Issue 1/2024
Haralanova, Ev., Haralanov, Sv.
UMBALNP „St. Naum”, First Psychiatric Clinic – Sofia
Based on own research and critical analysis of data from the literature, an integrative hierarchical concept of the split mind in schizophrenia has been developed. According to it, endogenous dysregulation of brain dopaminergic neurotransmission determines two parallel poles of affectivity that lead to withdrawal of affective energy from the objective reality (autism), but they result from two polar mechanisms. Negative pole is determined by primary mesocortical hypodopaminergia. It is manifested by an abnormal reduction of outwardly directed affective energy and leads to a pathologically lowered affective contact with the objective reality (hypoaffective autism), which underlies negative symptoms of the disease process in the brain. Positive pole is determined by secondary mesolimbic hyperdopaminergia. It is manifested by an abnormal production of inwardly directed affective energy and leads to a pathologically heightened affective contact with the subjective reality (hyperaffective autism), which underlies positive symptoms of the schizophrenic psychosis. Clinical and theoretical implications of the concept are discussed.
Key words: schizophrenia, autism, psychosis, dopamine, split mind, affectivity
Address for correspondence:
Haralanov, Sv.
UMBALNP „St. Naum”, First Psychiatric Clinic – Sofia
1 „Luben Rusev”, Str.
1113, Sofia