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Chapter 25. REACTIVE (PSYCHOGENIC) PSYCHOSES

Reactive psychoses (also known as psychogenic psychoses) are mental disorders of the psychotic level that manifest because of the impact of deeply supramaximal shocks and traumas to be emotionally significant for a person.

Already in his first classification of psychoses, F. Platter (1662) separated a special type, which was designated by the term "commotio animi" ("soul shocks, emotional shocks"). It can manifest itself with great joy, deadly sadness, impetuous rage and other types of pathology, including delusions. In ICD-10, the term "psychogenic disorder" includes cases when real-life events or problems are of great importance in the origin of the disorder. Nevertheless, it is clear that not every psychosis that develops after a mental trauma can be considered as reactive one: in several cases, a mental trauma appears for only a provoking factor, contributing to revealing of an already existing latent disease or its exacerbation.

In most cases, psychogenic diseases (reactive psychosis) tend to reverse development. All distinct specialities of onset, course and termination of reactive psychoses are formulated by K. Jaspers (1923) in his triad created.

► Mental disorders begin after mental traumas, i.e. there is a clear temporal connection between these phenomena.

► The course of mental disorders is reversible. The further in time, the psychic trauma, the more noticeable is the weakening of symptoms of mental disorders is; then full recovery most often is.

► There is a psychologically understandable connection (Verstehen - "comprehension", Germ.) between the content of psychological trauma and painful experiences.

Reactive psychoses are of particular importance for diagnostics of states developing in a judicial situation (arrest, investigation, awaiting the verdict), so descriptions of this pathology given by forensic physicians are quite understandable. S. Ganser (1897) described hysterical clouded conscience state in prison conditions - the so-called Ganser's syndrome. Later, there were descriptions of hysterical stupor (Raccke K., 1901), puerilism (E. Dupre, 1903), pseudodementia (C. Wernicke, 1906), delusional fantasies (K. Birnbaum, 1906),

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