Heller's syndrome: a form of childhood psychosis of multicausal origin. Case report and review of literature

Childhood disintegrative disorder: should it be considered a distinct diagnosis?

First termed Dementia Infantilis by Theodore Heller in 1908, Childhood Disintegrative Disorder (CDD) has had a history longer than that of Autistic Disorder. Presently, CDD is classified as a Pervasive Developmental Disorder in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The characteristics most often cited as distinguishing CDD from Autistic Disorder, another one of the Pervasive Developmental Disorders, is the age of onset and evidence of normal development prior to the presence of symptomatology. Otherwise, the behavioral symptoms of CDD and Autistic Disorder are strikingly similar. The purpose of this article is to provide a historical background on CDD, examine the evolution of diagnostic criteria, review the existing literature pertaining to the disorder, and, finally, to draw conclusions regarding the validity of CDD as a distinct diagnosis with reference to current and alternative classification approaches.

The concept and nosology of Heller's syndrome: review of articles and report of two cases

Based on a review of 60 historical cases of dementia infantilis and its synonyms (i.e., Heller's disease, Heller's dementia, Heller's syndrome and disintegrative psychosis) and a report of 2 new cases, the concept and nosology of Heller's syndrome, the most appropriate generic name for such conditions, were studied. In the age of onset, sex ratio, symptoms and a favorable prognosis in terms of life, a group of etiologically diverse conditions called Heller's syndrome differs from adult dementias and appears classifiable in pervasive developmental disorders according to DSM-III or DSM-III-R, even though its validity as a clinical syndrome remains to be studied.