The validity of the Scandinavian concept of reactive psychoses. 1994

A A Dahl
Research Unit, Gaustad Hospital, University of Oslo, Norway.

The historical background of the Scandinavian concept of reactive psychoses is presented. The reactivity concept consists of several elements. There has to be a traumatic life event of psychological or somatic nature but its duration can be discussed. What is the time lag between the life event and the psychotic reaction? Some say one week, others up to one year. Is a personal disposition (vulnerability) a necessary condition for the psychotic reaction? Are emotional turmoil or non-organic confusion specific symptoms of the reactive psychotic reaction? Does the psychotic reaction have a meaning as an escape or a defense? What is the duration of the psychosis in relation to the duration of the life event? Does reactive psychoses always imply full recovery (good outcome)? The various editions of the ICD- and the DSM-classification include some of these features in their definition of reactive psychoses. Scandinavian experts also emphasize various aspects in their descriptions of these psychoses. Studies have shown that reactive psychoses can be diagnosed reliably. Work on the operatinalization of "reactivity" is under way. In the Scandinavian tradition there is a diagnostic shift from reactive psychoses to schizophrenia in later admissions. Generally, the reactive psychoses have a good outcome, and the outcome is significantly better than for schizophrenia and as good as for manic-depressive psychoses. Most cases of reactive psychoses are treated with neuroleptic drugs for some months. Electroconvulsive treatment is rarely given for reactive psychoses. Scandinavian psychiatrists think that DSM-IV and ICD-10 have not taken the concept of reactive psychoses seriously, and that research work has to be done to convince international psychiatry of the value of the concept.

UI MeSH Term Description Entries
D008016 Life Change Events Those occurrences, including social, psychological, and environmental, which require an adjustment or effect a change in an individual's pattern of living. Life Course,Life Crises,Life Crisis,Life Experiences,Course, Life,Crisis, Life,Event, Life Change,Experience, Life,Life Change Event,Life Courses,Life Experience
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012537 Scandinavian and Nordic Countries NORWAY; SWEDEN; DENMARK; ICELAND; and FINLAND. Scandinavia,Nordic Countries

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