Leonhard Cycloid Psychoses

Emotional personality disorders: cycloids

Leonhard identified four groups of patients with emotional personality disorders, which are united by common symptoms - lethargy, lack of initiative, and mood instability. These were emotionally unstable individuals in some characterological manifestations, who are characterized by cyclical affective disorders with changes in mental tone, clear phases (hyperthymia is replaced by depression and vice versa).

With the affective development of cycloids - dysphoria with a decrease in all emotions, “bad” thoughts and wandering ideas of litigiousness and jealousy, the affect of anger, aggressive protest, the desire to conflict on this basis in everything. Motor agitation and overestimation of self-worth.

He described how with some so-called cycloids there is metamorphopsia (distortion and distortion of the perception of color, size), deterioration in judgment, impoverished speech, increased claims to one’s rights, self-deprecation, resentment, introversion in contacts with others, premorbid signs (enlarged lower jaw and eye shape). Immotivated mood swings are accompanied by phenomena of motor disinhibition (outbursts of rage and a feeling of boundless happiness, increased interest in erotic scenes, etc.).

One of the diseases of this cycle, undifferentiated cycloid psychosis with manic states, occurs as an episode in infectious diseases. Patients are noisy, talkative, active, carefree, cheerful, waving their arms, laughing loudly and for a long time, reading poetry, reciting. The speech is grammatically correct and contains many figurative expressions. Increased appetite is obvious, muscle tone is increased.

Less common are attacks of ecstatic madness. In epileptic states (twilight stupefaction), patients experience anxiety, fear of death, derealization, illusions, and hyperthermic algia. An affect of admiration and reverence for everything “sacred”, singing, staging prayers, running in circles around some object (sacred candle). Excitement is in the nature of an autoscopic phenomenon. It manifests itself as an aura in the form of “eyes” or “something in the gaze.” Hypomachia and psychosensory disorders are noted.

Leonhard's epileptic conversion disorder has in common that the disease is more common in young women. It is characterized by “astasia-abasia syndrome”: aimlessly moving with a glance or hand from one person to another, motor agitation (running, sleepwalking, rolling on the floor, screaming and moaning). Contact with others is completely broken (inadequate). All this is accompanied by pronounced autonomic reactions in the form of drooling, hiccups, and bloating. Speech is sometimes impaired, and ataxia is often noted. There is a pronounced hypochondriacal manifestation with imaginary motor disturbances, trunk spasms and