Meeting of the Psychoanalytic Association of New York

November 14, 1966. NOSOLOGICAL AND DIFFERENTIAL DIAGNOSTIC CONSIDERATIONS IN THE GROUP OF SCHIZOPHRENIAS, REGRESSOPHRENIAS. Jan Frank, M.D.

The author presents a classification of the regressive disorders, differentiating process schizophrenias from similar but prognostically and etiologically different disorders, called 'regressophrenias', as well as from the epileptogenic schizophrenias. Patients suffering from epileptogenic (especially temporal lobe) schizophrenic-like psychoses, in the post-ictal state may have paranoid ideas, ideas of influence, auditory hallucinations, and occasionally thought disorders. The affect, however, is warm and appropriate. The state of consciousness is disturbed and there is disturbance of attention.

The regressophrenias are characterized by regressophilia, i.e., a tendency to regress and a concomitant phobia about this regressive tendency. Typically the phobic aspect recedes, leaving the regressive behavior in the foreground. At this time the symptomatology may be egosyntonic and the patient may be resigned to his illness. There is object and affect hunger with an inability to satiate the hunger. The integrative function of the ego is unimpaired. The etiology of this group is based on an intense fixation to one psychotic parent. If this parent shows fragmented attention cathexis and thought disorganization, the patient, by identification, will display fragmentation of attention similar to hysterical or epileptic fuguelike states. Two cases are presented to illustrate this group.

Dr. Frank then discussed the process of the nuclear schizophrenias. These patients show impaired integrative function of the ego and disturbances of attention cathexis with oscillating states of awareness. There is disturbance of the harmonizing drive distribution into the smaller and delayed quanta of thinking. The characteristic obsessional thinking of many schizophrenics is rigid and unable to adapt to significant data of experience and sensor