Biomedical subjects
Publications and source records attributed to G Toffler.
The occurrence of neuroleptic malignant syndrome was examined in a prospective study of 335 neuroleptic-treated inpatients. It was not possible to identify a single unequivocal case of neuroleptic malignant syndrome. It appears to be a very rare condition in patients who are judiciously treated with relatively low doses of neuroleptics. The concept of incomplete forms of neuroleptic malignant syndrome could not be supported.
Using the method of a blind retrospective evaluation of clinical charts, 14 DSM-III pure schizotypal personality disorders (SPD) and 25 schizophrenic patients diagnosed with the help of the ICD-9 and the Flexible System were compared. Some differences emerged between the groups indicating that there may not only be a relationship between clinical samples of SPD (preferably defined by positive symptoms) and schizophrenia but also between SPD and borderline personality disorder. A group of 7 SPD and 17 schizophrenics could be followed up 4 years later. On a blind examination, SPD patients were found to be socially less well adjusted and they tended to be more symptomatic. Compared with a small DSM-III schizophrenia subgroup the differences diminished, SPD still rating higher on social dissatisfaction. A different definition of schizophrenia probably accounts for the greater part of the different results in this and previous studies.
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Using the method of blind retrospective evaluation of clinical records, 26 DSM-III borderline and 27 DSM-III nonborderline personality disorders were compared. Apart from the younger age of borderline patients, no really important differences emerged between the groups in the sociodemographic and clinical variables studied. It is possible that differences between borderline and nonborderline personality disorders are limited to the different phenomenology as defined by the respective diagnostic criteria. The borderline diagnosis proves to be a workable tool for further explorations, although its clinical justification remains to be demonstrated.
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Using a double-blind experimental design, two dosage regimens of haloperidol were compared in acutely decompensated, newly admitted schizophrenic patients. Patients in group A (n = 21) received 5 mg haloperidol tablets, patients in group B (n = 20) 15 mg haloperidol tablets. The number of tablets did not exceed six a day but could be varied according to the condition of each patient. On the average patients of group A were prescribed 4.0 tablets, corresponding to 20.0 mg haloperidol a day, and patients of group B 3.9 tablets, corresponding to 58.0 mg haloperidol a day. A significant amelioration of the psychopathology as measured by BPRS were observed in both groups. Between both groups investigated, no differences were found neither with regard to therapeutic efficacy nor to the tolerance of the treatment. Administration of higher oral haloperidol doses cannot be recommended as a standard procedure.