The role of psychotropic drugs in the insidious deconstruction of the Kraepelinian dichotomy.
62 patients suffering from mood disorders or schizophrenia diagnosed retrospectively according to DSM-4 as 295.xx or 296.xx were followed up by the author personally for 20 years. The DSM-IV diagnosis of schizophrenia (295.xx) was changed to a diagnosis of a mood disorder in 13 patients (26%). If schizoaffective disorder is classified as a mood disorder to form a group of periodic disorders, 41% of patients diagnosed as "pure" schizophrenia (295.xx without 295.70) at the start of the observation period were re-diagnosed as periodic disorder over 20 years. This "retrogression" of schizophrenia is seen as a result of the treatment with psychotropic drugs. The Kraepelian dichotomy is based on the relationship between the symptomatic pattern (syndrome) and the course of the illness. This relationship is disrupted by long-term treatment with psychotropic drugs.
Vinar
Oldrich
O
Private Psychiatric Practice, K Ovcinu 10, Prague 8, Czech Repubic. admed.vinar@ecn.cz
D014150:Antipsychotic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008134:Long-Term Care; D019964:Mood Disorders / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D010507:Periodicity; D011379:Prognosis; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs