Cycloid psychoses: Leonhard´s descriptions revisited
2012
Background and Objectives: Cycloid psychoses are characterized by polymorphic
symptomatology with intraphasic bipolarity, a remitting and recurrent course and
favourable prognosis. Perris and Brockington (P&B) described the first set of operational
criteria that were partly incorporated in ICD-10. The present study investigates psychopathological
profiles according to the P&B criteria and the original descriptions by
Leonhard, both against the background of the criteria from the prevailing international
classification systems.
Methods: Eighty patients with psychotic disorders were recruited and assessed with
various psychometric instruments at baseline and after six weeks of antipsychotic treatment
in order to investigate the presence of cycloid psychoses according to Leonhard
(LCP) and the effect of treatment with antipsychotics. The overlap between LCP and
DSM-IV Brief Psychotic Disorder (BPD), ICD Acute Polymorphic Psychotic Disorder
(APP) and P&B criteria was calculated
Results: Using P&B criteria and a symptom checklist adapted from the original descriptions
by Leonhard, 14 and 12 cases of cycloid psychosis were identified respectively
reflecting a prevalence of 15-18%. Small though significant concordance rates were found
between LCP and both DSM-BPD and ICD-APP. Concordance between LCP and P&B
criteria was also significant, but modest.
Conclusions: This study demonstrates that LCP can be identified in a substantial number
of patients with psychotic disorders. Cycloid psychoses are not adequately covered in
current classification systems and criteria. Since they are demonstrated to have a specific
psychopathological profile, relapsing course and favourable prognosis, it is advocated to
include these psychoses in daily differential diagnostic procedures.
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