Abstract
A double-blind crossover study was performed with lithium carbonate in a 22-year-old man with a 6-year course of schizophrenic-like psychotic episodes and personality deterioration manifested by antisocial behavior. A family history of lithium-responsive manic-depressive illness, as well as certain aspects of his behavior (aggressiveness, impulsivity, and hyperactivity), prompted the trial. Lithium was found to be effective in reducing overt antisocial behavior, as well as poor judgment, hyperactivity, impulsivity, and destructiveness, during a time when he was no longer psychotic. It also has been effective prophylactically against the previously recurrent schizophreniform psychosis. Use of family history is discussed as a heuristic device for revealing a spectrum of lithium-responsive disorders.
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