Clinical Impressions on Early and Chronic Schizophrenia and Diagnostic Procedures

This presentation is based upon conclusions drawn from my private practice of psychiatry over the past fifteen years. Having been trained in the formal concepts of classical dynamic psychiatry, I used that approach with the majority of my patients until about five years ago. Dissatisfaction with the results led me to the study of other approaches which revealed interesting findings. My results from classical psychotherapy were equal to spontaneous results which would likely have occurred with little or no treatment in many instances, particularly in schizophrenia; and I realized there were other approaches being used which apparently were obtaining better results than those gained through "talk therapy." I learned that logically, a person with a perceptual disorder would automatically respond to his environment with misinterpretations. The medical approach of which I am speaking is, of course, the biochemical and pharmacological approach, more popularly known as megavitamin or Orthomolecular. I contacted Dr. Abram Hoffer, who had begun experimentation in this area as early as 1952 and arrangements were made for me to visit him and personally observe his work and results. I then began to re-evaluate my particular private patients. Using the Hoffner-Osmond Diagnostic Test and with a different concept of the types of illnesses related to perception, I found that many of my patients who had previously been diagnosed as neurotic were basically suffering from early perceptual disorders, primarily schizophrenia. Upon completion of the reevaluations, I began employing the Orthomolecular treatment program. The first patients treated were placed on minimum dosages as recommended by Dr. Hoffer, namely three grams of Niacin and three grams of Ascorbic Acid daily; and I considered the nutritional state of each patient. Concern over the carbohydrate metabolism system led to routine evaluation and laboratory testing for possibilities of fluctuations and later, consideration of the entire endocrine system. All patients who were diagnosed schizophrenic, regardless of the length of illness, were started on this program. Patients who had been on other medications for alleviation of symptoms were continued on those medications until improvement which I felt was due to the new program was noted. The other medications were then decreased and/or eliminated.Illustrative cases are best used here to