory P300 abnormalities and left posterior superior temporal gyrus volume reduction in schizophrenia. Arch Gen Psychiatry. 1993;50:190197.CrossRefGoogle ScholarPubMed
15.Kügler, CFA, Taghavy, A, Platt, D. The event-related P300 potential analysis of cognitive human brain aging: a review. Gerontology. 1993;80:303.Google Scholar
16.Barbibeau-B, J, Picton, TW, Gosselin, JY. Schizophrenia: a neurophysiological evaluation of abnormal information processing. Science. 1983;219:874876.CrossRefGoogle Scholar
17.Blackwood, DHR, Whalley, LJ, Christie, JE, et al.Changes in auditory P3 event-related potential in schizophrenia and depression. Br J Psychiatry. 1987;150:154160.CrossRefGoogle ScholarPubMed
18.Kemali, D, Galderisi, S, Maj, M, et al.Lateralization patterns of event-related potential and performance indices in schizophrenia: relationship to clinical state and neuroleptic treatment. Int J Psychophysiol. 1991;10:225230.CrossRefGoogle ScholarPubMed
19.Roth, WT, Pfefferbaum, A, Horvath, TB, et al.P3 reduction in auditory evoked potentials of schizophrenics. Electroencephalogr Clin Neurophysiol. 1980;49:497505.CrossRefGoogle ScholarPubMed
20.Strik, WK, Dierks, T, Kulke, H, et al.The predictive value of auditory P300 on the course of schizophrenia. J Neur Transm. 1996;13511359.CrossRefGoogle Scholar
21.Maurer, K, Dierks, T, Ihl, R, et al.Mapping of evoked potentials in normals and patients with psychiatric diseases. In: Maurer, K, ed. Topographic Brain Mapping of EEG and Evoked Potentials. Berlin, Germany: Springer; 1989:329–335, 458473.CrossRefGoogle ScholarPubMed
22.Pfefferbaum, A, Wenegrat, BG, Ford, JM, et al.Clinical application of the P300 component of event-related potentials, I: normal aging. II: dementia, depression, and schizophrenia. Electroencephalogr Clin Neurophysiol. 1984:59(suppl):85124.Google Scholar
23.Ciesielski, KT, Beech, HR, Gordon, PK. Some electrophysiological observations in obsessional states. Br J Psychiatry. 1981;138:479484.CrossRefGoogle ScholarPubMed
24.Beech, HR, Ciesielski, KT, Gordon, PK. Further observations of evoked potential in obsessional patients. Br J Psychiatry. 1983;142:605609.CrossRefGoogle ScholarPubMed
25.Kutcher, SP, Blackwood, DHR, StClair, D, et al.Auditory P300 in borderline personality disorder and schizophrenia. Arch Gen Psychiatry. 1987;44:645650.CrossRefGoogle ScholarPubMed
26.Bauer, LO, O'Connor, S, Hesselbrock, VM. Frontal P300 decrements in antisocial personality disorder. Alcohol Clin Exp Res. 1994:18:13001305.CrossRefGoogle ScholarPubMed
27.Charles, G, Hansenne, M, Ansseau, M, et al.P300 in posttraumatic stress disorder. Biol Psychiatry. 1995;32:7274.Google ScholarPubMed
28.Brecher, M, Porjesz, B, Begleiter, H. Late positive component amplitude in schizophrenics and alcoholics in two different paradigms. Biol Psychiatry. 1987: 848856.CrossRefGoogle ScholarPubMed
29.Goodin, DS, Squires, KC, Starr, A. Long latency event-related components of the auditory evoked potential in dementia. Brain. 1978;101:635648.CrossRefGoogle ScholarPubMed
30.Roth, WT, Pfefferbaum, A, Kelly, AF, et al.Auditory event related potentials in schizophrenia and depression. Psychiatry Res. 1981;4:199212.CrossRefGoogle ScholarPubMed
31.Strik, WK, Dierks, T, Maurer, K. Amplitudes of auditory P300 in remitted and residual schizophrenics: correlations with clinical features. Neuropsychobiology. 1993;27:5460.CrossRefGoogle ScholarPubMed
32.Kathmann, N, Wagner, M, Rendtorff, N, et al.Information processing during eye tracking as revealed by event-related potentials in schizophrenics, alcoholics, and healthy controls. Schizophr Res. 1995;16:145156.CrossRefGoogle ScholarPubMed
33.Perris, C, Brockington, IF. Cycloid psychoses and their relation to the major psychoses. In: Perris, C. et al, eds. Biological Psychiatry. Amsterdam, The Netherlands: Elsevier; 1981:447450.Google Scholar
34.Strik, WK, Dierks, T, Franzek, E, et al.Differences in P300 amplitudes and topography between cycloid psychosis and schizophrenia in Leonhard's classification. Acta Psychiatr Scand. 1993;87:179183.CrossRefGoogle ScholarPubMed
35.Strik, WK, Ruchsow, M, Abele, S, et al.Distinct neurophysiological mechanisms for manic and cycloid psychoses: evidence from a P300 study on manic patients. Acta Psychiatr Scand. 1998;98:459466.CrossRefGoogle Scholar
36.Salisbury, DF, Shenton, ME, McCarley, RW. P300 topography differs in schizophrenia and manic psychosis. Biol Psychiatry. 1999;45:98106.CrossRefGoogle ScholarPubMed
37.Blumberg, HP, Stern, E, Ricketts, S, et al.Rostral and orbital prefrontal cortex dysfunction in the manic state of bipolar disorder. Am J Psychiatry. 1999;156:19861988.CrossRefGoogle ScholarPubMed
38.Warketin, S, Nilsson, A, Karlson, S, et al.Cycloid psychosis: regional cerebral blood flow correlates of a psychotic episode. Acta Psychiatr Scand. 1992;85:2329.CrossRefGoogle Scholar
39.Duncan, CC, Morihisa, JM, Fawcet, RW, et al.P300 in schizophrenia: state or trait marker? Psychopharmacol Bull. 1987;23:497501.Google Scholar
40.Coburn, KL, Shillcutt, SD, Tucker, KA, et al.P300 delay and attenuation in schizophrenia: reversal by neuroleptic medication. Biol Psychiatry. 1998;44:466474.CrossRefGoogle ScholarPubMed
41.Roth, WT, Horvath, TB, Pfefferbaum, A, et al.Late event-related potentials and schizophrenia. In: Begleiter, H, ed. Evoked Brain Potentials and Behaviour. New York, NY: Plenum Press; 1979:499515.CrossRefGoogle Scholar
42.Sabri, O, Erkwoh, R, Schreckenberger, M, et al.Correlation of positive symptoms exclusively to hyperperfusion or hypoperfusion of cerebral cortex in never-treated schizophrenics. Lancet. 1997;349:17351739.CrossRefGoogle ScholarPubMed