| dc.description.abstract | The problem of the classification of what are
generally designated the paranoid states of schizophrenia
has been discussed. In a brief historical
sketch some theories regarding the nature of the schizophrenic
and paranoid ps ychoseshay.e been reviewed, and
some of the more outstanding landmarks in the evolution
of our understanding of them has been dealt with. In
particular, reference has been made to the work of
Kraepelin, Bieuler,and Meyer and the more recent contri-
butions of Mapother, White, Macfie Campbell, and Henderson
and Gillespie . The division of this material into the
schizophrenic and paranoid reaction types following the
psychobiological approach has been considered the soundest
and the most practical basis for the differentiation
of cases and for a clearer understanding of their nature.
By comparing and contrasting these reaction types, from
the point of view of personality, reactive tendencies,
psychopathology, symptoms and course, important differ-
ences are brought out in the light of which the case
material is examined and reassessed. The problem resolved
itself into deciding to which of these reaction
types i.he paranoid states most closely approximate.
The relation of these states to the affective psychoses
has been examined, and their response to physical
methods of treatment, as shown by current literature,
considered
CONCLUSIONS:
(1) Paranoid states are more closely
allied to the paranoid reaction type than to the schizophrenic
reaction type for the following reasons:- -
(a) The pre -psychotic personality is rather differ-
ent from the schizoid type and approximates
more closely to the paranoid makeup, with fre-
quent appearance of latent homosexual trends.
(b) The social adaptability, as indicated by the
school and work record and general adjustment,
indicates a degree of maturity and personality
integration seldom found in pre -schizophrenic
states.
(c) The age of onset is usually later than in the
schizophrenic reaction type.
(d) The clinical picture is introduced by paranoid
delusions which continue dominant throughout
its course in contrast to the schizophrenic
reaction type, where delusions are secondarily
determined by affective delapidation.
(e) There is little to indicate personality disintegration
and mental deterioration after illnesses
of several years,of the kind that is
seen in the schizophrenic reaction type after
illnesses of two or three years and often very
much earlier.
(f) A common constellation of reactive tendencies
whose pattern is predominantly paranoid can be
traced throughout the life histories and psychotic
developments.
(2) Confirmation of the contention
that paranoid states involve a different process from
schizophrenia is obtained by a reference to the literature
in regard to the newer physical methods of treatment
in such conditions . There it is found that with
insulin, electric convulsions, and prefrontal leucotomy
the best results are claimed in the paranoid states.
(3) The association of paranoid and
affective disorders is here demonstrated, and it is
tentatively suggested that this association may be
stronger than has been generally realised. This relationship
may in part determine the more favourable
response to physical therapy so frequently found in
paranoid states. | en |
