Stability of intellect and personality in schizophrenia.

A group of 52 chronic schizophrenic patients (mean age 41) currently maintained on follow-up treatment at an outpatient clinic were re-evaluated 8.5 years after initial treatment at the Allan Memorial Institute. The instruments used were the Spitzer Mental Status Schedule (MSS), the verbal WAIS, Rorschach and several thinking disorder tests. A verbal IQ finding of 1.4 points of increase (n.s.) indicates that no intellectual deterioration has occurred as measured by the WAIS. The thinking disorder tests, however, reveal considerable deficit. The Rorschach shows no evidence of personality change although there is evidence of increasing personality impoverishment, as evident in a progressive flattening of affect, and an increasing withdrawal and isolation. These inferences are supported by case history data and by the MSS psychiatric rating scale.

Prediction of lithium response.

Even though lithium has been established as an effective agent in the management of primary affective disorders, not all manic-depressive patients respond favourably to lithium therapy. Therefore we attempted to delineate lithium responders from non-responders in a group of 54 manic-depressive patients on the basis of an assessment which included 64 variables and the results showed that only two thirds were pure responders. Females, patients with prior manic episodes, onset of the illness initially with a manic episode, and premorbid psychothymic personality were all indicators of favourable long-term lithium response. Patients with retarded depression, severe anxiety, though disorder and those with higher scores on the Psychopathic Deviate and Paranoia scales of the MMPI were poor lithium responders. It should be noted, however, that only a few of the differences between responders and non-responders were statistically significant. Our study suggests a number of predictive variables for the identification of lithium responders.

Penfluridol in the maintenance treatment of schizophrenic patients newly discharged from a brief therapy unit.

Penfluridol, a long-acting neuroleptic that can be administered orally once a week, was compared with chlorpromazine in the maintenance treatment of 29 schizophrenic patients newly discharged from a brief therapy unit. The results indicate that penfluridol was of a similar efficacy to chlorpromazine in the treatment of these patients. Penfluridol-treated patients experienced less drowsiness but more extrapyramidal symptoms than those treated with chlorpromazine.