[Realistic and unrealistic goals in psychiatry]. / Realistische und unrealistische Zielsetzungen in der Psychiatrie.

It would be unrealistic to try to turn psychiatry in all its aspects into an exact science. It is realistic to accept that it also deals with non-measurable phenomena; this we should always remember, so as to remain doctors and to preserve what is personal, warm and humane in our work. It is unrealistic to believe that the neurosciences are beginning today to explain all levels of psychic life. While fully recognizing the magnificent achievements of the neurosciences in explaining some basic elements of psychic life, we should keep ourselves aware that the psychic spheres of man remain inaccessible to the purely somatic explanations and are outside their influence. It is unrealistic to claim that our best and most effective treatment of schizophrenic psychoses is 'merely' symptomatic. It is realistic to accept the probability that it is appropriate to the nature of many schizophrenias and that it is radical. It is unrealistic to believe that our only task is to cure illnesses. Often it falls to us simply and in all modesty to accompany patients through their lives along a path chosen entirely by themselves and to be allowed now and then to give a little help to them. It is unrealistic to believe that psychiatry provides a key to improve the world. It is realistic if we concern ourselves in the main with helping the sick, if we critically reflect on the effect our work may have beyond our patient, on society, and if we keep pointing out again and again the good which is in every human being and that we may sometimes bring out this goodness in him.

[Chronicity or chronification among our schizophrenics]. / Chronizität oder Chronifikation bei unseren Schizophrenen.

We know of many different influences which are able either to prevent or to favour chronicity of schizophrenic psychoses: influences arising from treatment, from hospitalisation, from the relationship with others and even influences which have their origin in early childhood. All these good bad influences on the course of the psychoses, however, are not sufficient to explain the existence of chronification. Up to now it can be best understood by studying psychodynamics of chronic schizophrenics: they have reached an equilibrium between autistic and realistic thinking and perceiving. They protect their weak ego, with drawing partially into a fantastic world adapted to their dysharmonic nature and their dysharmonic surroundings, while they adapt themselves to reality as regards other experiences.

On schizophrenic psychoses.

The author traces the history of the concept of schizophrenic psychoses from Kraepelin's differentiation of dementia praecox from other mental illness and Bleuler's formulation of schizophrenia through the delimitation of the definition of schizophrenia to current thought on the etiology, treatment, and outcome of schizophrenic psychoses. He stresses the importance of our knowledge of both psychological and hereditary factors and urges that rather than searching only for a single, causal metabolic error we also accept the possibility that schizophrenia occurs in highly human, spiritual spheres and consider the schizophrenogenic influences in the lives and personalities of individual patients.

Comparison of a new antidepressive, lofepramine, with imipramine in a double-blind multicentre trial.

Lofepramine, an imipramine derivative, shows lower acute toxicity in animals when compared with desipramine and imipramine. Its anticholinergic effect is less pronounced than that of desipramine. In an open clinical trial lofepramine showed a marked antidepressive action. A double-blind multicenter trial of lofepramine v. imipramine, evaluated by means of the AMP system, showed a remarkable degree of concurrence with regards to the effects of those two products.