Showing papers in "American Journal of Psychiatry in 1970"
TL;DR: It was shown by follow-up and family studies that poor prognosis cases can be validly separated clinically from good prediction cases, and the authors conclude that good prognosis "schizophrenia" is not mild schizophrenia, but a different illness.
Abstract: A method for achieving diagnostic validity in psychiatric illness is described, consisting of five phases: clinical description, laboratory study, exclusion of other disorders, follow-up study, and family study. The method was applied in this paper to patients with the diagnosis of schizophrenia, and it was shown by follow-up and family studies that poor prognosis cases can be validly separated clinically from good prognosis cases. The authors conclude that good prognosis "schizophrenia" is not mild schizophrenia, but a different illness.
1,989 citations
TL;DR: The author believes that the killing of a newborn baby is a separate entity from other filicides, differing in regard to the diagnosis, motives, and legal disposition of the murderer.
Abstract: The author believes that the killing of a newborn baby is a separate entity from other filicides, differing in regard to the diagnosis, motives, and legal disposition of the murderer Whereas most filicides are committed for "altruistic" reasons, most neonaticides are carried out simply because the child is not wanted The author notes the different psychological characterisctics of mothers who commit these two crimes Legal considerations and the present status of neonaticide are also discussed
388 citations
TL;DR: There was no significant difference attributable to niacinamide; also, tests for the "mauve factor" in the urine of 28 of the children were negative.
Abstract: The author evaluated 57 schizophrenic children clinically and psychologically before and after a six-month administration of niacinamide. They were separated into three groups: those given niacinamide, those given niacinamide plus a tranquilizer, and those given a placebo. There was no significant difference attributable to niacinamide; also, tests for the "mauve factor" in the urine of 28 of the children were negative.
259 citations
TL;DR: It is shown that locomotor hyperactivity, an animal model for the central stimulant effects of amphetamine, is mediated by brain norepinephrine, and hyperactivity of dopamine systems in the brain may be a factor in the pathophysiology of this condition.
Abstract: By comparing biochemical and behavioral actions of d- and l- isomers of amphetamine, the authors show that locomotor hyperactivity, an animal model for the central stimulant effects of amphetamine, is mediated by brain norepinephrine. By contrast, stereotyped, compulsive gnawing behavior in rats, which resembles symptoms of amphetamine psychosis, appears to be regulated by brain dopamine. Since haloperidol, a potent blocker of dopamine receptors, is uniquely efficacious in treating Gilles de la Tourette's disease, the authors suggest that hyperactivity of dopamine systems in the brain may be a factor in the pathophysiology of this condition.
205 citations
TL;DR: Comparative measurement of the body-buffer zones of eight violent and six non-violent prisoners showed the zones of the violent group to be almost four times larger.
Abstract: Comparative measurement of the body-buffer zones of eight violent and six non-violent prisoners showed the zones of the violent group to be almost four times larger. In the violent group the rear zones were larger than the front zones; in the non-violent group the front zones were larger. The large zones of the violent group may reflect a pathological body image state. The author discusses potential application of body-buffer zone measurements in the detection, treatment, and prognosis of individuals predisposed to violent behavior.
164 citations
TL;DR: Three systems are operative in the selection of a living, genetically related, kidney donor: the self-selection of the volunteers, the medical team selection for the best match, and a family system that operates chiefly by excluding certain members from participation.
Abstract: Three systems are operative in the selection of a living, genetically related, kidney donor: the self-selection of the volunteers, the medical team selection for the best match, and a family system that operates chiefly by excluding certain members from participation. Only the medical team pays attention to the ethical guidelines for organ transplantation adopted by the American Medical Association. The decision making of the volunteers follows other identifiable principles.
158 citations
TL;DR: The authors present a technique for weight restoration in a condition that is often highly refractory to therapy, with mortality rates of up to 15 percent, by making access to physical activity contingent upon weight gain.
Abstract: The authors present a technique for weight restoration in a condition that is often highly refractory to therapy, with mortality rates of up to 15 percent. Operant reinforcement was applied to three consecutive patients by making access to physical activity contingent upon weight gain. Treatment of from four to six weeks resulted in rapid weight restoration. Modifications of the technique, illustrating variations in operant reinforcement, are also reported.
141 citations
TL;DR: The authors suggest that these children with the Lesch-Nyhan syndrome may have a very low threshold for the activation of a mechanism that controls repetitive, compulsive, pain-causing behavior.
Abstract: The authors report their observations of five children with the Lesch-Nyhan syndrome and review the literature to describe the general characteristics of the disorder, the development and types of self-mutilative behavior, and the types of outward-directed aggression. The authors suggest that these children may have a very low threshold for the activation of a mechanism that controls repetitive, compulsive, pain-causing behavior. This factor may also explain other forms of self-destructive behavior in children and may represent the psychobiological basis for the development of masochistic behavior.
129 citations
TL;DR: The author concludes that thyroid hormone potentiates the effects of the tricyclic antidepressants to some extent, but he suggests the need for further study in this area.
Abstract: The author conducted a study of 25 retarded depressed patients who previously responded inadequately to tricyclic antidepressants. Continuing the group on antidepressants, he also administered thyroid hormone. Fourteen showed an excellent response to the combination. He concludes that thyroid hormone potentiates the effects of the tricyclic antidepressants to some extent, but he suggests the need for further study in this area.
122 citations
TL;DR: A systematic psychiatric study with a group of convicted women felons confirmed other work suggesting that there is a significant association between sociopathy and hysteria.
Abstract: A systematic psychiatric study was carried out with a group of convicted women felons. All the women received at least one psychiatric diagnosis. Sociopathy, alcoholism, drug dependency. hysteria, and homosexuality were encountered more frequently than would be expected in the general female population. Sociopathy or hysteria was found in 80 percent; a 20 times greater prevalence of hysteria than is found in the general population was the most striking finding. The results of this study confirm other work suggesting that there is a significant association between sociopathy and hysteria.
118 citations
TL;DR: The role of the temporal limbic structures in the regulation of sexual arousal is documented and followed the abrupt cessation of temporal lobe seizure activity following either temporal lobectomy or seizures.
Abstract: The most common sexual abnormality in temporal lobe epilepsy is a marked lack of libidinal and genital arousal. The author documents the occurrence of hypersexual behavior in 50 temporal lobe epileptics, 42 of whom had unilateral temporal lobectomy. Twenty-nine (58 percent) were clearly hyposexual prior to surgery; seven (14 percent) had distinct episodes of hypersexuality. In six patients the hypersexual episodes followed the abrupt cessation of temporal lobe seizure activity following either temporal lobectomy or seizures. These findings document the role of the temporal limbic structures in the regulation of sexual arousal.
TL;DR: No definitive interpretation of these findings can yet be made; further extensive and systematic case studies are needed to determine whether the sleep disturbances reported here are an inherent aspect of all acute schizophrenic exacerbations.
Abstract: Sleep patterns were studied longitudinally in six acute schizophrenic patients throughout most of their hospital stays, ranging from 25 to 224 consecutive nights, and the data were compared with those from 15 normal control subjects. The sleep patterns of these six patients showed unique differences from those of the control subjects as well as from sleep patterns of severely depressed patients and normal subjects under experimental conditions. However, no definitive interpretation of these findings can yet be made; further extensive and systematic case studies are needed to determine whether the sleep disturbances reported here are an inherent aspect of all acute schizophrenic exacerbations.
TL;DR: Responses to questions about 46 symptoms show that quantitative resemblance exists, and regardless of clinicians' ratings of severity, the particular symptoms tended to be judged less serious by those who reported them in nonpatient than in patient groups.
Abstract: Do large proportions of the general population show psychiatric symptomatology resembling that seen in psychiatric patients? Responses by 248 adult leader, community sample, and patient subjects in Washington Heights. New York City, to questions about 46 symptoms show that quantitative resemblance exists. This resemblance is due mainly, however, to the high frequency of less serious symptoms in the nonpatient groups. Moreover, regardless of clinicians' ratings of severity, the particular symptoms tended to be judged less serious by those who reported them in nonpatient than in patient groups.
TL;DR: Thyroid stimulating hormone, when combined with imipramine, produces a more rapid recovery from depression than does imipramsine alone, but dose differences prevent accurate comparison.
Abstract: Thyroid stimulating hormone, when combined with imipramine, produces a more rapid recovery from depression than does imipramine alone. It seems more potent than triiodothyronine in potentiating imipramine, but dose differences prevent accurate comparison. This hormone has the clinical disadvantage of being long acting and difficult to control. Depressed patients show thyroid indices within the normal range. Serum indices of thyroid state respond normally to TSH injection, but ankle reflex time is not accelerated. Tantalizing clues have appeared, but the mechanism by which thyroid hormones potentiate tricyclic antidepressants remains unknown.
TL;DR: It was found that during intoxication subjects observed significantly more aggression, sexuality, and dysphoria in themselves than they had anticipated, and a marked increase in irresponsible behavior was successfully predicted.
Abstract: Using a modified Q-sort test administered to 13 male alcoholics, the authors attempted to assess alcoholics' expectancies prior to drinking and to compare these with their subsequent self-reports of feeling states and behavior during experimentally induced intoxication. They found that during intoxication subjects observed significantly more aggression, sexuality, and dysphoria in themselves than they had anticipated. A marked increase in irresponsible behavior, however, was successfully predicted.
TL;DR: Two subgroups—hyperactive and nonhyperactive—each with characteristics suggesting a different syndrome, are described, giving evidence of brain dysfunction in the groups with scholastic-behavioral problems.
Abstract: Psychometric, neurological, and EEG studies were made of 24 children with scholastic-behavioral problems but no classical evidence of neurological disease and of 24 matched controls. Differences between the two groups were significant in all three measures, giving evidence of brain dysfunction in the groups with scholastic-behavioral problems. Two subgroups—hyperactive and nonhyperactive—each with characteristics suggesting a different syndrome, are described.
TL;DR: Lithium, at a dosage of 1,800 mg.
Abstract: Lithium, at a dosage of 1,800 mg. daily, was found to be effective in the treatment of acute manic states. However, when compared with chlorpromazine by means of a double-blind technique using stringent diagnostic criteria, no significant difference between the two drugs was noted. In regard to the prophylactic effect of lithium, the data presented indicate that this question is still unresolved.
TL;DR: The authors compared the characteristics of auditory hallucinations experienced by 45 schizophrenics and those experienced by 18 patients with alcoholic hallucinosis to find that the alcoholics' hallucinations were localized in space and had a greater frequency than those of the schizophrenics.
Abstract: By means of a questionnaire the authors compared the characteristics of auditory hallucinations experienced by 45 schizophrenics and those experienced by 18 patients with alcoholic hallucinosis. The alcoholics' hallucinations were localized in space and had a greater frequency than those of the schizophrenics; the frequency was relatively independent of emotional state. The schizophrenics' hallucinations had a cognitive taint, were poorly localized, and showed a sensitivity to emotional arousal.
TL;DR: The authors describe the clinical and endocrine characteristics of the state of acute ego disorganization that initiated the schizophrenic episodes of four young men and suggest neuroendocrine differences between psychotic and neurotic anxiety.
Abstract: The authors describe the clinical and endocrine characteristics of the state of acute ego disorganization that initiated the schizophrenic episodes of four young men. Corticosteroid excretion during this phase reached levels 250 percent of subsequent recovery values, far exceeding the elevations seen in normals under stress. The patients subsequently recovered along two separate clinical pathways, which were associated with distinctive changes in adrenal cortical activity. The findings suggest neuroendocrine differences between psychotic and neurotic anxiety.
TL;DR: The authors describes several cases in which patients showed psychotic symptoms in interviews held in their native languages but not in those conducted in foreign languages, possibly because the effort of communicating in another tongue produces unconscious vigilance over the emotions.
Abstract: The author describes several cases in which patients showed psychotic symptoms in interviews held in their native languages but not in those conducted in foreign languages, possibly because the effort of communicating in another tongue produces unconscious vigilance over the emotions. While he does not offer a hypothesis, he suggests that further research in the area of psychiatry and linguistics would be rewarding.
TL;DR: The author discusses the problems militating against a valid research trial utilizing these medications in this type of patient and lithium carbonate proved superior to chlorpromazine on all six parameters selected from an objective rating scale.
Abstract: Thirteen manic patients were treated with lithium carbonate and ten manic patients with chlorpromazine in a double-blind, randomly selected drug trial. Lithium carbonate proved superior to chlorpromazine on all six parameters selected from an objective rating scale. The author discusses the problems militating against a valid research trial utilizing these medications in this type of patient.
TL;DR: The authors examined the attitudes and beliefs about mental illness of 20 faith healers in the Puerto Rican community of New York City and presented two case studies that may help to explain this lack of acknowledgment of the role native healers play.
Abstract: The authors examined the attitudes and beliefs about mental illness of 20 faith healers in the Puerto Rican community of New York City; these were compared with data collected earlier from samples of Spanish-speaking community leaders and a cross-section of Puerto Rican household heads. Spiritualists appear to be an idiosyncratic group differentiated within their culture for the purpose of healing. The authors emphasize the lack of professional acknowledgment of the role native healers play in this and other minorities and present two case studies that may help to explain this lack of acknowledgment.
TL;DR: A study of 57 homosexual women and 43 single heterosexual controls revealed slightly more clinically significant changes and disability in the lives of the homosexual women as compared with the heterosexual women.
Abstract: A study of 57 homosexual women and 43 single heterosexual controls revealed slightly more clinically significant changes and disability in the lives of the homosexual women as compared with the heterosexual women. The chief differences were in the increased prevalence of alcoholism and of attempted suicide. Despite these difficulties, the homosexual women were able to achieve, adapt, and be productive citizens.
TL;DR: Frequencies of schizophrenic versus affective psychoses from 1944 to 1968 at a university psychiatric clinic revealed an abrupt increase in the rate of schizophrenia diagnoses at the start of the phenothiazine treatment era and a sharp increase in diagnoses of affective psychosis with the advent of lithiumn therapy.
Abstract: Frequencies of schizophrenic versus affective psychoses from 1944 to 1968 at a university psychiatric clinic revealed an abrupt increase in the rate of schizophrenic diagnoses at the start of the phenothiazine treatment era and a sharp increase in diagnoses of affective psychosis with the advent of lithiumn therapy. As one group of diagnoses increased, the other decreased. One responsible factor may be the introduction—in the setting of a complex differential diagnostic problem—of observer bias, modified by the availability of novel and effective therapies.
TL;DR: The author stresses the need to focus also on the "compensated-transition" phase and the "depressive-neurasthenic" phase, which follow, which should be given more attention in residency training programs.
Abstract: When the treatment of an acute schizophrenic episode is considered, prime emphasis is usually placed on the acute psychotic state as the major occurrence. The author stresses the need to focus also on what he calls the "compensated-transition" phase and the "depressive-neurasthenic" phase, which follow. The importance of treating these latter phases effectively, preferably by the same physician who treated the acute stage, should be given more attention in residency training programs, he believes.
TL;DR: The authors review the influence of white racism on the image of the black patient, neglected problem areas, treatment accessibility, community mental health, research, and the professional functioning of psychiatrists to recommend new institutionalized practices supported by the white power structure of psychiatry.
Abstract: Defining institutional racism in terms of self-perpetuating barriers to blacks' participation as equals in all areas of psychiatry, the authors review the influence of white racism on the image of the black patient, neglected problem areas, treatment accessibility, community mental health, research, and the professional functioning of psychiatrists. These analyses lead to specific recommendations for new institutionalized practices to be supported by the white power structure of psychiatry if eradication of racism in psychiatry is to be accomplished.
TL;DR: While the drug appears to be relatively harmless, caution in prescribing it is advised, especially for women of childbearing age and for patients with a history of ulcer, gout, diabetes, or liver disease.
Abstract: The author reviews the literature on the possible toxicity of nicotinic acid, whose therapeutic value in the treatment of schizophrenia is still in dispute. While the drug appears to be relatively harmless, caution in prescribing it is advised, especially for women of childbearing age and for patients with a history of ulcer, gout, diabetes, or liver disease.
TL;DR: In a two-phase study of diagnostic decision making, psychiatrist observers viewed films of diagnostic interviews and recorded their comments and the symptoms they saw in the patients.
Abstract: In a two-phase study of diagnostic decision making, psychiatrist observers viewed films of diagnostic interviews and recorded their comments and the symptoms they saw in the patients. Analysis of the results, in terms of the time at which conclusions and symptoms were reported, revealed that the first three minutes of observation have a significant, and sometimes apparently decisive, impact upon the final diagnostic decision.
TL;DR: The "normalization principle" formulated by Scandinavian workers in mental retardation aims at eliciting and maintaining culturally normative behavior and using culturally normative means to this end.
Abstract: The "normalization principle" formulated by Scandinavian workers in mental retardation aims at eliciting and maintaining culturally normative behavior and using culturally normative means to this end The principle is simultaneously simple and comprehensive, and it can constitute a unifying ideology for all human management areas It provides guidance for decisions from the lowest clinical to the highest systems levels Some specific implications for psychiatry are discussed
TL;DR: It is concluded that unilateral ECT to the nondominant hemisphere reduced the chance of memory disturbance and offered the best chance of quick recovery with few side effects when ECT is given for depression.
Abstract: A double-blind clinical trial compared the effects on three patient groups of bilateral ECT and unilateral ECT to the dominant and nondominant hemispheres. After six ECTs there was no significant difference among the three groups in depression relief. However, unilateral ECT to the nondominant hemisphere reduced the chance of memory disturbance and offered the best chance of quick recovery with few side effects. The authors conclude that it is the treatment of choice when ECT is given for depression.