Improvement of cycloid psychosis following electroconvulsive therapy

Figures & data

Table 1. Brockington and Perris criteria for cycloid psychosis published in 1981 (10).

1. An acute psychotic condition, not related to the administration or the misuse of any drug, or to brain injury, occurring for the first time in subjects aged 15–50 years.

2. The condition has a sudden onset with a rapid change from a state of health to a full-blown psychotic condition within a few hours, at the most a few days.

3. At least four of the following must be present:

(a) Confusion of some degree, mostly expressed as perplexity or puzzlement.

(b) Mood-incongruent delusions of any kind, mostly with a persecutory content.

(c) Hallucinatory experiences of any kind, often related to themes of death.

(d) An overwhelming, frightening experience of anxiety, not bound to particular situations or circumstances (pan-anxiety).

(e) Deeper feelings of happiness or ecstasy, most often with a religious colouring.

(f) Motility disturbances of an akinetic or hyperkinetic type, which are mostly expressional.

(g) A particular concern with death.

(h) Mood swings in the background, and so pronounced as to justify a diagnosis of affective disorder.

4. There is no fixed combination of symptoms; in contrast, the symptoms may change frequently during an episode and show bipolar characteristics.

Table 2. Study population characteristics, stratified by sex.

	Women	Men	Whole sample
Number	30 (71.4)	12 (28.6)	42 (100.0)
Age
18–44 years	12 (40.0)	9 (75.0)	21 (50.0)
45–84 years	18 (60.0)	3 (25.0)	21 (50.0)
Antipsychotics
Yes	27 (90.0)	10 (16.7)	37 (88.1)
No	3 (10.0)	2 (83.3)	5 (11.9)
Number of ECT treatments	6.50 ± 3.30	6.75 ± 3.75	6.57 ± 3.39
Comorbid anxiety disorder
Yes	6 (20.0)	2 (16.7)	8 (19.0)
No	24 (80.0)	10 (83.3)	34 (81.0)
Comorbid substance dependence
Yes	2 (6.7)	1 (8.3)	3 (7.1)
No	28 (93.3)	11 (91.7)	39 (92.9)
Type of care
Inpatient	27 (90.0)	12 (100.0)	39 (92.9)
Outpatient	3 (10.0)	0 (0.0)	3 (7.1)
Compulsory treatment
Yes	16 (53.3)	5 (41.7)	21 (50.0)
No	14 (46.7)	7 (58.3)	21 (50.0)

Values are n (%) or mean ± standard deviation.

Table 3. Remission rates with possible predictors.

	Remission	No remission	p-value
Number	19 (45.2)	23 (54.8)
Sex			0.33
Women	15 (50.0)	15 (50.0)
Men	4 (33.3)	8 (66.7)
Age			0.12
18–44 years	7 (33.3)	14 (66.7)
45–84 years	12 (57.1)	9 (42.9)
Antipsychotics			1.00
Yes	17 (45.9)	20 (54.1)
No	2 (40.0)	3 (60.0)
Number of ECT treatments	7.16 ± 3.24	6.09 ± 3.50	0.31
Comorbidity
Anxiety disorder			0.71
Yes	3 (37.5)	5 (62.5)
No	16 (47.1)	18 (52.9)
Substance dependence			1.00
Yes	1 (33.3)	2 (66.7)
No	18 (46.2)	21 (53.8)

Values are n (%) or mean ± standard deviation.

Perris C, Brockington I, Cycloid psychosis and their relation to the major psychosis. In: Perris C, Struwe D, Janson D, eds. Biological Psychiatry. Amsterdam: Elsevier; 1981. p. 447–450.

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