The Systematic Schizophrenias

Abstract

The sharpness of their symptomatology differentiates the systematic schizophrenias from the unsystematic forms. Whereas in periodic catatonia, cataphasia, and affective paraphrenia we always drew attention to their sympto-matological polymorphism, precluding strict delineation, in the systematic forms we find sharply circumscribed pictures. Apparently this parallels what we have observed in the phasic psychoses where alongside the polymorphic forms we had pure forms with their firm symptomatology. Probably the parallel exists because both the pure phasic forms and the systematic schizophrenias involve specific functional areas, the limits of which produce the sharp borders of the psychoses. No further relationship should be assumed because the phasic psychoses may be remediable while the systematic schizophrenias show permanent defects. The functional areas affected by the two sets of disorders are not only different here and there but are in fact of a very different nature. Pure depressions, euphorias, and manic-depressive illness are disorders of the emotions in close association with the vegetative nervous system, whereas the schizophrenias clearly imply disorders of higher thought and of willpower. Even the affective flattening of the hebephrenias does not suggest a disorder of the basic emotional system; rather it is at a higher level that affectivily is changed, while the more bodily types of feelings and instinctual drives are maintained. As I have discussed precisely elsewhere (Leonhard 1970a), in the schizophrenias the highest, and at the same time the phylogenetically youngest human functions of the psyche are involved.