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Updated: May 20, 2025
It is plainly impossible for us to say with any positiveness that either these were or were not genuine convulsions, but it is nevertheless important to record them, because such phenomena are observed fairly frequently in dementia præcox cases but are practically unknown in manic-depressive insanity.
Even if they go through the motions of work or play with no sign of interest, such exercise should not be allowed to lapse. Then, too, the environment should be changed when practicable. A patient may improve on being moved to another building. Perhaps the most potent stimulus that we have observed is that of family visits. In most manic-depressive psychoses visits of relations have a bad effect.
It is largely with the hope of inducing other psychiatrists to carry on such work that this book is written. There is no other manic-depressive psychosis which, theoretically, offers such hope of simple psychological measures being of therapeutic value.
But this condition is temporary and the situation and appearance of the patient betrays the fact that he has just had a convulsion. Rarely, protracted stuporous states occur in epilepsy which closely resemble the conditions described in this book. In fact it is probable the true stupors may occur in epilepsy just as in dementia præcox or manic-depressive insanity.
In general, then, her ideas were, on the whole, not at all typical of stupor but much more like those met with in other manic-depressive conditions. Correlated with this was an unusual mood picture. Quietness and apparent apathy of the patient were interrupted by little bursts of emotion, and throughout the psychosis there was a coloring of perplexity.
There is usually little difficulty in the discrimination of hysterical stupor. Occasionally it shows, superficially, a similarity to the manic-depressive type.
In our opinion it is probably better to regard these as clinically impure types. Great difficulties are also met with in the manic-depressive group proper. So often a stupor begins with the same indefinite kind of upset as does another psychosis that the development may furnish no clew.
In fact, such evidences of affect as do appear in the course of the stupor are apt to be isolated, queer and “dissociated.” It does not seem as if the whole personality reacted in the emotion as it does in the other forms of manic-depressive insanity. For example, we may think of the resistiveness which is so frequently present when the patient seems in other respects to be psychically dead.
The next problem is to consider the meaning and classification of cases where these symptoms occur in conjunction with others. This naturally introduces the subject of relationship of stupor to other manic-depressive reactions. It is probably best to begin with presentation of three such cases. Anna L. Age: 24. Admitted to the Psychiatric Institute August 21, 1916.
From at first seeming to comport her usual uncertain hesitancy, Rita was now appearing as a decisive voice according to the perspective of the child before her. Gabriele pulled back inside herself for a moment, uncertain about swapping roles with the callow and manic-depressive neighbor whom she once cared about.
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