Prolonged and chronic endogenous manic and manic-delusional states (psychopathology, typology, dynamics, clinic)

Abstract

A clinical and psychopathological analysis, nosological differentiation of prolonged and chronic manic and manic-delusional states (PMDS) within the framework of the paroxysmal course of endogenous psychoses, determination of the patterns of their development, diagnostic criteria and prognosis. The study included 76 female patients (average age 37.2±8.3 years) who were hospitalized for endogenous mental illnesses with a paroxysmal course that occurred with the clinical picture of PMDS. The patients were divided into two groups: clinical (n=43) and follow-up (n=33). Clinical-psychopathological, clinical-follow-up, psychometric, statistical methods were used. A clinical and dynamic typology of PMDS has been developed, according to which 2 groups have been identified: «monomorphic» PMDS and «polymorphic» PMDS. «Monomorphic» PMDS included 2 subtypes - «acute» and «chronified» and were characterized by the same clinical picture that remained unchanged throughout, while «polymorphic», which also included 2 subtypes - «developing» and «double mania subtype», were characterized by the variability of clinical picture. «Acute» and «developing» subtypes of PMDS predominantly developed in schizoaffective psychosis and bipolar disorder; the «chronified» subtype and the «double mania» subtype were more often observed within the framework of the schizoaffective variant of paroxysmal-progressive schizophrenia. The clinical and dynamic structure of PMDS is heterogeneous and differs in psychopathological structure, as well as in the level of stability of symptoms and characteristics of its course. The developed clinical typology of PMDS is prognostically significant and provides information about the further dynamics of the disease.