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Subjective Response as a Predictor of Outcome in Pharmacotherapy: The Consumer Has a Point

Subjective Response as a Predictor of Outcome in Pharmacotherapy: The Consumer Has a Point Abstract • Forty-two newly admitted patients with a schizophrenic illness were given a test dose of chlorpromazine, and their subjective response was graded on a euphoric-dysphoric continuum. Subjective response at 4, 24, and 48 hours after the test dose was significantly correlated with the subsequent outcome of a therapeutic course of treatment with chlorpromazine, as measured by the Brief Psychiatric Rating Scale, the Global Assessment Scale, and a write-in symptom scale. An early dysphoric response to chlorpromazine seemed to augur a poor prognosis for further treatment with the drug. These findings suggest that the subjective response to a test dose of chlorpromazine may be a useful predictor of short-term symptomatic outcome. References 1. Cole JO, Davis JM: Anti-psychotic drugs , in Bellak L, Loeb L (eds): The Schizophrenic Syndrome . New York, Grune & Stratton Inc, 1969, pp 478-568. 2. Klein DF, Davis JM: Diagnosis and Drug Treatment of Psychiatric Disorders . Baltimore, Williams & Wilkins Co, 1969, pp 52-138. 3. Appleton WS, Davis JM: Practical Clinical Psychopharmacology . New York, Medcom Press, 1973. 4. Lorei TW, Gurel L: Use of a biographical investory to predict schizophrenics' post-hospital employment and readmission . J Const Clin Psychol 38:238-243, 1972.Crossref 5. Vaillant GE: The prediction of recovery in schizophrenia . J Nerv Ment Dis 135:534-543, 1962.Crossref 6. Farina A, Garmezy N, Zalusky M, et al: Premorbid behavior and prognosis in female schizophrenic patients . J Consult Psychol 26:56-60, 1962.Crossref 7. Phillips L: Case history data and prognosis in schizophernia . J Nerv Ment Dis 117:515-525, 1953.Crossref 8. Garmezy N, Rodnick EH: Premorbid adjustment and performance in schizophrenia: Implications for interpreting heterogeneity in schizophrenia . J Nerv Ment Dis 129:450-466, 1959.Crossref 9. Zigler E, Phillips L: Social competence and outcome in psychiatric disorders . J Abnorm Soc Psychol 65:264-271, 1961.Crossref 10. Gittelman-Klein R, Klein DF: Premorbid asocial adjustment and prognosis in schizophrenia . J Psychiatr Res 7:35-53, 1969.Crossref 11. Overall JE, Hollister LE, Kimbell I, et al: Extrinsic factors influencing responses to psychotherapeutic drugs . Arch Gen Psychiatry 21:89-94, 1969.Crossref 12. Goldberg SC, Mattsson N, Cole JO, et al: Prediction of improvement in schizophrenia under four phenothiazines . Arch Gen Psychiatry 16:107-111, 1967.Crossref 13. Wittenborn JR, May PRA (eds): Prediction of Response to Pharmacotherapy . Springfield, Ill, Charles C Thomas Publisher, 1966. 14. Galbrecht CR, Klett CJ: Predicting response to phenothiazines: The right drug for the right patient . J Nerv Ment Dis 147:173-183, 1968.Crossref 15. Goldberg SC, Frosch WA, Drossman AK, et al: Prediction of response to phenothiazines in schizophrenia: A cross validation study . Arch Gen Psychiatry 26:367-373, 1972.Crossref 16. Overall JE, Gorham DR: The Brief Psychiatric Rating Scale . Psychol Rep 10:799, 1962.Crossref 17. Honigfield G, Klett CJ: The Nurses' Observation Scale for Inpatient Evaluation: A new scale for measuring improvement in chronic schizophrenia . J Clin Psychol 21:65-71, 1965.Crossref 18. Endicott J, Spitzer RL, Fleiss JL, et al: The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance . Arch Gen Psychiatry 33:766-771, 1976.Crossref 19. Ellsworth RB, Clayton WH: Measurement of improvement in mental illness . J Consult Psychol 23:15-20, 1959.Crossref 20. Van Putten T: Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry 31:67-72, 1974.Crossref 21. Sarwer-Foner GJ, Kerenyi AB: Accumulated experience with transference and counter-transference aspects of the psychotropic drugs 1953-1960 , in Rothun F (ed): Neuropsychopharmacology . Amsterdam, Elsevier Publishing Co, 1961, pp 385-391. 22. Sarwer-Foner GJ: The role of neuroleptic medication in psychotherapeutic interaction . Compr Psychiatry 1:291-300, 1960.Crossref 23. Sarwer-Foner GJ: On the mechanisms of action of neuroleptic drugs: A theoretical psychodynamic explanation . Recent Adv Biol Psychiatry 6:217-232, 1963. 24. Sarwer-Foner GJ: Some comments on the psychodynamic aspects of the extrapyramidal reactions . Rev Can Biol Extrapyramidal System Neuroleptics 20:527-533, 1961. 25. Henninger G, DiMascio A, Klerman GL: Personality factors in variability of response to phenothiazines . Am J Psychiatry 121:1091-1094, 1965. 26. Singh MM, Smith JM: Kinetics and dynamics of response to haloperidol in acute schizophrenia: A longitudinal study of the therapeutic process . Compr Psychiatry 14:393-414, 1973.Crossref 27. Singh MM: Dysphoric response to neuroleptic treatment in schizophrenia and its prognostic significance . Dis Nerv Syst 37:191-196, 1976. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Subjective Response as a Predictor of Outcome in Pharmacotherapy: The Consumer Has a Point

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References (28)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1978.01770280087009
Publisher site
See Article on Publisher Site

Abstract

Abstract • Forty-two newly admitted patients with a schizophrenic illness were given a test dose of chlorpromazine, and their subjective response was graded on a euphoric-dysphoric continuum. Subjective response at 4, 24, and 48 hours after the test dose was significantly correlated with the subsequent outcome of a therapeutic course of treatment with chlorpromazine, as measured by the Brief Psychiatric Rating Scale, the Global Assessment Scale, and a write-in symptom scale. An early dysphoric response to chlorpromazine seemed to augur a poor prognosis for further treatment with the drug. These findings suggest that the subjective response to a test dose of chlorpromazine may be a useful predictor of short-term symptomatic outcome. References 1. Cole JO, Davis JM: Anti-psychotic drugs , in Bellak L, Loeb L (eds): The Schizophrenic Syndrome . New York, Grune & Stratton Inc, 1969, pp 478-568. 2. Klein DF, Davis JM: Diagnosis and Drug Treatment of Psychiatric Disorders . Baltimore, Williams & Wilkins Co, 1969, pp 52-138. 3. Appleton WS, Davis JM: Practical Clinical Psychopharmacology . New York, Medcom Press, 1973. 4. Lorei TW, Gurel L: Use of a biographical investory to predict schizophrenics' post-hospital employment and readmission . J Const Clin Psychol 38:238-243, 1972.Crossref 5. Vaillant GE: The prediction of recovery in schizophrenia . J Nerv Ment Dis 135:534-543, 1962.Crossref 6. Farina A, Garmezy N, Zalusky M, et al: Premorbid behavior and prognosis in female schizophrenic patients . J Consult Psychol 26:56-60, 1962.Crossref 7. Phillips L: Case history data and prognosis in schizophernia . J Nerv Ment Dis 117:515-525, 1953.Crossref 8. Garmezy N, Rodnick EH: Premorbid adjustment and performance in schizophrenia: Implications for interpreting heterogeneity in schizophrenia . J Nerv Ment Dis 129:450-466, 1959.Crossref 9. Zigler E, Phillips L: Social competence and outcome in psychiatric disorders . J Abnorm Soc Psychol 65:264-271, 1961.Crossref 10. Gittelman-Klein R, Klein DF: Premorbid asocial adjustment and prognosis in schizophrenia . J Psychiatr Res 7:35-53, 1969.Crossref 11. Overall JE, Hollister LE, Kimbell I, et al: Extrinsic factors influencing responses to psychotherapeutic drugs . Arch Gen Psychiatry 21:89-94, 1969.Crossref 12. Goldberg SC, Mattsson N, Cole JO, et al: Prediction of improvement in schizophrenia under four phenothiazines . Arch Gen Psychiatry 16:107-111, 1967.Crossref 13. Wittenborn JR, May PRA (eds): Prediction of Response to Pharmacotherapy . Springfield, Ill, Charles C Thomas Publisher, 1966. 14. Galbrecht CR, Klett CJ: Predicting response to phenothiazines: The right drug for the right patient . J Nerv Ment Dis 147:173-183, 1968.Crossref 15. Goldberg SC, Frosch WA, Drossman AK, et al: Prediction of response to phenothiazines in schizophrenia: A cross validation study . Arch Gen Psychiatry 26:367-373, 1972.Crossref 16. Overall JE, Gorham DR: The Brief Psychiatric Rating Scale . Psychol Rep 10:799, 1962.Crossref 17. Honigfield G, Klett CJ: The Nurses' Observation Scale for Inpatient Evaluation: A new scale for measuring improvement in chronic schizophrenia . J Clin Psychol 21:65-71, 1965.Crossref 18. Endicott J, Spitzer RL, Fleiss JL, et al: The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance . Arch Gen Psychiatry 33:766-771, 1976.Crossref 19. Ellsworth RB, Clayton WH: Measurement of improvement in mental illness . J Consult Psychol 23:15-20, 1959.Crossref 20. Van Putten T: Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry 31:67-72, 1974.Crossref 21. Sarwer-Foner GJ, Kerenyi AB: Accumulated experience with transference and counter-transference aspects of the psychotropic drugs 1953-1960 , in Rothun F (ed): Neuropsychopharmacology . Amsterdam, Elsevier Publishing Co, 1961, pp 385-391. 22. Sarwer-Foner GJ: The role of neuroleptic medication in psychotherapeutic interaction . Compr Psychiatry 1:291-300, 1960.Crossref 23. Sarwer-Foner GJ: On the mechanisms of action of neuroleptic drugs: A theoretical psychodynamic explanation . Recent Adv Biol Psychiatry 6:217-232, 1963. 24. Sarwer-Foner GJ: Some comments on the psychodynamic aspects of the extrapyramidal reactions . Rev Can Biol Extrapyramidal System Neuroleptics 20:527-533, 1961. 25. Henninger G, DiMascio A, Klerman GL: Personality factors in variability of response to phenothiazines . Am J Psychiatry 121:1091-1094, 1965. 26. Singh MM, Smith JM: Kinetics and dynamics of response to haloperidol in acute schizophrenia: A longitudinal study of the therapeutic process . Compr Psychiatry 14:393-414, 1973.Crossref 27. Singh MM: Dysphoric response to neuroleptic treatment in schizophrenia and its prognostic significance . Dis Nerv Syst 37:191-196, 1976.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Apr 1, 1978

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