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Alterations of Ego Functions in Chronic Schizophrenia

NATHANIEL S. APTER, M.D.
AMA Arch Gen Psychiatry. 1959;1(6):622-629. doi:10.1001/archpsyc.1959.03590060084008.
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Introduction  An investigative program, begun in 1952 at Manteno State Hospital in collaboration with representatives of ancillary disciplines, was designed to explore possibilities for resolving two neglected clinical problems in chronic schizophrenia. First, is it possible to differentiate more precisely among the various types of chronic schizophrenic states? Second, can the terminal phases of schizophrenia be more clearly aligned with their earlier clinical forms? Both questions are of considerable theoretical importance and contain potentialities for practical application to our daily clinical work and to the management of a large portion of our state hospital population.Diethelm1 has summarized the slighted attitude toward these questions.There are few contributions in literature discussing the course which schizophrenic illnesses may take. Eugen Bleuler gives an excellent summarized statement, while Kraepelin, and later Kolle, discuss the incidence of various types of schizophrenic reactions in different age groups. Some light has

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