It is often difficult to make a definite diagnosis and prognosis in psychiatry, even after several days of observation. Indeed, some symptoms that are ordinarily relied on are to be found in psychoses of very different prognosis. For instance, certain kinds of manic patients who will eventually recover may present mannerisms, mutism, negativism, opposition to examination, stereotyped speech and attitude and apparent manifestations of inaffectivity. On the other hand, dementia praecox patients may present an excitement comparable to that of manic patients, with disturbance of attention, mobility of ideas, rapid association and apparent hyperamnesia, and yet may show, behind this excitement, a real affective and intellectual deficiency.
The prognosis may also be difficult to determine in the case of depressed patients. Is it a manic-depressive depression from which the patient will recover? Is it a depression symptomatic of dementia praecox? Or is it one of the asthenias, the evolution of
SANTENOISE PHCD, TARGOWLA R. AN ATTEMPT AT A BIOLOGIC DIAGNOSIS OF STATES OF EXCITEMENT AND DEPRESSION. Arch NeurPsych. 1925;13(6):729-742. doi:10.1001/archneurpsyc.1925.02200120050004