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Héboïdophrenia: The hazardous interplay of psychosis and psychopathy
De Page, Louis; Englebert, Jérôme
2016Meeting of the Belgian Association for Psychological Science (BAPS)
 

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Keywords :
Schizophrenia; Psychopathy; Heboïdophrenia
Abstract :
[en] Introduction The diagnostic entity of heboidophrenia has been consigned to oblivion despite its clinical, prognostic, criminogenic value. At the core of this diagnosis lies specifics interactions between psychosis and psychopathy. The diagnosis was first coined by Kalhbaum in 1890, was revived by Anglo-Saxon literature in the first half of the 20th century, and by French psychiatrists in the late 90’. Method We integrated literary sources, clinical experience and an own pilot study as a stepping-stone for a more in-depth research. Cases (n=20) were selected out of samples of Mentally Disordered Offenders in Belgian Medium and High Risk Forensic Facilities. Files, records and therapist’s experiences were quantitatively analysed iteratively to cull subtypes from each other. We here present preliminary qualitative results, more indepth qualitative and quantitative results will be produced. Results The diagnosis subsumes more than a mere DSM-IV-TR Axis I & II comorbidity, it can be seen from a developmental perspective, or from a structural perspective. Both vantage points suggest an interplay between the (paranoid) psychotic process and the antisocial behaviour, where both trigger and induce each other. At this point, we found evidence for three subtypes modes of interplay; 1) mood instability patterns induced either psychopathic or psychotic phenotypic presentation, 2) according to personality organization and its defensive functioning (were psychopathy defends against psychosis), and 3) phenotypic expression of both components (psychopathy and psychosis) linearly co-dependent. Discussion Despite its incremental value, little is known about the therapeutic prospects of this diagnosis. Current results indicate that these patients do question competency to answer for their deeds in a peculiar manner, relapse more often, reoffend more often, do evade treatment opportunities (if they have any), act out more often (in both antisocial and psychotic ways), induce a particular negative counter-transference in psychiatric teams, etc. Because of these particularities and their versatile phenotype presentation, heboidophrenia patients cannot simply be assimilated to the “high risk & high care” population, but need special supervision and clinical insight. In this research, we aim(ed) at discerning semiologic signs in order to support the diagnostic process.
Disciplines :
Criminology
Psychiatry
Treatment & clinical psychology
Author, co-author :
De Page, Louis
Englebert, Jérôme ;  Université de Liège > Département de Psychologie > Département de Psychologie
Language :
English
Title :
Héboïdophrenia: The hazardous interplay of psychosis and psychopathy
Publication date :
24 May 2016
Event name :
Meeting of the Belgian Association for Psychological Science (BAPS)
Event organizer :
Belgian College of Neurological and Biological Psychiatry (BCNPB)
Event place :
Anvers, Belgium
Event date :
Le 24 mai 2016
Available on ORBi :
since 03 May 2016

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