SUGA Hidemichi Aichi Medical University, Dep.of Psychiatry, Lecturer, 医学部, 講師 (70187623)
OHARA Mitsugi Aichi Medical University, Dep.of Psychiatry, Professor, 医学部, 教授 (40065537)
|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1996 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1995 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1994 : ¥1,100,000 (Direct Cost : ¥1,100,000)
In order to reconsider atypical psychosis (Mitsuda) using ICD-10 criteria, we investigated 351 patients with psychotic symptoms, who were admitted to the psychiatric ward of Aichi Medical University Hospital from 1982 to 1991. These patients were diagnosed by the criteria of Mitsuda and ICD-10 (JCM : Japanese clinical modification), respectively, and the clinical features, family history and precipitating factors (judged to be colsely related to the onset of the illness) were examined. The results obtained are as follows.
1) Atypical psychoses in either criteria are mainly composed of acute transient psychotic disorder (F23) and schizoaffective psychosis (F25). However, there are some differences between the two diagnostic systems. Atypical psychosis (JCM) excludes and acute schizophrenia-like psychotic disorder (F23.2). On the other hand, Mitsuda's atypical psychosis includes these psychoses.
2) Schneider's first-rank symptoms are frequently found not only in schizophrenics but in atypi
cal psychotics. Auditory hallucinations and self-disturbances are more frequently encountered in schizophrenics, whereas delusional perception is more frequently found in atypical psychotics.
3) Atypical psychosis (Mitsuda) patients have more first-degree relatives with psychiatric disorders than schizophrenics. On the other hand, atypical psychosis (JCM) patients have significantly more relatives with psychiatric disorders, especially with affective disorders, than schizophrenics.
4) Precipitating factors were found more frequently in both categories of patients with atypical psychosis than in schizophrenics.
5) On the subdivisions of atypical psychosis, acute schizophrenia-like psychotic disorder (ICD : F23.2) patients have less family history than the other acute psychoses patients and schizophrenics, As for preipitating factors, they have them more frequently than the other acute psychoses patients, especially schizophrenics. On the contrary, patients with acute polymorphic psychotic disorder with symptoms of schizophrenia (F23.1) have more family history and fewer precipitating factors. Therefore, these two subtypes of atypical psychosis seem to have contrasting positions.
The present studies suggest that atypical psychosis is different disease entity from schizophrenia, and that this pyschosis is not homogeneous disease, therefore, further subclasification is warranted. Less