A Shakespeare’s tragedy: the unclear border between affective and psychotic disorders

Abstract

The original radical separation between early dementia and manic-depressive illness, even considered incompatible, has its correlate in the present nosological systems that difficultly include clinical pictures in which the affective coexists with the psychotic. The schizoaffective disorder is the only category that specifically includes this combination in the ICD-10 and DSM-IV international classifications. However, this is a very restrictive category. The concept of marginal psychosis, which has disappeared as a specific category, constituted an approach to those borderline cases, which in view of the diagnostic difficulties posed by pictures like the case presented, could be interesting to recover.