Du rattachement des bouffées délirantes chez l'adolescent aux troubles bipolaires dans leurs variantes psychopathiques

Abstract

Out of a series of patients coming to the psychiatric emergency ward of a general hospital in the Paris area serving a population of around 200,000 inhabitants we managed to spot a group of young adults presenting a marked agitation accompanied with psychotic manifestations for which the usual diagnosis is that of paranoid schizophrenia. We re-considered interesting to start giving diagnoses of polymorph delirious episode as temporary diagnoses in emergency psychiatrics with the aim of studying the semiotics and mode of evolution and with the hope of resolving the nosological problem this has set. We realised that the origin of these disorders seems to arise, more often than expected, from bipolar disorder than from schizophrenia. We learned to get the most out of certain clinical characteristics of these delirious episodes and we realized that psychiatric treatment and decisions of hospitalisation often produced delinquent behavior, drunkenness, and strong reticence. On the therapeutic level, we were surprised by the relevance of using new generation anti-psychotics in association with normothymic drugs. Finally, some of our diagnostic errors were due to under-evaluating the importance of certain clinical forms of bipolar disorders, more particularly their psychopathic variants.