A.M.A. Archives of General Psychiatry

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ISSN : 0375-8532
Published by: American Medical Association (AMA) (10.1001)
Total articles ≅ 51
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John N. Bicknell
A.M.A. Archives of General Psychiatry, Volume 2, pp 661-668; https://doi.org/10.1001/archpsyc.1960.03590120069008

Disulfiram (tetraethylthiuramdisulfide) was accidentally discovered to combine with ethyl alcohol to produce a noxious effect by Jacobsen and Hald, in Denmark, in 1947. After its therapeutic introduction by Martensen-Larsen in 1948, this chemical compound, with the market name of Antabuse, has been used in the treatment of patients suffering from chronic alcoholism in unknown numbers of thousands. As with any new treatment method, an overly enthusiastic reception occurred, with successes reported in 60% to 80% of the patients so treated and followed for six months to a year. However, the enthusiasm has diminished, until now the recovery rates are about the same as those reported for other therapeutic modalities. Unfortunately, rather than helping those who did not benefit from other techniques, disulfiram works best with those patients who generally do better with any type of treatment.1 Disturbing were the increasing number of reports of psychosis,
Max Pollack
A.M.A. Archives of General Psychiatry, Volume 2, pp 652-660; https://doi.org/10.1001/archpsyc.1960.03590120060007

Introduction Although the diagnosis of schizophrenia is applied to all ages, from the infant to the aged, there is increasing recognition that schizophrenia is not a single clinical entity but, rather, a descriptive term that reflects a variety of abnormalities.*Accurate delineation of these abnormalities (or the group of schizophrenias in Bleuler’s terminology11) is of major importance for the detection of basic defects and their ultimate prevention. One approach to delineating the factors associated with mental illness is the study of age of onset. Landis and Bolles49have remarked that “the most important single determining fact that we can know about mental disease is the age of the patient or the age distribution of a group of patients. If these data are available, one can make fairly accurate estimates of the beginning of the different diagnostic types of mental disease, the relative proportion of
James M. A. Weiss, Joseph W. Lamberti, Nathan Blackman
A.M.A. Archives of General Psychiatry, Volume 2, pp 669-678; https://doi.org/10.1001/archpsyc.1960.03590120077009

In this study, the “sudden murderer” is defined as a person who, without having been involved in any previous serious aggressive antisocial acts, suddenly, unlawfully, and intentionally kills (or makes a serious attempt to kill) another human being. The murder is “sudden” in the sense that it appears to be a single, isolated, unexpected episode of violent, impulsive acting-out behavior—behavior which is never well thought out, behavior which has no obvious purpose or hope for personal advantage or profit foreseeable as a result. Of 153 criminal offenders referred for psychiatric evaluation between July 1, 1956, and Dec. 30, 1957, to the Social Maladjustment Study Unit at the Malcolm Bliss Mental Health Center in St Louis,*13 could be called “sudden murderers” by this definition. Although in this group of patients the crime as a function of the personality of the patient concerned proved most
B. J. Meyer, B. Century, A. C. Meyer, M. K. Horwitt
A.M.A. Archives of General Psychiatry, Volume 2, pp 528-533; https://doi.org/10.1001/archpsyc.1960.03590110052006

In a previous paper, the effects of triiodothyronine on the psychiatric status, serum copper, basal metabolism, erythrocyte sedimentation rate, and C-reactive protein in schizophrenic subjects were described.1Changes in serum cholesterol, plasma tocopherol, and urinary creatine-to-creatinine ratio with respect to the basal metabolic rate (B. M. R.) in chronic schizophrenic subjects treated with triiodothyronine are reported here. At present, there is no reasonable evidence to indicate that metabolic data from these subjects would be different from those obtained from nonschizophrenic subjects. Elevated creatine excretion and B. M. R. and decreased creatinine in the urine, as well as corresponding changes in the serum level of these substances, have been observed in cases of hyperthyroidism.2,4Both serum cholesterol and tocopherol levels are increased in clinical states of hypothyroidism, and there appears to be an indirect relationship between B. M. R. and blood cholesterol.5,6
Irwin Feinberg
A.M.A. Archives of General Psychiatry, Volume 2, pp 504-511; https://doi.org/10.1001/archpsyc.1960.03590110028003

Investigations of performance on cognitive tasks usually result in the findings that normal subjects achieve the highest mean scores, schizophrenic subjects are intermediate, and subjects with organic brain disease perform most poorly. The range of performance of schizophrenic patients is usually quite broad, overlapping with that of good normal subjects, at one extreme, and with that of poor-performing patients with organic disease, at the other. However, the pattern of error scores of the schizophrenic subjects does not distinguish their performance from that of these other clinical groups. It seems likely, therefore, that such data reflect only nonspecific impairment of cognitive function. The degree of such impairment is usually less in randomly chosen groups of schizophrenic subjects than that found in similarly chosen groups of patients with organic brain disease.*Since cognition in these patient groups grossly differs in many respects, one must conclude
Ping-Nie Pao
A.M.A. Archives of General Psychiatry, Volume 2, pp 512-520; https://doi.org/10.1001/archpsyc.1960.03590110036004

Problems of rehabilitation and reintegration of the hospitalized psychotic patient into family and community have been a focus of growing interest and study in recent years. In a previous paper I described the usefulness of joint patient-family-doctor interviews in preparing the schizophrenic patient’s return to the community. The present paper is intended as a further contribution to the general problems of reintegration of patients into the community, with special reference to the crucial area of mother-child interaction. Indeed, for a patient who has been hospitalized for schizophrenic illness, the initial phase of his posthospital adjustment is a critical moment in his life, because his success or failure in making this transition may determine his future status at home and in the community. If he succeeds, he may gain the confidence he needs to meet the challenge of the complicated, demanding role of an adult
Sven J. Dencker
A.M.A. Archives of General Psychiatry, Volume 2, pp 569-575; https://doi.org/10.1001/archpsyc.1960.03590110093012

It has been discussed whether symptoms persisting a long time after a head injury are always of organic origin. Differences in opinions are expressed in the literature, perhaps mainly because it is hard to find controls that are sufficiently comparable to the injured persons. An attempt was made to throw light on this question by studying monozygotic twins with head injuries, using their co-twins as controls. This method meant that it was not possible to get a large series, but it also had a number of great advantages. In the first place, the noninjured controls were genetically identical with the injured twins and had also grown up in the same environment. Furthermore, because the twins grew up together and usually kept in close contact with each other after they grew up, the same persons, including the twins themselves, were able to give information about both subject and control.
Herbert Sprince
A.M.A. Archives of General Psychiatry, Volume 2, pp 385-389; https://doi.org/10.1001/archpsyc.1960.03590100025003

Two types of cholinesterase (ChE) have been found in brain and whole blood. These are (1) true cholinesterase (TChE), also known as acetylcholinesterase, which acts preferentially on acetylcholine (ACh) and is found chiefly in the gray matter (neurons) of the brain and in red blood cells, and (2) pseudocholinesterase (PChE), also known as butyrylcholinesterase, which acts preferentially on butyrylcholine (BuCh) and is found chiefly in the white matter (glial cells) of the brain and in blood serum. TChE is believed to be related to conduction in brain and nerve; in red blood cells it may be concerned with regulation of cell permeability. The functions of PChE in brain, nerve, and blood serum are all still obscure.1,2 Recently, Desmedt and La Grutta3demonstrated that pharmacological “arousal” reactions in the brain result from selective inhibition of PChE preferentially to TChE. This recalls to mind the observation4
H. R. Brickman
A.M.A. Archives of General Psychiatry, Volume 2, pp 470-476; https://doi.org/10.1001/archpsyc.1960.03590100110014

Sociology’s recent maturation as a responsible basic science of human behavior has already begun to contribute to the enrichment of psychiatric knowledge and practice. Studies in the areas of epidemiology and of treatment5,11in which clinical observations are related to social structure have cast a new light on our clinical efforts. Particularly valuable in what promises to be continued, if slow, progress toward a general theory of human behavior has been Parson’s structural-functional theory of social systems.19This presently most comprehensive theoretical approach to the regularities of human group behavior has elaborated, among other valuable notions, the concept of social role in behavioral motivation. According to Leighton, Clausen, and Wilson, in their significant collection of essays, “Explorations in Social Psychiatry,”16“role is a critical point of interlock between individual dynamism and social pattern, and is, therefore, a very sensitive indicator
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