Original Article - Transition of Schizophrenia - Persistant Delusional Disorders / Tranzitia formelor in schizofrenie - tulburarea deliranta persistenta - Ion Papava, Ana-Cristina Bredicean, Sorana Raluca Papava, Mircea Lazarescu

Ion Papava *, Ana-Cristina Bredicean **, Sorana Raluca Papava ***, Mircea Lãzãrescu ****

 

Abstract:
Background: Current nosologies accept nonschizophrenic and inorganic psychotic disorders, besides schizophrenia and mood disorders. Today's researchers and clinicians focus more on the interference and transitions between schizophrenia and periodical affective disorders, rather than predominantly delusional psychosis. As is the case of the transition between schizophrenia and periodical affective disorders, which is assessed by episodes and schizo-affective disorder, the combination and transition between persistent delusional
disorder and schizophrenia can also be discussed.

Aim: This paper aims to focus on schizophrenia and persistent delusional disorder, as two distinct nosological entities, between which we expect to find an intermediate area populated by mental entities neglected by current nosologies and psychiatric approaches.
Method: There have been three specific batches of endogenous psychoses (schizophrenic patients, patients with persistent delusion and psychotic patients with intermediate symptoms to the first and second batches of patients) with a long evolution (over 15 years of cathamnesis), from a Case Register from the Timisoara Psychiatric Clinic. Each batch is comprised of 25 cases, which have been actively and prospectively studied by a team of specialists in terms of demographic, social and evolutionary perspective.
Results: A comparison of these three batches has revealed significant differences in the age of onset of the mental entities, employment, marital and evolutional status and, in particular, between the batches of patients with schizophrenia and persistent delusion. The batch comprising patients with intermediate symptoms is occupying an equidistant position between the two aforementioned batches, in terms of the track parameters value.

Conclusions: Schizophrenia and persistent delusional disorder are not identical and need to be studied separately. There is the possibility of intermediate nosological entities that need current psychiatric attention and further research studies.
Key words : continuum, distinction, boundaries,similarities.interval prolongation.


Rezumat:
Context: Nosologiile actuale acceptã pe lângã schizofrenie si tulburãri afective, tulburãrile psihotice neschizofrene  si neorganice. Cercetãtorii si clinicienii actuali discutã mult interferenta si tranzitiile dintre schizofrenie si tulburãrile afective periodice, dar foarte putin cu psihozele predominant delirante. La fel ca în cazul tranzitiei dintre schizofrenie si tulburãrile afective periodice care e comentatã prin episoadele si tulburarea schizo-afectivã, se poate pune problema combinãrii si tranzitiei dintre tulburarea delirantã persistentã si schizofrenie .
Obiectiv: În cadrul acestei lucrãri se încearcã o focusare pe schizofrenie si tulburarea delirantã persistentã ca douã entitãti nosologice distincte, între care ne asteptãm sã gãsim o zonã intermediarã populatã de entitãti psihice neglijate de nosologiile si abordãrile psihiatriei actuale.
Metoda: S-au evidentiat trei loturi de psihoze endogene (un lot de schizofreni, un lot de deliranti persistenti si un lot de psihotici cu  simptomatologie intermediarã între cea a celor douã loturi anterioare) cu evolutie îndelungatã (peste 15 ani de catamnezã), dintr-un registru de cazuri al Clinicii de Psihiatrie Timisoara. Fiecare lot cuprinde un numãr de 25 de cazuri ce au fost urmãrite activ, prospectiv de cãtre o echipã de specialisti în perspectivã demograficã, socialã si evolutivã.
Rezultate: Compararea celor trei loturi au relevat diferente semnificative privind vârsta de debut a entitãtilor psihice, statutul profesional, marital si evolutiv, în special între loturile de schizofreni si deliranti persistenti, lotul cu simptomatologie intermediarã ocupând o pozitie echidistantã între cele douã loturi mai sus mentionate, în ceea ce priveste valoarea parametrilor urmãriti.
Concluzii: Schizofrenia si tulburãrile delirante persistente nu se identificã si se cer studiate separat. Existã posibilitatea unei (unor) entitãti nosologice intermediare ce necesitã atentia psihiatriei actuale prin studii si cercetãri ulterioare.
Cuvinte cheie: continuum, granite, asemãnãri, distinctie. prelungirea intervalului QT.

 

 

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*,** University Lecturer, Department of Psychiatry, Victor Babes University of Medicine and Pharmacy, Timisoara and Mara Institute, Timisoara
*** Fourth year resident Eduard Pamfil Psychiatry Clinic, Timisoara Clinical Emergency City Hospital
**** University Professor, Department of Psychiatry, Victor Babeº University of Medicine and Pharmacy , Timisoara Correspondence to: Ion Papava, MD, Department of Psychiatry, University of Medicine and Pharmacy, 21 I. Vãcãrescu, Timisoara300128 Romania, e-mail: papavaion@yahoo.com

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