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A traditional view in psychiatry is that personality disorders or traits are intimately related to primary mental disorders. Psychic functions with common roots might be constitutive of personality and psychosis or other disorders. Hoche held that paranoia, mania and melancholia lie in the normal psyche, and Kraepelin conceded such a view, explicitly implying personality. According to Carl Schneider, endogenous symptom complexes or associations and normal functional associations are fuzzy. Many other psychopathologists emphasize personality characteristics in connection with endogenous or functional psychoses, such as the sensitive and melancholic types. When adopting a continuum view of mental disorders, they behave in a unitary or systemic configuration, corresponding to endogenous-functional dispositions interacting with the milieu and composing personality.

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In his article 'On the question of unitary psychosis' (1926), Harry Marcuse (1876-1931) undertook a thought experiment in which he challenged clinical psychiatrists to entertain the possibility that the concept of unitary psychosis could be a useful diagnostic and nosological tool. Drawing on the psychology of Friedrich Jodl (1849-1914) and contemporary notions of energeticism, Marcuse proposed a non-empirical, 'analytic' method of overcoming growing dissatisfaction with Kraepelinian categories in the 1910s and 1920s.

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Kahlbaum's seminal approach to symptom complexes, as opposed to disease entities, is still relevant. Many psychopathologists have approached mental symptom complexes without prejudging them as necessary physical deficits or diseases, favouring a broader dimensional and anthropological view of mental disorders. Discussions of symptom complexes gained prominence in psychiatry in the early twentieth century - through Hoche - and in the period leading up to World War II - through Carl Schneider. Their works, alongside those of Kraepelin, Bumke, Kehrer, Jaspers and others, are reviewed in relation to the theme of symptom complexes, the mind, and mental disorders. A particular feature of symptom complexes is their relationship to aspects of the normal mind and how this affects clinical manifestations. It is further suggested that symptom complexes might offer a useful bridge between the psychic and the biological in theories of the mind.

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The concepts of the authors of 'unitary psychosis' doctrine preceeding the famous concepts of the XIX-th century authors J. Guislain, A. Zeller and W. Griesinger are analyzed. The beginnings of unitary psychosis doctrine are presented in the works of the antiquity period physician Aretaeus the Cappadician (II century), the founder of neurology, the English physician Thomas Willis (XVII century), the author of the term 'neurosis', the Scottish physician W. Cullen and the Florentine psychiatrist V. Chiarugi (XVIII century). The notions of partial and general insanity and some counter-arguments of the opponents of unitary psychosis concept are also discussed.

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Many psychopathologists have approached symptom complexes without prejudging them as physical deficits or diseases, an approach suitable to connections with normal mind, to a broad dimensional and anthropological view of mental disorders. It contrasts with the prevailing orientation in psychiatry toward the medical model of delimited diseases. Discussions of this order centered on symptom complexes gained special prominence in psychiatry between the early 20th century through Alfred Hoche and World War II through Carl Schneider. Their works, in addition to the work of other authors of that period, are considered. The late Kraepelin conceded the possibility that affective and schizophrenic manifestations do not represent disease processes but rather represent areas of human personality. Seeing mind or persons is a paradigmatic different perspective than seeing diseases. Re-emerge in this comprehensive or integrationist context the notion of unitary psychosis and philosophical questions as the mind-body problem; as background there was a process metaphysics. The possibility of human experience in a phenomenological sense is considered, and a matrix of symptom or function complexes is related to it. Examples of past unitary models of mental disorders with their neurophysiologic explanations are given, as well as an analogy to current biological aspects of the endogenous in chronobiology. The question or hypothesis arises whether mental symptom complexes are manifestations of mind constituents or functions that make human experience and mind possible. The present work is a conceptual analysis that indicates a positive answer to this question. The expectation is to emphasize the perspectives of investigation in psychopathology and sciences of mind fostered by this view of symptom complexes.

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The history of negative symptoms of schizophrenia rises early days of medicine in clinical and pathophysiological differences between positive and negative and their complex joint. Forming a set of typical core of symptoms, and some feature of a syndrome belonging to a specific pathophysiological mechanism, negative symptoms of schizophrenia emerge from old descriptions of clinical pictures, related to the overall look of madness, the heart of alienation, a central sign of early dementia, gradually more precisely describing the strange nature of the autistic withdrawal and schizophrenic apragmatism. At therapeutic era, negative symptoms have taken over the positive symptoms to establish an operational criteria whose importance lies in the progressive severity of this clinical type and in their contribution to therapeutic resistance. Despite the efforts of modern typological classifications, this work rehabilitates the old concept of "unitary psychosis" by defining a common symptomatic core to multiple clinical forms of psychosis, combining deficit of emotional expression and avolition, meaning a native psychopathology and a pathophysiology possibly in a common final way, and calling the arrival of new treatment strategies.

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Because of their compilation of contrasted symptoms and their variable clinical presentation, mixed episodes have been withdrawn from the DSM. However, mixed states question not only the bonds between depression and mania, but also the distinction between bipolar disorders and schizophrenia. Indeed, doubts about the dichotomy introduced by Kraepelin between bipolar disorders and schizophrenia is as old as the nosolgy itself, as attest the later works of this author revealing his hesitations on his own classification. But findings here reviewed issued from recent technical advances, particularly in the imaging and genetic fields, offer a better understanding of the boundaries between these two disorders. Yet, when confronted to an acute episode, clinicians may find it challenging to distinguish a mixed state from a schizophrenic relapse. Indeed, there is no pathognomonic manifestation allowing to retain a diagnosis with confidence. The physician will therefore have to identify a pattern of signs, which will orient his assessment with no certainty. Thus, negative rather than affective or psychotic symptomatology appears to be useful in discriminating schizophrenia (or schizoaffective) disorders from mixed mania. However, a conclusion during this acute stage appears in definitive a formal exercise, first because the final diagnosis will only be ascertained once the symptoms are amended, and second because, according to our classifications, a mood episode, including mania and mixed mania, can be observed without ruling out the diagnosis of schizophrenia.

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