[Late manic-depressive psychosis manifested by an endoreactive depression syndrome]

Among 140 patients with psychogenically induced depressive states first developing in old age the author identified a group of patients (n = 33) whose clinical picture of depressive disturbances was determined by a combination of reactive and endogenic features and corresponded to the description of the so-called endoreactive depressions. Four successive stages in their development are described. On the basis of analysis of the mechanisms of the development of these depressions, their clinico-psychopathologic structure, follow-up and constitutional-genetic data, these diseases have been referred to borderline forms of manic-depressive psychosis. It is suggested that the premorbid structure of the personality of the studied patients is the expression of the constitutional-genetic predisposition for affective disturbances while its premanifest time-course may be considered as a latent stage of the disease development.