The paper presents contemporary international criteria for diagnosing schizophrenia, and two proposed approaches to their sub-classification. The first approach is based on the traditional schizophrenia subtypes, while the other on the so-called dimensions empirically revealed by means of factor analysis. Clinical scales most frequently wed to describe schizophrenic syndromes, and a frequency of clinically most significant groups of symptoms are presented as well.
Language pathology in schizophrenia is one of the key diagnostic criteria for this psychosis. Schizophasic phenomena seem to belong either to the positive syndrome of schizophrenia, or may be distinguished as a separate syndrome of schizophasia in the clinical picture of schizophrenia. Schizophasia in this sense results from incoherence of utterances and disorganization at the sentence (utterance) level.
The author presents current views and research findings concerning the etiopathogenesis of schizophrenia. Results of studies in molecular genetics, neurotransmission, brain development and structure are analyzed. On this background the vulnerability-stress conception is outlined, explaining interrelations between biological and environmental pathogenetic factors. (Ed.)
The CNS development at the cellular level is outlined and findings of neuroimaging and pathomorphological studies of the CNS in schizophrenic patients are discussed in the paper. Brain structure abnormalities noted in schizophrenia seem to be determined by disorders in the process of the CNS formation, especially of the migration stage of cells eventually forming the temporal lobe and frontal cortex structures. Presented data underpin the concept of neurodevelopmental determinants of some types of schizophrenia.
Basic premises and principles of antipsychotic drugs administration in schizophrenia are presented - the choice of drug, medication management, combined treatment. (Ed.)
Some concepts are presented focusing on psychodynamic and psychosocial factors important for the results of pharmacological treatment and prognosis in schizophrenia. Effective treatment of schizophrenic disorders over a long period of time requires a number of concurrent factors, including: a well-matched neuroleptic drug, a positive subjective interpretation of the medication effects by the patient, adequate (non-biological) therapeutic methods, and appropriate interventions aimed at the patient's psychosocial relations (the family, social environment). The aim of various concepts presented in the paper is to assess the role of each of these factors and to consider their mutual relations, with the focus on pharmacological treatment and subjective experiences of patients in the course of treatment.
The aim of this study was to assess changes in graphical representation of the patient's family after treatment of an episode of paranoid schizophrenia. The analyzed material consisted of 60 drawings of the family made by patients during a relapse (prior to treatment), 60 family drawings made in remission after an intense treatment, and 120 drawings by healthy controls. A modification of the Family Drawing Test, developed by the authors was used. In the first part of the study a formal analysis of the drawings was conducted, and in the second stage – post-treatment changes in anxiety, aggression and self-depreciation were assessed. In comparison to the control group, schizophrenic patients in pharmacologically induced remission indicated a decrease in the anxiety level (by over 50%), over a twice as high increase in aggression rate, and a significant decrease in self-depreciation.
Views on the etiology of catatonia are briefly outlined from the historical perspective, and then current theories of this disorder are presented. Moreover, the clinical picture of catatonic syndromes is discussed on the grounds of both an abundant literature of the subject and the most recent classification systems: ICD-10 and DSM-IV. The problem of diagnostics and management of catatonic states is discussed with a special emphasis on the application of Lorazepam as proposed recently in the treatment of catatonia.
The paper presents the case history and biography of Kazimierz Cytowicz, who took part in the national uprising of 1863 (so-called "January Uprising", against Russian occupation in the period of Poland's partition by the three neighboring countries). His illness, i.e. catatonic syndrome, was an insolvable mystery to the medical profession of that time. Thus, his case was presented to the highest medical authority of the Russian Empire – the Physicians' Council of the Medical Department at the Ministry of Internal Affairs. The case of Cytowicz illustrates the diagnostic and therapeutic difficulties, as well as clinical reasoning in the period preceding Kahlbaum. The paper is based on archival materials discovered by the author in archives of Moscow, Sankt-Petersburg and Vilnius. The biographical note of Cytowicz, due to his services to the cause of Poland's freedom was included in the Polish Biographical Dictionary. However, his biographic record is inaccurate, above all- because the most important aspect of his life, the illness, is omitted there, and so the whole tragedy of this Polish fighter for freedom is not shown. In the paper, due to the current accessibility of all archival sources, his life is fully described on a wide background of tsar's administration activities in the period following the January Uprising.
Brief notes on patients of the Cracow mental hospital, preserved from the early 19th century are presented together with data on basic principles of this institution functioning. Special attention is paid to the language used to describe the patients' mental states and behaviors.