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Indian Journal of Psychiatry
Medknow Publications
Publication Date
  • Original Article
  • Medicine


Indian J. Psychiat., (1981), 23(3), 200—205 ACUTE SCHIZOPHRENIC EPISODES—ARE THEY SCHIZOPHRENIC? GURMEET SINGH1, M.R.C. Psy., Dip. Psych. (McGill), D.P.M. (Lond.), Diplomate American Board of Psy. and Neur. J . S. SACHDEV, M.D. The diagnosis and nosology of Psy- chotic disorders have been matters of interest and debate since Kraeplin 's original delineation of Manic depressive illness and schizophrenia. Although in the past, it was largely of academic interset, the accurate classification of these disorders has assumed greater importance with the availability of newer and more specific treatments for the psychoses. About fifty years after its introduction by Bleuler (1924), acute schizo- phrenia remains a diagnostic label without a disease. Bleuler's term arose from his observation that individuals with an acute onset of typical schizophrenic symptoms did not necessarily have a deterioratory course, as had been suggested by Kraeplin, and that nearly 25 per cent remitted. I .C.D.-8 and I.C.D.-9 have defined acute schizophrenic episodes as a type of schizophrenia but DSM I I I rules out the very existence of acute schizophrenia by the requirement of a minimum durat ion of symptoms of six months. Tayler et al. (1974) examined twenty-six consecutive patients who had a diagnosis of acute schizo- phrenia and found that only one patient satisfied research criteria of schizophrenia and half of the sample satisfied research criteria for mania. Tsuang et al. (1976), Fowler (1978) and Coryell and Tsuang (1979) also suggest that so-called atypical or good prognosis schizophrenics have close similarity to affective disorders. Hirschowitz et al. (1980) tried Lithium in good prog- nosis schizophrenia and found that one third of patients showed reduction of their schizophrenia like symptoms during the Lithium trial. M a n y authors have described patients with schizophrenias with acute onset whose illness ended in recovery. Kasamin 's schizo- affective schizop

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