편집형 정신분연증 양상으로 시작된 조울병 3례

THREE CASES OF MANIC DEPRESSIVE ILLNESS ANTECEDED BY PARANOID SCHIZOPHRENIC PICTURES

Inspite of the fact that prognosis of schizophrenia has been increasingly interested in the field of clinical psychiatry, few studies have been reported on the changeability of schizophrenia into the other type of psychosis, especially manic depressive illness. The authors tried to prove the possibility that typical schizophrenia could be shifted into typical manic depressive illness by a clinical study of three cases. Three cases of manic depressive illness wero examined who had been diagnosed as acute paranoid schizophrenia. Diagnosis was made in the DSM-1. It was obviously confirmed that the three cases of acute paranoid schizophrenia had shifted into two cases of cyclic type and one case of depressive type of manic depressive illness. Clinical characteristics of the cases were as follows; a) intial diagnosis of all cases was acute paranoid schizophrenia with systematic persecutory delusion, b) apparent affective picture could be seen even in the acute schizophrenic phase secondary to schizophrenic thinking disorders, c) there were noticed mixed symptoms during the period of typical schizophrenic phase shifting into manic depressive one, d) abrupt Onset, short duration of active illness and continuing recurrence were the common pictures. Three Speculative but possijbje factors in shifting of schizophrenia into manic depressive illness were discussed,； a ) psychpdynamic reasons, insight and stigmata of insanty, b) biochemical change due to antipsychotics, c) changeability of schizopitrenia per se into manic depressive illness. The reason of shifting in disease entity and changeability of other types of schizophrenia would be interestingly suggested for the futnre study