Showing papers in "Journal of Nervous and Mental Disease in 1967"

Delirium, clouding of consciousness and confusion.

Abstract: Delirium has been for years the Cinderella of English-language psychiatry: taken for granted, ignored, and not considered worthy of study. Whatever the reasons for this neglect might be, several recent developments in psychiatry and psychology fully justify a reexamination of this syndrome and its conceptual framework. The growth of experimental psychopathology, and particularly the study of drug-induced model psychoses as well as of the psychological effects of variation of sensory input and of sleep deprivation, invite comparison with that “experiment of nature” which is delirium. The concept of consciousness has recovered its respectability in psychology and the class of disorders designated “disturbances of consciousness” has recently attracted the attention of scientists from various disciplines.111 Progress in the understanding of the neural substrate of conscious experience has been spearheaded by neuroanatomists and neurophysiologists.14,36 The rapid development of general hospital psychiatry has given access and opportunity for the study of psychiatric complications of somatic disease to an extent unparalleled in the history of psychiatry. Psychiatrists working on the medical and surgical wards must deal with the diagnostic and therapeutic problems of delirium and related states as part of their liaison work.86 There has been dissatisfaction with the current classification of the so-called organic brain syndromes and salutary recognition that their study “touches on the basic questions of the biological organization of drives, affects, and cognitive processes.”99 Current interest in cognition60 should extend to delirium in which disorganization of cognitive processes is the chief feature.

Clinical evaluation of some hallucinogenic tryptamine derivatives.

Abstract: Several tryptamine derivatives such as N. N -dimethyltryptamine (DMT) (27) , N. N-diethyltryptamine (DET) (2, 8), psilocybin (11) and psilocin (12) have been reported to produce in man hallucinogenic effects similar to those of LSD-25. These compounds, classified as hallucinogens, have the unique quality of being able to produce in man marked alterations in sensory perception, intensification of colors, visual hallucinations and illusions. Distortion of body image and feelings of depersonalization can also occur. Marked lability of mood with rapid shifts from elation to depression can be seen, and anxiety states, ranging from mild apprehension to panic can occur. Sometimes, the passage of time can be distorted (59). Speeter and Anthony (26) reported that N. N-dipropyltryptamine (DPT) , another tryptamine derivative, produced observable effects in dogs. Barlow and Kahn (1) and Vane (31) used isolated organ preparations to study the effects of DPT and other tryptamine derivatives. Szara (29) using a nontoxic dose of DPT observed hyperactivity in mice. The similarity in chemical structure between DPT (see Figure 1) and other hallucinogenic tryptamine derivatives and its reported effects in animals indicated that this compound might be capable of producing hallucinogenic effects in humans. One of the major problems in evaluating hallucinogenic compounds is the absence of an effective placebo which could mimic

Post-Mastectomy Breast Phantoms

Abstract: Although the breast is the external body part most frequently amputated, little has been written about breast phantoms. From an original 92 item questionnaire completed by 104 post-mastectomy patients, it was found that 24 (23%) reported having had phantom breast sensations[1]. Itching was the most common sensation. While phantom pain was reported by eight of those 24 patients, it was minor in nature with only 1 patient requiring a simple anodyne for relief. There was no typical pattern of appearance of the phantom sensation. It most frequently began two to six months after the operation.