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Updated: July 1, 2025
But even our typical cases did not present this picture during the entire psychosis. They showed phases when, superficially viewed, they were not in stupor but suffered from the above symptoms as tendencies rather than states. There are also many psychoses where complete stupor is never developed. The analogy to mania and hypomania is compelling. The latter is merely a dilution of the former.
The commonest introductory psychosis, he claims, is depression, but from his brief case reports it would seem that most of his patients were not stuporous, in the narrow sense of the term, but severely retarded depressions.
Babbage's engine the title of a calculating machine on the same grounds. Thus it seems to me that a gamekeeper reasons, whether he is conscious or unconscious, whether his reasoning is carried on by neurosis alone, or whether it involves more or less psychosis. And if this is true of the gamekeeper, it is also true of the greyhound.
Some five years later she had another somewhat similar attack, again following a quarrel, this time with a fellow employee. In this second psychosis, however, manic elements were much more prominent.
Occasionally she spoke of thinking that people talked about her, but the informant doubted if she brooded over this, because she was not of a worrying disposition. Considering the ideas which appeared in her psychosis, it is striking that in her normal life she was rather antagonistic towards her father on account of his alcoholism and the crudity of his speech and manners.
In fact, if the theory we are now advancing be correct and we had had it then, we believe it would have been possible to state at the time of his first attack that his psychosis would not show rapid deterioration; we might even have gone further and predicted that he would reach some such stage of relative sanity as he now enjoys. He has presented three types of ideas.
History of Psychosis: For six months before admission she said frequently that her boss was giving her hints that he liked her. Nevertheless, she went back next day and was again sent home. At home she sat gazing. Next day again wanted to go and see the boss, but was prevented.
F. H. Four years after this attack her mother was a patient in the hospital with an atypical manic-depressive psychosis from which she apparently recovered. P. H. The patient herself was described by superficial observers as being bright, sociable, well-informed and very ambitious.
The mind is not a blank, as in the stupor, or concerned only with delusions of death. Finally, there are the absorbed manic states. These are the most difficult, inasmuch as the patient is often so withdrawn and so introverted that at any given interview there may be no objective evidence of mood or ideas. Here the development of the psychosis is often an aid to diagnosis.
Following a suggestion of Dr. Hoch we have termed these ideas "constructive delusions." As they correspond to what was historically a compromise between reality and phantasy, they should represent a corresponding mildness or severity in the psychosis where they appear.
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