Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-29T11:27:22.642Z Has data issue: false hasContentIssue false

Observations on the Relation Between Insulin Coma Dosage and Prognosis in Schizophrenia

Published online by Cambridge University Press:  08 February 2018

R. K. Freudenberg*
Affiliation:
Netherne Hospital, Coulsdon, Surrey

Extract

The evidence for somatological differences between various types of schizophrenia and its different stages of severity or chronicity is still scanty and often contradictory. The present investigation mainly concerns itself with endocrinological factors. Kraepelin, already, suggested disturbances in the endocrine system. The incidence of schizophrenia in different age-groups, especially its steep rise at puberty, reaching its peak at 20 in men and 25 in women and the rapid decline of its occurrence after these ages (Haas, 1938), has for a long time pointed to the sex steroids as an important factor in the pathology of this disorder. Hemphill et al. (1944, 1945, 1948) found an atrophy of the testes in many cases of schizophrenia, and considered the severity of the testicular change to be proportional to the severity of the psychosis. They suggest that the testicular lesions are not the cause of schizophrenia, but probably effects of the “pathogenic process” and related to hypothalamic or pituitary function. In confirmation of these findings Hoskins and Pincus (1949) observed the output of androgen in schizophrenics to be significantly lower than in normal men. Sears (1937) made similar observations in females, and found that the blood-œstrin level of female schizophrenics was much lower than in normal women. Possibilities for primary endocrinological factors suggest themselves; the “pathogenic process” can, however, still be primarily a psychological “stress” in this new constellation or a combination of both, or the effect of another central disturbance. Some of our somatological findings can, therefore, tentatively be interpreted as related to or identical with the primary stress or others only as secondary correlates or results, though the present state of our knowledge does not yet allow a final decision as to what is primary and what only secondary. Recent evidence, on the relationship of sex hormones and insulin (Houssay, 1951) suggests that oestrogens have a “sensitizing” and androgens a “desensitizing” effect. An investigation into the insulin sensitivity in clinically different schizophrenic groups and the two sexes expressed in the amount of insulin needed to produce a hypoglycaemic coma should, therefore, throw some light on other endocrinological mechanisms.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1952 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ashby, , Ross, W., J. Ment. Sci., 1949, 95, 275.Google Scholar
Axelrod, H. R., Lobe, S., Orton, J. M., and Meyers, C. B., Ann. Int. Med., 1947, 27, 555.Google Scholar
Bleuler, M., Wiener Ztschr f. Nervenkrankheiten, 1948, 1, 129.Google Scholar
Idem, Arch. I. Psychiatr. u. Nervenkrankheiten, 1948, 180, 271.Google Scholar
Idem, Brit. Med. J., 1951, No. 4742, p. 1233.Google Scholar
Dayton, N. H., New Facts on Mental Disorders, 1940. Springfield, Illinois, Baltimore. Maryland: Charles C. Thomas.Google Scholar
Engle, E. O., in Cowdrey, E. N. Problems of Ageing, 1942. Baltimore: Williams & Williams Co.Google Scholar
Everett, J. W., Progress in Clinical Endocrinology, 1950, p. 321. London: W. Heinemann Med. Books.Google Scholar
Guttmann, E., Mayer-Gross, W., and Slater, E. T. O., J. Neur. and Psych., 1939, 2, 25.Google Scholar
Haas, M., Inaug.-Diss., 1935. Munich.Google Scholar
Idem, Arch. I. Psychiat., 1938, 108, 552.Google Scholar
Hemphill, R. E., J. Ment. Sci., 1944, 90, 696.Google Scholar
Idem, Reiss, M., and Taylor, A. L., ibid., 1944, 90, 681.Google Scholar
Idem and Reiss, M., ibid., 1945, 91, 1.Google Scholar
Idem, Proc. Roy. Soc. Med., 1948, 41, 8.Google Scholar
Hoch, P., and Polatin, P., Psych. Quart., 1949, 23, 248.Google Scholar
Hoskins, R. G., Biology of Schizophrenia, 1946. New York.Google Scholar
Houssay, B. A., and Biasotti, A., Endocrinology, 1941, 15, 511.Google Scholar
Idem, Brit. Med. J., 1 Sept., 1951, p. 505.Google Scholar
Malzberg, B., Social and Biological Aspects of Mental Diseases, Utica Slater Hospitals Press, 1940.Google Scholar
Idem, Psychiatric Ann., 1943, 17, 488.Google Scholar
Martin, W. P., Martin, H. E., Lyser, R. W., and Strouse, S., J. Endocrinology, 1941, 1, 387 398.Google Scholar
Idem, J. Clin. and Exp. Psychopath., 1951, 125.Google Scholar
Meduna, L. J., Congrès International de Psychiatrie, Paris, 1950, 9, 135.Google Scholar
Mitchelson, W. P., and Hutchins, T. T., Endocrinology, 1948, 42, 394.Google Scholar
Parsons, E. H., Gildea, E. F., Ronwin, E., and Hulbert, S. Z., Am. J. Psych., 1949, 105, 573.Google Scholar
Pincus, G., and Hoskins, H., ibid., 1950, 106, 641.Google Scholar
Idem, ibid., 1950, 106, 651.Google Scholar
Idem, Psychosomatic Med., 1949, 2, 102.Google Scholar
Rees, L., and Eysenck, H. J., J. Ment. Sci., 1945, 91, 8.Google Scholar
Idem, ibid., 1945, 91, 89.Google Scholar
Idem, ibid., 1949, 95, 162.Google Scholar
Idem, ibid., 1949, 95, 171.Google Scholar
Idem, ibid., 1950, 96, 168.Google Scholar
Idem, ibid., 1951, 97, 376.Google Scholar
Reiss, M., ibid., 1950, 2, 148.Google Scholar
Sackler, A. M., Sackler, M. D., Sackler, R. R., Co Tui, , and Ophuijsen, J. W. W., J. Clin. and Exp. Psychopath., 1951, 12, 30.Google Scholar
Idem, ibid., 1950, 11, 1.Google Scholar
Idem, ibid., 1950, 11, 17.Google Scholar
Idem, ibid., 1951, 12, 15.Google Scholar
Idem, Proc. Soc. Exp. Biol. and Med., 1951, 76, 226.Google Scholar
Sears, H. A., Morter, R. A., Simosen, M., and Williams, C., Am. J. Psychiat., 1937, 93, 1293.Google Scholar
Seyle, H., The Physiology and Pathology of Exposure to Stress, 1950. Montreal, Canada: Acta Endocrinologica Inc.Google Scholar
Sincto, L. S., Proc. Am. Diabetes Ass., 1948, 8, 75.Google Scholar
Thorn, G. W., and Forsham, P. H., in Textbook of Endocrinology, 1950, pp. 468469. Philadelphia, London: W. R. Saunders Co.Google Scholar
Tsai, S. Y., Bennett, A., May, L. G., and Gregory, R. L., Proc. Soc. Exp. Biol., N.Y., 1950. 744.Google Scholar
Williams, R. H., Textbook of Endocrinology, 1950. Philadelphia, London: W. R. Saunders Co.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.