
Editorial
Select search scope: search across all journals or within the current journal

This article explores the history of psychiatry and the rise of biological psychiatry and suggests ways in which the study of history can shed light on current psychiatric practice and debate. Focusing on anxiolytics (meprobomate in the 1950s and benzodiazepines in the 1960s, 1970s, and 1980s) as a case study in the development of psychopharmacology, it shows how social and political factors converged to popularize and later stigmatize outpatient treatments for anxiety. The importance of social context in the creation of new therapeutic paradigms in modern psychiatry suggests the need to take into account a broad range of historical variables to understand how modern psychopharmacology has emerged and how particular treatments for disorders have been developed, diffused, and assessed.
In the popular mind, d-lysergic acid diethylamide (LSD) research in psychiatry has long been associated with the CIA-funded experiments conducted by Ewen Cameron at the Allen Memorial Institute in Montreal, Quebec. Despite this reputation, a host of medical researchers in the post–World War II era explored LSD for its potential therapeutic value. Some of the most widespread trials in the Western world occurred in Saskatchewan, under the direction of psychiatrists Humphry Osmond (in Weyburn) and Abram Hoffer (in Saskatoon). These medical researchers were first drawn to LSD because of its ability to produce a “model psychosis.” Their experiments with the drug that Osmond was to famously describe as a “psychedelic” led them to hypothesize and promote the biochemical nature of schizophrenia. This brief paper examines the early trials in Saskatchewan, drawing on hospital records, interviews with former research subjects, and the private papers of Hoffer and Osmond. It demonstrates that, far from being fringe medical research, these LSD trials represented a fruitful, and indeed encouraging, branch of psychiatric research occurring alongside more famous and successful trials of the first generation of psychopharmacological agents, such as chlropromazine and imipramine. Ultimately, these LSD experiments failed for 2 reasons, one scientific and the other cultural. First, in the 1950s and early 1960s, the scientific parameters of clinical trials shifted to necessitate randomized controlled trials, which the Saskatchewan researchers had failed to construct. Second, as LSD became increasingly associated with student riots, antiwar demonstrations, and the counterculture, governments intervened to criminalize the drug, restricting and then terminating formal medical research into its potential therapeutic effects.
To investigate the psychiatric symptomatology and personality characteristics of Korean senior high school students considered to use the Internet to excess.
We administered a questionnaire packet to students that included 4 measures. These measures included a questionnaire on Internet use patterns during the previous month, the Internet Addiction Test (IAT), the Symptom Checklist-90-R (SCL-90-R), and the Sixteen Personality Factor Questionnaire (16PF). A total of 328 students, aged 15 to 19 years, participated in the study.
Students were divided into 4 Internet user groups according to their IAT total scores: nonusers (
This study suggests that senior high school students who use the Internet to excess report and subsequently exhibit significantly more psychiatric symptoms than students who use the Internet less frequently. In addition, excessive users appear to have a distinctive personality profile when compared with nonusers, minimal, and moderate users.
To assess open-label adjunctive topiramate in the treatment of outpatients with unstable bipolar disorder (BD).
Outpatients with DSM-IV–defined BD (I or II) exhibiting mood instability were enrolled in this 16-week, open-label, multicentre study. Topiramate was added to existing mood stabilizers and other psychotropic treatments. The primary effectiveness measure was the Clinical Global Impression of Severity (CGI-S) scale; other scales included the Young Mania Rating Scale (YMRS) and the Montgomery–Asberg Depression Rating Scale (MADRS). Safety assessments included monitoring adverse events, measuring tremor, monitoring vital signs and weight, and laboratory indices. We also evaluated patient satisfaction with treatment.
A total of 109 patients were enrolled. Intent-to-treat analysis showed significant improvement from baseline in the CGI-S, YMRS, and MADRS, starting at Week 2 (
Adjunctive topiramate treatment can reduce the severity of manic and depressive symptoms, as well as reducing tremor and weight in outpatients with BD I or II.
Les symptômes obsessionnels et compulsifs (SOC) sont fréquents, dans la schizophrénie, et semblent aggraver le pronostic. Plusieurs études de cas suggèrent l'apparition ou l'aggravation des SOC lors de traitements neuroleptiques atypiques (rispéridone, olanzapine et clozapine). Il semble donc souhaitable de rechercher des antécédents familiaux ou personnels de SOC avant d'initier un tel traitement, et de surveiller l'apparition des SOC après l'avoir instauré. Une grande partie de ces cas concerne la clozapine. En cas d'apparition de SOC sous clozapine, on peut diminuer les doses de clozapine et adjoindre un traitement par inhibiteur du recaptage de la sérotonine. Les travaux actuels suggèrent que les patients souffrant de schizophrénie avec des SOC devraient bénéficier d'un traitement neuroleptique et d'un traitement anti-obsessionnel. Il existe 2 études contrôlées portant sur le traitement des SOC dans la schizophrénie: l'une avec la clomipramine, l'autre avec la fluvoxamine. Toutes 2 ont démontré leur efficacité. Cependant, ces essais comprennent un faible nombre de patients aux caractéristiques hétérogènes.
The purpose of this study was to establish rates of spontaneous parkinsonism (SP) among the different types of psychosis. We hypothesized that the rate would be higher among persons with affective symptoms.
We included in the study consecutive patients admitted to a first-episode psychosis intervention program. We recorded sociodemographic data from interviews with patients and caregivers and from medical records. We used the Simpson–Angus Rating Scale at baseline to assess parkinsonism and a diagnosis of SP was established if the Simpson–Angus score was ≥ 0.3.
A total of 174 patients were examined; of these, only 4 (2.3%; 2 Chinese women, 1 Chinese man, and 1 Malay man) had SP. There was a significant difference in the rates of SP in patients with affective psychosis and schizoaffective disorder, compared with those with nonaffective psychoses (15.4% vs 1.2%; χ2 = 10.7,
The rate of SP in Asian patients with first-episode psychosis was low, and it was significantly higher in those with affective symptoms.
