Pattern recognition in mental disorders and the organic integrity tests (OIT)

Critical Study of the Organic Integrity Test as a Diagnostic and Therapeutic Index in Schizophrenia1

The Organic Integrity Test (OIT) was repeatedly administered in conjunction with other clinical measures to 18 hospitalized schizophrenics over a 20-wk. period, during which patients were treated with neuroleptics. The results showed inadequacies with regard to reliability and stability of the OIT. There was no evidence to indicate that the test is valid for detecting and evaluating schizophrenic psychopathology or for monitoring clinical changes during the course of treatment. Problems with the theoretical and empirical validity of the OIT and shortcomings in the test design were cited in explanation of the findings.

Covariance of personality, neurocognition, and schizophrenia spectrum traits in the community

Clinical researchers have observed in relatives of schizophrenic individuals abnormal personality traits resembling the psychopathology of schizophrenia. Further similarities have been observed in correlations between measures of brain function, including attention and executive abilities, and these personality psychopathologies. However, two methodologic factors might account for the covariation of these 'schizophrenia spectrum' personality traits and measures of brain function. Clinical selection bias (Berkson's bias) might result in subjects with overlapping conditions being more likely to be studied, and normal personality attributes could affect performance on neurobehavioral tasks. This study investigated relationships between neurobehavioral correlates of schizophrenia, clinical schizophrenia spectrum personality traits, and normal personality dimensions in the five-factor model of personality. To avoid Berkson's bias, subjects expected to have a high probability of spectrum traits were recruited from the Baltimore Epidemiologic Catchment Area Survey community sample. About 40% of the sample were found to have DSM-IIIR Schizotypal, Schizoid, or Paranoid Personality Traits or Disorders. Schizophrenia Spectrum traits showed significant associations with personality dimensions of the five factor model, particularly Openness to Experience and Neuroticism. In ordinary linear regression models, after adjustment for a number of normal personality characteristics, Schizotypal Personality Traits were still strongly associated with perseverative responses on the Wisconsin Card Sorting Test (WCST). In logistic regression models, subjects with Schizotypal, Schizoid, or Paranoid Traits differed in terms of normal personality profiles and WCST performance.

New vistas in chronic schizophrenia

In view of the distinct possibility that the disturbed glucose regulation in the frontal area and basal ganglia of chronic schizophrenia is very germane to the successful treatment of this condition, a survey is given of the many factors that have to be considered in developing a therapy that takes into account this new information. The suggestion is made that the balance between cAMP and cGMP in the cells affected are dysregulated so that there is an excessive activity of the cAMP generating system which eventually leads to the pathological picture found in this condition. To restore the normal metabolic balance, use will have to be made of the various substances that are known to enhance the cGMP generating system in the cell, thereby restoring a more normal metabolic integrity. In this connection, the use of high doses of insulin under cover of hyperglycaemia and also the addition of D-ribose could become the cornerstone of a series of treatments to enhance the action of currently used medications in this often intractable illness.