장기 추적치료에 따른 정신분열증과 조울병의 진단변화에 대한 고찰

The Changes of Psychiatric Diagnoses During Long Term Follow-up：Schizophrenia or Manic Depressive Illness

This study attempted to offer more accurate differential diagnoses between schizophrenia and manic depressive illness. The study subjects were 12 cases of functional psychoses whose diagnosis had been changed more than 3 times during the courses of their illness. These patients had been admitted to the neuropsychiatric ward of Kyung Hee University Hospital from January 1，1981 to February 15, 1987. Hospital records of these patients were analized. The results were as follows * 1) Among 12 patients, several types of schizophrenia snd schizoaffective disorder were rediagnosed later as 9 manic depressive illness (8 manic, 1 depressive) and 3 schizo-affective disorders. But there was no case whose diagnosis had been changed from manic depressive illness to schizophrenia. 2) Schizophrenic symptoms decreased in frequency and were replaced by prominent affective symptoms during follow up. 3) The electric convulsive therapy was applied on 10 patients at initial stage of illness, and 9 were given lithium carbonate late. 4) The overall degree of psychosocial functioning and treatment outcome were judged to be above average. The results indicate that some group of manic depressive illness have prominent schizophrenic- like symptoms initially but later reveal typical affective features as the disorders progress and more accurate diagnosis of this group could be possible only by longitudinal follow up.