Brief report: effects of clozapine on self-injurious behavior of two risperidone nonresponders with mental retardation.

Atypical antipsychotic medications for self-injurious behavior (SIB), aggression, and destruction among people with mental retardation and development disabilities are becoming increasingly accepted. Most studies are on risperidone and fewer have been conducted on clozapine. The present single-blind study reports marked reductions in SIB and aggression of two persons with profound mental retardation who were nonresponsive to all other behavioral and psychopharmacological interventions, including risperidone. The most effective dose was 200 mg/day. Side effects were mild and the drug was tolerated well.

The effect of clozapine on self-injurious behavior.

Traditional neuroleptic drugs like thioridazine and haloperidol have not proven to be systematically effective with the treatment of self-injurious behavior (SIB). These drugs may be ineffective because they primarily block D2 dopamine receptors. Based on research with humans and other animals, it appears that another dopamine receptor, D1, may be responsible for mediating some SIB. Clozapine, a neuroleptic recently introduced in the United States, has proven effective in treatment of refractory cases of schizophrenia and is known to have an affinity for blocking D1 receptors. The drug was used to complete a 93-week double-blind crossover trial with a client displaying chronic SIB. Though clozapine is known to affect other neurotransmitter systems, the successful treatment of the participant is consistent with the D1 hypothesis of self-injurious behavior and suggests the possibility that clozapine could be an effective pharmacological intervention for some cases of SIB.

Rehabilitation techniques for ligament injuries of the wrist.

The goal of treatment after any wrist injury is a pain-free, stable joint with sufficient strength and mobility to carry out the daily recreational, and occupational tasks required by the individual. Treatment varies considerably depending on the age of the patient, the severity of the initial injury, the operative procedure performed, and the specific guidelines requested by the referring physician.

In vivo EMG biofeedback in violin and viola pedagogy.

In vivo EMG biofeedback was found to be an effective pedagogical tool for removing unwanted left-hand tension in nine violin and viola players. Improvement occurred rapidly and persisted throughout a 5-month follow-up period. Further studies will be necessary to assess the effect of biofeedback independent of placebo effects. The brevity of the method and the magnitude of improvement warrant further investigation.

Behavioral and biofeedback therapy for a functionally impaired musician: a case report.

A performing musician with severe occupational palsy accompanied by obsessions and compulsions was treated by an in vivo temperature biofeedback exercise. The treatment appeared highly successful in removing both the palsy and the obsessions, with improvement seen after six 1/2-day sessions and persisting for 4 years after the termination of treatment. This is the second reported case of functional palsy in a performing musician successfully treated by applying feedback apparatus directly to the affected part of the body. Occupational palsy, traditionally thought to be highly resistant to treatment, seems surprisingly amenable to in vivo biofeedback.

Sleep and growth hormone secretion in alcoholics.

The effect of alcoholism on slow wave sleep (SWS) and SWS-related human growth hormone (HGH) secretion was investigated in 8 sober male alcoholics and 13 non-alcoholic controls. Sleep onset was temporally correlated with both elevated HGH levels and a high percentage of SWS in control subjects, with several specific qualifications related to age. By contrast, alcoholism was associated with a dissociation of sleep onset, SWS, and HGH elevation. The first noticeable HGH elevation in sober alcoholics often occurred several hours after sleep onset and in the absence of any SWS in the same time interval. Acute intoxication appeared to "normalize" the sleep onset-SWS linkage in alcoholics but did not influence the dissociation of HGH elevation from sleep onset and SWS.

The classification of schizophrenic neologisms.

The use of neologisms has long been considered a symptom of schizophrenic thought disorder. However, a review of current literature and psychiatric textbooks reveals few clinical examples of neologism that may be used for illustrative purposes. A prominent exception is a paper by Forest (1969). The purpose of this communication is to present the case history of a schizophrenic patient, a partial list of his neologistic productions, and a brief analysis of the classification of neologisms.