The Concepts of Axis Syndromes 1965–1983

Abstract

The first purpose of the paper is to sketch the development of the concept of axial syndromes, starting with the generation of the hypotheses in Berner’s monograph on ‘The paranoiac syndrome’ published in 1965 and leading to the last formulation of the Viennese Research Criteria in 1983. The second purpose is to draw the attention on a series of empirical studies which have been undertaken in order to evaluate the classificatory validity of the concept, studies dealing with the long-term course of paranoid psychoses (both in a retrospective and a prospective design) and secondary cases of different diagnostic classes in the families of the same patients (first-degree relatives).

Dysphoric Mood in Paranoid Psychoses

“…Both these points have been neglected for decades after Specht [1901]. Mainly the second one has grown in actuality recently through the Vienna Research Group on Paranoid Psy choses [Berner et al, 1986;Gabriel, 1985], and DSM-III [American Psychiatric Asso ciation, 1980], Kraepelin [1913], in differentiating para noid, i.e. delusional psychoses in dementia paranoides (later on the paranoid form of schizophrenia), the paraphrenias and some other forms (paranoia being the best known), described affective symptoms in paraphrenia, different ones in different stages of the disorder: anxiety, depression, despair -suspiciousness, tension, hostilityarrogance, scornfulness.…”

Quality of Affective Symptomatology and Its Importance for the Definition of Schizoaffective Disorders

“…DSM-III. DSM-III-R], There is similar variation among the strategies regarding the manic symptoms [Berner and Lenz, 1986;Gabriel, 1985;Marneros et al, 1986aMarneros et al, , 1988a, Earlier findings of the Cologne study showed that there arc some important differ ences between schizophrenic syndromes ac companied -concurrently or sequentially -by a melancholic or manic affective symp tomatology and those accompanied by a nonmelancholic depressive or a nonmanic euphoric symptomatology [Marneros et al, 1986c]. In the present investigation we ex amine two hypotheses:…”

“…1986;Zaudig and Vogel, 1983, see also reviews in Marne ros and Tsuang, 1986], especially in regard to the affective part of the symptomatology. Some systems use a narrow definition, con sidering only the constellation of 'endoge-nous depression', 'melancholia' or 'cyclothy mia' [Berner and Simhandl, 1983;Berner and Lenz, 1986;Gabriel, 1985;Kendell, 1986;Marneros et al. 1986aMarneros et al.…”

Continental Viewpoints on the Concept of Reactive Psychoses

“…Instead it will depend on the author's professional position as a psychiatrist who was trained in the sixties in Zürich (during the last years of M. Bleuler as the director of the Burgholzli) and in Vienna, collaborating here in a working group of psychopathological orientation under the lead ership of Berner since 1968 [Gabriel, 1985], who became interested in classification problems with regard to both basic research and clinical practice. Therefore he will con fine himself (a) geographically to the Ger man-speaking countries (this also with re gard to the paper of Pichot [1986] on the French concept of 'bouffée délirante' with special reference to the concept of reactive psychosis which was published only recent ly); (b) historically to early contributions to the notion of psychogenic/reactive psychosis which have been operating on further and even recent developments (this also with re gard to the several papers published until recently by Stromgren [1987], which contain comprehensive information on the roots of the concept), and (c) mainly to a reflection upon the reasons for the poor acceptance of the concept in the German-speaking coun tries and a rather preliminary evaluation of the present state in this field comparing the concept of reactive psychosis (vs. other etiologically determinated categories) with mod ern concepts which are multidimensional also with regard to etiology.…”