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We know that pure paranoia is not a deteriorating psychosis that it does not necessarily preclude the possibility of considerable social usefulness and that it grades off almost imperceptibly into dementia praecox. The features differentiating these two diseases should therefore supply us with data for determining the prognosis.
That, of course, is a tremendously difficult problem to tackle. If we are to regard it as a psychosis then we expect it to show other reactions, just as dementia praecox shows manic depressive symptoms. If we are to find out what the epileptic reaction is, we must study it in those who are typically epileptic and nothing else.
Any institutional physician is familiar with the chronically elated patient, who has become a hospital character a good worker often who seems to be sufficiently repaid for his toil by the privilege of stopping the passerby to expound his ideas. Such a case is usually diagnosed as a chronic manic or a dementia praecox, according to the taste of the examiner.
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