Aphanisis: the syndrome of pseudo-depression in chronic schizophrenia

A syndrome of psychic blankness, or pseudo-depression, here labeled aphanisis, is seen commonly in chronic schizophrenic patients. it is frequently confused with and misidentified as a postpsychotic depression. Clinical observations deriving from a setting of intensive psychotherapy with three chronic schizophrenic patients are compared with recent information concerning the normal and pathological development of affects in children to identify the state of aphanisis as distinct from states of depression phenomenologically, developmentally, and psychodynamically. Careful scrutiny reveals aphanisis to be an actively maintained regressive or primitive psychological state of an autistic nature serving important defensive/adaptive aims. Discussion highlights the differential diagnosis between aphanisis, postpsychotic depression, and maturational grief and how this may help reduce heterogeneity in the sampling of various postpsychotic syndromes for treatment and research purposes.