A Study on Some Clinical Aspects of the Relationship between Obsessional Neurosis and Psychotic Reaction Types

Abstract

The interrelationship between neurotic manifestations and psychotic reaction types represents one of the major problems of psychiatry. Psychotic reactions sometimes develop in patients with old-standing neuroses. It is also well known that neurotic symptoms are not uncommon in the preliminary stages and during the course of psychoses. However, the knowledge of the interaction between neurotic and psychotic manifestations is still incomplete. In this study an attempt is made to elucidate some of the clinical aspects of this problem. It is not intended to discuss here such basic issues as the definition of neurosis and psychosis and their interrelationship in general. Those questions have been widely debated, and it seems doubtful whether much can be gained from a continuation of this discussion at the present stage of psychiatric knowledge. In a clinical study the question whether or not there is a fundamental difference between neurotic and psychotic symptoms and behaviour is better left open. An investigation into the interplay between various phenomena of mental illness occurring in individual patients is justified, even if one looks at them as manifestations of a single and continuous development.