Blackwell Reference Online

Extract

Defined by Bleuler (1911) (from the Greek skhizein , to split, to separate; and phrēn , the mind) as a set of chronic psychoses occurring in adolescents or young adults which develop either gradually or by sudden surges in such a way that the state of illness is, in appearnace, irreversible (the possibilities of ameliorating the condition do not extend so far as a restituo ad integrum ). Bleuler distinguishes between (a) ‘fundamental’ and (b) ‘accessory’ symptoms. The fundamental irreversible symptoms distrub: •  the elementary functions: distrubances of association (logical syncretism, incoherent associations), emotional deterioration, parathymia, paradoxical and discordant affective reactions, ambivalence; •  the complex functions: autism (detachment from reality, retreat into a world of one's own); loss of active attention, passive attention focused on apparently random events; persistent blockings of the will; lacunae in the expression of thoughts and intelligent behaviour (rather than dementia). These fundamental symptoms are compatible with social life. Accessory symptoms include hallucinations, paranoid delusions, catatonic psychomotor distrubances; these generally require hospitalization, but are theoretically reversible, depending upon events relating to changes of context. The four main forms are: 1   Schizophrenia simplex (in which only the fundamental signs of ... log in or subscribe to read full text