Showing papers in "Journal of Nervous and Mental Disease in 1970"

Postpartum psychoses in patients with manic depressive disease.

Abstract: From a consecutive series of 61 manic depressive patients a group of 20 bipolar manic depressive mothers and 29 female first degree relatives who had children and an episodic affective disorder were examined with respect to their postpartum state. The frequency of postpartum breakdowns was significa

Neuropsychological patterns in chronic schizophrenia.

Abstract: The purposes of the present research were two-fold. First, the psychiatric and psychological status of a group of chronic schizophrenics (N = 66) was followed over a period of 8 years. These variables, as measured by the Malamud and Sands (8) psychiatric rating scale and the Wechsler Adult Intellige

The Electromyographic Study Of Verbal Hallucination

Abstract: This study was made to examine the hypothesis that verbal hallucination is an expression of so-called “inner speech,” using electromyographic techniques. In 9 schizophrenic patients, it was found that the experience of verbal hallucination was accompanied by an increase of electromyogram (EMG) discharge of the speech musculature in 47.6%. The time lag between the start of increase of EMG discharge and that of verbal hallucination was usually within 1.5 seconds. The duration of the EMG increase was positively correlated with the duration of verbal hallucination. It was further found that the verbal hallucination with an increase of EMG of the speech musculatures was experienced as a relatively loud one by the subjects, while the hallucination without EMG increase was experienced as a small one. It is suggested that subvocal speech, a part of inner speech, is produced at the moment of experiencing verbal hallucinations as demonstrated by the increase of EMG of the speech musculatures.

Role of fantasies in psychotherapy and psychopathology.

Abstract: Despite the central role of induced fantasies in systematic desensitization, the theoretical formulations by the behavior therapists have excluded consideration of the psychological matrix of these complex intrapsychic phenomena. Furthermore, Wolpe and many of his followers appear to have jettisoned

The schizophrenic patient and depressive symptomatology

Abstract: The present research provides data to evaluate the hypothesis that during the postpsychotic period of schizophrenic patients a depressive reaction frequently appears. Data are presented on 80 consecutive psychiatric admissions (44 patients with acute schizophrenic reactions and 36 depressed patients were studied for comparative purposes). The results on depressive feelings in these patients were gathered from three sources: 1) standardized weekly rating scales by psychiatrists; 2) standardized daily nurses' ratings; and 3) subjective ratings. We conclude from self-reports of depressive feelings and observational reports by nurses and physicians that these schizophrenic patients do not show what has been described as a depressive reaction in the recovery period or what has been termed the “postpsychotic period.” It is suggested that the clinical data responsible for this impression are related to the schizophrenic's defect in affect and, in some settings, to the recognition of depressive features which have always been present and are actually decreasing. In the past these depressive symptoms have sometimes been overshadowed by the more florid psychotic symptoms. The theoretical implications of this are discussed.

Role preparation and expectation of improvement in psychotherapy.

Abstract: An explanation of the process of psychotherapy combined with the suggestion that the patient should improve in a few months has been shown to produce better therapy results. The present study sought to determine whether the explanation or the suggestion was the more powerful aid to improvement. It a

An electroencephalographic study of behavioral rapid eye movement states in the human newborn.

Abstract: Rapid eye movements occur in the normal newborn when eyes are closed (sleep-REM), when eyes are open (drowsy-REM), and during some portion of the time when there is sucking, fussing, or crying (sucking-REM, fussy-REM, and crying-REM). In an electroencephalographic (EEG)-polygraphic study of these behavioral states, it was found that they are all associated with stage-REM physiology. Although the states can reliably be distinguished from one another using behavioral criteria alone, they cannot easily be distinguished from one another on the basis of isolated study of electrophysiological recordings. Independent behavioral and EEG-polygraphic assessments show high agreement in distinguishing these states as a group from other sleep and nonsleep states. The term “undifferentiated” is applied to drowsy-REM, sucking-REM, fussy-REM, and crying-REM because their behavioral and physiological indices are relatively unpatterned and, from the viewpoint of infant development, these states disappear during the first 3 months of postnatal life. Neonatal REM sleep is also conceptualized as undifferentiated as it shows an initial high variability of physiological patterning which tends toward stability over the first 3 months. This change is concomitant with another major change: at 3 months, sleep begins with non-rapid eye movement sleep instead of REM sleep.

Associations of subnormal serum folate and vitamin B12 values and effects of replacement therapy.

Abstract: An investigation of some of the clinical associations of low serum folate and B12 values found in a previous survey of 432 psychiatric inpatients is presented. There were 105 (22.5 per cent) “low folate” ( Most low serum values were associated with extrinsic provocative factors. Thus 89 per cent of low folate, 58 per cent of low folate-low B12, and 44.1 per cent of low B12 patients had received drugs during the three preadmission weeks; barbiturates, phenothiazines, and antidepressants (in that order) were the commonest drugs among low folate patients, and phenothiazines among low B12 patients. Significantly more low B12 patients (38.2 per cent) than low folate patients (18.6 per cent) were physically ill. Many low folate (61.6 per cent) and low B12 (47.1 per cent) patients had been ill for more than 1 year, and serious malnutrition was frequent among both low folate (22.1 per cent) and low B12 (32.4 per cent) groups. Low serum levels were infrequently associated with pregnancy and gastrectomy, and no case of intestinal malabsorption was seen. These extrinsic factors were not found in only 21 low folate and 14 low B12 patients (“primary” or “idiopathic” group) among whom no particular mode of psychiatric presentation was seen. Low folate patients had significantly more hematological abnormalities than normal folate patients, whereas low B12 compared with normal B12 patients did not. A retrospective survey of the results of treatment with folic acid and vitamin B12 supplements was carried out because it was found that they had been given to patients with low values in such a haphazard way as to be distributed virtually randomly. Among the low folate patients, 39 received folate and 63 did not. Folate-treated patients with organic psychoses, endogenous depression, and schizophrenia, when assessed on a 4-point scale, were found to be in a better clinical state at discharge than untreated patients; and their stay in the hospital was significantly shorter. There was no evidence that cyanocobalamin-treated low B12 patients were in a better clinical state at discharge or spent a shorter time in the hospital than similar untreated patients, though the assessment period was probably too short for firm conclusions to be drawn.

Psychotherapy in primary anorexia nervosa

Abstract: The literature on the value of psychotherapeutic intervention in anorexia nervosa is hopelessly inconclusive. This is due to the fact that authors frequently fail to differentiate between the genuine anorexia nervosa syndrome and emaciation associated with various psychological problems, and that on

Childlessness, intentional and unintentional.

Abstract: 6 states of childlessness are defined. Among the motivations for having children are innate feelings ego gratification providing an outlet for love and chiefly the many societal pressures that make even the unintentionally childless feel miserable and can propel them to an adoption agency. Motivations for childlessness include the cost of rearing children restrictions on a womans career the physical and emotional strain rejection of the feminine role and concern about overpopulation. The decision to remain childless usually is not made overnight but evolves over a number of years. Several avenues for attaining a degree of population control by promoting childlessness include elevating the status of childless married women and removing some of the incentives and pressures which force women into motherhood. Cooperative living arrangements could be formed so that childless couples could play a role in child rearing. An attempt could be made to encourage fertile women to adopt rather than bear children.

Field dependence as a predictor of alcoholic therapy dropouts.

Abstract: The present study was designed to investigate relationships between perceptual field dependence and selection criteria and dropout rates for alcoholic outpatients assigned to psychotherapy and drug therapy programs. Nineteen selectees for individual “insight” psychotherapy were compared with 19 nonselectees and with 18 drug therapy patients. On the basis of prior studies of field dependence it was hypothesized that alcoholics selected, by traditional clinical criteria, for insight psychotherapy would be significantly more field-independent than nonselectees. This hypothesis was supported by the results. It was further hypothesized that field dependence would be related to dropout status of alcoholic patients. Relatively field-dependent patients were expected to be early dropouts from psychotherapy, and relatively field-independent patients were expected to be early dropouts from drug therapy. The present results suggest that early dropouts from psychotherapy are significantly more field-dependent than remainers. However, no differences in field dependence were obtained between dropouts and remainers in drug therapy.

Lysergic acid diethylamide as a variable in the hospital treatment of alcoholism: a follow-up study.

Abstract: The use of lysergic acid diethylamide (LSD) in the treatment of alcoholism has led to many claims as to the drug's efficacy, but without a controlled study of both in-hospital application and posthospital adjustment of patients. The present paper is concerned with the use of LSD in placebo and maxim

The effects of lithium on electroencephalogram, behavior and serum electrolytes

Abstract: The effect of acute and chronic administration of lithium carbonate on electroencephalogram (EEG), behavior and serum electrolytes was studied in 10 patients. Five patients, 3 of whom are manic-depressive in the manic phase, and 2 who were schizo-affective in the excited phase, received lithium as p

On the relationship between aggressive activation, symbiotic merging, intactness of body boundaries, and manifest pathology in schizophrenics.

Abstract: Sixty relatively differentiated schizophrenics were seen individually for three sessions. In each session, a base line assessment first was made of the amount of manifest psychopathology and the degree to which ego boundaries were intact. Then, on different days in counterbalanced order, in one group Ss were subliminally exposed to pictures containing: 1) aggressive content; 2) neutral content; 3) content suggesting the theme of symbiotic merging. The other group was shown the same stimuli, but at a supraliminal level. Then, for both groups, there followed a “critical” assessment of manifest pathology and body boundary intactness. The Ss in the subliminal group responded to both the aggressive and merging stimuli with changes in both manifest pathology and body boundary intactness, while the Ss in the supraliminal group were unaffected by the two kinds of stimulation. Also, the reaction of the subliminal group, under both experimental conditions, varied as a function of whether the Ss were assessed soon after stimulation or after a somewhat longer period of time had elapsed, this being seen as bearing on the variability of schizophrenic behavior. These results were discussed with the aim of elucidating the motivational state underlying changes in manifest pathology and body boundary intactness.

Verbally induced behavioral responses during sleep.

Abstract: This study explored the possibility of eliciting motor responses from sleeping Ss. Nineteen Ss slept in the laboratory for 2 nights. Some Ss responded behaviorally, while remaining asleep, to verbal suggestions which had been administered previously during stage 1 sleep. Many responses were obtained

Lateral preference and right-left awareness in schizophrenic children.

Abstract: Lateral dominance and right-left awareness were evaluated in 80 males, ages 8 through 11 years, residing in a psychiatric hospital. The sample consisted of children with the diagnosis of childhood schizophrenia in whom localizing signs of central nervous system damage and mental subnormality were both absent. Analyses of hand and eye usage, of hand-eye coordination, and of awareness of lateral spatial organization resulted in findings of poorly developed lateral preference and awareness in the schizophrenic children. In contrast to normal children who display age-specific progressions of hand preference and lateral awareness, the schizophrenic boys showed no clear evidence of improvement in these abilities with increasing age. The level of organization of lateral function was only weakly related to IQ level, and normal IQ in these aberrant children was not reflected in normal patterns of competence for lateral preference and awareness. Such disturbances in development may be considered to indicate the presence in schizophrenic children of primary central nervous system dysfunction and may be a factor contributing to clinical manifestations.

The Neuropsychology of Development

Abstract: Will reading habit influence your life? Many say yes. Reading neuropsychology of development is a good habit; you can develop this habit to be such interesting way. Yeah, reading habit will not only make you have any favourite activity. It will be one of guidance of your life. When reading has become a habit, you will not make it as disturbing activities or as boring activity. You can gain many benefits and importances of reading.

Compulsive self-mutilation.

Abstract: Self-mutilation as a compulsive act is rare; self-inflicted injury to the eyes, other than enucleation, is also rare. Only two instances of eye banging, similar to that of the patient whose history was presented, were found in the world literature. While the patient's disorder descriptively and psy-

Depressive pattern, social background, and hospitalization

Abstract: All admissions to three different psychiatric inpatient facilities were screened, and patients fitting defined criteria for depression were further studied by semistructured interview, rating scales, and self-report questionnaires. The three facilities, all serving the same area, were the psychiatric ward of a general hospital, a mental health center, and a state mental hospital. Differences in the depressed patient groups admitted to the three facilities were examined. Major differences were found among the three facilities regarding social class and other related social indices. The general hospital admitted patients of highest and the state mental hospital patients of lowest social class, with the mental health center intermediate. Clinical differences were less striking but suggested a higher incidence of endogenous depression in the general hospital patients, with an even higher incidence in a group of patients subsequently studied who were admitted to a clinical research ward. The state mental hospital group showed a particularly high incidence of recurrent illnesses. These results contrast with previous findings that when outpatients and partially hospitalized patients are compared with inpatients, a continuum of degree of hospitalization can be demonstrated, in which the main distinguishing features are clinical rather than sociodemographic. The findings emphasize the heterogeneity of depression and the need for caution in generalizing from selected samples of depressives in clinical and biological research. They illustrate aspects of the sorting process within a community by which patients are admitted to different facilities, and suggest that, within a single level of hospitalization, social factors are the most important.

Attention and eye movements.

Abstract: Horizontal conjugate eye movements were recorded from 11 subjects during conditions of relative inattention and attention with eyes open and eyes closed. Eye closure alone was observed to have a strong reducing effect upon the rate of occurrence of random saccadic eye movements (REM rate). Attention was found to have no significant effect upon REM rate when the eyes were closed. In contrast, when the eyes were open, there was a marked reduction in REM rate associated with attentive activity. The latter results are discussed in the light of seemingly opposite earlier findings of Amadeo and Shagass. Various problems relevant to research on attention and eye movements are also considered.

Studies of mineral metabolism in mental depression

Abstract: Calcium metabolic studies in 9 emotionally depressed patients before and after electric convulsive therapy or administration of a course of imipramine showed that treatment was associated with marked decrease in serum calcium concentration in most patients. The possible relationship of this finding to the phenomenon of depression has been discussed. Treatment with ECT in all patients and with imipramine in most was associated with improved calcium retention manifested by a shift toward positive balance. In most of these cases this resulted from increase in net absorption from the gut and decreased urinary calcium excretion. Calcium kinetic studies indicated that the increased retention due to electric convulsive therapy was caused by decreased bone resorption. In 3 out of 4 patients treated with imipramine, the increased calcium retention was associated with increased bone formation, which was marked in 2 patients and less marked in 1. The possible use of imipramine for treating osteopenia of unknown origin where bone formation is low has been suggested.

The destruction of both anterior thalamic nuclei in a patient with intractable agitated depression.

Abstract: A patient with chronic intractable agitated depression resistant to psychotherapy, pharmacological agents, and electroshock therapy was presented. In spite of the mood elevation produced by anterior thalamic nucleus destructions, the patient's impulse control was insufficient to prevent a suicide. A thorough examination of the patient's brain made it possible to make an anatomical clinical correlation of anterior thalamic nucleus function.

The frequency of sleep talking in the laboratory among chronic sleep talkers and good dream recallers.

Abstract: Chronic sleep talkers utter sleep speech under laboratory conditions at a sufficiently frequent rate as to be capable of providing useful material for study. Fifty-three base line experiments consisting of one or more nights of monitored, otherwise undisturbed sleep were performed on 13 paid subjects offering a history of chronic sleep talking. A total of 206 speeches was recorded. Marked individual differences were observed in total frequency of sleep speech episodes as well as differences in tendencies of association with sleep stages. In general, 20 to 25% of speeches are associated with rapid eye movement period sleep and 75 to 80% are associated with non-rapid eye movement sleep. Additional similar experiments were performed on two larger subject pools: one of chronic sleep talkers and another of good dream recallers with a low arousal threshold. Frequencies of sleep speech and association with specific sleep stages are reported for these conditions as well.

Some psychiatric aspects of abortion.

Abstract: The psychiatric elements found in or attributed to women who request and obtain abortions under regular medical auspices are presented as distilled from relevant literature and experience with several hundred unwillingly pregnant females. The confusion of the present situation prevailing in most sta

Differential effects of psychiatric ward settings on patient change

Abstract: Twelve psychiatric patients were observed in and were asked to descibe their reactions to six psychiatric ward subsettings (e.g., individual therapy, community meeting, free time) both during their 1st or 2nd week of hospitalization and during the week before they left the ward. The results showed that persons and person by setting interactions accounted for substantial proportions, whereas consistent differences between settings accounted for very little of the variance in change scores. This indicates that there are only small general differential effects of ward subsettings, but that instead settings elicit differential amounts of therapeutic change in different patients. Implications discussed include that different psychiatric ward subsettings may be differentially beneficial to different groups of patients, that conclusions about therapeutic change drawn about a patient from observations in one setting may not generalize to other settings, and that the findings bear on the upper limit of intercorrelations of different change scores obtained on the same individuals.