Psychotic Subjects Research Articles

BLOOD-SUGAR STUDIES IN ABNORMAL MENTAL STATES.

1. A study of the sugar tolerance curves of 85 psychotic subjects has been made. 2. The hyperglycaemic index is defined, and is a quantitative measure of the departure of a sugar-tolerance curve from that found normally. It is an expression of the sustainment of hyperglycaemia found in many psychotic cases. The index is referred to as H.I. 3. It is shown— 1. That in the manic-depressive group there is the closest parallelism between the magnitude of the H.I. and the emotional tension of the patient. Out of 43 melancholic patients examined, only 10 gave a normal or slightly abnormal index. An explanation is given for this anomalous behaviour of the 10 patients. 2. That in the schizophrenic group there is a relatively low incidence of patients (2 out of 29) showing an index consistently greater than 50. High figures in the schizophrenic group are associated with toxaemia, endocrine imbalance or other physical disorder. 4. In cases of mania a low index is recorded, except when the excitement is accompanied by an aggressive, paranoid mood. 5. In cases of benign stupor a low index has been recorded, showing that the defence mechanism of the stupor reaction has abolished the emotional tension. 6. Arterio-sclerosis per se is not a cause of a high H.I. 7. During menstruation there is a departure from the normal sugar tolerance curve in both normal and psychotic cases. 8. Practical use is made of the H.I. in determining prognosis, progress and recovery of the patient.

Blood-Sugar Studies in Abnormal Mental States

Some explanation may seem to be necessary to account for further research into the question of sugar tolerance in psychotic subjects, as it may be thought that this line of research has been exhausted by the numerous workers in this field. A study of their work, however, shows that no critical attempt has been made to correlate the result of the sugar tolerance test with the mental and physical state of the subject at the actual time of the test. Instead, groups of patients suffering from certain psychoses have been investigated, and the results reported as percentages of abnormal curves in such psychoses. Thus, when it has been reported that a certain percentage of melancholics or schizophrenics show sustained hyperglycæmia after glucose ingestion, no attempt has been made to find out in what way these differed from the remainder in whom normal sugar tolerance was found.

A Note on Urinary Reactions in Relation to Intestinal Toxæmia in Psychotic Subjects

Within the last year a series of papers has been issued (1, 2, 3) from this laboratory indicating that in the psychotic there exists a disturbed regulation of the respiratory mechanism for the control of acid-base equilibrium, which, in the cases examined, mainly depressed psychoses, manifested itself as an inexcitability of the respiratory centre, shown by a failure of response to CO2 stimulation. The work was done on uncertified borderline cases of insanity; it has since been confirmed by Marsh (4) on certified patients, and his results in 73 cases confirm the original findings and indicate plainly that dementia præcox and depressive psychoses fall into a group showing a variable inexcitability of the respiratory centre. The question naturally arises whether this condition is a cause or an effect of the mental state, and, from the point of view of cause, whether it is due to the drug-like action of some substance arising from faulty metabolism, or is an exhaustion effect. The question of intestinal toxæmia obviously needs investigation in this respect. This subject has been freely discussed in the literature and its significance becomes of greater importance in relation to psychoses owing to the work of Buscaino (5, 6) and Scheiner (7, 8) in Italy, and of Stewart (9) in this country. Buscaino describes a reaction of the urine with silver nitrate in certain psychotic cases, alcoholic insanities and dementia præcox, and from this assumes the existence of a toxic substance from liver derangement in these cases. He further describes lesions of the small intestine of mental patients which may result in undue permeability of its walls; it is not proposed to discuss this latter aspect of his work, but to deal with his silver nitrate reaction.

Electrical Skin Resistance in Normal and in Psychotic Subjects. (Arch. of Neur. and Psychiat., June, 1928.) Syz, H. C., and Kinder, E. F.

<i>Electrical Skin Resistance in Normal and in Psychotic Subjects. (Arch. of Neur. and Psychiat., June</i>, 1928.) <i>Syz, H. C., and Kinder, E. F.</i>

Part II. The Significance of Urinary Reaction in Psychotic Subjects

In the normal subject the reaction of the urine denotes the tendency to reaction change of the blood and organism—a tendency which is adjusted by the respiratory mechanisms. To maintain a constant blood pH and CO2/NaHCO3, the kidney retains or rejects base and the lungs increase or decrease acid (C02) output, these compensatory processes being interdependent. With a definite relationship between urinary acidity, blood alkali reserve and alveolar air CO2tension the ratios are maintained. Urinary reaction represents the acid or alkaline “pressure”on the organism. The reaction of the blood and tissues depends on the adequacy of respiratory adjustment: in fact, as Henderson says, “low pH (acidity) in a fluid buffered like blood can never be due immediately to any other cause than relatively depressed breathing.”

INTELLIGENCE AND PSYCHOSIS

Abstract according to diagnosis of 102 psychotic cases examined by the Stanford intelligence scale: par. 1-11. Retests: par. 12-13. Scattering: of tests: par. 14-20. Technical considerations and criticisms of detail: par. 25-34. Incidents: par. 35-42. Cases dominated by volitional disturbance: par. 43-51. Cases with IQ above 1.00: par. 52-74. "Intelligence" as ideational capacity, distinguished from capacities for dealing with concrete things, or adjustments to other personalities: par. 75-87. Interrelations of intelligence, psychosis, happiness and general adaptation: par. 88. 1. This study is based upon examination in 102 cases of mental disease. The observations cover a period between September, 1916, and July, 1917, and from February, 1919, to April, 1919. The number examined represents approximately the cases in McLean Hospital within these periods from whom the necessary cooperation was obtainable. The percentage of admissions thus susceptible to examination was about 60. The material is not otherwi...