조증에서의 정신병적 증상

Psychotic Features in Mania

In order to evaluate the nature, severity and characteristics of psychotic symptoms in mania, we investigated 22 manic patients with psychotic features and also 22 manic patients without psychotic features and 22 schizophrenics as control group. All of these patients were assessed with SADS (Schedule for Affective Disorders and Schizophrenia) at admission and two months later. The results were as follows ; 1) At admission, manic patients with pschotic features and schizophrenics showed similar scores on the following items 5 ie delusion of reference, delusion of being controlled, mind being read, thought broadcasting and the severity of delusions. Two months later, the total severity of delusions-hallucinations were significantly greater in schizophrenics than in manic patients with psychotic features(p<C0.05). 2) Manic patients with psychotic features showed significantly higher scores on the items of loss of sleep, usually energetic, increased activity, grandiosity, speeded thinking, and poor judgement than manic patients without psychotic features at admission and two months later (p<0.05). 3) Flight of ideas was significantly greater in the manic patients with psychotic features than in schizophrenics(p<C0.001). Incoherence, loosening of associations, illogical thinking, and neologisms occured in manic patients with psychotic features as frequently as in schizophrenics. Poverty of content of speech was significantly greater in schizophrenics than in manic patients with psychotic features(p<0.001). 4) In manic patients with psychotic features, treatment responses were significantly better than in schizophrenics(p<0.001), but poorer than in manic patients without psychotic features ( p < 0 .0 1 ) . 5) Manic patients have more alcoholics in their first-degree relatives than schizophrenic group. These results suggest that the manic with psychotic features is a distinct diagnostic entity from schizophrenia, and a more severe form of mania.