Evidence for unaltered brain electrical topography during prefrontal response control in cycloid psychoses

Ehlis, Ann‐Christine; Zielasek, Jürgen; Ringel, Thomas M.; Jacob, Christian; Wagener, Annika; Fallgatter, Andreas J.

doi:10.1016/j.ijpsycho.2004.07.010

Cited by 9 publications

(6 citation statements)

References 69 publications

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“…In light of the fact that, so far, treatment guidelines are mainly based on pragmatic considerations (Leucht more severe frontal lobe defi cits in patients suffering from chronic as compared to phasic forms of the disease, particularly with respect to the parameter of the NGA (e.g., Ehlis et al 2005b). However, the present results do not replicate this fi nding, as chronic and phasic courses of the illness were equally distributed across all four study groups, including both frontal lobe groups ( χ 2 ϭ 3.39, P ϭ 0.34).…”

Section: Discussionmentioning

confidence: 99%

Hypofrontality in schizophrenic patients and its relevance for the choice of antipsychotic medication: An event-related potential study

Ehlis¹,

Pauli

Plichta

et al. 2011

The World Journal of Biological Psychiatry

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Section: Discussionmentioning

confidence: 99%

Hypofrontality in schizophrenic patients and its relevance for the choice of antipsychotic medication: An event-related potential study

Ehlis¹,

Pauli

Plichta

et al. 2011

The World Journal of Biological Psychiatry

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“…In studies with auditory evoked responses, patients with cycloid psychosis had normal latencies but higher amplitudes, suggesting a greater level of activation (25)(26)(27). On an electrophysiologically monitored continuous performance test, 37 patients with cycloid psychosis showed reduced global field power and decreased latencies during no-go trials compared with 37 healthy control subjects, suggesting a frontalization of the brain electrical field in cycloid psychosis (5).…”

Section: Pathophysiologymentioning

confidence: 96%

“…The illness is quite cyclical, in this case occurring every 1-2 years in the late fall or early winter, even at different latitudes (south and north of the Tropic of Cancer). While superficially these individual symptoms appear in both bipolar illness and schizophrenia, studies examining biological markers (2)(3)(4)(5) or diagnostic specificity (6, 7) consistently demonstrate that cycloid psychosis is distinct from both schizophrenia and affective disorders, but perhaps with more similarities to the mood disorders (8). However, family members of patients with cycloid psychosis are not at an increased risk for severe psychiatric illness, with their risk being similar to that of non-ill comparison subjects (9,10).…”

Section: The Classification Of Cycloid Psychosismentioning

confidence: 99%

Cycloid Psychosis

El‐Mallakh

Furdek

2018

AJP

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What clinical feature has been associated with cycloid psychosis? A. Frequently occurring sleep disturbances. B. Acute stress. C. Disorganized thought. D. Prodromal symptoms."Ms. A," a 27-year-old Army captain with 5 years of service, was on her third overseas combat deployment in less than 4 years when she developed psychosis characterized by sudden onset of paranoia, sense of failure, delusional guilt, withdrawal from those around her, difficulty articulating, and an initial inability to sleep. Her commander stated that her previous level of functioning was very high and that she had been a top-performing soldier. The onset of this psychosis was sudden and was not associated with energy disturbance or mood disturbance, and it was independent of any change in stressors (the severe stress of the combat setting was relatively constant). She was initially treated for heat exhaustion, but when the symptoms did not resolve, she was started on olanzapine (5 mg/day) and then switched to risperidone (2 mg/day). She was evacuated to Europe, where she recovered within 1 week on a psychiatric ward and was diagnosed as having brief psychotic disorder. She was subsequently evacuated to a psychiatric ward in the United States, and, 3 weeks later, to her home base for further observation and outpatient care. After a 4-month observation period during which her risperidone dosage was gradually tapered and discontinued, she was returned to duty and able to resume her deployment on no medications. However, within 3 months of returning to the combat zone, the same symptoms recurred. Again, there were minimal mood symptoms and no hallucinations. She was again evacuated to Europe, recovered within a week, and was subsequently evacuated to the United States, where she was hospitalized for observation. She was treated with aripiprazole (30 mg/day), and tapered off within 3 months. She was honorably retired and released from the military and joined the civilian workforce 7 months after her return from overseas.Ms. A experienced a recurrence 1 year later (9 months after being tapered off her medication) with similar AUTHOR AND ARTICLE INFORMATION

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“…affective disorder (19). However, other studies also suggest neurobiological differences between cycloid psychosis, bipolar disorder and schizophrenia (24)(25)(26)(27). In clinical routine, patients presenting with cycloid psychosis would be most likely assigned to DSM-5's unspecified psychosis category or brief psychotic disorders (19).…”

Section: Introductionmentioning

confidence: 99%

Does a Lack of Awareness of Cycloid Psychosis Hamper Adequate Treatment for Patients Suffering From This Disorder? A Case Report

et al. 2020

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Categorial systems of nosology are based on a cross-sectional enumeration of symptoms with a predefined cut-off, but hardly capture rapid fluctuations of manifestation nor longitudinal characteristics, e.g., cyclicity. Especially with disorders presenting with an admixture or frequent change of psychotic and affective symptoms, diagnostic specifity of the DSM and ICD diminishes. In those instances, alternative concepts as cycloid psychosis might display more accurately the very characteristics and course of a mental disorder and help to tailor individualized treatments. Karl Leonhard described three major subtypes of cycloid psychosis: anxiety–happiness psychosis, confusion psychosis, and motility psychosis, all showing a pleiomorphic symptom profile resembling intraphasic switching of poles. Here we present the case of a 59-year-old woman suffering from cycloid psychosis as defined by the criteria of Perris. Between 2013 and June 2019, the patient was admitted 35 times for compulsory treatment. A frequent change of diagnoses, ranging from adjustment disorder to complex PTSD, and from unipolar depression to “pseudoneurotic schizophrenia,” resembles the puzzling manifestations. Most of the time the patient was labeled as schizoaffective disorder despite never displaying clear psychotic core symptoms. Despite treatment with different antipsychotics including LAI the cumulative length of hospitalization increased steadily from 74 days in 2014 to 292 days in 2017. When reviewing the case in 2017 the longitudinal pattern of her disorder and the diverse acute manifestations were finally conceptualized as a cyclic on-off of an atypical psychosis. After starting lithium to pre-existing LAI antipsychotics and valproic acid, the number of days per year spent in inpatient care sharply dropped to 136 in 2018. We propose to reconsider cycloid psychosis as a useful clinical concept whose descriptive value, validity and utility for treatment decisions should be further evaluated. Lithium alone or in addition to valproic acid may act on cyclicity as a core symptom of cycloid psychosis as well as of bipolar disorder, even in the absence of major affective symptoms.

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Evidence for unaltered brain electrical topography during prefrontal response control in cycloid psychoses

Cited by 9 publications

References 69 publications

Hypofrontality in schizophrenic patients and its relevance for the choice of antipsychotic medication: An event-related potential study

Hypofrontality in schizophrenic patients and its relevance for the choice of antipsychotic medication: An event-related potential study

Cycloid Psychosis

Does a Lack of Awareness of Cycloid Psychosis Hamper Adequate Treatment for Patients Suffering From This Disorder? A Case Report

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