Psychological symptoms can be grouped into two main classes: the first includes initial symptoms which appear during the latent phase of the disorder, when cerebral control is already insufficient, but not permanently so. The second class includes those symptoms which appear when the disorder reaches its active phase, and the insufficiency is more stabilized and complete. Symptoms during the latent phaseDuring the latent period, symptoms are not pathognomonic
(pathognostic); they are therefore often difficult to detect.
Doctors have little opportunity to observe them, since patients hardly have anything to complain about, nor do they seek treatment. They are only potentially psychasthenic, and since this period may last for years without becoming aggravated, it is very rare for them to be in the care of medical professionals. However, it is of the utmost importance that patients at this stage be treated, since insufficient control is much easier to cure when discovered in its early stages; if detected early, it is easier to prevent the onset of complete insufficiency.
At this stage, the role of education is primordial, and if doctors had more opportunity to intervene, they could at least detect the symptoms, warn the patients’ parents, and save many an unfortunate child from years of suffering. Although the individual symptoms do not have any obviously distinguishing characteristics, hardly differing from those observed
in cases of simple nervous disorders, when taken as a whole, they become easily identifiable to even to the inexperienced observer. The first symptom is exaggerated impressionability: its distinguishing characteristic is that it is not permanent, as in cases of simple nervousness - the patient’s character is unstable, sometimes gay, sometimes morose, sometimes gregarious and outgoing, sometimes totally self-centered, and all this for no apparent reason.
Interrogate a patient and s/he will not be able to explain the condition, ascribing it to a lack of morale, or some indefinite vague fear, or even to a loss of memory. Such patients often let themselves fall into a kind of dreamlike semi-conscious state, which they do not find unpleasant, but whose dangers they do not recognize, and which they will be hard put to get
out of later on. The longer this state lasts, the more pronounced the symptoms become: apathy, fatigue, and a general disinterest in life soon take hold and refuse to let go.
In cases where such daydreaming does not occur, patients will at least show a marked instability in their thought processes: they can never seem to concentrate, and suffer from a condition which we call mental wandering.
This form of the disorder does not represent a major inconvenience, and may persist for a very long time without becoming aggravated. However, it is just as characteristic of unstable mental control as the dream state is.
Cerebral instability, however temporary, results in mental fatigue, and eventually leads to an inability to make decisions, and a lack of self confidence. Patients ponder over everything they do, endlessly deliberating, without ever being able to reach any definite and practical solutions. They hardly exist in the present; their thoughts come and go, and their minds are either lost in reveries about the past, or are consumed with worry about the future.
Remember that all these phenomena are temporary -they may occur twenty times a day, but patients revert to normal between bouts, which is characteristic of unstable cerebral control. They also occur when the disorder has reached its active phase, with the difference that they cause patients real suffering, and there is no period of remission.
We have said that the latency period does not have any specific duration; it can persist for years, and then suddenly, because of some moral or emotional shock, even one which is relatively minor, progress to the active phase of the disorder.