A Phenomenological Overview of Trance

The clinical features of postpartum psychoses

The concept of autism has changed across time, from the Bleulerian concept, which defined it as one of several symptoms of dementia praecox, to the present-day concept representing a pervasive development disorder. The present theoretical contribution to this special issue of EJN on autism introduces new theoretical ideas and discusses them in light of selected prior theories, clinical examples, and recent empirical evidence. The overall aim is to identify some present challenges of diagnostic practice and autism research and to suggest new pathways that may help direct future research. Future research must agree on the definitions of core concepts such as autism and psychosis. A possible redefinition of the concept of autism may be a condition in which the rationale of an individual's behaviour differs qualitatively from that of the social environment due to characteristic cognitive impairments affecting reasoning. A broad concept of psychosis could focus on deviances in the experience of reality resulting from impairments of reasoning. In this light and consistent with recent empirical evidence, it may be appropriate to redefine dementia praecox as a developmental disorder of reasoning. A future challenge of autism research may be to develop theoretical models that can account for the impact of complex processes acting at the social level in addition to complex neurobiological and psychological processes. Such models could profit from a distinction among processes related to (i) basic susceptibility, (ii) adaptive processes and (iii) decompensating factors involved in the development of manifest illness.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/ejn.13599

Autism: a transdiagnostic, dimensional, construct of reasoning?

Two groups of patients in disturbed states of consciousness (DSC's) were compared with three groups of patients in clear states of consciousness (CSC's): demented, schizophrenic, and non-psychotic patients. In each of the groups, 15 patients were evaluated for 21 "objective" symptoms; each patient was evaluated by two psychiatrists. In this way, reliable symptoms were sought out which could discriminate: 1) elderly patients in DSC's from elderly demented but clear patients; and 2) schizophrenic patients from patients in DSC's caused by either withdrawal states after abuse of alcohol or barbiturates, or psychogenic psychoses. Reliable and discriminating symptoms were found. However, different symptoms discriminated when patients in different diagnostic groups were compared. Three kinds of discriminating values of a symptom may be distinguished from one another: 1) only the presence of a symptom is informative; 2) only its absence is informative; 3) both presence and absence of the symptom are informative.

Empirical investigations on the reliability and the value for differential diagnosis of 21 clinical symptoms of disturbed states of consciousness.

Prior experiences and delusion content The Italian pilot study by Catone and colleagues (2) in this issue focuses on the relationship between stressful experiences and delusion content in adolescents with psychotic disorders. The authors hypothesize that a biographic continuity or “thematic link” can develop between the themes of previous life experiences and the content of a patient’s delusions. They examine the relationship between the prior experiences and delusions of a sample of 16 patients experiencing their first psychotic episodes. The researchers expected to find a statistically significant association between past experiences and psychotic symptom content, and they did discover a significant association between humiliating experiences and persecutory delusions. The authors suggest that the thematic link concept may provide clinicians with a greater awareness of the patient’s thoughts and emotions and that addressing past experiences and linking them to emerging or consolidated delusions may make experiences like bullying less frightening for the patient.

/pdf/rethinking-the-concept-of-psychosis-and-the-link-between-4vr82um4nu.pdf

Rethinking the Concept of Psychosis and the Link Between Autism and Schizophrenia

A theoretical analysis is made of the two concepts: “disturbed state of consciousness” (DSC) and “psychosis”, and these concepts are defined in ways which are consistent with actual clinical psychiatric work on the Continent.



Concerning DSC's two points are emphasized: Whether we, as psychiatrists, are conscious of it or not - one of our premisses for classifying a state as a pathological DSC is an evaluation of the client's ability to change the state voluntarily. Furthermore, stating that a DSC was present in the time interval t1-tn implies stating that all experiences were abnormal in some way during the interval - when the word “experience” is taken in the broad sense, including William James' “fringe” and “embeddedness” in the stream of consciousness.



Reality testing may remain the cardinal point in the definition of “psychosis” - if we make the distinction between theoretical, “fullblown”, syndromes and concrete syndromes with fewer symptoms clear to ourselves.

The concepts: disturbed state of consciousness and psychosis

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The concepts: disturbed state of consciousness and psychosis