Percept-genetic codings of defense in chronic schizophrenia.

Hitherto available studies on the percept-genetic defensive organization of Schizophrenia have not distinguished between acute and chronic stages of the disorder. The present research with the Defense Mechanism Test included 30 chronic inpatients with several years of hospitalization and with acceptable perceptual thresholds. Compared with 30 sex- and age-matched nonschizophrenic psychiatric control patients, schizophrenics resorted significantly more often to (a) regression, (b) disappearance of the peripheral figure, (c) introjection (wrong sex attribution to the hero), and (d) significantly less often to the most mature variants of repression. In a further comparison of a subgroup of 16 women schizophrenic patients and a matched group of melancholic inpatients, the findings on regression, introjection, and repression were replicated.

Adjunctive trazodone in the treatment of negative symptoms of schizophrenia.

OBJECTIVE: The study examined whether adjunctive treatment with trazodone would reduce negative symptomatology in patients with chronic, residual schizophrenia. METHODS: Patients selected for the study had an established clinical diagnosis of chronic schizophrenia with stable symptomatology, an absence of florid psychotic symptons, a stable regimen of neuroleptic medication, and an absence of depressive disorder. Active psychotic symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS) score on the thinking disturbance factor. Negative symptoms were assessed using the BPRS withdrawal retardation factor as well as the affective flattening and alogia subscales from the Scale for Assessment of Negative Symptoms. Forty-nine patients were randomly assigned to either trazodone or placebo in a six-week double-blind trial. RESULTS: Forty-seven patients, 23 men and 24 women with an average age of 60 years, completed the six-week trial. Twenty-six of the patients received trazodone. Adjunctive treatment with trazodone significantly reduced the severity ratings on two of three measures of negative symptoms and did not significantly increase the severity of positive symptoms; however, the magnitude of the therapeutic effect was modest. The scores for negative symptoms were reduced by approximately 10 to 15 percent, and only three of the 26 actively treated patients showed moderate clinical improvement. CONCLUSIONS: Trazodone, used in conjunction with neuroleptics, mildly reduces the severity of negative symptoms in residual schizophrenia and does not exacerbate florid psychosis. The potential benefits of adjunctive trazodone therapy may outweigh the risk of worsening psychosis.