Loxapine versus perphenazine in psychotic patients. A double-blind, randomized, multicentre trial.

A double-blind, randomized, multicentre trial was carried out in 47 psychotic patients to evaluate the efficacy of oral treatment with loxapine compared with perphenazine. In total, 22 patients were included in diagnostic Group I (cases of acute schizophrenia and psychogenic (reactive) psychoses). The average maximum daily dose was 60.0 mg in the loxapine group and 36.8 mg in the perphenazine group. After 3-weeks' treatment, no significant differences were found between the two treatment groups according to the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) Scale or side-effect records. Twenty-five patients were included in diagnostic Group II (cases of chronic schizophrenia). The average daily dosage was 81.1 mg in the loxapine group and 90.1 mg in the perphenazine group. After 10 to 12-weeks' treatment, no significant differences between the two treatment groups could be found according to BPRS, CGI scale, Nurses' Observation Scale for In-patient Evaluation (NOSIE) or side-effect records. The diastolic blood pressure (lying and standing) tended to increase slightly in both treatment groups. In conclusion, it was found that loxapine and perphenazine seemed to be equally effective and, based on experience with parenteral loxapine treatment, it is suggested that further investigation of oral loxapine should be carried out in psychotic patients in whom agitation is a feature.

Psychological assessment before and after augmentation mammaplasty.

Twenty patients selected for augmentation mammaplasty paid for by the Health Service, were evaluated pre- and postoperatively by psychological and psychiatric examinations. Some 70% deviated from the normal psychological picture, with symptoms of remarkable similarity. The follow-up investigation one year after the operation revealed an unchanged basic personality structure, but the alteration to the breasts had relieved the patients from their previous distress and shyness and made them feel less inhibited. An attempt was made to predict the benefit each patient would gain from the operation, and the results were usually found to exceed the expectations. Only one patient was disappointed. In no case had the operation aggravated the preoperative psychological condition. Preoperative psychiatric examination of such patients would probably not provide any better selection.

Personality in unipolar and bipolar manic-malancholic patients.

By use of standardized case-recording criteria (MULTI-CLAD) manic-melancholic patients were classified as unipolar (n = 13) and bipolar (n = 23). Personality patterns are evaluated when patients were in neutral mood (defined by low symptom rating scale scores). Results showed that the similarities in the personality patterns of unipolars and bipolars were much pronounced than the differences. In general, the score patterns of the various scales in both groups of patients were found to be within the normal score range. However, this was indirectly expressed by high Lie (or denial) score levels on the Eysenck scale. The dynamic explanations of this form of symptom-denial are discussed. Moreover, our findings are discussed in connection with lithium treatment which was the main therapy the patients had received.