With the cycloid type of character accentuation, the presence of two phases is observed — hyperthymia and subdepression. They are not expressed sharply, usually short-term (1-2 weeks) and may be interspersed with long breaks. A person with a cycloid accentuation experiences cyclical mood swings, when depression is replaced by elevated mood. With a decline in mood, such people show increased sensitivity to reproaches, they do not tolerate public humiliation. However, they are proactive, cheerful and sociable. Their hobbies are unstable, during the recession there is a tendency to abandon business. Sexual life is highly dependent on the ups and downs of their general condition. In the elevated, hyperthymic phase, such people are extremely similar to hyperthyms.
Detailed description according to A.E. Lichko
As you know, this type of character was described in 1921 by E. Kretschmer and at first was often mentioned in psychiatric studies. P. B. Gannushkin (1933) included four types of psychopathy in the «group of cycloids» — constitutionally depressive, constitutionally excited (hyperthymic), cyclothymic and emotively labile. Cyclothymia was considered by him as a type of psychopathy. However, later this concept began to mean relatively mild cases of manic-depressive psychosis, and the existence of cycloid ™ outside the framework of this disease was called into question. Since the 40s, cycloid psychopathy has disappeared from psychiatric manuals. In recent years, cycloidism has again attracted attention, but as one of the premorbid types of patients with endogenous psychoses, the cycloid and hyperthymic types are often not separated.
Meanwhile, there is a special group of cases where cyclic changes in the emotional background never even approach the psychotic level [Michaux L., 1953]. G. E. Sukhareva (1959) noted similar non-psychotic cyclothymic fluctuations in adolescents, which can generally smooth out with the onset of maturity. Such cases, from our point of view, would be more correct to consider as cycloid accentuations.
Our studies with S. D. Ozeretskovsky [Lichko A. E., Ozeretskovsky S. D., 1972] made it possible to distinguish two variants of cycloid accentuation in adolescence — typical and labile cycloids.
Typical cycloids in childhood are no different from their peers or give the impression of hyperthyms. With the onset of puberty (in girls, this may coincide with menarche), and even more often at 16-19 years old, when puberty is completed, the first subdepressive phase occurs. More often it is manifested by apathy and irritability. In the morning, there is a breakdown, everything falls out of hand. What used to be easy and simple, now requires incredible effort. It becomes harder to learn. Human society begins to weigh. Noisy peer groups, previously attracted, are now avoided. Adventure and risk lose all appeal. Previously lively teenagers are now becoming dull homebodies. Appetite drops, previously favorite foods cease to cause pleasure. Instead of insomnia characteristic of severe depression, drowsiness is often observed. In tune with the mood, everything acquires a pessimistic coloring. Minor troubles and failures, which usually begin to crumble due to a drop in working capacity, are experienced extremely hard. They can respond to remarks and reproaches with irritation, even goo and anger, but deep down they fall into even more despondency. Serious failures and complaints from others can deepen the subdepressive state or cause an acute affective reaction of the intrapunitive type with suicidal attempts. Usually only in this case, adolescents come to the attention of a psychiatrist.
Yuri P., 16 years old. Grew up in a friendly family. He studied well at an English school until the last grade. He was distinguished by a cheerful disposition, sociability, liveliness, was fond of sports, willingly participating in social work, was the chairman of the school club.
The last few weeks have changed. For no reason, the mood worsened, “some kind of melancholy attacked”, everything began to fall out of hand, it became difficult to study, abandoned social work, playing sports, quarreled with comrades. After class, I sat at home. Sometimes he argued with his father, arguing that «there is no truth in life.» Sleep and appetite worsened These days, he accidentally came across a popular science magazine with an article about the dangers of onanism. Since he himself secretly masturbated, but previously did not attach any importance to this, now he decided to quit, but found that «there is not enough will.» He thought that he was waiting for «impotence, insanity and dementia.» On the same days at school, at a general Komsomol meeting, he was subjected to severe criticism by his comrades for the collapse of public work, which he had previously led. One of his classmates called him «the mold of society.» At the meeting, at first he snapped, then fell silent. I realized that he was a «inferior person.» The thought of suicide came up. After returning home from school, he waited for the night and, when his parents fell asleep, he took 50 tablets of meprobamate. He left a note where he wrote that he was a «spiritually poor person» to blame before the school and the state.
From the resuscitation center he was taken to the teenage department of a psychiatric hospital. Here, in the very first days, the state suddenly and dramatically changed, although he did not receive antidepressants. The mood became slightly elevated, became sociable, active, easily made contact, was full of energy. He did not understand what was happening to him, «for no reason, some kind of blues found.» Now everything has passed, the mood has improved, I am glad that I survived. Suicidal attempt evaluates critically. He feels well, his appetite is even increased, his sleep has become strong and calm. He misses his family, school and friends. Eager to continue studying.
Survey using PDO. The cycloid type was diagnosed on the objective assessment scale. Conformity is average, emancipation reaction is not expressed. There is a negative attitude to alcoholism. According to the scale of subjective assessment, self-esteem is insufficient: there were no traits of any type.
Diagnosis. Acute affective intrapunitive reaction with a true attempted suicide against the background of cycloid type accentuation.
Follow-up after 2 years. He successfully graduated from high school and is studying at the institute. He notes that after leaving the hospital there were «bad periods» lasting 1-2 weeks and repeated every 1-2 months. By the time of catamnesis, these fluctuations were smoothed out.
In typical cycloids, the phases are usually short, 1-2 weeks [Ozeretskovsky SD, 1974]. Subdepression can be replaced by a normal state or a period of recovery, when the cycloid again turns into hyperthymia, seeks company, makes acquaintances, claims leadership and usually makes up for what was missed in study and work in the subdepressive phase. Upswings are less frequent than subdepressive phases and are less intense. According to the observation of Yu. A. Strogonov (1972), sometimes only usually unusual risky jokes on elders and the desire to make jokes everywhere and everywhere can catch the eye of others.
Cycloid teenagers have their places of «least resistance». They are different in the subdepressive phase and during the rise. In the latter case, the same weaknesses appear as in the hyperthymic type: intolerance to loneliness, monotonous and measured life, painstaking work, promiscuity in acquaintances, etc. In the subdepressive phase, the radical breaking of the life stereotype becomes the Achilles’ heel. This, apparently, explains the protracted subdepressive states inherent in cycloids in the first years of higher educational institutions [Strogonov Yu. A., 1973]. the term of the test-examination session is much more material than at school — all this breaks the educational stereotype instilled in the previous decade. You have to make up for lost time with enhanced exercises, and in the subdepressive phase this does not lead to the desired results. Overwork and asthenia prolong the subdepressive phase, there is an aversion to study and mental pursuits in general.
In the subdepressive phase, selective sensitivity to reproaches, reproaches, accusations against oneself also appears — to everything that contributes to thoughts about one’s own inferiority, worthlessness, uselessness.
Labile cycloids, in contrast to typical ones, in many respects approach the labile (emotionally labile) type. The phases here are much shorter — two or three «good» days are replaced by several «bad» ones. «Bad» days are more marked by bad mood than by lethargy, lack of energy, or poor health. Within one period, short mood swings are possible, caused by relevant news or events. But unlike the labile type described below, there is no excessive emotional reactivity, the constant readiness of the mood to change easily and abruptly from minor causes
Valery R., 16 years old Grew up in a friendly family, attached to his parents and older brother, who serves in the army. From childhood he was lively, affectionate, sociable, obedient. Studying well. In the last two or three years, he himself began to notice that his mood fluctuates: two or three good days, when he feels uplifted, alternate with days of “spleen”, when he quarrels easily, there appears, in his words, “intolerance to remarks and bossy tone” , prefers loneliness, reluctantly goes to school, which he generally loves. Has been in love with a classmate for more than two years, is very attached to her. A few days ago, the mood deteriorated again. It seemed that the beloved girl was interested in another boy. Out of jealousy, he purposely told her that he himself had fallen in love with another—there was a break. It was extremely hard for what happened. I thought about her all the time, could not find a place for myself, secretly cried, every night I saw her in a dream. I was looking for sympathy and empathy from my friends — I was amazed by their «indifference». At their suggestion, he took part in a joint drink, but the melancholy only intensified from wine. When he returned home, he felt «complete hopelessness and loneliness.» When my parents fell asleep, I climbed into a hot bath and inflicted several deep cuts on myself with a razor. Lost consciousness from bleeding. He woke up in the arms of his father, who accidentally discovered him.
In the teenage department of the psychiatric hospital for the first three days he remained depressed, spoke of his unwillingness to live. His beloved girl found him through the help desk of the ambulance and came to visit him — he refused to meet with her.
Then the mood changed for the better (he did not receive psychotropic drugs), met with his beloved, reconciled with her. There was a “rise” for two days — he became cheerful, sociable, strove to go home, missed school. In the subsequent mood is even. Critically evaluates his act, considers himself guilty. In a conversation, he discovers emotional lability, seeks empathy.
Survey using PDO. According to the objective assessment scale, the labile-cycloid type was diagnosed. Medium conformity, moderate emancipation reaction. A high B-index (B-6) was found, although neither in the anamnesis, nor during a neurological examination, nor on the EEG data for the presence of residual organic brain damage was found. The psychological tendency to alcoholism is high. According to the scale of subjective assessment, self-assessment is correct, labile, cycloid, hyperthymic features are distinguished, sensitive features are rejected.
Diagnosis. Reactive depression with a suicide attempt on the background of accentuation of the labile-cycloid type.
Follow-up after 2 years. Healthy. Studying at the university. There were no repeated suicide attempts. Still notes variability of mood.
In both typical and labile cycloids, the reactions of emancipation and grouping with peers are intensified during periods of upsurge. Hobbies are characterized by instability — during subdepressive periods they are abandoned, during the period of recovery they return to them or find new ones. Adolescents themselves do not notice a noticeable decrease in sexual desire in the subdepressive phase, although, according to the observations of relatives, sexual interests go out on “bad days”. Severe behavioral disorders (delinquency, running away from home, etc.) are not characteristic of cycloids. But during periods of upsurge, they may find themselves prone to alcoholism in companies. Suicidal behavior in the form of affective (but not demonstrative) attempts or true suicide attempts is possible in the subdepressive phase, if at this time the teenager is subjected to mental trauma, which strengthens him in thoughts of his inferiority.
Self-assessment of character in cycloids is formed gradually, as the experience of “good” and “bad” periods accumulates. A teenager may not yet have such experience and therefore self-esteem may be imperfect.
Cycloid accentuation, as indicated, only occasionally falls under the supervision of a psychiatrist (usually these are cases of suicidal attempts). However, in healthy adolescents, it can be detected in 2-5% [Ivanov N. Ya., 1976], and half of them can be classified as typical, and the other half as labile cycloids. In post-adolescence (18-19 years) the percentage of cycloids increases significantly, and the percentage of hyperthyms decreases [Borovik T. Ya., 1976; Peretyaka O.P., 1981] Apparently, due to some endogenous patterns, the hyperthymic type can be transformed into a cycloid type — against the background of previously constant hyperthymia, short subdepressive phases appear.