Heredity of Schizophrenia in India: A 1928 debate.

Shaw, a British psychiatrist working in India, observed that the incidence of Schizophrenia was higher among a community of Parsis as compared to other ethnic groups. He published his findings in two British journals. The paper drew responses from two other psychiatrists. The debate is examined in colonial context during which occurred and some implications for contemporary research.

Medical education in ancient India.

The article being submitted concerns medical education in the antiquity. A lot is known about how physicians were trained in ancient Greece. Most of us a familiar with Hippocrates and his contribution to Medicine. Relatively little is known about how physicians were trained in non-Western cultures. The author focuses on ancient India. Based on three extant medical texts the author reconstructs training of physicians in that epoch, and offers an account of the journey undertaken by students of medicine and their eventual role as physicians. This glance at how physicians were trained in these ancient times may be of interest to physicians, particularly to psychiatrists, at a time when we plan curriculum is response to rapid changes that are occurring in medicine. I hope that the readers will appreciate where and how the journey as physicians began and medical and psychiatry educators will glean from history a new perspective on how we train modern day physicians and psychiatrists.

Madness and Crime: A Non-Western Historical Perspective.

It is generally acknowledged that the insanity defense has its roots in ancient Greek philosophy. There are references to the insanity defense in the works of Plato and Homer. Little, though, is known about how non-Western cultures dealt with the insane who commit crimes. This article focuses on one non-Western culture: ancient India. The author refers to extant medical texts and Sanskrit literature to argue that the notion that the insane are not responsible for criminal acts was current during that epoch.

The madness of Dyce Sombre.

Dyce Sombre was an Indian prince who lost his kingdom but inherited a vast fortune. He arrived in England and became a member of the Parliament. His wife's family had him declared as a lunatic. He escaped to France and tried unsuccessfully to be declared sane again. He was examined by several well-known 19th century psychiatrists, many of whom declared him sane. Dyce Sombre's trial was reported in medical journals as well as newspapers. He wrote a book questioning his certification as a lunatic. Sombre's trials reveal several issues concerning diagnosing individuals from different cultures and have contemporary relevance in our multicultural societies.

The mysterious illness of dyce sombre.

The alleged "madness" of the Anglo-Indian prince known as Dyce Sombre (1808-1851) has been attributed to anti-Asian prejudice, biased observations, and insensitivity to ethno-cultural variations in behavior. However, whereas all these factors may have contributed to misdiagnosis and mistreatment, there is compelling evidence pointing to an "organic" explanation for Dyce Sombre's aberrant behavior. We posit that the interaction of drug toxicity and possible central nervous system infection were primarily responsible for Dyce Sombre's clinical symptoms. The case provides an important lesson for modern-day psychiatrists confronting patients from other cultures who may also have underlying neuropsychiatric disorders.

Psychiatric nosology and taxonomy in ancient India.

This article considers the nosology and taxonomy of psychiatric disorders in Sushruta Samhita, an ancient Indian treatise on medicine. Some implications of this treatise for modern psychiatry are discussed.

Bipolar affective disorder. I. Comprehensive quantitative computed tomography.

Based on clinical similarities with schizophrenics and previous computed tomography (CT) studies that found distinct structural abnormalities in the brains of bipolar patients, we evaluated 26 DSM-III bipolar patients and 22 controls by CT, using quantitative measures of ventricular and sulcal size and of cerebral parenchymal density. Third ventricle size was increased, as was periventricular and cortical density. Comparison is made with results found in other psychotic conditions and the possible etiopathological significance discussed.

Bipolar affective disorder. II. EEG, neuropsychological, and clinical correlates of CT abnormality.

Since the clinical significance of CT abnormalities found in bipolar patients remains obscure, we studied 26 DSM-III bipolar patients who had specific CT abnormalities (third ventricle enlargement, and hyperdensity of the caudate, thalamus, anterior frontal white matter, and right temporal lobe) on numerous parameters such as EEG, the Halstead-Reitan Neuropsychological Battery, premorbid personality adjustment, family history of affective disorder, positive and negative symptoms, employment history, and response to lithium carbonate treatment. None of these measures could differentiate between the CT abnormal and CT normal subgroups. The implications of these findings are discussed.

Normal cerebral asymmetry in bipolar patients.

Reversal of normal cerebral asymmetry has been reported to be more frequent in children with higher cortical dysfunction and in schizophrenics, in whom it has clinical significance as well. As there are few studies of bipolar patients, we attempted to determine if significant reversal would be found in a clearly diagnosed sample of bipolar patients. As technical differences may account for varying results, we used two previously reported methods and a modified technique. Correlations of computed tomography (CT) findings with neuropsychological variables (Halstead Reitan Battery and WAIS subtests) were also studied. Bipolars and controls did not differ on any CT measure, nor were there meaningful correlations between asymmetry and neuropsychological variables. If if is confirmed that schizophrenics have increased reversed cerebral asymmetry but bipolars do not, it may point to an important difference, as all other CT abnormalities initially described in schizophrenics are now also noted in bipolar patients.

Stressful life events and psychiatric hospitalization of mentally retarded patients.

The authors compared the type and number of life events experienced by 19 mentally retarded patients and 19 nonretarded control subjects in the month before their admission to the same unit of a state mental hospital. The retarded patients had exhibited fewer changes in eating and other personal habits. On admission they presented fewer signs of intrapsychic disturbance but more of self-destruction or aggression. These results imply that clinicians need specific training to diagnose and treat psychiatric disorders in the mentally retarded patients who now use community mental health facilities, because their presentations may be atypical.

A psychosocial study of early-onset bipolar disorder.

A 4-year study of 48 bipolar subjects and matched controls looked closely at the psychosocial histories of an early-onset subsample. A significant majority of these biographies include five distinct features: treatment as the special child of the family, high achievement in school, evidence of symptomatology in childhood, first episode soon after leaving home, and characteristic content in later symptomatology. The authors suggest that the findings provide a replication of a well-known study and that they further specify the increasingly evident differences between early- and late-onset bipolar patients.