Benign Stupors: A Study of a New Manic-Depressive Reaction TypeHoch, August
Science
Benign Stupors: A Study of a New Manic-Depressive Reaction Type
Hoch, August
Manic-depressive illness; Stupor
Then, she claimed, she got stupid, but neither sad nor
happy. She claimed to have known all along where she was,
but felt mixed up at times, her thoughts wandered and she
felt confused about the people. She thought she was in
everybody’s way, thought others wanted to get ahead of her,
did not speak because she did not know if it were right or
wrong, felt she might cause disturbance if she answered.
(It is not clear whether she had complete insight into the
morbid nature of these statements.) She also claimed again
that all along she “saw shadows on the wall,” “scenes from
Heaven and Earth,” “shadows of dead friends laid out for
burial.” She had insight into the hallucinatory nature of
these visions. Sometimes she thought she was dead also. She
claimed that she began to feel better when these shadows
stopped appearing in June (the actual time of her
improvement).
She was discharged recovered a month later, after having
been sent to another ward.
In this case, then, we find that the two months of stupor were ushered
in by a brief state in which, in addition to the usual inactivity, there
was a certain bewilderment, increased by questions, while the
orientation which in the preceding manic state had been good became
seriously interfered with. The psychosis bordered on deep stupor for
brief periods when the inactivity seemed to be complete or she lay in
bed with her head raised from the pillow. On the other hand, there were
occasional sudden spells of free activity even with a certain elation.
She could often be persuaded to answer questions or to write, the
slowness of this spoken or written speech varying considerably. Her
replies revealed the fact that she was essentially affectless and that
her intellectual processes were interfered with, even to the extent of
paragraphic writing. We have, therefore, here again features similar to
those of the preceding cases. In addition we must add as important that
this patient said retrospectively that she thought she was dead, that
she saw “shadows from Heaven and Earth,” “shadows of dead friends laid
out for burial,” all this without any fear. We shall see later that this
is a typical stupor content.
We will here include state 3 of Anna G. (See Chapter I, Case 1) who
after the pronounced stupor was for two months merely dull, somewhat
slowed and markedly apathetic. Although her orientation was not
seriously affected, there was considerable interference with her
intellectual processes, as shown in her wrong answers or her lack of
answers when more difficult questions were asked.
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