1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070013001
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Gittelman, Rachel;Eskenazi, Brenda
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070017002pmid: 6683492
Abstract • The purposes of this study were to examine whether hyperactive children had elevated lead levels, to assess whether lead levels were associated with poor psychometric performance in hyperactive children, and to replicate previous reports of hyperactive children with perinatal insult having lower lead levels than those with normal perinatal history. Hyperactive, learning-disabled children and normal siblings were studied. The hyperactive children had higher chelated urine lead levels than their own siblings. Other contrasts were not significant. Cognitive performance and lead levels were weakly associated in the hyperactive sample. Contrary to previous reports, lead levels and perinatal complications were not negatively correlated. These results support the notion that lead levels are weakly associated with hyperactive disorders. References 1. Byers RK, Lord EE: Late effects of lead poisoning on mental development . Am J Dis Child 1943;66:471-494. 2. Chisolm JJ, Kaplan E: Lead poisoning in childhood: Comprehensive management and prevention . J Pediatr 1968;73:942-950.Crossref 3. De la Burdé B, Choate MS: Early asymptomatic lead exposure and development at school age . J Pediatr 1975;87:638-642.Crossref 4. Landrigan PJ, Whitworth RH, Baloh RW, et al: Neuropsychological dysfunction in children with chronic low-level lead absorption . Lancet 1975;2:708-712.Crossref 5. Perino J, Ernhardt CB: The relation of subclinical lead level to cognitive and sensorimotor impairment in black preschoolers . J Learning Disabil 1974;7:26-30.Crossref 6. Pihl RO, Parkes M: Hair element content in learning disabled children . Science 1977;198:204-206.Crossref 7. Baloh R, Sturm R, Green B, et al: Neuropsychological effects of chronic asymptomatic increased lead absorption . Arch N eurol 1975;32:326-330.Crossref 8. Needleman HL, Gunnoe C, Levitón A, et al: Deficits in psychological and classroom performance of children with elevated dentine lead levels . N Engl J Med 1979;300:689-695.Crossref 9. David O, Clark J, Voeller K: Lead and hyperactivity . Lancet 1972;2:900-903.Crossref 10. David OJ, Hoffman SP, Sverd J, et al: Lead and hyperactivity: Lead levels among hyperactive children . J Abnorm Child Psychol 1977;5:405-416.Crossref 11. Rutter M: Raised lead levels and impaired cognitive/behavioural functioning: A review of the evidence . Dev Med Child Neurol 1980; 22( (suppl) ):1-26. 12. Gittelman-Klein R, Klein DF, Katz S, et al: Comparative effects of methylphenidate and thioridazine in hyperkinetic children . Arch Gen Psychiatry 1976;33:1217-1231.Crossref 13. Gittelman R, Abikoff H, Pollack E, et al: A controlled trial of behavior modification and methylphenidate in hyperactive children , in Whalen C, Henker B: Hyperactive Children . New York, Academic Press Ine, 1980, pp 221-243. 14. Gittelman R, Feingold I: Efficacy of remediation in reading disabled children . J Child Psychol Psychiatry 1983;24:167-191.Crossref 15. Conners CK: A teacher rating scale for use in drug studies with children . Am J Psychiatry 1969;126:152-156. 16. Werry J: Hyperactivity , in Costello CG (ed): Symptoms of Psychopathology . New York, John Wiley & Sons Ine, 1970, pp 397-417. 17. Diagnostic and Statistical Manual of Mental Disorders, ed 2. Washington, DC, American Psychiatric Association, 1968. 18. Wender P: Minimal Brain Dysfunction in Children . New York, John Wiley & Sons Ine, 1971. 19. Halperin JM, Gittelman R: Do hyperactive children and their siblings differ in IQ and academic achievement? Psychiatr Res 1982;6:253-258.Crossref 20. Woerner MG, Pollack M, Klein DF: Pregnancy and birth complications in schizophrenics, personality disorders, and their siblings . Acta Psychiatr Scand 1973;49:712-731.Crossref 21. Hollingshead AB, Redlich FC: Social Class and Mental Illness: A Community Study . New York, John Wiley & Sons Ine, 1958. 22. Winneke GA, Hrdina KG, Brockhaus A: Neuropsychological studies in children with elevated tooth-lead concentrations: I. Pilot Study . Int Arch Occup Environ Health 1982;51:169-183.Crossref
Judson, Barbara A.;Goldstein, Avram;Inturrisi, Charles E.
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070024003pmid: 6347117
Abstract • One hundred nineteen patients were admitted to a sixmonth (26-week) prenaltrexone detoxification program comparing abrupt and gradual withdrawal from methadyl acetate (LAAM) therapy. All patients were brought to a maintenance level of 50, 50, and 65 mg (Monday, Wednesday, and Friday). Patients randomly assigned to the gradual group (group G) began a 4-mg/wk reduction the Monday of week 9 and reached zero dosage (placebo) the Monday of week 23; patients in the abrupt group (group A) continued to receive 50,50, and 65 mg until the Monday of week 23, when their dosage was dropped to zero (placebo). All patients were given placebo for four weeks. This study showed the superiority of abrupt withdrawal over this gradual-withdrawal schedule. Forty-six percent of group A compared with 28% of group G made the transition to naltrexone treatment. Severity of withdrawal problems was in no case significantly greater in group A. References 1. Ling W, Blakis M, Holmes ED, et al: Restabilization with methadone after methadyl acetate maintenance . Arch Gen Psychiatry 1980;37:194-196.Crossref 2. Wilson BK, Spannagel V, Thomson CP: The use of L-α-acetylmethadol in treatment of heroin addiction: An open study . Int J Addict 1976;11:1091-1100. 3. Judson BA, Goldstein A: Levo-α-acetylmethadol (LAAM) in the treatment of heroin addicts: I. Dosage schedule for induction and stabilization . Drug Alcohol Depend 1979;4:461-466.Crossref 4. Kaiko RF, Inturrisi CE: Disposition of acetylmethadol in relation to pharmacologic action . Clin Pharmacol Ther 1975;18:96-103. 5. Henderson GL, Wilson BK, Lau DHM: Plasma L-α-acetylmethadol (LAAM) after acute and chronic administration . Clin Pharmacol Ther 1977;21:16-25. 6. Ling W, Charuvastra VC, Kaim SC, et al: Methadyl acetate and methadone as maintenance treatments for heroin addicts . Arch Gen Psychiatry 1976;33:709-720.Crossref 7. Judson BA, Himmelberger DU, Goldstein A: The naloxone test for opiate dependence . Clin Pharmacol Ther 1980;27:492-501.Crossref 8. Goldstein A, Judson BA: Efficacy and side effects of three widely different methadone doses, in Proceedings of the Fifth National Conference on Methadone Treatment, Washington, D.C., 1973. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 21-43. 9. Beck AT, Ward CH, Mendelson M, et al: An inventory for measuring depression . Arch Gen Psychiatry 1961;4:53-63.Crossref 10. Kiang C, Campos-Flor S, Inturrisi CE: Determination of acetylmethadol and metabolites by use of high-performance liquid chromatography . J Chromatogr 1981;222:81-93.Crossref 11. Goldstein A: Biostatistics: An Introductory Text . New York, Macmillan Publishing Co Inc, 1964. 12. Gehan EA: A generalized Wilcoxon test for comparing arbitrarily singly-censored samples . Biometrika 1965;52:203-223.Crossref 13. Savage C, Karp EG, Curran SF, et al: Methadone/LAAM maintenance: A comparison study . Compr Psychiatry 1976;17:415-424.Crossref 14. Zaks A, Fink M, Freedman AM: Levomethadyl in maintenance treatment of opiate dependence . JAMA 1972;220:811-813.Crossref 15. Taintor Z, Hough G, Plumb M, et al: L-α-acetylmethadol and methadone in Buffalo: Safety and efficacy . Am J Drug Alcohol Abuse 1975;2:317-330.Crossref 16. Trueblood B, Judson BA, Goldstein A: Acceptability of methadyl acetate (LAAM) as compared with methadone in a treatment program for heroin addicts . Drug Alcohol Depend 1978;3:125-132.Crossref 17. Senay EC, Dorus W, Goldberg F, et al: Withdrawal from methadone maintenance: Rate of withdrawal and expectation . Arch Gen Psychiatry 1977;34:361-367.Crossref 18. Isbell H, Wikler A, Eisenman AJ, et al: Liability of addiction to 6-dimethylamino-4-4-diphenyl-3-heptanone (methadon, 'amidone' or '10820') in man: Experimental addiction to methadon . Arch Intern Med 1948;82:362-392.Crossref 19. Lipkowitz MH, Schwartz DW, Lazarus RJ: Abrupt withdrawal of maintenance methadone . JAMA 1971;217:1860-1861.Crossref 20. Lal B, Singh G: Experiences of a methadone detoxification programme for opium addicts . Drug Alcohol Depend 1976;1:391-398.Crossref 21. Blachly PH, Casey D, Marcel LJ, et al: A model for study of the treatment of the opiate abstinence syndrome , in Senay E, Shorty V, Alksne H (eds): Developments in the Field of Drug Abuse: Proceedings 1974 of the National Association for the Prevention of Addiction to Narcotics . Cambridge, Mass, Shenkman Publishing Co, 1975, pp 327-335. 22. Resnick RB, Kestenbaum RS, Washton A, et al: Naloxone-precipitated withdrawal: A method for abrupt induction onto naltrexone . Clin Pharmacol Ther 1977;21:409-413. 23. Kleber HD, Gold MS: Use of psychotropic drugs in treatment of methadone maintained narcotic addicts . Ann NY Acad Sci 1978;311:81-98.Crossref 24. Woody GE, O'Brien CP, Greenstein R: Misuse and abuse of diazepam: An increasingly common medical problem . Int J Addict 1975;10:843-848. 25. Sola SA, Wieland WF: The psychopathology of narcotic dependent individuals: Some objective considerations , in Committee on Problems of Drug Dependence . Toronto, National Academy of Science/National Research Council, 1971, pp 319-334. 26. Jegede RO: Depressive symptomatology in drug addicts: Therapeutic and aetiological implications . Afr J Med Sci 1978;7:171-173. 27. Fisch A, Patch VD, Greenfield A, et al: Depression and self-concept as variables in the differential response to methadone maintenance combined with therapy, in Proceedings of the Fifth National Conference on Methadone Treatment, Washington, D.C., 1973. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 440-445. 28. Weissman MM, Slobetz F, Prusoff B, et al: Clinical depression among narcotic addicts maintained on methadone in the community . Am J Psychiatry 1976;133:1434-1438. 29. Steer RA, Emery GD, Beck AT: Correlates of self-reported and clinically assessed depression in male heroin addicts . J Clin Psychol 1980;36:798-800.Crossref 30. Kleber HD, Gold MS, Riordan CE: The use of clonidine in detoxification from opiates . Bull Narc 1980;32:1-10. 31. Gold MS, Pottash AC, Annitto WJ, et al: Lofexidine, a clonidine analogue effective in opiate withdrawal . Lancet 1981;1:992-993. 32. Washton AM, Resnick RB, Perzel JF, et al: Lofexidine, a clonidine analogue effective in opiate withdrawal . Lancet 1981;1:991-992.Crossref 33. Senay E, Dorus W: Short-term detoxification with methadone . Ann NY Acad Sci 1981;362:203-216.Crossref 34. Tennant FS Jr, Janowski P, Shannon JA, et al: Detoxification from methadone maintenance: Double-blind comparison of two methods . Drug Alcohol Depend 1978;3:85-92.Crossref
De Leon-Jones, Frank A.;Davis, John M.;Inwang, Edet E.;Dekirmenjian, Haroutune
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070031004pmid: 6870481
Abstract • Catecholamine metabolites excreted by long-term methadone hydrochloride—dependent subjects were studied in a protocol involving a two-study design. After a two-week methadone maintenance period, 15 subjects underwent abrupt methadone withdrawal and 12 subjects, gradual methadone withdrawal. The first study compared levels of catecholamine metabolites excreted during the stable methadone period with those excreted during the abrupt withdrawal period, as well as with those eliminated by healthy nonaddicted controls. No changes in the excretion of 3-methoxy-4-hydroxyphenylglycol and normetanephrine were noted between the methadone maintenance period and the time of abrupt methadone with drawal. These values did not differ from those obtained for controls. However, higher levels of metanephrine were excreted during the stable methadone period than those in controls. During withdrawal, levels of metanephrine dropped a statistically significant amount in comparison with levels observed during the stable methadone period. The gradual withdrawal study confirmed these findings. References 1. Gold MS, Redmond DE Jr, Kleber HD: Clonidine in opiate withdrawal . Lancet 1978;2:929-930.Crossref 2. Gold MS, Redmond DE Jr, Kleber HD: Clonidine blocks opiate withdrawal symptoms . Lancet 1978;2:599-602.Crossref 3. Washton AM, Resnick RB, Rawson RA: Clonidine hydrochloride: A nonopiate treatment for opiate withdrawal, in Harris LS (ed): Problems of Drug Dependence. US Dept of Health, Education, and Welfare, National Institute on Drug Abuse, 1979, pp 233-239. 4. Washton AM, Resnick RB, Perzel JF Jr, et al: Lofexidine: A clonidine analogue effective in opiate withdrawal . Lancet 1981;2:991-992.Crossref 5. Lipman JJ, Spencer PSJ: Clonidine and opiate withdrawal . Lancet 1978;2:521.Crossref 6. Sparber S, Meyer DR: Clonidine antagonizes naloxone-induced suppression of conditioned behavior and body weight in morphine dependent rats . Pharmacol Biochem Behav 1978;9:319-325.Crossref 7. Vetulani J, Bednarczyk B: Depression by clonidine of shaking behavior elicited by nalorphine in morphine dependent rats . J Pharmacol 1978;29:567-569.Crossref 8. Tseng LF, Loh H, Wei E: Effects on morphine withdrawal signs in the rat . Eur J Pharmacol 1975;30:93-99.Crossref 9. Fieldurg S, Wilkeo J, Hynes M, et al: A comparison of clonidine with norepinephrine for antinociceptive and antiwithdrawal actions . J Pharmacol 1978;207:899-905. 10. Redmond DE Jr: Alterations in the function of the nucleus locus coeruleus: A possible model for studies of anxiety , in Hinin L, Usdin E (eds): Animal Models in Psychiatry and Neurology . Oxford, England, Pergamon Press, 1977, pp 293-305. 11. Cedarbaum JM, Aghajanian GK: Catecholamine receptors on locus coeruleus neurons: Pharmacological characterization . Eur J Pharmacol 1977;44:375-385.Crossref 12. Young WS, Bird SJ, Juhar MJ: Iontophoresis of methionine enkephalin in the locus coeruleus area . Brain Res 1977;129:366-370.Crossref 13. Aghajanian GK: Tolerance of locus coeruleus neurones to morphine and suppression of withdrawal response by clonidine . Nature 1978;276:186-188.Crossref 14. Gold MS, Redmond DE Jr: Pharmacological activation and inhibition of noradrenergic activity after specific behaviors in nonhuman primates . Neurosci Abstr 1977;3:250. 15. Aghajanian GK, Cedarbaum JM: Central noradrenergic neurons: Interactions of autoregulatory mechanisms with extreme influences , in Usdin E, Kopin IP, Barcas J (eds): Catecholamines: Basic & Clinical Frontiers . Oxford, England, Pergamon Press, 1979, pp 619-621. 16. Tang SW, Helmeste M, Stancer HC: The effect of clonidine withdrawal on total 3-methoxy-4-hydroxyphenylglycol in the rat brain . Psychopharmacology 1979;61:11-12.Crossref 17. Leckman JF, Maas JW, Redmond DE, et al: Effects of oral clonidine on plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) in man: Preliminary report . Life Sci 1980;26:2179-2185.Crossref 18. Crawley JN, Laverty R, Roth RH: Clonidine reversal of increased norepinephrine metabolite levels during morphine withdrawal . Eur J Pharmacol 1979;57:247-250.Crossref 19. Maynert EW, Klingman GE: Tolerance to morphine: I. Effects on catecholamines in the brain and adrenal glands . J Pharmacol Exp Ther 1962;135:285-295. 20. Bloom AS, Dewey WL, Harris LS, et al: The correlation between antinociceptive activity of narcotics and their antagonists as measured in the mouse tail flick test and increased synthesis of brain catecholamines . J Pharmacol Exp Ther 1976;198:33-41. 21. Smith CB, Sheldon MI, Bednarczyk JH, et al: Morphine-induced increase in the incorporation of 14C-tyrosine into 14C-dopamine and 14C-norepinephrine in the mouse brain: Antagonism by naloxone and tolerance . J Pharmacol Exp Ther 1972;180:547-557. 22. Smith CB, Villarreal JE, Bednarczyk JH, et al: Tolerance to morphine-induced increases in 14C-catecholamine synthesis in mouse brain . Science 1972;170:1106-1107.Crossref 23. Clouet DH, Ratner M: Catecholamine biosynthesis in brains of rats treated with morphine . Science 1970;168:854-856.Crossref 24. Garcia-Sevilla JA, Ahtee L, Magnusson T, et al: Opiate-receptor mediated changes in monoamine synthesis in rat brain . J Pharmacol 1978;30:613-621.Crossref 25. Roffman M, Cassens G, Schildkraut JJ: The effects of acute and chronic administration of morphine on norepinephrine turnover in rat brain regions . Biochem Pharmacol 1977;26:2355-2358.Crossref 26. Roffman M, Reigle T, Orsulak P, et al: The effects of acute and chronic morphine administration on the levels of 3-methoxy-4-hydroxyphenylglycol sulfate in rat brain . Res Commun Chem Pathol Pharmacol 1975;10:403-417. 27. Roffman M, Reigle T, Orsulak P, et al: Effects of morphine on the turnover of norepinephrine in rat brain . Pharmacologist 1974;16:270. 28. Reigle TG, Huff JW: Single-dose tolerance to the effects of morphine on brain 3-methoxy-4-hydroxyphenylglycol sulfate . Biochem Pharmacol 1980;29:2249-2251.Crossref 29. LoPachin RM, Reigle TG: The effects of several narcotic analgesics on brain levels of 3-methoxy-4-hydroxyphenylglycol sulfate in rat . J Pharmacol Exp Ther 1978;207:151-158. 30. Rosenman SJ, Smith CB: 14C-Catecholamine synthesis in mouse brain during morphine withdrawal . Nature 1972;240:153-155.Crossref 31. Middaugh L, Zemp J: Effects of methadone on activity and on brain monoamines in two strains of mice . Pharmacol Biochem Behav 1976;5:367-370.Crossref 32. Lee JR, Fennessy MR: The relationship between analgesia and the levels of biogenic amines in the mouse brain . Eur J Pharmacol 1970;12:65-70.Crossref 33. Rethy CR, Smith CB, Villarreal JE: Effects of narcotic analgesics upon locomotor activity and brain catecholamine content of the mouse . J Pharmacol Exp Ther 1971;176:472-479. 34. Fennessy MR, Lee JR: Modification of morphine analgesia by drugs affecting adrenergic and tryptaminergic mechanisms . J Pharm Pharmacol 1970;22:930-935.Crossref 35. Segal M, Deneau GA, Seevers MH: Levels and distribution of central nervous system amines in the normal and morphine-dependent monkeys . Neuropharmacology 1972;11:211-222.Crossref 36. Sugrue MF: The effects of acutely administered analgesics on the turnover of noradrenaline and dopamine in various regions of the rat brain . Br J Pharmacol 1974;52:159-165.Crossref 37. Shiomi H, Takagi H: Morphine analgesia and the bulbospinal noradrenergic system: Increase in the concentration of normetanephrine in the spinal cord of the rat caused by analgesics . Br J Pharmacol 1974;52:519-526.Crossref 38. Slotkin TA, Lau C, Bartolome M: Effects of neonatal or maternal methadone administration on ornithine decarboxylase activity in brain and heart of developing rats . J Pharmacol Exp Ther 1976;199:1412-1418. 39. Slotkin TA, Lau C, Bartolome M, et al: Alteration by methadone of catecholamine uptake and release in isolated rat adrenomedullary storage vesicles . Life Sci 1976;19:483-492.Crossref 40. Slotkin TA, Lau C, Bartolome M, et al: Catecholamine synthesis, storage and release in adrenal medulla and whole brain during acute and chronic methadone administration . Biochem Pharmacol 1976;25:2523-2527.Crossref 41. Bareis DL, Slotkin T: Responses of heart ornithine decarboxylase and adrenal catecholamines to methadone and sympathetic stimulants in developing and adult rats . J Pharmacol Exp Ther 1978;205:164-174. 42. Lau C, Bartolome M, Slotkin TA: Development of central and peripheral catecholaminergic systems in rats addicted perinatally to methadone . Neuropharmacology 1977;16:473-478.Crossref 43. Anderson TR, Slotkin TA: Maturation of the adrenal medulla: IV. Effects of morphine . Biochem Pharmacol 1975;24:1469-1474.Crossref 44. Anderson TR, Slotkin TA: The role of neural input in the effects of morphine on the rat adrenal medulla . Biochem Pharmacol 1976;25:1071-1074.Crossref 45. Clouet DH, Iwatsube K: Mechanism of tolerance to and dependence on narcotic analgesic drugs . Annu Rev Pharmacol Toxicol 1975;15:49-71.Crossref 46. Schildkraut JJ, Meyer RE, Orsulak PJ, et al: Catecholamine metabolism during heroin use . Am J Psychiatry 1977;134:534-537. 47. Weil-Malherbe H, Smith ERB, Eisenman AJ, et al: Plasma catecholamine levels and urinary excretion of catecholamines and metabolites in two human subjects during cycle of morphine addiction and withdrawal . Biochem Pharmacol 1965;14:1621-1633.Crossref 48. Eisenman AJ, Sloan JW, Martin WR, et al: Catecholamine and 17-hydroxycorticosteroid excretion during a cycle of morphine dependence in man . J Psychiatr Res 1969;7:19-28.Crossref 49. Bonsnes RW, Taussky HH: On colorimetric determination of creatinine by the Jaffe reaction . J Biol Chem 1945;158:581-591. 50. Dekirmenjian H, Maas JW: An improved procedure of 3-methoxy-4-hydroxyphenylethylene glycol determination by gas-liquid chromatography . Anal Biochem 1970;35:113-122.Crossref 51. Taniguchi K, Kakimoto Y, Armstrong MD: Quantitative determination of metanephrine and normetanephrine in urine . J Lab Clin Med 1964;64:469-484. 52. De Leon-Jones F, Davis JM, Garver D, et al: Effects of methadone maintenance and gradual withdrawal upon urinary excretion of cate cholamine metabolites. Proceedings of the American Psychiatric Association, Detroit, May 2-8, 1974. 53. Bock RD: Multivariate Statistical Methods in Behavioral Research . New York, McGraw-Hill Book Co, 1975. 54. Finn JD: Multivariance: Univariance and Multivariance Analysis of Variance, Covariance and Regression . Chicago, National Educational Resources, 1972. 55. Martin WR, Jasinski DR, Haertzen CA, et al: Methadone: A reevaluation . Arch Gen Psychiatry 1973;28:286-295.Crossref 56. Uhde T, Redmond E Jr, Kleber HD: Clonidine suppresses the opioid abstinence syndrome without clonidine-withdrawal symptoms: A blind inpatient study . Psychiatry Res 1980;2:37-47.Crossref 57. Washton AM, Resnick RB: Clonidine versus methadone for opiate detoxification . Lancet 1980;2:1297.Crossref 58. Isbell H, Wilker A, Eisenman AJ, et al: Liability of addiction of 6-dimethylamino-4, 4-diphenyl-3-heptanone (methadone, amione or '10820') in man . Arch Intern Med 1948;82:362-396.Crossref 59. Maas JW, Hattox SE, Greene NM, et al: 3-methoxy-4-hydroxy-phenylglycol production by human brain in vivo . Science 1979;205:1025-1027.Crossref 60. Blombery PA, Kopin IJ, Gordon EK, et al: Conversion of MHPG to vanillylmandelic acid . Arch Gen Psychiatry 1980;37:1095-1098.Crossref 61. Riordin CE, Kleber HD: Rapid opiate detoxification with clonidine and naloxone . Lancet 1980;1:1079-1080.Crossref 62. Meisheri KS: Involvement of cyclic AMP and prostaglandins in morphine analgesia, tolerance, and physical dependence . Indian J Physiol Pharmacol 1978;22:339-346. 63. Kuriyama K, Nakagawa K, Naito K, et al: Morphine-induced changes in cyclic AMP metabolism and protein kinase activity in the brain . Jpn J Pharmacol 1978;28:73-84.Crossref 64. Llorens C, Martres MP, Bandry M, et al: Hypersensitivity to noradrenaline in cortex after chronic morphine: Relevance to tolerance and dependence . Nature 1978;274:603-605.Crossref 65. NathansonJA, Redmond DE Jr: Morphine withdrawal causes subsensitivity of adrenergic receptor response . Life Sci 1981;28:1353-1360.Crossref 66. Charalampaus KP, Askew WE: cAMP levels following acute and chronic morphine administration . Can J Physiol Pharmacol 1977;55:117-120.Crossref 67. Klee WA, Sharma SK, Nirenberg M: Opiate receptors as regulators of adenylate cyclase . Life Sci 1975;16:1869-1874.Crossref 68. Sharma SK, Nirenberg M, Klee WA: Morphine receptors as regulators of adenylate cyclase activity . Proc Natl Acad Sci USA 1975;72:590-594.Crossref 69. Collier HOJ, Francis DI: Morphine abstinence is associated with increased brain cyclic AMP . Nature 1975;255:159-162.Crossref 70. Collier HOJ, Francis DL, McDonald-Gibson WJ, et al: Prostaglandins, cyclic AMP and the mechanism of opiate dependence . Life Sci 1975;17:85-90.Crossref 71. Mehta CS, Johnson WE: Possible role of cyclic AMP and dopamine in morphine tolerance and physical dependence . Life Sci 1975;16:1883-1888.Crossref 72. Sharma SK, Klee WA, Nirenberg M: Dual regulation of adenylate cyclase accounts for narcotic dependence and tolerance . Proc Natl Acad Sci USA 1975;72:3092-3096.Crossref 73. Pandey GN, De Leon-Jones F, Inwang E, et al: Effect of acute methadone withdrawal on prostaglandin E-stimulated 3H-cyclic adenosine monophosphate accumulation in human platelets . Clin Pharmacol Ther 1980;27:607-611.Crossref 74. Gold MS, Pottash ALC, Extein I, et al: Clonidine in acute opiate withdrawal . N Engl J Med 1980;302:1421-1422. 75. Gold MS, Kleber H: A rationale for opiate withdrawal symptomatology . Drug Alcohol Depend 1979;4:419-424.Crossref 76. Gold MS, Byck R, Sweeney DR, et al: Endorphin—locus coeruleus connection mediates opiate action and withdrawal . Biomedicine 1979;30:1-4.
Ling, Walter;Weiss, David G.;Charuvastra, V. Charles;O'Brien, Charles P.;Blakis, Mara;Wang, Richard;Savage, Charles;Roszell, Douglas;Way, Edward L.;McIntyre, Joyce
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070041005pmid: 6347118
Abstract • A multicentered clinical trial studied the efficacy and safety of disulfiram in controlling heavy alcohol consumption by patients on methadone maintenance regimens. The trial was stopped when sample size targets were not achieved. Efficacy comparisons were based on 82 patients who started the study; safety comparisons were based on 35 patients who completed 12 weeks of study. Patients received either disulfiram and methadone or placebo and methadone. Disulfiram was administered at a dosage of 125 mg/day for seven days and 250 mg/day thereafter for 36 weeks. No significant differences between the disulfiram and placebo groups were observed in either the retention in study or any other important end point. Both groups showed improvement in control of drinking during the study. There were no serious adverse reactions that could be attributed to the combined use of the two drugs. References 1. Scott NR, Winslow WW, Gorman DG: Epidemiology of alcoholism: A methadone maintenance program, in DuPont RL (ed): Proceedings of Fifth National Conference on Methadone Treatment. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 284-287. 2. Ling W, Holmes ED, Post GB, et al: A systematic psychiatric study of the heroin addicts, in DuPont RL (ed): Proceedings of Fifth National Conference on Methadone Treatment. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 429-432. 3. Kreek MJ: Psychiatric study of the heroin addict, in DuPont RL (ed): Proceedings of Fifth National Conference on Methadone Treatment. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 824-835. 4. Schut J, File F, Wohlwuth T: Alcohol use by narcotic addicts in methadone maintenance treatment . Q J S Alcohol 1973;34:1356-1359. 5. Barr HL, Cohen A: The problem drinking drug addict, in Gardner SE (ed): National Drug/Alcohol Collaborative Project: Issues in Multiple Substance Abuse, US Dept of Health, Education, and Welfare publication (ADM) 80-957. Government Printing Office, 1980, pp 78-115. 6. Gearing FR: Evaluation of methadone maintenance treatment programs . Int J Addict 1970;5:517-543. 7. Simpson DD, Savage LJ: Use of Alcohol on DARP Patients in Treatment for Drug Abuse, 1969-1971 Admissions , IBR report 73-7. Fort Worth, Tex, Texas Christian University, 1973. 8. Liebson I, Bigelow G, Flamer R: Alcoholism among methadone patients: A specific treatment method . Am J Psychiatry 1973;130:483-485. 9. Stimmal B: Methadone maintenance and alcohol use, in Gardner SE (ed): Drug and Alcohol Abuse: Implications for Treatment, US Dept of Health; Education, and Welfare publication (ADM) 80-958. Government Printing Office, 1980, pp 57-74. 10. Roizin L: Interactions of methadone and ethanol. Read at the annual meeting of the Eastern Psychiatric Research Association, New York, 1969. 11. Pascarelli EF: Disulfiram (Antabuse) in the treatment of methadone maintenance alcoholics, in Proceedings of Fifth National Conference on Methadone Treatment. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 316-323. 12. Pugliese A, Martinez M, Maselli A, et al: Treatment of alcoholic methadone maintenance patients with disulfiram . J Stud Alcohol 1975;36:1584-1588. 13. Mintz J, Beck AT, Woody G, et al: Depression in treated narcotic addicts, ex-addicts, non-addicts and suicide attempters: Validation of a very brief depression scale . Am J Alcohol Abuse 1979;6:385-396.Crossref 14. Kaplan EL, Meier P: Nonparametric estimation from incomplete observations . J Am Stat Assoc 1958;53:457-481.Crossref
Pollock, Vicki E.;Volavka, Jan;Goodwin, Donald W.;Mednick, Sarnoff A.;Gabrielli, William F.;Knop, Joachim;Schulsinger, Fini
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070047006pmid: 6870482
Abstract • The biologic sons of alcoholics constitute a group at high risk (HR) for alcoholism. A 0.5-g/kg dose of alcohol was administered to HR and control subjects aged 19 to 21 years. Blood alcohol concentration measurements failed to distinguish HR from control subjects, but quantitative measures of EEG alpha activity differentiated them. The HR subjects exhibited greater increases of slow alpha energy and greater decreases of fast alpha energy after alcohol administration than controls; the HR subjects also showed greater decreases in mean alpha frequency after alcohol administration. These EEG findings suggest that subjects at high risk for alcoholism are physiologically more sensitive to alcohol than control subjects. References 1. Goodwin DW: Family and adoption studies of alcoholism , in Mednick SA, Christiansen KO (eds): Biosocial Bases of Criminal Behavior . New York, Gardner Press Inc, 1977, pp 143-159. 2. Cloninger CR, Bohman M, Sigvardsson S: Inheritance of alcohol abuse: Cross-fostering analysis of adopted men . Arch Gen Psychiatry 1981;38:861-868.Crossref 3. Bohman M: Some genetic aspects of alcoholism and criminality . Arch Gen Psychiatry 1978;35:269-276.Crossref 4. Propping P, Kruger J, Mark N: Genetic disposition to alcoholism: An EEG study in alcoholics and their relatives . Hum Genet 1981;59:51-59.Crossref 5. Docter RF, Naitoh P, Smith JC: Electroencephalographic changes and vigilance behavior during experimentally induced intoxication with alcoholic subjects . Psychosom Med 1966;28:605-615.Crossref 6. Vogel F, Schalt E, Kruger J, et al: The electroencephalogram (EEG) as a research tool in human behavior genetics: Psychological examinations in healthy males with various inherited EEG variants . Hum Genet 1979;47:1-45.Crossref 7. Begleiter H, Platz A: The effects of alcohol on the central nervous system in humans , in Kissin B, Begleiter H (eds): The Biology of Alcoholism . New York, Plenum Press, 1972, vol 2: Physiology and Behavior, pp 308-316. 8. Propping P, Kruger J, Janah A: Effect of alcohol on genetically determined variants of the normal electroencephalogram . Psychiatr Res 1980;2:85-98.Crossref 9. Zachau-Christiansen B, Ross EM: Babies: Human Development During the First Year . New York, John Wiley & Sons Inc, 1975. 10. Knop J: A Danish prospective study on alcoholism , in Goodwin DW, Van Dusen K, Mednick SA (eds): Longitudinal Research in Drug and Alcohol Abuse . The Hague, Kluwer-Nijhoff, in press. 11. Jasper HH: The 10-20 electrode system of the International Federation . EEG Clin Neurophysiol 1958;10:371-375. 12. Volavka J, James B, Reker D, et al: Electroencephalographic effects of naloxone in normal men . Life Sci 1979;25:1267-1272.Crossref 13. Winer BJ: Statistical Principles in Experimental Design , ed 2. New York, McGraw-Hill Book Co, 1971. 14. Becker D, Schwibbe M: Zur psychologischen Relevanz spektraler EEG-Parameter: Ein korrelationsstatistischer Vergleich faktoren analytish ermittelter und klassischer EEG-Frequenzbandvariablen , in Kubicki ST, Hermann WM, Laudahn G (eds): Factor Analysis and EEG Variables . Stuttgart, Germany, Gustav Fischer Verlag, 1980. 15. Elmgren J, Lowenhardt P: A Factor Analysis of the Human EEG . Göteborg, Sweden, Psychological Laboratory, University of Göteborg, 1969. 16. Goodwin D: Alcoholism: The Facts . Oxford, England, Oxford University Press, 1981. 17. Lipscomb T, Nathan P, Wilson T, et al: Effects of tolerance on the anxiety-reducing function of alcohol . Arch Gen Psychiatry 1980;37:577-582.Crossref 18. Ryan LJ, Barr JE, Sharpless SK: Electrophysiological responses to ethanol, pentobarbital, and nicotine in mice genetically selected for differential sensitivity to ethanol . J Comp Physiol Psychol 1979;93:1035-1053.Crossref 19. Heston WDW, Erwin VG, Anderson SM, et al: A comparison of the effects of alcohol on mice selectively bred for differences in ethanol sleep time . Life Sci 1974;14:365-370.Crossref 20. Tabakoff B, Ritzmann RF, Raju TS, et al: Characterization of acute and chronic tolerance in mice selected for inherent differences in sensitivity to ethanol . Alc Clin Exp Res 1980;5:64-66. 21. Propping P: Alcohol and alcoholism . Hum Genet 1977;35:309-334.Crossref 22. Wallgren H, Barry H: Actions of Alcohol . Amsterdam, Elsevier North Holland Inc, 1970, vol 1, pp 281-301. 23. Utne HE, Hansen FV, Winkler K, et al: Alcohol elimination rates in adoptees with and without alcoholic parents . J Stud Alcohol 1977;38:1219-1223. 24. Schuckit MA: Peak blood alcohol concentrations in men at high risk for the future development of alcoholism . Ale Clin Exp Res 1981;5:64-66.Crossref 25. Mikeska JA, Klemm WR: Evidence against a role of acetaldehyde in electroencephalographic signs of ethanol induced intoxication . Science 1979;203:54-55.Crossref 26. Schuckit MA, Rayses V: Ethanol ingestion: Differences in blood acetaldehyde concentrations in relatives of alcoholics and controls . Science 1979;203:54-55.Crossref 27. Knop J, Angelo H, Christensen JM: Is the role of acetaldehyde in alcoholism based on analytical artifact? Lancet 1981;2:102.Crossref 28. Berg C, Laberg JC, Skutle A, et al: Instructed versus pharmacological effects of alcohol in alcoholics and social drinkers . Behav Res Ther 1981;19:55-66.Crossref
Griffiths, Roland R.;Bigelow, George E.;Liebson, Ira
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070055007pmid: 6870483
Abstract • The effects of administering moderately high doses of diazepam and pentobarbital sodium for five consecutive days to subjects with histories of sedative drug abuse were examined. The two drugs produced similar dose-related effects on psychomotor performance, daytime sleeping, and ratings of magnitude of drug effects. Diazepam, but not pentobarbital, produced dose-related decreases in staff ratings of subjects' mood and social interactions and increases in staff ratings of subjects' hostility, complaining, and unusual behavior. During the placebo washout periods that followed drug administration, diazepam, but not pentobarbital, was associated with carry-over effects. The diazepam-produced deterioration in mood and social behavior was a subtle effect observed in a population for which usual therapeutic indications were lacking and at higher than usual therapeutic doses. The syndrome may, however, occur with long-term diazepam use or misuse in therapeutic settings and, hence, warrants clinical awareness in monitoring the course of treatment. References 1. Feldman PE: An analysis of the efficacy of diazepam . J Neuropsychiatry 1962;3:62-67. 2. DiMascio A, Shader RI, Giller DR: Behavioral toxicity: III. Perceptual-cognitive functions and IV. Emotional (mood) states , in Shader RI, DiMascio A (eds): Psychotropic Drug Side Effects . Baltimore, Williams & Wilkins Co, 1970, pp 132-141. 3. Greenblatt DJ, Shader RI: Benzodiazepines in Clinical Practice . New York, Raven Press, 1974. 4. Zisook S, DeVaul RA: Adverse behavioral effects of benzodiazepines . J Fam Pract 1977;5:963-966. 5. Ryan HF, Merrill FB, Scott GE, et al: Increase in suicidal thoughts and tendencies . JAMA 1968;203:135-137.Crossref 6. Hall RCW, Joffe JR: Aberrant response to diazepam: A new syndrome . Am J Psychiatry 1972;129:114-118. 7. Hollister LO, Bennett JL, Kimbell I, et al: Diazepam in newly admitted schizophrenics . Dis Nerv Syst 1963;24:1-4. 8. Gundlach R, Engelhardt DM, Hankoff L, et al: A double-blind outpatient study of diazepam (Valium) and placebo . Psychopharmacology 1966;9:81-92.Crossref 9. Hall RCW, Zisook S: Paradoxical reactions to benzodiazepines . Br J Clin Pharmacol 1981;11:99-104.Crossref 10. Gardos G, DiMascio A, Salzman C, et al: Differential actions of chlordiazepoxide and oxazepam on hostility . Arch Gen Psychiatry 1968;18:757-760.Crossref 11. Salzman C, Kochansky GE, Shader RI, et al: Chlordiazepoxide-induced hostility in a small group setting . Arch Gen Psychiatry 1974; 31:401-405.Crossref 12. Kochansky GE, Salzman C, Shader RI, et al: The differential effects of chlordiazepoxide and oxazepam on hostility in a small group setting . Am J Psychiatry 1975;132:861-863. 13. Kochansky GE, Salzman C, Shader RI, et al: Effects of chlordiazepoxide and oxazepam administration on verbal hostility . Arch Gen Psychiatry 1977;34:1457-1459.Crossref 14. Rickels K, Downing RW: Chlordiazepoxide and hostility in anxious outpatients . Am J Psychiatry 1974;131:442-444. 15. Griffiths RR, Bigelow GE, Liebson I, et al: Drug preference in humans: Double-blind choice comparison of pentobarbital, diazepam and placebo . J Pharmacol Exp Ther 1980;215:649-661. 16. Griffiths RR, Bigelow GE, Liebson I: Human drug self-administration: Double-blind comparison of pentobarbital, diazepam, chlorpromazine and placebo . J Pharmacol Exp Ther 1979;210:301-310. 17. Martin WR, Sloan JW, Sapira JD, et al: Physiologic, subjective and behavioral effects of amphetamine, ephedrine, phenmetrazine and methylphenidate in man . Clin Pharmacol Ther 1971;12:245-258. 18. McNairDM, Lorr M, Droppleman LF: Manual for the Profile of Mood States . San Diego, Educational and Industrial Testing Service, 1971. 19. Thompson BC, Caplan YH: A gas chromatographic method for the determination of methadone and its metabolites in biological fluids and tissues . J Anal Toxicol 1977;1:66-69.Crossref 20. Caplan YH, Orloff KG, Thompson BC, et al: Detection of phencyclidine in medical examiner's cases . J Anal Toxicol 1979;3:47-52.Crossref 21. Geisser S, Greenhouse SW: An extension of Box's results on the use of the F distribution in multivariate analysis . Ann Math Statist 1958;29:885-891.Crossref 22. Jennings JR, Wood CC: The ∈-adjustment procedure for repeated measures of analysis of variance . Psychophysiology 1976;13:277-278.Crossref 23. Eatman FB, Colburn WA, Boxenbaum HG, et al: Pharmacokinetics of diazepam following multiple-dose oral administration to healthy human subjects . J Pharmacokinet Biopharm 1977;5:481-493.Crossref 24. Dasberg H, Van der Klegn E, Geulan PJR, et al: Plasma concentrations of diazepam and of its metabolite N-desmethyldiazepam in relation to anxiolytic effect . Clin Pharmacol Ther 1974;15:473-483. 25. Dasberg HH: Effect of plasma levels of N-desmethyldiazepam after oral administration in normal volunteers . Psychopharmacology 1975;43:191-198.Crossref 26. Salzman C, Kochansky GE, Shader RI, et al: Is oxazepam associated with hostility? Dis Nerv Sys 1975;36:30-32. 27. Breimer DD, Jochemsen R, von Albert HH: Pharmacokinetics of benzodiazepines . Arzneim Forsch Drug Res 1980;30:875-881. 28. Isbell H, Altschul S, Kornetsky CH, et al: Chronic barbiturate intoxication: An experimental study . Arch Neurol 1950;64:1-28.Crossref 29. Fraser HF, Isbell H, Eisenman AJ, et al: Chronic barbiturate intoxication: Further studies . Arch Interm Med 1954;94:34-41.Crossref 30. Meyer RE, Mirin SM: The Heroin Stimulus: Implications for a Theory of Addiction . New York, Plenum Medical Book Co, 1979. 31. McNamee HB, Mello NK, Mendelson JH: Experimental analysis of drinking patterns of alcoholics: Concurrent psychiatric observations . Am J Psychiatry 1968;124:1063-1069. 32. Yanagita T, Takahashi S: Dependence liability of several sedativehypnotic agents evaluated in monkeys . J Pharmacol Exp Ther 1973;185:307-316. 33. Griffiths RR, Lukas SE, Bradford LD, et al: Self-injection of barbiturates and benzodiazepines in baboons . Psychopharmacology 1981; 75:101-109.Crossref 34. Marks J: The Benzodiazepines: Use, Overuse, Misuse, Abuse . Baltimore, University Park Press, 1978. 35. Stitzer ML, Griffiths RR, McLellan AT, et al: Diazepam use among methadone maintenance patients: Patterns and dosages . Drug Alcohol Depend 1981;8:189-199.Crossref
Vardy, Michael M.;Kay, Stanley R.
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070067008pmid: 6870484
Abstract • We studied whether patients hospitalized for LSD psychosis are clinically separable from acute schizophrenics. The family histories, manifest symptoms, premorbid adjustment, and profiles on an extensive test battery were analyzed for 52 LSD psychotics and 29 matched first-break schizophrenics. The LSD patients did not differ from schizophrenics in incidence of psychosis or suicide among the parents. However, the rate of parental alcoholism for LSD psychotics far exceeded that for schizophrenics and the general population. The two groups were distinguished on some clinical features but were equivalent in premorbid adjustment, on most cognitive measures when initially hospitalized or reassessed three to five years later, and in number of subsequent rehospitalizations. Thus, in most respects the LSD psychotics were fundamentally similar to schizophrenics in genealogy, phenomenology, and course of illness. The findings supported a model of LSD psychosis as a drug-induced schizophreniform reaction in persons vulnerable to both substance abuse and psychosis. References 1. Bowers MB Jr, Freedman DX: Psychoses associated with drug use , in Arieti S (ed): American Handbook of Psychiatry , ed 2. New York, Basic Books Inc, 1975, vol 4, pp 356-370. 2. Klee G, Weintraub W: Paranoid response following lysergic acid diethylamide (LSD-25) , in Bradley P (ed): Neuropsychopharmacology . Princeton, NJ, Van Nostrand Reinhold Co, 1959, pp 457-460. 3. Langs RJ, Barr HL: Lysergic acid diethylamide (LSD-25) and schizophrenic reactions . J Nerv Ment Dis 1968;147:163-172.Crossref 4. Anastasopoulos G, Photiades H: Effects of LSD-25 on relatives of schizophrenic patients . J Ment Sci 1962;108:95-98. 5. Cohen SA: Classification of LSD complications . Psychosomatics 1966; 7:182-186.Crossref 6. Glass GS, Bowers MB Jr: Chronic psychosis associated with long-term psychotomimetic drug abuse . Arch Gen Psychiatry 1970;23:97-103.Crossref 7. Brown F: Hallucinogenic Drugs . Springfield, Ill, Charles C Thomas Publisher, 1972. 8. Stone MH: Drug-related schizophrenic syndromes . Int J Psychiatry 1973;11:391-437. 9. Robbins E, Frosch W, Stern M: Further observations on untoward reactions to LSD . Am J Psychiatry 1967;124:393-395. 10. Blumenfield M, Glickman L: Ten months' experience with LSD users admitted to a county psychiatric receiving hospital . NY State J Med 1967;67:1849-1853. 11. Hensala J, Epstein L, Blacker KH: LSD and psychiatric inpatients . Arch Gen Psychiatry 1967;16:554-559.Crossref 12. Bowers MB Jr: Acute psychosis induced by psychotomimetic drugs: I. Clinical findings . Arch Gen Psychiatry 1972;27:437-440.Crossref 13. Bowers MB Jr: Psychoses precipitated by psychotomimetic drugs: A follow-up study . Arch Gen Psychiatry 1977;34:832-835.Crossref 14. Breakey WR, Goodell H, Lorenz PC, et al: Hallucinogenic drugs as precipitants of schizophrenia . Psychol Med 1974;4:255-261.Crossref 15. Ungerleider JT, Fisher DD, Fuller M, et al: The 'bad trip': The etiology of the adverse LSD reaction . Am J Psychiatry 1968;124:1483-1490. 16. Smart RG, Jones D: Illicit LSD users: Their personality characteristics and psychopathology . J Abnorm Soc Psychol 1970;75:286-292.Crossref 17. Tucker GJ, Quinlan D, Harrow M: Chronic hallucinogenic use and thought disturbance . Arch Gen Psychiatry 1972;27:443-447.Crossref 18. Ungerleider JT, Fisher DD, Goldsmith S, etal: A statistical survey of adverse reactions to LSD in Los Angeles County . Am J Psychiatry 1968;125:353-357. 19. Phillips L: Case history data and prognosis in schizophrenia: A review . Arch Gen Psychiatry 1969;21:267-283.Crossref 20. Seidel C: The relationship between Klopfer's Rorschach prognostic rating scale and Phillips' case history prognostic rating scale . J Consult Psychol 1960;24:46-49.Crossref 21. Payne RW: Cognitive abnormalities , in Eysenck HJ (ed): Handbook of Abnormal Psychology , ed 2. London, Pitman Medical Press, 1973, pp 420-483. 22. Levine A, Abramson H, Kaufman M, et al: Lysergic acid diethylamide (LSD-25): XVI. The effect on intellectual functioning as measured by the Wechsler-Bellevue intelligence scale . J Psychol 1955;40:385-395.Crossref 23. Batman RH, Albee GW, Lane EA: Intelligence test performance of chronic and recovered schizophrenics, in Proceedings of the 74th Annual Meeting of the American Psychological Association. Washington, DC, American Psychological Association, 1966, pp 173-174. 24. Pascal GR, Suttell BJ: The Bender Gestalt Test: Quantification and Validity for Adults . New York, Grune & Stratton Inc, 1951. 25. Benton A: The Revised Visual Retention Tests: Clinical and Experimental Applications . New York, Psychological Corporation, 1955. 26. Barr HL, Langs RJ, Holt R, et al: LSD: Personality and Experience . New York, John Wiley & Sons Inc, 1972. 27. Becker W: A genetic approach to the interpretation and evaluation of the process-reactive distinction in schizophrenia . J Abnorm Soc Psychol 1956;53:229-236.Crossref 28. Quinlan D, Harrow M, Tucker GJ, et al: Varieties of disordered thinking on the Rorschach: Findings in schizophrenic and non-schizophrenic patients . J Abnorm Psychol 1972;79:47-53.Crossref 29. Rapaport DO, Gill MM, Schafer R: Diagnostic Psychological Testing . Chicago, Year Book Medical Publishers, 1946, vol 2. 30. Watkins JG, Stauffacher JC: An index of pathological thinking on the Rorschach . J Proj Techniques 1952;16:276-286.Crossref 31. Fowler CR, Tsuang MT, Cadoret RJ: Parental psychiatric illness associated with schizophrenia in the siblings of schizophrenics . Compr Psychiatry 1977;18:271-275.Crossref 32. Freedman AM, Kaplan HI, Sadock BJ: Modern Synopsis of Comprehensive Textbook of Psychiatry . Baltimore, Williams & Wilkins Co, 1972. 33. Stephens DA, Atkinson MW, Kay DWK, et al: Psychiatric morbidity in parents and sibs of schizophrenics and nonschizophrenics . Br J Psychiatry 1975;127:97-108.Crossref 34. Report on Epidemiological and Vital Statistics. Geneva, World Health Organization, Statistical Report 9, 1956. 35. Goodwin DW: Is alcoholism hereditary? A review and critique . Arch Gen Psychiatry 1971;25:545-549.Crossref 36. Dahlberg G, Sternberg S: Alkoholismen som Samhaltsproblem . Stockholm, Oscar Ekleens, 1934. 37. Karman M, Blumenberg S: Comparative efficiency of some tests of cerebral damage . J Consult Psychol 1963;27:303-309.Crossref 38. Allison J, Blatt SJ: The relationship of Rorschach whole response to intelligence . J Proj Techniques Pers Assessment 1964;28:255-260.Crossref 39. Goldfried M: Some normative data on Rorschach developmental level 'card pull' in a psychiatric population . J Proj Techniques 1962;26:283-287.Crossref 40. Tsuang MT, Simpson JC, Kronfol Z: Subtypes of drug abuse with psychosis . Arch Gen Psychiatry 1982;39:141-147.Crossref 41. McGlothlin WH, Arnold D, Freedman DX: Organicity measures following repeated LSD ingestion . Arch Gen Psychiatry 1969;21:704-709.Crossref 42. Acord LD, Barker DD: Hallucinogenic drugs and cerebral deficit . J Nerv Ment Dis 1973;156:281-283.Crossref 43. Hale MS, Hesselbrock M, Hesselbrock V: Childhood deviance and sociopathy in alcoholism . J Psychiatr Treat Eval 1982;4:33-36.
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070074009pmid: 6135405
Abstract • One hundred twenty-three persons with a history of LSD use were studied for the presence of the LSD flashback phenomenon and compared with 40 control subjects. A syndrome emerged that included ten distinct visual disturbances. It had lasted for five years in half of the population, was treatable with benzodiazepines, exacerbated by phenothiazines, and precipitated by 19 different stimuli, most commonly emergence into a dark environment. Sensitivity to LSD as determined by flashbacks appears to divide the study sample into three discrete subgroups. There may be a genetic basis to LSD sensitivity. References 1. Halikas JA: Marijuana use and psychiatric illness , in Miller LL (ed): Marijuana, Effects on Human Behavior . New York, Academic Press Inc, 1974. 2. Terrill J, Savage C, Jackson DD: LSD, transcendence and the new beginning . J Nerv Ment Dis 1962;135:425-439.Crossref 3. Tucker GJ, Quinlan D, Harrow M: Chronic hallucinogenic drug use and thought disturbance . Arch Gen Psychiatry 1972;27:443-447.Crossref 4. Blacker KH, Jones RT, Stone GC, et al: Chronic users of LSD: The acidheads . Am J Psychiatry 1968;125:341-351. 5. Acord LD, Barker DD: Hallucinogenic drugs and cerebral deficit . J Nerv Ment Dis 1973;156:281-283.Crossref 6. Keller J, Redfering DL: Comparison between the personalities of LSD users and non-users as measured by the Minnesota Multiphasic Personality Inventory . J Nerv Ment Dis 1973;156:271-277.Crossref 7. Abraham HD: A chronic impairment of colour vision in users of LSD . Br J Psychiatry 1982;140:518-520.Crossref 8. Bowers MB Jr: Acute psychosis induced by psychotomimetic drug abuse: II. Neurochemical findings . Arch Gen Psychiatry 1972;27:440-442.Crossref 9. McLellan AT, Woody GE, O'Brien CP: Development of psychiatric illness in drug abusers: Possible role of drug preference . N Engl J Med 1979;301:1310-1314.Crossref 10. Abraham HD: Psychiatric illness in drug abusers . N Engl J Med 1980;302:868-869. 11. McGlothlin WH, Arnold DO: LSD revisited: A ten-year follow-up of medical LSD use . Arch Gen Psychiatry 1971;24:35-49.Crossref 12. Culver CM, King FW: Neuropsychological assessment of undergraduate marihuana and LSD users . Arch Gen Psychiatry 1974;31:707-711.Crossref 13. McGlothlin WH, Arnold DO, Freedman DX: Organicity measures following repeated LSD ingestion . Arch Gen Psychiatry 1969;21:704-709.Crossref 14. Elkes C, Elkes J, Mayer-Gross W: Hallucinogenic drugs . Lancet 1955;268:719.Crossref 15. Eisner BG, Cohen S: Psychotherapy with lysergic acid diethylamide . J Nerv Ment Dis 1958;127:528-539.Crossref 16. Rosenthal SH: Persistent hallucinosis following repeated administration of hallucinogenic drugs . Am J Psychiatry 1964;121:238-244. 17. Cohen S, Ditman KS: Prolonged adverse reactions to lysergic acid diethylamide . Arch Gen Psychiatry 1963;8:475-480.Crossref 18. Horowitz MJ: Flashbacks: Recurrent intrusive images after the use of LSD . Am J Psychiatry 1969;126:565-569. 19. Shick JF, Smith D: Analysis of the LSD flashback . J Psychedelic Drugs 1970;3:13-19.Crossref 20. Robbins E, Frosch W, Stern M: Further observations on untoward reactions to LSD . Am J Psychiatry 1967;124:393-395. 21. Blumenfield M: Flashback phenomena in basic trainees who enter the US Air Force . Military Med 1971;136:39-41. 22. Stanton MD, Bardoni A: Drug flashbacks: Reported frequency in a military population . Am J Psychiatry 1972;129:751-755. 23. Holsten F: Flashbacks: A personal follow-up . Arch Psychiatr Nervenkr 1976;222:293-304.Crossref 24. Freedman DX, Van Praag HM, Lader MH, et al: Mode of action of hallucinogenic drugs , in Van Praag HM, (ed): Handbook of Biological Psychiatry . New York, Marcel Dekker Inc, 1981, pt 4, pp 859-884. 25. Snyder SH, Reivich M: Regional localization of lysergic acid diethylamide in monkey brain . Nature 1966;209:1093-1095.Crossref 26. Smith DE: The acute and chronic toxicity of marijuana . J Psychedelic Drugs 1968;2:37-47.Crossref 27. Favazza A, Domino E: Recurrent LSD experiences (flashbacks) triggered by marijuana . Univ Mich Med Center J 1969;35:214-216. 28. Weil AT: Adverse reactions to marijuana. Classification and suggested treatment . N Engl J Med 1970;282:997-1000.Crossref 29. Stanton MD, Mintz J, Franklin RM: Drug flashbacks: II. Some additional findings . Int J Addict 1976;2:53-69. 30. Tennant FS, Groesbeck CJ: Psychiatric effects of hashish . Arch Gen Psychiatry 1972;27:133-136.Crossref 31. Moskowitz D: Use of haloperidol to reduce LSD flashbacks . Military Med 1971;136:754-757. 32. Anderson W, O'Malley J: Trifluoperazine for the trailing phenomenon . JAMA 1972;220:1244-1245.Crossref 33. Schwarz CJ: Paradoxical responses to chlorpromazine after LSD . Psychosomatics 1967;8:210-211.Crossref 34. Thurlow HJ, Girvin JP: Use of antiepileptic medication in treating 'flashbacks' from hallucinogenic drugs . Can Med Assoc J 1971;105:947-948. 35. Freedman DX: On the use and abuse of LSD . Arch Gen Psychiatry 1968;18:330-347.Crossref 36. MarshmanJA, Gibbons RJ: A note on the composition of illicit drugs . Ontario Med Rev 1970;37:429-441. 37. Scott ME: The flashback phenomenon . Va Med Monthly 1971;98:317-320. 38. Siegel RK, Jarvik ME: Drug-induced hallucinations in animals and man , in Siegel RK, West LJ (eds): Hallucinations . New York, John Wiley & Sons Inc, 1975, pp 81-162. 39. Klüver H: Mescal and Mechanisms of Hallucinations . Chicago, University of Chicago Press, 1966. 40. Hamilton M (ed): Fish's Clinical Psychopathology . Baltimore, Williams & Wilkins Co, 1974. 41. Ladd-Franklin C: Visible radiation from excited nerve fiber: The reddish blue arcs and the reddish blue glow of the retina . Science 1927; 66:239-241.Crossref 42. Murch GM: Visual and Auditory Perception . New York, Bobbs-Merrill Co Inc, 1973. 43. Cheek FE, Newell S, Joffee M: Deceptions in the illicit drug market . Science 1970;167:1226.Crossref 44. DeValois RL, Smith CJ, Kitai ST, et al: Response of single cells in monkey lateral geniculate nuclei to monochromatic light . Science 1958; 127:238-239.Crossref 45. Evarts EV, Landau W, Freygang E, et al: Some effects of lysergic acid diethylamide and bufotenine on electrical activity in the cat's visual system . Am J Physiol 1955;182:594-598. 46. Bishop PO, Field G, Hennessy BL, et al: Action of d-lysergic acid diethylamide on lateral geniculate synapses . J Neurophysiol 1958;21:529-549. 47. Daw NW: Neurophysiology of color vision . Physiol Rev 1973;53:571-611. 48. Baldessarini RJ: Drugs used in the treatment of psychoses , in Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics . New York, MacMillan Publishing Co Inc, 1980, chap 19. 49. Vernon MD: The Psychology of Perception . Hammondsworth, England, Penguin Books Ltd, 1973, p 202. 50. Shapiro D: Neurotic Styles . New York, Basic Books Inc, 1965, p 2. 51. Freedman DX, Aghajanian GK, Ornitz EM, et al: Patterns of tolerance to lysergic acid diethylamide and mescaline in rats . Science 1958;127:1173-1174.Crossref 52. Isbell H, Belleville RE, Fraser HF, et al: Studies on lysergic acid diethylamide (LSD-25): I. Effects in former morphine addicts and development of tolerance during chronic intoxication . Arch Neurol Psychiatry 1956;76:468-478.Crossref 53. Davis M, Sheard MH: Habituation and sensitization of the rat startle response: Effects of raphé lesions . Physiol Behav 1974;12:425-431.Crossref 54. Brunelli M, Castellucci V, Kandel ER: Synaptic facilitation and behavioral sensitization in Aplysia: Possible role of serotonin and cyclic AMP . Science 1976;194:1178-1181.Crossref 55. Halaris A, Freedman DX: Vesicular and juxtavesicular serotonin: Effects of lysergic acid diethylamide and reserpine . J Pharmacol Exp Ther 1977;203:575-586. 56. Fischer R: The 'flashback': Arousal-statebound recall of experience . J Psychedelic Drugs 1971;3:31-39.Crossref 57. Winters WD: The continuum of CNS excitatory states and hallucinosis , in Siegel RK, West LJ (eds): Hallucinations . New York, John Wiley & Sons Inc, 1975, pp 53-70. 58. Horowitz MJ: Hallucinations: An information processing approach , in Siegel RK, West LJ (eds): Hallucinations . New York, John Wiley & Sons Inc, 1975, pp 163-196. 59. Bowers MB Jr: Serotonin (5HT) systems in psychotic states . Psychopharmacol Community 1975;1:655-662. 60. Tsuang MT, Simpson JC, Kronfol Z: Subtypes of drug abuse with psychosis: Demographic characteristics, clinical features, and family history . Arch Gen Psychiatry 1982;39:141-147.Crossref 61. Ewing JA: Identifying the hidden alcoholic. Read before the 29th Congress on Alcohol and Drug Dependence, Sydney, Australia, Feb 3, 1970.
Kane, John M.;Rifkin, Arthur;Woerner, Margaret;Reardon, Gerard;Sarantakos, Stavros;Schiebel, David;Ramos-Lorenzi, Jorge
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070083010pmid: 6347119
Abstract • In an attempt to begin to establish minimum effective dosage requirements for the maintenance treatment of schizophrenia, we undertook a double-blind comparison of low-dose fluphenazine decanoate (1.25 to 5.0 mg/2 wk) with the standard-dose regimen (12.5 to 50.0 mg/2 wk) in outpatient schizophrenics. For the first 126 patients studied, cumulative relapse rates at one year for the low dose were 56% and for the standard dose 7%, a significant difference. Despite the fact that very little dyskinetic symptomatology developed in the sample as a whole, the low-dose treatment appeared to have a significant advantage in producing fewer early signs of tardive dyskinesia. Severity of relapse and total cumulative dosage were also considered. References 1. Davis JM: Overview: Maintenance therapy in psychiatry: I. Schizophrenia . Am J Psychiatry 1975;132:1237-1245. 2. Davis JM, Schaffer CB, Killian GA, et al: Important issues in the drug treatment of schizophrenia . Schizophr Bull 1980;6:70-87.Crossref 3. Rifkin A, Quitkin F, Rabiner DJ, et al: Fluphenazine decanoate, fluphenazine hydrochloride given orally, and placebo in remitted schizophrenics . Arch Gen Psychiatry 1977;34:43-47.Crossref 4. Hogarty GE, Goldberg SC, Collaborative Study Group: Drugs and social therapy in the aftercare of schizophrenic patients . Arch Gen Psychiatry 1973;28:54-63.Crossref 5. Hogarty GE, Goldberg SC, Schooler NR, et al: Drugs and social therapy in the aftercare of schizophrenic patients: II. Two-year relapse rates . Arch Gen Psychiatry 1974;31:603-608.Crossref 6. Hogarty GE, Goldberg SC, Schooler NR: Drugs and social therapy in the aftercare of schizophrenia: III. Adjustment of nonrelapsed patients . Arch Gen Psychiatry 1974;31:609-618.Crossref 7. Hogarty GE, Ulrich RF, Mussare F, et al: Drug discontinuation among long-term successfully maintained schizophrenic outpatients . Dis Nerv System 1976;37:494-500. 8. Hogarty GE, Schooler NR, Ulrich RF, et al: Fluphenazine and social therapy in the aftercare of schizophrenic patients . Arch Gen Psychiatry 1979;36:1283-1294.Crossref 9. Schooler NR, Levine J, Severe JB, et al: Prevention of relapse in schizophrenia . Arch Gen Psychiatry 1980;37:16-24.Crossref 10. Quitkin F, Rifkin A, Kane JM, et al: Long-acting oral vs injectable antipsychotic drugs in schizophrenics . Arch Gen Psychiatry 1978;35:889-892.Crossref 11. Kane JM, Rifkin A, Quitkin F, et al: Fluphenazine vs placebo in patients with remitted, acute first-episode schizophrenia . Arch Gen Psychiatry 1982;39:70-73.Crossref 12. Kane JM, Smith JM: Tardive dyskinesia: Prevalence and risk factors 1959-1979 . Arch Gen Psychiatry 1982;39:473-481.Crossref 13. Kane JM, Woerner M, Weinhold P, et al: A prospective study of tardive dyskinesia development: Preliminary results . J Clin Psychopharmacol 1982;2:345-349. 14. Rifkin A, Quitkin F, Kane J, et al: Are prophylactic antiparkinson drugs necessary? A controlled study of procyclidine withdrawal . Arch Gen Psychiatry 1978;35:483-489.Crossref 15. Goldstein M, Rodnick E, Evans J, et al: Drug and family therapy in the aftercare treatment of acute schizophrenics . Arch Gen Psychiatry 1978; 35:1169-1177.Crossref 16. Brown GW, Wing JK: Influence of family life on the course of schizophrenic disorders: A replication . Br J Psychiatry 1972;121:241-258.Crossref 17. Leff JP, Vaughn C: The role of maintenance therapy and relatives' expressed emotion in relapse of schizophrenia: A two year follow-up . Br J Psychiatry 1981;139:102-104.Crossref 18. Leff JP, Kuipers L, Berkowitz R, et al: A controlled trial of social intervention in the families of schizophrenic patients . Br J Psychiatry 1982;141:121-134.Crossref 19. Baldessarini RJ, Davis JM: What is the best maintenance dose of neuroleptics in schizophrenia? Psychiatr Res 1980;3:115-122.Crossref 20. Kane J, Rifkin A, Quitkin F, et al: Low dose fluphenazine decanoate in maintenance treatment of schizophrenia . Psychiatr Res 1979;1:341-348.Crossref 21. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders , ed 3. New York, New York State Psychiatric Institute, 1977. 22. Spitzer RL, Gibbon M, Endicott J: Global Assessment Scale , in Guy W (ed): ECDEU Assessment Manual . Dept of Health, Education, and Welfare, publication (ADM) 76-338, 1976, pp 583-585. 23. Overall J, Gorham D: Brief Psychiatric Rating Scale . Psychol Rep 1962;10:799-812.Crossref 24. Endicott J, Spitzer R: A diagnostic interview: The Schedule for Affective Disorders and Schizophrenia . Arch Gen Psychiatry 1978;25:837-844.Crossref 25. Clinical Global Impression Scale , in Guy W (ed): ECDEU Assessment Manual . Dept of Health, Education, and Welfare, publication (ADM) 76-338, 1976, pp 218-222. 26. Simpson GM, Lee JH, Zoubak B, et al: Rating scale for tardive dyskinesia . Psychopharmacology 1979;64:171-179.Crossref 27. Simpson GM, Angus JSW: A rating scale for extrapyramidal side effects . Acta Psychiatr Scand 1970;212( (suppl) ):11-19.Crossref
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070090011
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1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070091012pmid: 6870485
Abstract If science does not see that the time has come to recognize as its central concern the whole of man, as individual and group, it fails to do justice to its greatest task and opportunity. Adolphmeyer Adolph Meyer, to the best of our knowledge, first publicly uttered his term psychobiology in 1906 at the Clark University (Worcester, Mass) symposium, in the presence of Sigmund Freud.1 Meyer thereby espoused a clinical application of holism, the idea that the study of patients— and of humanity—should encompass the entire life experience, including biologic processes. In 1935, he stated that "any truly human study of man will always include life history and situation as well as function of structure and function of function."2 For this holistic examination of patients, he designed a life chart for noting biologic aberrations in the major body systems and important life experiences, both normative and traumatic. References 1. Meyer A: The dynamic interpretation of dementia praecox: Clark University (20th anniversary Lecture) . Am J Psychol 1910;21:385-398.Crossref 2. Meyer A: The birth and development of the mental hygiene movement (25th anniversary Mental Health Service.) Ment Hyg 1935;19:29-36. 3. Freud S: Neue Folge der Vorlesungen zur Einfuhrung in die Psychoanalyse Gesammelte Werke . London, Imago Publishing Co Ltd, 1940, vol 15, p 102. 4. Von Bertalanffy L: Organismic Psychology and Systems Theory . Worcester, Ma, Clark University Press, 1968. 5. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 6. Masserman JH: The comparative scientific status of psychiatry , in Masserman JH (ed): Current Psychiatric Therapies . New York, Grune & Stratton Inc, 1981, vol 20, pp 3-15. 7. Gray W, Duhl F, Rizzo N: General Systems Theory and Psychiatry . Boston, Little Brown & Co, 1969. 8. Grinker RR Sr: The relevance of general systems theory to psychiatry , in Hamburg DA, Brodie HK (eds): American Handbook of Psychiatry . New York, Basic Books, 1975, vol 6, pp 251-272. 9. Miller JG: General living systems theory , in Kaplan H, Freedman A, Sadock B (eds): Comprehensive Textbook of Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1980, vol 1, pp 98-114. 10. Anthony EJ: Do emotional problems of the child always have their origin in the family? in Brady P, Brodie KH (eds): Psychiatry at the Crossroads . Philadelphia, WB Saunders Co, 1980, pp 97-115. 11. Fisher L: On classification of families: A progress report . Arch Gen Psychiatry 1977;34:424-433.Crossref 12. Reiss D: The Family's Construction of Reality . Cambridge, Mass, Harvard University Press, 1981. 13. Jenkins RL: The varieties of children's behavioral problems in family dynamics . Am J Psychiatry 1968;124:233-251. 14. Lewis J, Beavers WR, Gossett JT, et al: No Single Thread: Psychological Health in Family Systems . New York, Brunner/Mazel, 1976. 15. Singer MT, Wynne LC, Toohey ML: Communication disorders and the families of schizophrenics , in Wynne LC, Cromwell RL, Matthysse S (eds): The Nature of Schizophrenia: New Approaches to Research and Treatment . New York, John Wiley & Sons Inc, 1978, p 499-511. 16. Fleck S (ed): Yale Guide to Family Assessment . New Haven, Conn, Department of Psychiatry, Yale University School of Medicine, 1980. 17. Fleck S: Family functioning and family pathology . Psychiatr Ann 1980;10:17-35.Crossref 18. Klaus MH, Kennell JH: Maternal-Infant Bonding . St Louis, CV Mosby Co, 1976. 19. Greenspan SL, Pollock GH (eds): The Course of Life. National Institute of Mental Health, 1980, vol 1: Infancy and Early Childhood, US Dept of Health and Human Services publica tion (ADM) 80-786. 20. Mahler M, Pine F, Bergman A: The mother's reaction to her toddler's drive for individuation , in Anthony EJ, Benedek T (eds): Parenthood: Its Psychology and Psychopathology . Boston, Little Brown & Co, 1970, pp 257-274. 21. Lidz T, Fleck S, Cornelison A: Schizophrenia and the Family . New York, International University Press, 1965. 22. Stierlin H: Separating Parents and Adolescents . New York, Times Book Corp, 1972. 23. Wynne LC, Singer MT: Thought disorder and family relations of schizophrenics: II. A classification of forms of thinking . Arch Gen Psychiatry 1963;9:199-206.Crossref 24. Whitehorn JD: Guide to interviewing and clinical personality study . Arch Neurol 1944;52:197-216.Crossref
1983 Archives of General Psychiatry
doi: 10.1001/archpsyc.1983.01790070099013pmid: 6870486
Abstract • I reviewed the substantial psychiatric literature on the technical strategies of intensive individual psychotherapy of schizophrenia. Numerous issues were covered: the nature of intensive psychotherapy and the nature of schizophrenia from the psychotherapist's point of view, elements of the treatment situation, general technical attitudes, general technical interventions (establishing a relationship, elucidating, tolerating, integrating, and working through), special technical interventions with specific symptoms and resistances, and a final brief discussion of mutative mechanisms. References 1. Freud S: Psychoanalytic notes on an autobiographical account of a case of paranoia , in Strachey J (ed): Standard Edition of The Complete Psychological Works of Sigmund Freud . London, Hogarth Press, 1971, vol 12, pp 3-82. 2. Jung CG: The psychology of dementia praecox , in Brill AA (ed): Nervous and Mental Disease Monographs . New York, Nervous and Mental Disease Publishing Co, 1936, vol 3. 3. Meyer A: The evolution of the dementia praecox concept , in Winters EE (ed): Collected Papers . Baltimore, Johns Hopkins University Press, 1951, vol 2. 4. Sullivan HS: Schizophrenia as a Human Process . New York, WW Norton & Co Inc, 1962. 5. Fromm-Reichmann F: Principles of Intensive Psychotherapy . Chicago, Phoenix Books, 1967. 6. McGlashan TH: Psychotherapy and the DSM III schizophrenias . J Nerv Ment Dis 1982;120:752-757.Crossref 7. Mullahy PF: Harry Stack Sullivan , in Kaplan HI, Freedman AM, Sadock BJ (eds): Comprehensive Textbook of Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1980, vol 1, pp 748-774. 8. Schulz CG: An individual psychotherapeutic approach with the schizophrenic patient . Schizophr Bull 1975;1:46-69.Crossref 9. Pao P: Schizophrenic Disorders . New York, International Universities Press, 1979. 10. 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Fromm-Reichmann F: Notes on the development of treatment of schizophrenics by psychoanalytic psychotherapy . Psychiatry 1948;11:263-273. 18. Bion WR: Second Thoughts . New York, Jason Aronson Inc, 1967, pp 36-42, 43-64, 93-109. 19. Searles HF: Collected Papers on Schizophrenia and Related Subjects . New York, International Universities Press, 1965, pp 521-559, 654-716. 20. Grotstein JS: The pscyhoanalytic concept of schizophrenia: I. The dilemma . Int J Psychoanal 1977;58:403-425. 21. GrotsteinJS: The psychoanalytic concept of schizophrenia: II. Reconciliation . Int J Psychoanal 1977;58:427-452. 22. Rosenfeld H: Notes on the psychoanalytic treatment of psychotic states , in Chiland C (ed): Long-term Treatments of Psychotic States . New York, Human Sciences Press, 1977, pp 202-216. 23. Arieti S: Psychotherapy of schizophrenia: New or revised procedures . Am J Psychother 1980;34:464-476. 24. Hill LB: Psychotherapeutic Intervention in Schizophrenia . Chicago, University of Chicago Press, 1955. 25. Gedo JE, Goldberg A: Models of the Mind . Chicago, Phoenix Books, 1976. 26. Giovacchini P: Treatment of Primitive Mental States . New York, Jason Aronson Inc, 1979. 27. Fromm-Reichmann F: Remarks on the philosophy of mental disorder . Psychiatry 1946;9:293-308. 28. Fromm-Reichmann F: Psychotherapy of schizophrenia . Am J Psychiatry 1954;111:410-419. 29. May PRA, Simpson GM: Schizophrenia: Overview of treatment methods , in Kaplan HI, Freedman AM, Sadock BJ (eds): Comprehensive Textbook of Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1980, vol 2, pp 1192-1216. 30. Rosenfeld H: Psychotic States . New York, International Universities Press, 1966, pp 155-168. 31. Rosenfeld H: On the treatment of psychotic states by psychoanalysis: An historical approach . Int J Psychoanal 1969;50:615-631. 32. 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Stanton AH: The significance of ego interpretive states in insightdirected psychotherapy . Psychiatry 1978;41:129-140. 39. Burnham DL, Gladstone AI, Gibson RW: Schizophrenia and the Need-Fear Dilemma . New York, International Universities Press, 1969. 40. Gunderson JG, Moser LR (eds): Psychotherapy of Schizophrenia . New York, Jason Aronson Inc, 1975. 41. Gunderson JG: Individual psychotherapy , in Bellak L (ed): Disorders of the Schizophrenic Syndrome . New York, Basic Books Inc, 1979. 42. Lidz T: The developing guidelines to the psychotherapy of schizophrenia , in Strauss JS, Bowers M, Downey TW, et al (eds): Psychotherapy of Schizophrenia . New York, Plenum Press, 1980, pp 217-226. 43. Day M, Semrad E: Schizophrenic reactions , in Nicholi A (ed): The Harvard Guide to Modern Psychiatry . Cambridge, Mass, Belknap Press, 1978, pp 199-241. 44. Schur M: The Id and the Regulatory Principles of Mental Functioning . New York, International Universities Press, 1966, p 21. 45. Boyer LB: Working with the borderline patient . Psychoanal Q 1977;46:386-424. 46. Bellak L, Loeb L: The Schizophrenic Syndrome . New York, Grune & Stratton Inc, 1969, pp 343-377. 47. Gunderson JG: Patient-therapist matching: A research evaluation . Am J Psychiatry 1978;135:1193-1197. 48. Bellak L: Enabling conditions for the ambulatory psychotherapy of acute schizophrenics , in Karasu TB, Bellak L (eds): Specialized Techniques in Individual Psychotherapy . New York, Brunner/Mazel Inc, 1980, pp 76-84. 49. Boyer LB: Office treatment of schizophrenic patients: The use of psychoanalytic treatment with few parameters , in Boyer LB, Giovacchini PL (eds): Psychoanalytic Treatment of Schizophrenic, Borderline and Characterological Disorders . New York, Jason Aronson Inc, 1980, pp 129-170. 50. McGlashan TH: Aphanisis: The syndrome of pseudo-depression in chronic schizophrenia . Schizophr Bull 1982;8:118-134.Crossref 51. 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Giovacchini P: Primitive agitation and primal confusion , in Boyer LB, Giovacchini PL (eds): Psychoanalytic Treatment of Schizophrenic, Borderline and Characterological Disorders . New York, Jason Aronson Inc, 1980, pp 301-340. 77. Segal H: Notes on the psychoanalytic treatment of psychotic states , in Chiland C (ed): Long-term Treatments of Psychotic States . New York, Human Sciences Press, 1977, pp 217-223. 78. Giovacchini P: The influence of interpretation upon schizophrenic patients . Int J Psychoanal 1969;50:179-186. 79. Stanton AH: Insight and self observation , in Strauss JS, Bowers M, Downey TW, et al (eds): Psychotherapy of Schizophrenia . New York, Plenum Press, 1980, pp 131-144. 80. McGlashan TH, Levy ST, Carpenter WT: Integration and sealing over: Clinically distinct recovery styles from schizophrenia . Arch Gen Psychiatry 1975;32:1269-1272.Crossref 81. 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