Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-02T19:08:29.587Z Has data issue: false hasContentIssue false

The course and outcome of cycloid psychosis

Published online by Cambridge University Press:  09 July 2009

I. F. Brockington*
Affiliation:
Institute of Psychiatry, London
C. Perris
Affiliation:
Institute of Psychiatry, London
R. E. Kendell
Affiliation:
Institute of Psychiatry, London
V. E. Hillier
Affiliation:
Institute of Psychiatry, London
S. Wainwright
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr I. F. Brockington, Department of Psychiatry, University of South Manchester, West Didsbury, Manchester M20 8LR.

Synopsis

Thirty patients with cycloid psychosis were found among 244 general psychotic and schizo-affective patients studied in London. The main clues to the diagnosis were the presence of ‘confusion’, a pleomorphic clinical picture or an acute onset. Most of the patients were classified as schizophrenic by British psychiatrists and the Catego system, and as schizo-affective or mood-incongruent affective psychotics by the American Research Diagnostic Criteria and DSM-III. There was little overlap between the cycloids and any Anglo-American category, and cycloid psychosis is not synonymous with schizo-affective psychosis. The outcome of the cycloids was better than that of psychotic patients as a whole, and much better than schizophrenia as defined by Catego, Schneider's, Langfeldt's or Carpenter's rules, or by the guidelines set by the International Classification of Diseases. Compared with manic-depressive patients (defined by the presence of mania at some stage), cycloids had more schizophrenic and fewer depressive and manic symptoms. There was a negligible concordance between the diagnosis of cycloid psychosis and the final diagnosis of manic-depressive disease. It is concluded that these patients should not be diagnosed as schizophrenic, but that the relation of cycloid psychosis to manic-depressive disease is not yet resolved.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1982

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

REFERENCES

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn). APA: Washington, D.C.Google Scholar
Anderson, E. W. (1937). A clinical study of states of ‘ecstasy’ occurring in affective disorders. Journal of Neurology, Neurosurgery and Psychiatry 1, 8099.CrossRefGoogle Scholar
Brockington, I. F., Kendell, R. E. & Leff, J. P. (1978 a). Definitions of schizophrenia: concordance and prediction of outcome. Psychological Medicine 8, 387398.CrossRefGoogle ScholarPubMed
Brockington, I. F., Kendell, R. E., Kellett, J. M., Curry, S. H. & Wainwright, S. (1978 b). Trials of lithium, chlorpromazine and amitriptyline in schizoaffective patients. British Journal of Psychiatry 133, 162168.CrossRefGoogle ScholarPubMed
Brockington, I. F., Wainwright, S. & Kendell, R. E. (1980 a). Manic patients with schizophrenic or paranoid symptoms. Psychological Medicine 10, 7383.CrossRefGoogle ScholarPubMed
Brockington, I. F., Kendell, R. E. & Wainwright, S. (1980 b). Depressed patients with schizophrenic or paranoid symptoms. Psychological Medicine 10, 665675.CrossRefGoogle ScholarPubMed
Carpenter, W. T., Strauss, J. S. & Bartko, J. J. (1973). Flexible system for the diagnosis of schizophrenia: report from the W.H.O. Pilot Study of Schizophrenia. Science 182, 12751278.CrossRefGoogle Scholar
Cooper, J. E., Kendell, R. E., Gurland, B. J., Sharpe, L., Copeland, J. R. M. & Simon, R. (1972). Psychiatric Diagnosis in New York and London. Oxford University Press: London.Google Scholar
Cutting, J. C., Clare, A. W. & Mann, A. H. (1978). Cycloid psychosis: an investigation of the diagnostic concept. Psychological Medicine 8, 637648.CrossRefGoogle ScholarPubMed
Helzer, J. E., Brockington, I. F. & Kendell, R. E. (1981). The predictive validity of DSM-III and Feighner definitions of schizophrenia: a comparison with R.D.C. and Catego. Archives of General Psychiatry 38, 791797.CrossRefGoogle Scholar
Kasanin, J. (1933). The acute schizoaffective psychoses. American Journal of Psychiatry 13, 97126.CrossRefGoogle Scholar
Kendell, R. E. & Brockington, I. F. (1980). The identification of disease entities and the relationship between schizophrenic and affective psychoses. British Journal of Psychiatry, 137, 324331.CrossRefGoogle ScholarPubMed
Langfeldt, G. (1960). Diagnosis and prognosis in schizophrenia. Proceedings of the Royal Society of Medicine 53, 10471052.CrossRefGoogle ScholarPubMed
Leonhard, K. (1961). Cycloid psychoses–endogenous psychoses which are neither schizophrenic nor manic depressive. Journal of Mental Science 197, 632648.Google Scholar
Perris, C. (1973). Cycloid psychoses: historical background and nosology. Sartryck ur Nordisk Psykiatrisk Tidsskrift 27, 369378.CrossRefGoogle Scholar
Perris, C. (1974). Study of cycloid psychosis. Acta psychiatrica scandinavica. Supplement 253.CrossRefGoogle Scholar
Schneider, K. (1959). Clinical Psychopathology (trans. Hamilton, M. W.), pp. 133134. Grune & Stratton: London and New York.Google Scholar
Spitzer, R., Endicott, J. & Robins, E. (1975). Research Diagnostic Criteria. Instrument no. 58. New York State Psychiatric Institute: New York.Google ScholarPubMed
Wing, J. K., Birley, J. L. T., Cooper, J. E., Graham, P. & Isaacs, A. (1967). Reliability of a procedure for measuring and classifying present psychiatric state. British Journal of Psychiatry 113, 499515.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar