Dysphrenia

The term dysphrenia was coined by the German medical specialist Karl Kahlbaum to designate a clinical picture in 19th century psychiatry. Today the concept is still used in the western world as a lay generic synonym for mental disorder in adults, and as a term to describe different cognitive/verbal/behavioral deficits in children and adolescents. It is also used in the People's Republic of China, controversially, to identify a local medical diagnostic category. A number of followers of the Falun Gong cult and other social movements considered insurrectionary by the regime are said to have been diagnosed with dysphrenia.

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The medical expression tardive dysphrenia was first proposed by the American neurologist Stanley Fahn and collaborators in the 1970s. It was originally linked to a unique and rare non-motor behavioral/mental neuroleptic drug-induced tardive syndrome observed in psychiatric patients—schizophrenia in particular—and was treated with typical antipsychotics or neuroleptics, the only kind of antipsychotic drugs available at the time.

Tardive dysphrenia was conceived to precede tardive dyskinesia and the other already-known neuroleptic-induced tardive syndromes (tardive dystonia, tardive akathisia). More recently, the Brazilian psychiatrist Leopoldo Hugo Frota extended Fahn's original construct to encompass the independently-described but etiologically-related concepts of rebound psychosis, supersensitivity psychosis (Guy Chouinard), and schizophrenia pseudo-refractoriness (Heinz Lehmann & Thomas Ban) or secondary acquired refractoriness.

References

• Chouinard G, Jones BD. Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. Am J Psychiatry. 1980 Jan;137(1):16-21.

• Fink M, Taylor MA. Catatonia. A History. In: Catatonia. A Clinician’s Guide to Diagnosis and Treatment. Cambridge University Press, Cambridge, 2003. ISBN 0-521-82226-2

• Forrest DV, Fahn S. Tardive dysphrenia and subjective akathisia. J Clin Psychiatry. 1979 Apr;40(4):206. PMID 33972

• Frota LH. Partial Agonists in the Schizophrenia Armamentarium. Tardive Dysphrenia: The newest challenge to the last generation atypical antipsychotics drugs? J Bras Psiquiatr 2003; Vol 52 Supl 1;14-24.

• Lehmann HE, Ban TA. The History of Psychopharmacology of Schizophrenia. Canadian Journal of Psychiatry 1997; 42:152-62.