Jönsson S A, Jonsson H, Nyman A K, Nyman G E
Department of Psychiatry and Neurochemistry, Lund, Sweden.
Acta Psychiatr Scand. 1991 May;83(5):353-62. doi: 10.1111/j.1600-0447.1991.tb05556.x.
A total of 154 patients admitted for the first time to hospital for a psychotic or affective disorder in 1925 were rediagnosed in accordance with DSM-III and Leonhard's diagnostic system. Symptoms were rated in accordance with a rating protocol containing 33 items based on Leonhard's descriptions of cycloid psychoses. The patients were followed up through parish registers and hospital records. Of 42 cases considered to be cycloid psychosis at index admission, 34 were prognostically verified. The symptom ratings of the 154 patients were analysed by K-means cluster analysis to test whether the patients with cycloid psychoses would separate from the rest of the material. With a 2-cluster solution, 30 of 34 cases (88%) were contained in the same cluster. The sensitivity of the ratings was therefore judged to be acceptable. Specificity was low, however, since 19 cases in the cluster were differently diagnosed. A subcohort of 64 patients, satisfying at least 5 items of the rating protocol, was then analysed by Q-factor analysis to test whether nuclear cases of cycloid psychosis differ from symptomatically related syndromes. No such differences could be statistically verified; no symptom profile specifically indicating cycloid psychosis could be found. Prominent confusion symptoms appear, however, to be prognostically favourable, whereas motility symptoms without confusion seem to indicate an unfavourable course.
1925年首次因精神障碍或情感障碍入院的154名患者，根据《精神疾病诊断与统计手册》第三版（DSM-III）和莱昂哈德诊断系统进行了重新诊断。症状根据一份包含33项内容的评定方案进行评分，该方案基于莱昂哈德对环性精神病的描述。通过教区登记册和医院记录对患者进行随访。在首次入院时被认为是环性精神病的42例病例中，有34例得到了预后验证。对154名患者的症状评分进行K均值聚类分析，以检验环性精神病患者是否会与其他病例区分开来。采用两聚类解决方案时，34例中的30例（88%）归为同一聚类。因此，评定的敏感性被认为是可以接受的。然而，特异性较低，因为该聚类中的19例病例诊断不同。然后，对至少满足评定方案5项内容的64名患者亚组进行Q因子分析，以检验环性精神病的核心病例是否与症状相关综合征不同。未发现此类差异具有统计学意义；未发现明确表明环性精神病的症状特征。然而，明显的意识模糊症状在预后方面似乎较好，而无意识模糊的运动症状似乎表明病程不佳。
