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A Case of Resistant Schizophrenia

Published online by Cambridge University Press:  29 January 2018

J. E. Roberts*
Affiliation:
Addiction Research Unit, Institute of Psychiatry
J. G. Edwards
Affiliation:
Addiction Research Unit, Institute of Psychiatry
S. Checkley
Affiliation:
Bethlem Royal and Maudsley Hospitals
J. L. Crammer
Affiliation:
Institute of Psychiatry
J. C. Cutting
Affiliation:
Bethlem Royal and Maudsley Hospitals
M. H. Lader
Affiliation:
Institute of Psychiatry
R. M. Murray
Affiliation:
Bethlem Royal and Maudsley Hospitals
*
Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK

Abstract

In an era when it is generally believed that the acute Symptoms of schizophrenia can be controlled pharmacologically, the case of a young man who has remained almost continuously floridly psychotic for 13 years, despite treatment, is disquieting. Conventional psychiatrie treatment appears to be rendered impotent. It is in this context that it may be of interest to report a summary of the proceedings of a Special Problems Conference held at the Institute of Psychiatry on 18 February 1985 to discuss such a case.

Type
Brief Reports
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Aubree, J. C. & Lader, M. H.(1980) High and very high dosage anti-psychotics: A critical review. Clinical Psychiatry, 41, 341350.Google Scholar
Bland, R. C. & Orn, H.(1978) 14 year outcome in schizophrenia Acta Psychiatrica Scandinavica, 58, 327338.Google Scholar
Bleuler, M.(1972) The Schizophrenie Disorders: Long-Term Patient and Family Studies, translated by Clemens, S. M. Newhaven and London: Yale University Press.Google Scholar
Carpenter, W. T. Jr., Sadler, J. H., Light, P. D., Hanlon, T. E., Kurland, A. A., Penna, M. W., Reed, W. P., Wilkinson, E. H. & Bartko, J. J.(1983) Haemodialysis in schizophrenia. New England Journal of Medicine, 308, 669675.Google Scholar
Ciompi, L.(1980) The natural history of schizophrenia in the long term. British Journal of Psychiatry, 136, 413420.Google Scholar
Curry, S. H., Marshall, J. H. L., Davis, J. M. & Janowsky, D. S.(1970) Chlorpromazine plasma levels and effects Archives of General Psychiatry, 22, 289296.Google Scholar
Davies, J. M.(1976) Recent developments in the drug treatment of schizophrenia. American Journal of Psychiatry, 133, 208214.Google Scholar
Feinsilver, D. B. & Yates, B. T.(1984) Combined use of psychotherapy and drugs in chronic, treatment-resistant schizophrenie patients. A retrospective study. Journal of Mental and Nervous Disease, 172, 133139.Google Scholar
Freedman, R., Kirch, D., Adler, L. E., Pecevich, M., Pachtman, E. & Denver, P.(1982) Clonidine treatment of schizophrenia. Double-blind comparison to placebo and neuroleptic drugs. Acta Psychiatrica Scandinavica, 65, 3545.Google Scholar
Gelder, M. & Kolakawska, T.(1979) Variability of response to neuroleptics in schizophrenia: clinical, pharmacologie and neuroendocrine correlates. Comprehensive Psychiatry, 20, 397407.Google Scholar
Gerlach, J., Behnke, K., Heltberg, J., Munk-Andersen, E. & Neilsen, H.(1985) Sulpiride and haloperidol in schizophrenia. A double-blind cross-over study of therapeutic effect, side effects and plasma concentrations. British Journal of Psychiatry, 147, 283288.Google Scholar
Huber, G., Gross, G. & Schüttler, R.(1975) A long term follow- up study of schizophrenia: psychiatrie course of illness and prognosis. Acta Psychiatrica Scandinavica, 52, 4957.Google Scholar
Kolakawska, T., Williams, A. O., Ardern, M., Revele Y, M. A., Jambor, K., Gelder, M. G. & Mandelbrote, B. M.(1985) Schizophrenia with good and poor outcome I. Early clinical features, response to neuroleptics and signs of organic dysfunction. British Journal of Psychiatry, 146, 229239.CrossRefGoogle Scholar
Kolakawska, T., Williams, A. O., Ardern, M., Reveley, M. A., Jambor, K., Gelder, M. G. & Mandelbrote, B. M., Jambor, K. & Ardern, M.(1985) Schizophrenia with good and poor outcome III. Neurological “soft” signs, cognitive impairment and their clinical significance. British Journal of Psychiatry, 146, 348357.Google Scholar
Leff, J. P. & Wing, J. K.(1971) Trial of maintenance therapy in schizophrenia. British Medical Journal, 3, 559604.Google Scholar
Lehmann, C. R., Ereshefsky, L., Saklad, S. R. & Mings, T. E.(1981) Very high dose loxapine in refractory schizophrenie patients. American Journal of Psychiatry, 138, 12121214.Google Scholar
Luchins, D. J., Lewine, R. R. J. & Metzer, H. Y.(1984) Lateral ventricular size, psychopathology and response to medication in the psychoses. Biological Psychiatry, 19, 2944.Google Scholar
Mattes, J. A., Hom, W., Rochford, J. M. & Orlosky, M.(1985) Ceruletide for schizophrenia: a double-blind study Biological Psychiatry, 20, 533538.Google Scholar
Murray, R. M.(1984) Prognostic factors in schizophrenia. In Seminars on Schizophrenia (ed. S. R. Hirsch) London: Update Publications.Google Scholar
Pugh, C. R., Steinert, J. & Priest, R. G.(1983) Propranolol in schizophrenia: A double-blind, placebo controlled trial of propranolol as an adjunct to neuroleptic medication. British Journal of Psychiatry, 143, 151155.Google Scholar
The Second Report from the Social Services Committee (Sessions 1984–1985) (1985) Community Care: with Special Reference to Adult Mental Illness and Mentally Handicapped People. London: HMSO.Google Scholar
Sherman, L. J., Mosely, E. C., Ging, R. & Bookbinder, L. J.(1964) Archives of General Psychiatry, 10, 123130.CrossRefGoogle Scholar
Tuma, A. H. & May, P. R. A.(1979) “And if that doesn't work, what next?” A study of treatment failures in schizophrenia. Journal of Nervous and Mental Disease, 167, 566571.Google Scholar
Van Putten, T., Crumpton, E. & Yale, C.(1976) Drug refusai in schizophrenia and the wish to be crazy. Archives of General Psychiatry, 33, 14431446.Google Scholar
Weinberger, D. R., Bigelow, L. B., Kleinman, J. E., Klein, S. T., Rosenblatt, J. E. & Wyatt, R. J.(1980) Cerebral ventricular enlargement in chronic schizophrenia. An association with poor response to treatment. Archives of General Psychiatry, 37, 1113.Google Scholar
Williams, A. O., Reverley, M. A., Kolakawska, T., Ardern, M. & Mandelbrote, B. M.(1985) Schizophrenia with good and poor outcome II. Cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239246.CrossRefGoogle ScholarPubMed
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