Arch Gen Psychiat
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Comparative Study
Comparative studies of thought disorders. II. Schizoaffective disorder.
We examined thought disorder in 22 patients with schizoaffective disorder (12 schizoaffective-manic and ten schizoaffective-depressed) using Research Diagnostic Criteria. The Thought Disorder Index was used to tag 22 categories of thought disorder that ranged from mild to severe. Qualitative patterns in the thought disorder of schizoaffective patients were compared with those of 20 manic and 43 schizophrenic patients. ⋯ The schizoaffective-manic patients, like the schizophrenic patients, produced a high number of responses in the categories of idiosyncratic verbalizations, autistic thinking, and confusion. Unlike the manic patients, schizoaffective-depressed patients generally produced a few absurd and idiosyncratic responses in a setting of constricted output. The data strongly suggest that the thinking disorders of schizoaffective patients are like those of the schizophrenic patients.
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Clinical Trial
Combined psychotherapy and pharmacotherapy for depression. A systematic analysis of the evidence.
To determine whether combined psychotherapy and pharmacotherapy is superior to alternative therapies for unipolar depression, we reviewed all controlled studies of outpatients treated for unipolar depression reported between 1974 and 1984. To accomplish this, we developed a new statistical approach that is specific in its method of evaluating the quality of each study and specific about the weights given to each outcome. The combined active treatments (drugs plus psychotherapy) were appreciably more effective than the placebo conditions but only slightly superior to psychotherapy alone, pharmacotherapy alone, or either of these combined with a placebo.
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Various methods for estimating the cost of mandated mental health benefits have been devised, each resulting in substantially different estimates. These methods neglect to distinguish between the two components of cost to the insurer: social cost (due to increased utilization) and shifted cost (from other sources of payment). ⋯ We expect payments by the largest carrier in the state to increase by a factor of 1.65. More than half of this increase represents shifted costs rather than new costs to society.
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Letter Clinical Trial Controlled Clinical Trial
Effect of acute beta-adrenergic blockade on lactate-induced panic.
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We studied "formal thought disorder" in schizophrenics, schizoaffectives, and manics by examining syntax processing and perception of meaning, using the "embedded click" and "memory for gist tasks," two paradigms that were developed by psycholinguists. To control for generalized performance deficits, a matched-task design was used. ⋯ We concluded that psychotic patients have no specific language perception deficit but do have a short-term memory deficit. This deficit tends to remit for manics and schizoaffectives, but not for schizophrenics.