Current biochemical approaches to schizophrenia

Rational-Emotive Therapy: Research Data That Supports The Clinical and Personality Hypotheses of RET and Other Modes of Cognitive-Behavior Therapy

This article examines 32 important clinical and personality hypotheses of rational-emotive therapy (RET) and other modes of cognitive-behavior therapy and lists a large number of research studies that provide empirical confirmation of these hypotheses. It concludes that (1) a vast amount of research data exists, most of which tends to confirm the major clinical and personality hypotheses of RET; (2) this data keeps increasing by leaps and bounds; (3) RET hypotheses nicely lend themselves to experimental investigation and therefore encourage a considerable amount of research; (4) researchers have not yet tested some of the major RET formulations and could do so with profit to the field of psychotherapy and personality theory.

Systematic mutation analysis of the catechol O-methyltransferase gene as a candidate gene for schizophrenia

OBJECTIVE

Catechol O-methyltransferase (COMT) is involved in the degradation of catecholamine neurotransmitters. Recent linkage studies of schizophrenia and molecular studies of velocardiofacial syndrome suggest that the COMT gene might be a candidate gene for schizophrenia.

METHOD

The authors systematically searched for mutations and microdeletion of the COMT gene in 177 Chinese schizophrenic patients from Taiwan; 99 comparison subjects were also studied.

RESULTS

Five molecular variants were identified: c.186C > T at exon 3, c.408C > G at exon 4, c.472G > A at exon 4, c.597G > A at exon 5, and c.821-827insC at the 3' untranslated region. However, no differences in the genotype and haplotype frequencies of these molecular variants between the schizophrenic and comparison subjects were detected. Furthermore, no microdeletion was identified among the patients.

CONCLUSIONS

These data suggest that the COMT gene does not play a major role in the pathogenesis of schizophrenia, and the genotypic overlap between schizophrenia and velocardiofacial syndrome was rare in this cohort.

A field-work case in the teaching of clinical psychiatry

This paper describes the teaching program developed at the University of Virginia in which observation and treatment of a hospitalized mental patient provide the focus for the learning experience of residents without previous training in psychiatry. The performance of each resident vis-à-vis a patient is reviewed by the group, which also engages in learning as a group through preceptorship and didactic techniques. The dynamics of the group itself are put to use in elucidating psychiatric principles. The case of a young schizophrenic with the delusion of “an influencing machine” is described to indicate the manner in which a patient under treatment may exemplify phenomena with which the learner must become acquainted, the meaning of which he is encouraged to weigh with increasing insight, so that he will be guided into good therapeutic practices.

[Methodology for the biochemical study of schizophrenia]

All the hypotheses concerning the basic problems of schizophrenia have been disproved, challenged or simply never corroborated. We tried to find the reasons.

The first step in any research seems to be the definition of its object, but there is no definition of schizophrenia.

The influence of the organogenesis versus psychogenesis dispute and of the personal convictions of searchers is inevitable and very often unconscious; it is felt at all the levels of research. The interference of other personal factors is also controversial at the research team level and notably regarding the importance of the illness concerned.

Bleuler spoke about “the group of schizophrenias”, but all the studies are carried out as if, behind the diversity of the clinical description there was one single and constant organic substratum. The limitations which this idea engenders are discussed. The emphasis is on the interest in studying acute beginning forms. Various etiopathogenetic hypotheses are taken into consideration when choosing methodology; it is the least limitating hypothesis which must be the deciding factor, namely that there are, in schizophrenia, some social-psychological and some organic factors, but the presence of only one factor of any kind is sufficient. The methodological conclusions are: the value of longitudinal studies compared with sectional studies, the importance of setting up homogeneous sub-groups for at least one additional datum over that of schizophrenia and the interest of repeating the tests recommended by different schools on the same subjects.

For reasons of facility, most studies deal with chronic patients, and various criteria of selection are shown. Consequences of ‘institutionalization' in a mental hospital (secondary alienation) are also looked at from the point of view of the body: it seems to us that chronicity gradually changes a person into ‘another man’, biologically speaking. The peculiarities of diets in mental hospitals were at the beginning of many contradictions and mistakes in those studies; the part of other independent variables is taken into consideration; such as the level of physical activity, stress and chemical treatments. The problem of control groups for the sectional studies is shown.

Throughout the text, examples are given of repercussions on some studies of the methodological problems raised.

Concentrações do magnésio e do enxofre no soro e no líquido cefalorraqueano de pacientes esquizofrênicos

Foram estudados 42 casos de esquizofrenia. O magnesio foi dosado no sangue (26 casos) e no líquido cefalorraqueano (11 casos) e o enxofre foi dosado no sangue (22 casos). Após análise estatística dos resultados os autores chegaram às seguintes conclusões: 1) as variações dos níveis de magnesio do líquido cefalorraqueano e de enxofre do sangue não são significantes; 2) o nível de magnesio do sangue está significativamente mais baixo nos esquizofrênicos em relação aos normais.