Paul H. Hoch

The diagnosis of pseudoneurotic schizophrenia.

Summary1.Some of the literature on pseudoneurotic schizophrenia is reviewed, as well as literature on the other terms which have been used to designate the pseudoneurotic group.2.A re-formulation of the primary symptoms and secondary symptoms of pseudoneurotic schizophrenia is given, thus clarifying the criteria for diagnosis.3.The primary symptoms are formulated in terms of disorders in thinking and associations; disorders of emotional regulation; and disorders of sensorimotor and autonomic functioning. The disturbances in thinking, and in emotional regulation, are further subdivided into disorders of process or form, and disorders of content.4.The secondary symptoms are pan-anxiety, pan-neurosis, and pansexuality.5.A short discussion raises a number of unanswered questions and mentions forthcoming material on incidence, course, psychodynamics, and psychotherapy of pseudoneurotic schizophrenia.

Some observations on psilocybin, a new hallucinogen, in volunteer subjects.

Summary Fourteen paid volunteers, sereened by clinical interviews, received Psilocybin orally over a dosage range of 8 to 36 mg. The perceptual, affective, cognitive, behavioral and autonomic responses observed were qualitatively similar to those previously described with d-LSD-25, but quantitatively, a greater impairment of cognition with Psilocybin was noted which may have been related to dosage or personality differences. EEG findings in four out of eight subjects were similar to those previously reported with d-LSD-25 and mescaline. The use of psychotomimetic drugs as therapeutic agents in an out-patient setting may prove potentially hazardous. Acute states of excitement, depression with suicidal ideation and impairment of judgment may occur with these drugs even in the most carefully supervised in-patient setting. With out-patients, the danger of self-administration and inadequate supervision could compound such occurrences. Further research is indicated regarding the site of action of hallucinogens, the relationship between personality, dosage level and total behavioral pattern, and the possible prognostic value of such drugs in assessing ego strength in specific individuals.

Blood pressure studies in schizophrenia: Atropine and saline

The effects of atropine and saline on the systolic blood pressure have been studied in 50 schizophrenic patients and 15 volunteer normal control subjects. It was found that as a group the schizophrenics responded with greater intragroup variability than normal, but it is stated that this observation will need greater numbers of subjects for actual statistical analysis. It was also found that the schizophrenics responded to both stimuli with less reaction, as a group, than did the controls. The significance of the reactions to saline, as well as to atropine, is discussed, together with reference to the mass of previous physiological and pharmacological literature on schizophrenia. It is considered that the tendency of the schizophrenic to respond to most stimuli in a variable, yet rigid, fashion is the crux of these or any similar investigations.SummaryThe effects of atropine and saline on the systolic blood pressure have been studied in 50 schizophrenic patients and 15 volunteer normal control subjects. It was found that as a group the schizophrenics responded with greater intragroup variability than normal, but it is stated that this observation will need greater numbers of subjects for actual statistical analysis. It was also found that the schizophrenics responded to both stimuli with less reaction, as a group, than did the controls. The significance of the reactions to saline, as well as to atropine, is discussed, together with reference to the mass of previous physiological and pharmacological literature on schizophrenia. It is considered that the tendency of the schizophrenic to respond to most stimuli in a variable, yet rigid, fashion is the crux of these or any similar investigations.

CLINICAL PSYCHIATRY INCLUDING PSYCHOTHERAPY

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