Psicosis cicloides: a propósito de dos probables casos Cycloid psychosis: regarding two probable cases

Los casos de psicosis aguda que durante el seguimiento longitudinal no reúnen criterios de esquizofrenia ni de psicosis afectivas son frecuentes en la práctica clínica habitual; sin embargo, pueden ser catalogados dentro de categorías diagnósticas que no representan de modo suficiente su individualidad nosológica. Este grupo intermedio de psicosis: caracterizado por su inicio agudo, curso usualmente breve, sintomatología polimórfica y recuperación sin defecto, ha sido concebido en diferentes escuelas psiquiátricas mediante diferentes conceptos: en tal sentido, el constructo de Psicosis Cicloides, proveniente de la psiquiatría alemana, ha demostrado validez y se halla engarzado en un sistema diagnóstico heurísticamente valioso (el de Wernicke-Kleist-Leonhard). A propósito de dos casos representativos, revisamos la literatura pertinente y resaltamos la necesidad de considerar esta posibilidad diagnóstica, a fin de evitar prolongados y potencialmente perjudiciales tratamientos antipsicóticos, prescritos bajo hipótesis incorrectas y gravosas. Cases of acute psychosis which during longitudinal follow-up did not meet criteria for schizophrenic psychosis or affective psychosis are common in clinical practice; however, those cases can be classified into diagnostic categories that are not sufficiently representative of their nosological individuality. This intermediate group of psychosis: characterized by acute onset, usually brief course, polymorphic symptomatology and recovery without defect, has been conceived in different psychiatric schools through different concepts: in this sense, the construct of Cycloid Psychoses, original from German psychiatry, has demonstrated validity and is embedded in a heuristically profitable diagnostic system (the Wernicke-Kleist-Leonhard classification). Apropos of two representative cases, we review here the relevant literature and highlight the need to consider this diagnostic possibility - not fully considered in the present diagnostic systems yet- in order to avoid prolonged antipsychotic treatments based on unnecessarily ominous nosological hypothesis.