Clinical Pictures of Phasic Psychoses (without Cycloid Psychoses)

Abstract

Until very recently nearly all psychiatrists were united in the opinion that manic and depressive disease pictures were all part of manic-depressive illness. It was the work of ANGST (1966) and PERRIS (1966) that helped spread my theory that unipolar and bipolar diseases were separable. I carried out my first investigations together with NEELE. KLEIST (1943), with whom we were working, shared my opinion. Previously, KLEIST had claimed that there was no independent manic-depressive illness, but rather only melancholia and mania with a certain reciprocal affinity. Thus he had already postulated the independence of the unipolar forms, but had gone too far by denying the independent existence of manic-depressive illness. The genetic difference between the unipolar and bipolar forms was seen in that the manic-depressive form had a significantly higher rate of psychoses among relatives than did unipolar forms. WINOKUR (1969) and others followed in this line of thinking. However the two disease forms also have different clinical pictures. The bipolar form displays a considerably more colorful appearance; it varies not only between the two poles, but in each phase offers different pictures. The unipolar forms, of which there are several (ANGST, PERRIS, WINOKUR do not treat this) return, in a periodic course, with the same symptomatology.