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METHODS OF ESTIMATING CAPACITY FOR RECOVERY IN PATIENTS WITH MANIC-DEPRESSIVE AND SCHIZOPHRENIC PSYCHOSES
EDWIN F. GILDEA; EVELYN B. MAN
Am J Psychiatry 1943;99:496-506.
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The Department of Psychiatry and Mental Hygiene, Yale University School of Medicine.

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Abstract

Methods of evaluating capacity for recovery, including conventional psychiatric procedures and determination of serum lipoids, have been investigated in 142 patients with manic-depressive and schizophrenic psychoses.The conventional clinical psychiatric methods yielded relatively dependable results in patients presenting clear-cut symptoms of manic-depressive psychosis provided all patients with catatonic symptoms and other schizophrenic symptoms were excluded. Eighty-one per cent of 90 patients so selected were doing well five to ten years after the onset of their illnesses.In the case of the schizophrenics the results were little better than chance when patients with catatonic symptoms were included. This was also true of the patients presenting mixtures of symptoms of both syndromes.Exclusion of patients with catatonic symptoms and queer states of excitement, however, yielded a group of schizophrenics in which 74 per cent were showing no signs of capacity for recovery five or more years after the onset of their illnesses.The serum lipoids, fatty acids and cholesterol, were found to be associated in some way with subsequent capacity for recovery. High lipoids occurred in most patients who subsequently recovered, while low lipoids were found in those who did not.Serum lipoid determinations, therefore, when considered in conjunction with other historical and clinical data offer a promising supplement to methods of estimating the capacity for recovery of patients with schizophrenic and manic-depressive symptoms.

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