Stress-induced depression and reactive schizophrenia

ABSTRACT A number of concepts exist which reveal an interaction between endogenous and psychogenic factors in stress-induced disorders in patients with schizophrenia. These concepts relate to psychological, pathophysiological, and sociological aspects of the problem. In this study we look at the respective states described within the clinical concept of reactive schizophrenia. Materials: Fifty clinical cases were included: 32 females and 18 males, mean age 38.6 ± 12.5. Thirty-three patients (66%) had a diagnosis of ‘schizophrenia’, 17 patients (34%) were diagnosed with ‘schizotypal personality disorder’ according to DSM-5 criteria. The performed examination included a clinical interview, analysis of the current clinical state, analysis of the medical history. Results: From the perspective of concept of ‘reactive schizophrenia’, the subjects of our study can be split into two groups based on their mechanism of development and psychogenic vs. endogenous contributions. These two groups may be characterized as ‘psychogenic provocation of a schizophreniform disorder’ and ‘endogenous provocation of a psychogenic disorder’ respectively. Conclusions: The results observed made it possible to re-establish the hypothesis of ‘reactive schizophrenia’. The principal feature is the specific interaction between endogenous and psychogenic factors, i.e. the psychogenic provocation of endogenous disorders.