Siefert[9] was the first to clearly differentiate the purely endogenetic
disorders from those dependent upon a degenerative soil, and evoked
exclusively by outside influences. He divided the eighty-seven cases of
psychoses in criminals studied by him into two distinct groups, namely,
the real psychoses and the degenerative psychoses. Under the former
thirty-three cases he places the well-known forms of dementia præcox,
epilepsy, paresis, etc. These, according to him, are not in the least
influenced by the milieu in which they occur (in this instance, prison
environment). His fifty-four cases of degenerative psychoses, on the
other hand, were characterized above all by the fact that they stood in
the most intimate relation with the environment in which they occurred,
and were wholly influenced by the same. The pathologic, degenerative
soil which permitted of the development of the psychosis in these
individuals consisted of irritability, lability, autochthonous
fluctuations of mood, fantastic day-dreaming, a heightened subjectivity
to the environment, inability to form correct critical judgment
concerning unpleasant occurrences about them and a strong tendency to
suggestibility. On the physical side these patients were subject to
headaches, migraine, restlessness and anxiety, often associated with
disturbances of heart-action, hypochondriacal complaints, and a tendency
to become easily tired upon physical or psychic exertion. They also
showed, as a rule, intolerance for alcohol, and were wont to react to
alcoholism in a strongly pathologic manner.
Siefert divides his fifty-four cases of degenerative prison psychoses
into the following groups:--
First:--Hysterical degenerative state. These consist of undoubted cases
of grave hysteria, with convulsions, physical stigmata, endogenous
states of ill-temper, confusional states, Ganser twilight syndromes,
etc.
Second:--Simple degenerative states. These differ from the preceding
group in that hysterical stigmata are wanting. These patients are
subject to severe maniacal outbreaks, motor excitements, mutism, attacks
of anxious, delirious states, with confusion, etc.
Third:--Fantastic degenerative forms. This group concerns markedly
degenerated individuals with a pathologically exaggerated imaginative
faculty, a strong auto-suggestibility, a tendency to deceit and lying,
to inherent fluctuations of mood and hysterical stigmata. On this basis
there develop conditions of pseudologia-phantastica, systematized
delusional formations of all sorts, delirious psychoses, etc.
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