Revisiting cycloid psychosis: An unexpected approach to a diagnostic challenge

• DOI: 10.1016/j.psycr.2022.100008
• Publication Date: 2022-04-08T15:05:30Z
• Authors: Drew Cumming; Jennifer Schreiber; Sarah Magaziner; Susmita N. Sarangi
• Keywords: Etiology; Prodrome

Background: Cycloid Psychosis is a diagnosis which emerged from the Wernicke-Kleist-Leonhard school of psychiatry and has long history in Europe. Despite an estimated incidence up to 15% first psychotic episodes, well-established diagnostic criteria with high discriminant validity, unique disease course, demonstrated biomarkers, this remains relatively unknown North American as it not included DSM-5 or ICD-10. Review available literature, especially work by Leonhard, Perris, Peralta, amongst others, supports several features CP differentiate other conditions: abrupt onset; complete, near inter-episode remission; shifting polymorphic symptoms. Given its atypical presentation, requires appropriate rule-out somatic causes psychiatric Case Presentation: Here we share case report young woman ultra-rapid onset manic example cycloid psychosis. This required significant consideration psychosomatic etiologies, particularly autoimmune encephalitis, were ultimately negative. She was treated olanzapine clonazepam while hospital quickly tapered off following discharge without symptom recurrence. psychosis qualifiers presentation rapid-onset illnesses course impacts treatment decisions. Conclusions: term considerations. However, per within DSM, primary disorders are diagnoses exclusion once physiologic effects substances medical conditions have been excluded. both secondary disorders.