Archives of General Psychiatry

Robins, Lee N.;Helzer, John E.;Davis, Darlene H.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260019001pmid: 1156114

Abstract From all US Army enlistees leaving Vietnam in September 1971, a random sample of 943 men was selected. Of these, 470 represented a "general" sample of all enlistees returning at that time, and 495 represented a "drug-positive" sample whose urine samples had been positive for opiates at the time of departure. We attempted to locate and personally interview all of the men in the samples. Results indicate that before arrival, hard drug use was largely casual, and less than 1% had ever been addicted to narcotics. In Vietnam, almost half the general sample tried narcotics and 20% reported opiate addiction. After return, usage and addiction essentially decreased to pre-Vietnam levels. We discuss the use of nonnarcotic drugs, predictors and correlates of drug use in the samples, and the relationship of drugs to post-Vietnam social adjustment. References 1. Robins LN: The Vietnam Drug User Returns, special action office monograph, series A, No. 2. Washington, DC, US Government Printing Office, 1974. 2. Astin AW, Boruch RF: A "link" system for assuring confidentiality of research data in longitudinal studies . Am Educ Res J 7:615-624, 1970.Crossref 3. Johnston L: Drugs and American Youth . Ann Arbor, The Institute for Social Research, University of Michigan, 1973. 4. Sonquist JA, Baker EL, Morgan JN: Searching for Structure . Ann Arbor, The Institute for Social Research, University of Michigan, 1971. 5. Stephens R, Cottrell E: A follow-up study of 200 narcotic addicts committed for treatment under the Narcotic Addict Rehabilitation Act (NARA) . Br J Addict 67:45-53, 1972.Crossref 6. Vaillant GE: A 12 year follow-up of New York narcotic addicts . Am J Psychiatry 122:727-737, 1966. 7. O'Donnell JA: Narcotic Addicts in Kentucky, publication No. 1881. Washington, DC, Public Health Service, US Government Printing Office, 1969. 8. Hunt GH, Odoroff ME: Follow-up study of narcotic drug addicts after hospitalization . Public Health Rep 77:41-54, 1962.Crossref 9. Nace EP, Meyers AL: The prognosis for addicted Vietnam returnees: A comparison with civilian addicts . Compr Psychiatry 15:49-56, 1974.Crossref 10. Robins LN, Murphy GE: Drug use in a normal population of young Negro men . Am J Public Health 57:1580-1596, 1967.Crossref 11. National Commission on Marijuana and Drug Abuse (second report): Drug Use in America: Problem in Perspective. Washington, DC, Superintendent of Documents, US Government Printing Office, 1973.

Blumenthal, Monica D.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260035002pmid: 1156115

Abstract Three hundred twenty respondents in selected geographic areas were interviewed with a structured questionnaire that included the Zung Self-Rating Depression Scale. Dimensional analysis indicates that some items are not pure measures of the constructs they were originally intended to assess. Moreover, some of the dimensions within the scale apparently convey different meanings to different segments in the population. In addition, different dimensions within the scale have varying demographic correlates. The analysis suggests that in order for the scale to be a truly useful device for assessing depressive symptomatology in a general population, additional items need to be added and some questions need to be followed by probes to clarify the exact frame of reference of the respondents. References 1. Silverman C: The epidemiology of depression: A review . Am J Psychiatry 124:43-51, 1968. 2. Hordern A: Medical progress: The antidepressant drugs . N Engl J Med 272:1159-1169, 1965.Crossref 3. Schwab JJ, Biglow M, Brown J, et al: Diagnosing depression in madical inpatients . Ann Intern Med 67:695-707, 1967.Crossref 4. Stewart MA, Drake F, Winokur G, et al: Depression among medically ill patients . Dis Nerv Syst 26:479-484, 1965. 5. Poe RO, Lowell FM, Fox HM: Depression . JAMA 195:345-350, 1966.Crossref 6. Blum RH: Case identification in psychiatric epidemiology: Methods and problems . Milbank Mem Fund Q 40:253-287, 1962.Crossref 7. Ash P: Short articles and notes: The reliability of psychiatric diagnoses . J Abnorm Psychol 44:272-276, 1949.Crossref 8. Beck AT: Reliability of psychiatric diagnoses: I. A critique of systematic studies . Am J Psychiatry 119:210-216, 1962. 9. Beck AT, Ward CH, Mendelson M, et al: Reliability of psychiatric diagnoses: II. A study of consistency of clinical judgments and ratings . Am J Psychiatry 119:351-357, 1962. 10. Sandifer MG Jr, Pettus C, Quade D: A study of psychiatric diagnosis . J Nerv Ment Dis 139:350-356, 1964.Crossref 11. Ley P: The reliability of psychiatric diagnosis: Some new thoughts . Br J Psychiatry 121:41-43, 1972.Crossref 12. Leighton DC, Harding JS, Macklin DB, et al: The Character of Danger: The Stirling County Study of Psychiatric Disorder: Psychiatric Symptoms in Selected Communities . New York, Basic Books Inc, 1963, vol 3. 13. Srole L, Langner TS, Michael ST, et al: Mental Health in the Metropolis: The Midtown Manhattan Study . New York, McGraw-Hill Book Co Inc, 1962, vol 1. 14. Zung WWK: A self-rating depression scale . Arch Gen Psychiatry 12:63-70, 1965.Crossref 15. Zung WWK, Richards CB, Short MJ: Self-rating depression scale in an outpatient clinic . Arch Gen Psychiatry 13:508-515, 1965.Crossref 16. Burke TF, Templar DI: Comparison of Abbott A-10749 with imipramine . Curr Ther Res 10:335-341, 1968. 17. Wilson IC, Alltop LB, Riley L: Tofranil in the treatment of post-alcoholic depressions . Psychosomatics 11:488-494, 1970.Crossref 18. Wilson IC, Prange AJJ, McClane PK, et al: Thyroid-hormone enhancement of imipramine in nonretarded depressions . N Engl J Med 282:1063-1067, 1970.Crossref 19. McLaughlin B, Rickels K, Manzoor A, et al: Mepreobamate-benactyzine (Deprol) and placebo in two depressed outpatient populations . Psychosomatics 10:73-81, 1969.Crossref 20. Crosby AR: The use of the self-rating depression scale after traumatic injuries . J Am Osteopath Assoc 69:269-270, 1969. 21. Jacobs TJ, Fogelson S, Charles E: Depression ratings in hypochondria . NY State J Med 68:3119-3122, 1968. 22. Weingold HP, Lachin JM, Bell AH, et al: Depression as a symptom of alcoholism: Search for a phenomenon . J Abnorm Psychol 73:195-197, 1968.Crossref 23. Zung WWK: A cross-cultural survey of symptoms in depression . Am J Psychiatry 126:116-121, 1969. 24. Zung WWK: Factors influencing the Self-Rating Depression Scale . Arch Gen Psychiatry 16:543-547, 1967.Crossref 25. Zung WWK: The depression status inventory: An adjunct to the Self Rating Depression Scale . J Clin Psychol 28:539-543, 1972.Crossref 26. Mikesell RH, Calhoun LG: Faking on the Zung Self-Rating Depression Scale . Psychol Rep 25:173-174, 1969.Crossref 27. Mikesell RH, Calhoun LG: Response set on the Zung Self-Rating Depression Scale . Percept Mot Skills 30:22, 1970.Crossref 28. Hunt SM Jr, Singer K, Cobb S: Components of depression: Identified from a self-rating depression inventory for survey use . Arch Gen Psychiatry 16:441-447, 1967.Crossref 29. Carrol BJ, Fielding JM, Blashki TG: Depression rating scales . Arch Gen Psychiatry 28:361-366, 1973.Crossref 30. Rickels K, Downing RW, Lipman RS, et al: The Self-Rating Depression Scale (SDS) as a measure of psychotropic drug response . Dis Nerv Syst 34:98-104, 1973. 31. Zung WWK: Depression in the normal aged . Psychosomatics 8:287-292, 1967.Crossref 32. Muehl D: A Manual for Coders . Ann Arbor, Mich, Institute for Social Research, 1961. 33. Freedman LC: Elementary Applied Statistics . New York, John Wiley & Sons Inc, 1965. 34. Guttman L: A general non-metric technique for finding the smallest euclidian space for configuration of points . Psychometrika 33:469-506, 1968.Crossref 35. Lingoes JC, Guttman L: Non-metric factor analysis: A rank-reducing alternative to linear factor analysis . Mult Behav Res 2:485-505, 1967.Crossref 36. Blumenthal MD, Kahn RL, Andrews FA, et al: Justifying Violence: Attitudes of American Men . Ann Arbor, Mich, Institute for Social Research, 1972. 37. Blumenthal MD, Dielman TE: The Zung Self-Rating Depression Scale , in Psychiatric Epidemiology , technical memo No. 1. Ann Arbor, Mich, Institute for Social Research, 1974. 38. Schwab JJ, Biglow MR, Brown JN, et al: Sociocultural aspects of depression in medical inpatients . Arch Gen Psychiatry 17:533-538, 1967.Crossref 39. Blumenthal MD: Sex as a source of heterogeneity in a mental health survey . J Psychiatr Res 5:75-87, 1967.Crossref 40. Paykel ES, Klerman GL, Prusoff BA: Treatment setting and clinical depression . Arch Gen Psychiatry 22:11-21, 1970.Crossref 41. Spicer CC, Hare EH, Slater E: Neurotic and psychotic forms of depressive illness: Evidence from age-incidence in a national sample . Br J Psychiatry 123:535-541, 1973.Crossref 42. Winokur G: The types of affective disorder . J Nerv Ment Dis 156:82-96, 1973.Crossref 43. Feighner JP, Robins E, Guze SB, et al: Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 26:57-63, 1972.Crossref 44. Dohrenwend BP, Crandell DL: Psychiatric symptoms in community, clinic, and mental hospital groups . Am J Psychiatry 126:1611-1621, 1970.

Blumenthal, Monica D.;Dielman, Ted E.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260049003pmid: 1156116

Abstract Depressive symptomatology, marital satisfaction and functioning, job satisfaction, and social relationships were investigated in 320 respondents comprising 160 married couples. Responses to the Zung Self-Rating Depression Scale indicated that 13% of the respondents had scores similar to those obtained by patients with diagnosed depressions and an additional 27% had scores comparable to those of persons with other psychiatric problems. Responses to a variety of questions about the respondents' social life, job satisfaction, and marital function indicate that increased depressive symptomatology in this general population is associated with a decline in satisfaction and functioning in these areas. The data suggest that this association is not solely due to response bias but is associated with a real decline in function, particularly in the area of child rearing. References 1. Schwartz RA: Psychiatry's drift away from medicine . Am J Psychiatry 131:129-133, 1974. 2. Kasl SV, Cobb S: Health behavior and sick role behavior: I. Health and illness behavior . Arch Environ Health 12:246-265, 1966.Crossref 3. Kasl SV, Cobb S: Health behavior, illness behavior and sick role behavior: II. Sick role behavior . Arch Environ Health 12:531-541, 1966.Crossref 4. Dohrenwend BP, Crandell DL: Psychiatric symptoms in community, clinic and mental hospital groups . Am J Psychiatry 126:87-97, 1970. 5. Dohrenwend BP, Chin-Shong ET: Social status and attitudes toward psychological disorder: The problem of tolerance and deviance . Am Soc Rev 32:417-433, 1967.Crossref 6. Zung WWK: A self-rating depression scale . Arch Gen Psychiatry 12:63-70, 1965.Crossref 7. Blumenthal MD: Measuring depressive symptomatology in a general population . Arch Gen Psychiatry , to be published. 8. Hinchliffe M, Lancashire M, Roberts FJ: Eye contact and depression: A preliminary report . Br J Psychiatry 117:571-572, 1970.Crossref 9. Zung WWK: A cross-cultural survey of symptoms in depression . Am J Psychiatry 126:154-159, 1969. 10. Humphrey M: Functional impairment in psychiatric outpatients . Br J Psychiatry 113:1141-1151, 1967.Crossref 11. Zung WWK: Depression in the normal adult population . Psychosomatics 12:164-167, 1971.Crossref 12. Marshall MH: The psychopharmacology of depression: Perspectives in research . Psychosomatics 12:49-55, 1971.Crossref 13. Shanfield S, Tucker GJ, Harrow M, et al: The schizophrenic patient and depressive symptomatology . J Nerv Ment Dis 151:203-210, 1970.Crossref 14. Jacobs TJ, Fogelson S, Charles E: Depression ratings in hypochondria . NY State J Med 68:3119-3122, 1968. 15. Wilson IC, Prange AJ Jr, McClane PK, et al: Thyroid hormone enhancement of imipramine in nonretarded depressions . N Engl J Med 282:1063-1067, 1970.Crossref 16. Zung WWK: Factors influencing the Self-Rating Depression Scale Arch Gen Psychiatry 16:543-547, 1967.Crossref 17. Katz MM: The classification of depression , in Fieve RR (ed): Depression in the 1970's . Amsterdam, Excerpta Medica, 1971, pp 31-40. 18. Quinn RP, Seashore S, Kahn R, et al: Survey of Working Conditions . US Department of Labor, 1971. 19. Blumenthal MD, Dielman TE, Bongort KJ: Relationships of Demographic Variables and Mental Health Indices to Social Satisfaction and Functioning , technical memorandum No. 3598. Ann Arbor, Mich, Institute for Social Research, 1974. 20. Blumenthal MD, Dielman TE: Marital Functioning and Satisfaction , technical memorandum No. 4004. Ann Arbor, Mich, Institute for Social Research, 1974. 21. Gershon ES, Cramer M, Klerman GL: Hostility and depression . Psychiatry 31:224-235, 1968. 22. Bullock RC, Siegal R, Weissman M, et al: The weeping wife: Marital relations of depressed women . J Marriage Family 34:488-495, 1972.Crossref 23. Freeman LD: Elementary Applied Statistics . New York, John Wiley & Sons Inc, 1965.

Luborsky, Lester;Singer, Barton;Luborsky, Lise

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260059004pmid: 239666

Abstract Tallies were made of outcomes of all reasonably controlled comparisons of psychotherapies with each other and with other treatments. For comparisons of psychotherapy with each other, most studies found insignificant differences in proportions of patients who improved (though most patients benefited). This "tie score effect" did not apply to psychotherapies vs psychopharmacotherapies compared singly—psychopharmacotherapies did better. Combined treatments often did better than single treatments. Among the comparisons, only two specially beneficial matches between type of patient and type of treatment were found. Our explanations for the usual tie score effect emphasize the common components among psychotherapies, especially the helping relationship with a therapist. However, we believe the research does not justify the conclusion that we should randomly assign patients to treatments—research results are usually based on amount of improvement; "amount" may not disclose differences in quality of improvement from each treatment. References 1. Rozenzweig S: Some implicit common factors in diverse methods of psychotherapy . Am J Orthopsychiatry 6:412-415, 1936.Crossref 2. Fiske DW, Hunt H, Luborsky L, et al: The planning of research on effectiveness of psychotherapy . Arch Gen Psychiatry 22:22-32, 1970.Crossref 3. Luborsky L: Assessment of the outcome of psychotherapy by independent clinical evaluators: A review of the most highly recommended research measures , in Waskow I, Parloff M (eds): Measures for the Outcome of Psychotherapy: Report of the Clinical Research Branch . Bethesda, Md, National Institute of Mental Health, to be published. 4. Bergin AE: The evaluation of therapeutic outcomes , in Bergin AE, Garfield SL (eds): Handbook of Psychotherapy and Behavior Change . New York, John Wiley & Sons, 1971, pp 217-270. 5. Meltzoff J, Kornreich M: Research in Psychotherapy . New York, Atherton Press, 1970. 6. Luborsky L, Chandler M, Auerbach AH, et al: Factors influencing the outcome of psychotherapy: A review of quantitative research . Psychol Bull 75:145-185, 1971.Crossref 7. Luborsky L: A note on Eysenck's article: The effects of psychotherapy: An evaluation . Br J Psychology 45:129-131, 1954. 8. Luborsky L: Another reply to Eysenck . Psychol Bull 78:406-408, 1972.Crossref 9. Baehr GO: The comparative effectiveness of individual psychotherapy, group psychotherapy and a combination of these methods . J Consult Psychol 18:179-183, 1954.Crossref 10. Barron F, Leary TF: Changes in psychoneurotic patients with and without psychotherapy . J Consult Psychol 19:239-245, 1955.Crossref 11. Imber SD, Frank JD, Nash EH Jr, et al: Improvement and amount of therapeutic contact: An alternative to the use of notreatment controls in psychotherapy . J Consult Psychol 21:308-315, 1957. 12. Haimowitz NR, Haimowitz ML: Personality changes in client-centered therapy , in Wolff W, Precher JA (eds): Success in Psychotherapy . New York, Grune & Stratton Inc, 1952, pp 63-93. 13. Thorley AS, Craske N: Comparisons and estimate of group and individual methods of treatment . Br Med J 1:97-100, 1950.Crossref 14. O'Brien C, Hamm K, Ray B, et al: Group versus individual psychotherapy with schizophrenics: A controlled outcome study . Arch Gen Psychiatry 27:474-478, 1972.Crossref 15. Gelder MG, Marks IM, Wolff HH: Desensitization and psychotherapy in the treatment of phobic states: A controlled inquiry . Br J Psychiatry 113:53-73, 1967.Crossref 16. Peck RE: Comparison of adjunct group therapy with individual psychotherapy . Arch Neurol Psychiatry 62:173-177, 1949.Crossref 17. Slawson PF: Psychodrama as a treatment for hospitalized patients: A controlled study . Am J Psychiatry 122:530-533, 1965. 18. Boe E, Gocka EF, Kogan WS: The effect of group psychotherapy on interpersonal perceptions of psychiatric patients . Multivar Behav Res 1:177-187, 1966.Crossref 19. Pearl D: Psychotherapy and ethnocentrism . J Abnorm Soc Psychol 50:227-229, 1955.Crossref 20. Covi L, Lipman RS, Derogatis LR, et al: Drugs and group psychotherapy in neurotic depression . Am J Psychiatry 131:191-198, 1974. 21. Henry WE, Shlien JM: Effective complexity and psychotherapy: Some comparisons of time-limited and unlimited treatment . J Project Techniques 22:153-162, 1958.Crossref 22. Muench GA: An investigation of the efficacy of time-limited psychotherapy . J Counsel Psychol 12:294-298, 1965.Crossref 23. Shlien JM: Time-limited psychotherapy: An experimental investigation of practical values and theoretical implications . J Counsel Psychol 4:318-322, 1957.Crossref 24. Shlien JM, Mosak HH, Dreikurs R: Effects of time limits: A comparison of two psychotherapies . J Counsel Psychol 9:31-34, 1962.Crossref 25. Frank JD, Gliedman LH, Imber SD, et al: Patients' expectancies and relearning as factors determining improvement in psychotherapy . Am J Psychiatry 115:961-968, 1959. 26. Pascal GR, Zax M: Psychotherapeutics: Success or failure? J Consult Psychol 20:325-331, 1956.Crossref 27. Reid WJ, Schyne AW: Brief and Extended Casework . New York, Columbia University Press, 1969. 28. Cartwright RD: A comparison of the response to psychoanalytic and client centered psychotherapy , in Gottschalk L, Auerbach A (eds): Methods of Research in Psychotherapy , New York, Appleton-Century-Crofts Inc, 1966, pp 517-529. 29. Heine RW: A comparison of patients' reports on psychotherapeutic experience with psychoanalytic, nondirective and Adlerian therapists . Am J Psychother 7:16-25, 1953. 30. Baker E: The differential effects of psychotherapeutic approaches on client perceptions . J Counsel Psychol 7:46-50, 1960.Crossref 31. Ashby JD, Ford DG, Guerney BG Jr, et al: Effects on clients of a reflective and a leading type of psychotherapy . Psychol Mono 71:1-453, 1957.Crossref 32. Cooper JE, Gelder MG, Marks IM: Results of behaviour therapy in 77 psychiatric patients . Br Med J 1:1222-1225, 1965.Crossref 33. Cooper JE: A study of behaviour therapy in 30 psychiatric patients . Lancet 1:411-415, 1963.Crossref 34. Gelder MG, Marks IM: Severe agoraphobia: A controlled prospective trial of behaviour therapy . Br J Psychiatry 112:309-319, 1966.Crossref 35. Crighton J, Jehu D: Treatment of examination anxiety by systematic desensitization or psychotherapy in groups . Behav Res Ther 7:245-248, 1969.Crossref 36. King GF, Armitage SG, Tilton JR: A therapeutic approach to schizophrenics of extreme pathology: An operant-interpersonal method . J Abnorm Soc Psychol 61:276-286, 1960.Crossref 37. Lazarus AA: Group therapy of phobic disorders by systematic desensitization . J Abnorm Soc Psychol 63:504-510, 1961.Crossref 38. Levis DJ, Carrera R: Effects of ten hours of implosive therapy in the treatment of outpatients: A preliminary report . J Abnorm Psychol 76:504-508, 1967.Crossref 39. McReynolds WT: Systematic Desensitization, Insight-Oriented Psychotherapy and Relaxation Therapy in a Psychiatric Population, thesis. University of Texas, Austin, 1969. 40. Marks IM, Gelder MG: A controlled retrospective study of behaviour therapy in phobic patients . Br J Psychiatry 111:561-573, 1965.Crossref 41. Patterson V, Levene H, Berger L: Treatment and training outcomes with two time-limited therapies . Arch Gen Psychiatry 25:161-167, 1971.Crossref 42. Gorham DR, Pokorny AD, Moseley EC, et al: Effects of a phenothiazine and/or group psychotherapy with schizophrenics . Dis Nerv Syst 25:77-86, 1964. 43. May PRA, Tuma AH: The effect of psychotherapy and stelazine on length of hospital stay, release rate and supplemental treatment of schizophrenic patients . J Nerv Ment Dis 139:362-369, 1964.Crossref 44. May PRA, Tuma AH: Treatment of schizophrenia . Br J Psychiatry 3:503-510, 1965.Crossref 45. Evangelakis MG: De-institutionalization of patients (the triad of trifluoperazine-group-adjunctive therapy) . Dis Nerv Syst 22:26-32, 1961. 46. Lorr M, McNair DM, Weinstein GJ: Early effects of chlordiazepoxide (Librium) used with psychotherapy . J Psychiatr Res 1:257-270, 1963.Crossref 47. Overall JE, Tupin JP, Investigation of clinical outcome in a doctor's choice treatment setting . Dis Nerv Syst 30:305-313, 1969. 48. Koegler RR, Brill NQ: Treatment of Psychiatric Outpatients . New York, Appleton-Century-Crofts Inc, 1967. 49. Klerman GL, DiMascio A, Weissman M, et al: Treatment of depression by drugs and psychotherapy . Am J Psychiatry 131:186-191, 1974. 50. Klerman GL, Paykel ES, Prusoff BA: Antidepressant drugs and clinical psychopathology , in Cole J, Freeman A, Friedhoff A (eds): Psychopathology and Psychopharmacology . Baltimore, Johns Hopkins Press, 1973, pp 177-189. 51. Hogarty GE, Goldberg SC: Drug and sociotherapy in the aftercare of schizophrenic patients . Arch Gen Psychiatry 28:54-64, 1973.Crossref 52. Cowden RC, Zax M, Hague JR, et al: Chlorpromazine, alone and as an adjunct to group psychotherapy in the treatment of psychiatric patients . Am J Psychiatry 12:552-572, 1956. 53. King PD: Regressive ECT, chlorpromazine and group therapy in treatment of hospitalized chronic schizophrenics . Am J Psychiatry 115:354-357, 1958. 54. King PD: Controlled study of group psychotherapy in schizophrenics receiving chlorpromazine . Psychiatr Dig 24:21-26, 1963. 55. Grinspoon L, Ewalt JR, Shader R: Long-term treatment of chronic schizophrenia: A preliminary report . Int J Psychiatry 4:116-128, 1967. 56. Grinspoon L, Ewalt JR, Shader R: Psychotherapy and pharmacotherapy in chronic schizophrenia . Am J Psychiatry 124:1645-1652, 1968. 57. Shader R, Grinspoon L, Ewalt JR, et al: Drug responses in acute schizophrenia , in Sankar DVS (ed): Schizophrenia: Current Concepts and Research . Hicksville, NY, PJD Publications, 1969, pp 161-173. 58. Gibbs JJ, Wilkins B, Lautergach CG: A controlled clinical psychiatric study of chlorpromazine . J Clin Exp Psychopathol 18:269-283, 1957. 59. Lorr M, McNair DM, Weinstein GJ, et al: Meprobamate and chlorpromazine in psychotherapy: Some effects on anxiety and hostility of outpatients . Arch Gen Psychiatry 4:381-389, 1961.Crossref 60. Rickels K, Cattell RB, Weise C, et al: Controlled psychopharmacological research in private psychiatric practice . Psychopharmacologia 9:288-306, 1966.Crossref 61. Daneman EA: Imipramine in office management of depressive reactions (a double-blind study) . Dis Nerv Syst 22:213-217, 1961. 62. Hesbacher PT, Rickels K, Hutchinson J, et al: Setting, patient, and doctor effects on drug response in neurotic patients: II. Differential improvement . Psychopharmacologia 18:209-226, 1970.Crossref 63. Podobnikar IG: Implementation of psychotherapy by Librium in a pioneering rural-industrial psychiatric practice . Psychosomatics 12:205-209, 1971.Crossref 64. Karon BP, Vandenbos GR: Experience, medication and the effectiveness of psychotherapy with schizophrenics . Br J Psychiatry 116:427-428, 1970.Crossref 65. Brown DG, Bettley FR: Psychiatric treatment of eczema: A controlled trial . Br Med J 2:729-734, 1971.Crossref 66. Chappell MN, Stevenson TI: Group psychological training in some organic conditions . Ment Hyg 20:588-597, 1936. 67. Grace WJ, Pinsky RH, Wolff HG: The treatment of ulcerative colitis . Gastroenterology 26:462-468, 1954. 68. Glen AIM: Psychotherapy and medical treatment for duodenal ulcer compared using the augmented histamine test . J Psychosom Res 12:163-169, 1968.Crossref 69. Groen J, Pelser HE: Experiences with, and results of group psychotherapy in patients with bronchial asthma . J Psychosom Res 4:191-205, 1960.Crossref 70. Maher-Loughnan GP, MacDonald N, Mason AA, et al: Controlled trial of hypnosis in the symptomatic treatment of asthma . Br Med J 2:371-376, 1962.Crossref 71. O'Connor JF, Daniels G, Flood C, et al: An evaluation of the effectiveness of psychotherapy in the treatment of ulcerative colitis . Ann Intern Med 60:587-602, 1964.Crossref 72. Sinclair-Gieban AGC, Chalmers D: Evaluation of treatment of warts by hypnosis . Lancet 2:480-482, 1959.Crossref 73. Titchener JL, Sheldon MB, Rose WD: Changes in blood pressure of hypertensive patients with and without group therapy . J Psychosom Res 4:10-12, 1959.Crossref 74. Zhukov IA: Hypnotherapy of dermatoses in resort treatment , in Winn RB (ed): Psychotherapy in the Soviet Union . New York, Philosophical Library, 1961, pp 178-181. 75. Morton RB: An experiment in brief psychotherapy . Psychol Mono 69:1-386, 1955.Crossref 76. Tucker JE: Group psychotherapy with chronic psychotic soiling patients . J Consult Psychol 20:430, 1956.Crossref 77. Coons WH: Interaction and insight in group psychotherapy . Can J Psychol 11:1-8, 1957.Crossref 78. Jensen MB: Consultation vs. therapy in the psychological treatment of NP hospital patients . J Clin Psychol 17:265-268, 1961.Crossref 79. Sheldon A: An evaluation of psychiatric after-care . Br J Psychiatry 110:662-667, 1964.Crossref 80. Shattan SP, Decamp L, Fujii E, et al: Group treatment of conditionally discharged patients in a mental health clinic . Am J Psychiatry 122:798-805, 1966. 81. Stotsky BA, Daston PG, Vardack CN: An evaluation of the counseling of chronic schizophrenics . J Counsel Psychol 2:248-255, 1955.Crossref 82. Peyman DAR: An investigation of the effects of group psychotherapy on chronic schizophrenic patients . Group Psychother 9:35-39, 1956. 83. MacDonald WS, Blochberger CW, Maynard HM: Group therapy: A comparison of patient-led and staff-led groups in an open hospital ward . Psychiatr Q Suppl 38:290-303, 1964. 84. Volsky T Jr, Magoon TM, Norman WT, et al: The Outcomes of Counseling and Psychotherapy, Theory and Research . Minneapolis, University of Minnesota Press, 1965. 85. Brill NQ, Koegler RR, Epstein LJ, et al: Controlled study of psychiatric outpatient treatment . Arch Gen Psychiatry 10:581-595, 1964.Crossref 86. Endicott NA, Endicott J: Prediction of improvement in treated and untreated patients using the Rorschach Prognostic Rating Scale . J Consult Psychol 28:342-348, 1964.Crossref 87. Walker RG, Kelley FE: Short-term psychotherapy with hospitalized schizophrenic patients . Acta Psychiatr Neurol Scand 35:34-55, 1960.Crossref 88. Rogers DR, Dymond RF (eds): Psychotherapy and Personality Change . Chicago, University of Chicago Press, 1954. 89. 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Messick S: The criterion problem in the evaluation of instruction: Assessing possible not just intended, outcomes , in Wittrock MC, Wiley D (eds): The Evaluation of Instruction: Issues and Problems . New York, Holt Rinehart & Winston Inc, 1970. 104. Luborsky L: Research cannot yet influence clinical practice . Int J Psychiatry 7:135-140, 1969. 105. Strupp HH: Toward a reformulation of the psychotherapeutic influence . Int J Psychiatry , to be published.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260072005

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Reprints Available; Word Omitted.—Two errors occurred in the article "Narcissism and the Readiness for Psychotherapy Termination," published in the June ARCHIVES (32:695-699, 1975). On page 695, the last footnote (column 1) should read "Reprintrequests to30 N Michigan Ave, Chicago, IL60602(Dr Goldberg)." And on page 696, in column 1, the second sentence in the paragraph preceding the centerhead should read "They are not in analysis...." As published, the word "not" was omitted.

Rakoff, Vivian M.;Sigal, John J.;Epstein, Nathan B.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260077006pmid: 1156109

Abstract Following initial diagnostic interviews with 20 families in an outpatient psychiatric clinic, a group of therapists made predictions of the anticipated responses of the families to therapy. Changes in family structure, organization, and transactional patterns were predicted with use of the Family Category Schema. The families' responses to the process of therapy was predicted in a questionnaire. The results showed poor predictions of response to process. However, a normative response picture of a family in therapy did emerge. Also, all predictions erred in the direction of underrating the overall effectiveness of conjoint family therapy. References 1. Beck AT, Ward CN, Mendelsohn M, et al: Reliability of psychiatric diagnosis: A study of consistency of clinical judgements and ratings . Am J Psychiatry 119:351-357, 1962. 2. Katz MM, Cole JO, Lowery HA: Studies of the diagnostic procedure: The influence of symptom, perception, past experience and ethnic background on diagnostic decisions . Am J Psychiatry 125:937-947, 1969. 3. Sargent HD: Prediction in psychotherapy research: A method for the transformation of clinical judgements into T stable hypotheses, monograph 21 , in Psychological Issues . New York, International Universities Press, 1968. 4. Schmidt HO, Fonda CP: The reliability of the psychiatric diagnosis: A new look . J Abnorm Soc Pathol 52:262-267, 1956.Crossref 5. Committee on the Family: The Field of Family Therapy, No. 78. New York, Group for the Advancement of Psychiatry, 1970, vol 7. 6. Steinhauer P: Reflections on criteria for selection and prognosis in family therapy . Can Psychiatr Assoc J 13:317-321, 1968. 7. Guttman HA: A contraindication for family therapy: The prepsychotic or postpsychotic young adult and his parents . Arch Gen Psychiatry 29:352-355, 1973.Crossref 8. Epstein NB, Rakoff VM, Sigal JJ: Some issues in family therapy . Laval Med 37:146-150, 1966. 9. Epstein NB, Rakoff VM, Sigal JJ: The Family Category Schema . Montreal, Mimeo, 1964. 10. Sigal JJ, Rakoff VM, Epstein NB: Indicators of therapeutic outcome in conjoint family therapy . Family Process 6:215-227, 1967.Crossref 11. Hollingshead AB, Redlich FC: Social Class and Mental Illness . New York, John Wiley & Sons Inc, 1958. 12. Rakoff VM: Training in family psychiatry . Can Psychiatr Assoc J 10:206-213, 1965. 13. Rakoff VM, Sigal JJ, Epstein NB: Repetition and working through in family therapy . Am J Psychother 21:782-790, 1967.

Kellner, Robert

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260085007pmid: 1156110

Abstract Published controlled studies of various psychotherapeutic techniques in psychosomatic disorders with adequate designs have formed the basis for the following conclusions: Psychotherapeutic techniques are effective in some patients with psychosomatic disorders. Some psychosomatic disorders, for example, bronchial asthma, peptic ulcer, and migraine headaches are perhaps more amenable to psychotherapy than others, for example, hypertension and ulcerative colitis. There is evidence to suggest that there are differences between the effectiveness of various psychotherapeutic techniques; a few patients differ perhaps from the rest in that they are helped most by the technique that is less effective for the majority. References 1. Stunkard A: New therapies for the eating disorders . Arch Gen Psychiatry 26:391-398, 1972.Crossref 2. Blanchard EB, Young LD: Clinical applications of biofeedback training . Arch Gen Psychiatry 30:573-589, 1974.Crossref 3. Biofeedback, editorial. Br J Med 3:427-428, 1974.Crossref 4. Yates AJ: Behavior Therapy . New York, John Wiley & Sons Inc, 1970. 5. Chappell MN, Stevenson TI: Group psychological training in some organic conditions . Ment Hyg 20:588-597, 1936. 6. Chappell MN, Stefano JJ, Rogerson JS, et al: The value of group psychological procedures in the treatment of peptic ulcer . Am J Dig Dis 3:813-817, 1936.Crossref 7. Orgel SZ: Effect of psychoanalysis on the course of peptic ulcer . Psychosom Med 20:117-123, 1958.Crossref 8. Grace WJ, Pinsky RH, Wolff HG: Treatment of ulcerative colitis . Gastroenterology 26:462-468, 1954. 9. O'Connor JF, Daniels G, Flood C, et al: An evaluation of the effectiveness of psychotherapy in the treatment of ulcerative colitis . Ann Intern Med 60:587-602, 1964.Crossref 10. Draspa LJ: Psychological factors in muscular pain . Br J Med Psychol 32:106-116, 1959.Crossref 11. Titchener JL, Sheldon MB, Ross WD: Changes in blood pressure of hypertensive patients with and without group psychotherapy . J Psychosom Res 4:10-12, 1959.Crossref 12. Smith JM, Burns CLC: The treatment of asthmatic children by hypnotic suggestion . Br J Dis Chest 54:78-81, 1960.Crossref 13. Sclare AB, Crocket JA: Group psychotherapy in bronchial asthma . J Psychosom Res 2:157-171, 1957.Crossref 14. Groen JJ, Pelser HE: Experiences with, and results of, group psychotherapy in patients with bronchial asthma . J Psychosom Res 4:191-205, 1960.Crossref 15. Barendregt JT: A psychological investigation of the effect of group psychotherapy in patients with bronchial asthma . J Psychosom Res 2:115-119, 1957.Crossref 16. Maher-Loughnan GP, MacDonald N, Mason AA, et al: Controlled trial of hypnosis in the symptomatic treatment of asthma . Br Med J 2:371-374, 1962.Crossref 17. British Tuberculosis Association: Hypnosis for asthma-a controlled trial: A report to the research committee of the British Tuberculosis Association . Br Med J 4:71-76, 1968.Crossref 18. Moore N: Behaviour therapy in bronchial asthma: A controlled study . J Psychosom Res 9:257-276, 1965.Crossref 19. Wolpe J: Psychotherapy by Reciprocal Inhibition . Stanford, Calif, Stanford University Press, 1958. 20. Williams DH: Management of atopic dermatitis in children: Control of the maternal rejection factor . Arch Dermatol 63:545-560, 1951.Crossref 21. Zhukov IA: Hypnotherapy of dermatoses in resort treatment, in Winn RB (ed): Psychotherapy in the Soviet Union . New York, Philosophical Library, 1961, pp 178-181. 22. Brown DG, Bettley FR: Psychiatric treatment of eczema: A controlled trial . Br Med J 2:729-734, 1971.Crossref 23. Memmesheimer AM, Eisenlohr E: Untersuchungen über die Suggestivbehandlung der Warzen . Dermatol Z 62:63-68, 1931.Crossref 24. Clarke GHV: The charming of warts . J Invest Dermatol 45:15-21, 1965.Crossref 25. Sinclair-Gieben AHC, Chalmers D: Evaluation of treatment of warts by suggestion . Lancet 2:480-482, 1959.Crossref 26. Stankler L: A critical assessment of the cure of warts by suggestion . Practitioner 198:690-694, 1967. 27. Tenzel JH, Taylor RL: An evaluation of hypnosis and suggestion as treatment for warts . Psychosomatics 10:252-257, 1969.Crossref 28. Surman OS, Gottlieb SK, Hackett TP, et al: Hypnosis in the treatment of warts . Arch Gen Psychiatry 28:439-441, 1973.Crossref 29. Asher R: Respectable hypnosis . Br Med J 1:309-313, 1956.Crossref 30. Ullman M, Dudek SZ: On the psyche and warts: II. Hypnotic suggestion and warts . Psychosom Med 22:68-76, 1960.Crossref 31. Mitchell KR, Mitchell DM: Migraine: An exploratory treatment application of programmed behaviour therapy techniques . J Psychosom Res 15:137-157, 1971.Crossref 32. Kellner R: The evidence in favour of psychotherapy . Br J Med Psychol 40:341-358, 1967.Crossref 33. Strupp HH, Bergin AE: Research in Individual Psychotherapy, Public Health Service, US Government Printing Office, 1944. 34. Meltzoff J, Kornreich M: Research in Psychotherapy . New York, Atherton Press, 1970. 35. Mason AA, Black S: Allergic skin responses abolished under treatment of asthma and hayfever by hypnosis . Lancet 1:877-1129, 1958.Crossref 36. Black S: Shift in the dose response curve of Prausnitz-Kiistner reaction by direct suggestion under hypnosis . Br Med J 1:990-992, 1963.Crossref

Minuchin, Salvador;Baker, Lester;Rosman, Bernice L.;Liebman, Ronald;Milman, Leroy;Todd, Thomas C.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260095008pmid: 808191

Abstract Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa. References 1. Cannon WB: Bodily Changes in Pain, Hunger, Fear and Rage . New York, Appleton-Century-Crofts Inc, 1920. 2. Mason JW: Organization of psychoendocrine mechanisms . Psychosom Med 30:791-808, 1968.Crossref 3. Dunbar HF: Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships . New York, Columbia University, 1954. 4. Ruesch J: The infantile personality . Psychosom Med 10:134-144, 1948.Crossref 5. Alexander F: The Scope of Psychoanalysis . New York, Basic Books Inc, 1961. 6. Alexander F, French TM: Studies in Psychosomatic Medicine . New York, Ronald Press Co, 1948. 7. Mirsky IA: Physiologic, psychologic, and social determinants of psychosomatic disorders . Dis Nerv Sys 21:950-956, 1960. 8. Weiner H, Thaler M, Reiser MF, et al: Etiology of dudoenal ulcer . Psychosom Med 19:1-10, 1957.Crossref 9. Holmes TH, Rahe RH: The social readjustment scale . J Psychosom Res 11:213-218, 1967.Crossref 10. Wolff NG: Stress and Disease . Springfield, Ill, Charles C Thomas Publisher, 1961. 11. Hinkle LE, Wolf S: A summary of experimental evidence relating life stress to diabetes mellitus . J Mt Sinai Hosp 19:537-570, 1952. 12. Grinker RR, Robbins FP: Psychosomatic Casebook . New York, Blakiston Co, 1954. 13. Senay EC, Redlich FC: Cultural and social factors in neuroses and psychosomatic illnesses . Soc Psychiatry 3:89-97, 1968.Crossref 14. Bastiaans J, Groen J: Psychogenesis and psychotherapy of bronchial asthma , in O'Neill D (ed): Modern Trends in Psychosomatic Medicine . New York, Paul B Hoeber Inc, 1955, pp 242-268. 15. Finch SM, Hess HH: Ulcerative colitis in children . Am J Psychiatry 118:819-826, 1962. 16. Lidz T, Rubenstein R: Psychology of gastrointestinal disorders , in Arieti S (ed): American Handbook of Psychiatry . New York, Basic Books Inc, 1959, vol 1, pp 678-689. 17. Long RT, Lamont J, Whipple B, et al: A psychosomatic study of allergic and emotional factors in children with asthma . Am J Psychiatry 114:890-899, 1958. 18. Lieberman MA, Stock D, Whitman RM: Self-perceptual patterns among ulcer patients . Arch Gen Psychiatry 1:167-176, 1959.Crossref 19. Wahl CW: The psychodynamics of hypertension . Calif Med 92:336-337, 1960. 20. Meyer RJ, Haggerty RJ: Streptococcal infections in families: Factors altering individual susceptibility . Pediatrics 29:539-549, 1962. 21. Schmale AH Jr: Relationship of separation and depression to disease: A report on a hospitalized medical population . Psychosom Med 20:259-277, 1958.Crossref 22. Pinkerton P: Correlating physiologic with psychodynamic data in the study and management of childhood asthma . J Psychosom Res 11:11-25, 1967.Crossref 23. Pinkerton P: Patho-physiology and psychopathology as co-determinants of pharmaco-therapeutic response in childhood asthma , in Pletscher A, Marino A (eds): Psychotropic Drugs in Internal Medicine . Amsterdam, Excerpta Medica, 1969, pp 115-127. 24. Selvini-Palazzoli M: The families of patients with anorexia nervosa , in Anthony EJ, Koupernik C (eds): The Child in His Family . New York, John Wiley & Sons Inc, 1970, pp 319-332. 25. Mishler EG, Waxler NE: Interaction in Families: An Experimental Study of Family Processes and Schizophrenia . New York, John Wiley & Sons Inc, 1968. 26. Waxler NE, Mishler EG: Sequential patterning of family interaction: A methodological note . Family Proc 9:211-220, 1970.Crossref 27. Minuchin S, Montalvo B, Guerney BG, et al: Families of the Slums: An Exploration of Their Structure and Treatment . New York, Basic Books Inc, 1967. 28. Minuchin S: Families and Family Therapy: A Strucutural Approach . Cambridge, Mass, Harvard Press, 1974. 29. Minuchin S, Baker L, Liebman R, et al: Anorexia nervosa: Successful application of a family therapy approach, abstracted . Pediatr Res 7:294, 1973. 30. Liebman R, Minuchin S, Baker L: An integrated treatment program for anorexia nervosa . Am J Psychiatry 131:432-436, 1974. 31. Baker L, Minuchin S, Milman L, et al: Psychosomatic aspects of juvenile diabetes mellitus: A progress report . Israel J Med Sci , to be published. 32. Minuchin S, Barcai A: Therapeutically induced family crisis , in Masserman J (ed): Science and Psychoanalysis . New York, Grune & Stratton Inc, 1969, vol 14, pp 199-205. 33. Liebman R, Minuchin S, Baker L: The use of structural family therapy in the treatment of intractable asthma . Am J Psychiatry 131:535-540, 1974. 34. Redlich FC, Freedman DX: The Theory and Practice of Psychiatry . New York, Basic Books Inc, 1966, pp 403-458. 35. Minuchin S: The use of an ecological framework in the treatment of a child , in Anthony EJ, Koupernik C (eds): The Child in His Family . New York, John Wiley & Sons Inc, 1970, pp 41-57 36. Liebman R, Minuchin S, Baker L: The role of the family in the treatment of anorexia nervosa . Child Psychiatry 13:264-274, 1974.Crossref 37. Pinkerton P, Weaver CM: Childhood asthma , in Hill 0 (ed): Modern Trends in Psychosomatic Medicine . London, Butterworths, 1970, pp 81-104.

Bernstein, Irving C.;Callahan, William A.;Jaranson, James M.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260105009pmid: 1156111

Abstract In a follow-up of 43 private psychiatric patients referred for open bimedial prefrontal lobotomies between 1948 and 1970, patients were rated by personal interviews and review of medical records for symptom improvement and organic brain syndromes. Initial diagnoses were obsessive-compulsive neurotic (27), hypochondriacal neurotic (five), manic-depressive (depressed) (one), and schizophrenic (ten). All had been severely impaired by illness intractable to extensive previous treatment. Thirty-five were found to be virtually free of symptoms that prompted operation, six had some improvement, and two were unimproved. Six had moderate to severe organic brain syndromes; three had seizure disorders necessitating treatment; and 17 incurred substantial weight gains. Best results were for hypochondriacal and obsessive-compulsive neurotic patients with phobic symptoms: poorest results were for paranoid schizophrenic subjects. This study was undertaken to provide some increment of data that could aid ongoing efforts to evaluate the consequences of this treatment. References 1. Miller A: The lobotomy patient—A decade later: A follow-up study of a research project started in 1948 . Can Med Assoc J 96:1095-1103, 1967. 2. Pippard J: Leucotomy in Britain today . Br J Psychiatry 108:249-255, 1962.Crossref 3. Greenblatt M: Relation between history, personality and family pattern and behavioral responses after frontal lobe surgery . Am J Psychiatry 116:193-202, 1959. 4. Sargant W: The present indications for leucotomy . Lancet 1:1197-1200, 1962.Crossref 5. Post F, Rees WL, Schurr PH: An evaluation of bimedial leucotomy . Br J Psychiatry 114:1223-1246, 1968.Crossref 6. Sykes MK, Tredgold RF: Restricted orbital undercutting: A study of its effects on 350 patients over the ten years 1951-1960 . Br J Psychiatry 110:609-640, 1964.Crossref 7. Holden JMC, Itel TM, Hofstatter L: Prefrontal lobotomy: Stepping stone or pitfall? Am J Psychiatry 127:591-598, 1970. 8. Baker EFW, Young MP, Gauld DM, et al: A new look at bimedial prefrontal leukotomy . Can Med Assoc J 102:37-41, 1970. 9. Tucker WI: Indications for modified leucotomy . Bull Lahey Clin Found 15:131-139, 1966. 10. Modified prefrontal leucotomy , editorial. Br Med J 3:595-596, 1971. 11. Freeman W: Frontal lobotomy 1936-1956: A follow-up study of 3,000 patients from 1 to 20 years . Am J Psychiatry 113:877-886, 1957. 12. Shobe FO, Gildea MC-L: Long-term follow-up of selected lobotomized private patients . JAMA 206:327-332, 1968.Crossref 13. Freeman W: Lobotomy and epilepsy: A study of 1,000 patients . Neurology 3:479-494, 1953.Crossref 14. Logothetis J: A long-term evaluation of convulsive seizures following prefrontal lobotomy . J Nerv Ment Dis 146:71-79, 1968.Crossref 15. Scherer IW, Klett CJ, Winne JF: Psychological changes over a fiveyear period following bilateral prefrontal lobotomy . J Consult Clin Psychol 21:291-295, 1957.Crossref 16. Partridge M: Complications and sequelae , in Pre-Frontal Leucotomy: A Survey of 300 Cases Personally Followed Over lH-3 Years . Oxford, England, Blackwell Scientific Publications, 1950, p 31.

Carenzi, Angelo;Gillin, J. Christan;Guidotti, Allesandro;Schwartz, Michael A.;Trabucchi, Marco;Wyatt, Richard J.

1975 Archives of General Psychiatry

doi: 10.1001/archpsyc.1975.01760260120010pmid: 1156112

Abstract Striatal adenylyl cyclase activity from autopsied human brain is selectively stimulated by low concentrations of dopamine. Under the experimental conditions used, norepinephrine was about three times less potent than dopamine. Histamine and serotonin were ineffective. The stimulation by dopamine was competitively inhibited by haloperidol. There was no difference between the basal adenylyl cyclase activity or its level after dopamine stimulation between nine control subjects without a psychiatric history and seven patients with chronic schizophrenia. References 1. Stevens J: An anatomy of schizophrenia? Arch Gen Psychiatry 29:177-189, 1973.Crossref 2. Snyder JM, Banerjee SP, Yamamura HI, et al: Drugs, neurotransmitters and schizophrenia . Science 184:1243-1253, 1974.Crossref 3. Griffith JD, Cavanaugh JH, Held J, et al: Experimental psychosis induced by the administration of d-amphetamine , in Costa E, Garattini S (eds): Amphetamines and Related Compounds . New York, Raven Press, 1969, pp 897-904. 4. Kebabian JW, Petzold G, Greengard P: Dopamine sensitive adenylate cyclase in the caudate nucleus of rat brain and its similarity to the "dopamine receptor . Proc Natl Acad Sci USA 69:2145-2149, 1972.Crossref 5. Clement-Cormier YC, Kebabian JW, Petzold GL, et al: Dopamine-sensitive adenylate cyclase in mammalian brain: A possible site of action of antipsychotic drugs . Proc Natl Acad Sci USA 71:1113-1117, 1974.Crossref 6. Miller RJ, Horn AJ, Iversen LL: The action of neuroleptic drugs on dopamine-stimulated adenosine cyclic 3',5' monophosphate production in rat neostriatum and limbic forebrain . Mol Pharmacol 10:759-766, 1974. 7. Neff NH, Costa E: Effect of tricyclic antidepressants and chlorpromazine on brain catecholamine systhesis, in Garattini S, Duke MN (eds): Proceedings of the First International Symposium on Antidepressant Drugs, series 122. New York, Excerpta Medica, 1966, pp 28-34. 8. Zivkovic B, Guidotti A, Revuelta A, et al: Effect of thioridazine, clozapine, and other antipsychotics on the kinetic state of tyrosine hydroxylase and on the turnover rate of dopamine in striatum and accumbens . J Pharmacol Exp Ther , to be published. 9. Zivkovic B, Guidotti A, Costa E: Effect of neuroleptics on striatal tyrosine hydroxylase: Change in the affinity for the pteridine cofactor . Mol Pharmacol 10:727-735, 1974. 10. Guidotti A, Costa E: A role of nicotinic receptors in the regulation of the adenylate cyclase of adrenal medulla . J Pharmacol Exp Ther 189:665-675, 1974. 11. Lowry OH, Rosebrough NJ, Farr AL, et al: Protein measurement with the folin phenol reagent . J Biol Chem 193:265-275, 1951.