Psychoendocrinology of Ego Disintegration
EDWARD J. SACHAR M.D.1,
STANLEY S. KANTER M.D.2,
DANIEL BUIE M.D.3,
RALPH ENGLE M.D.4, , and
ROBERT MEHLMAN M.D.5
1 Associate professor of psychiatry, Albert Einstein College of Medicine at Montefiore Hospital, 111 E. 210th St., Bronx, N.Y. 10467
2 Clinical associate in psychiatry, Harvard Medical School, Boston, Mass.
3 Assistant professor of psychiatry, Tufts University School of Medicine, Boston, Mass.
4 Instructor in psychiatry, Harvard Medical School, Boston, Mass.
5 Assistant in psychiatry, Harvard Medical School, Boston, Mass.
The authors describe the clinical and endocrine characteristics of the state of acute ego disorganization that initiated the schizophrenic episodes of four young men. Corticosteroid excretion during this phase reached levels 250 percent of subsequent recovery values, far exceeding the elevations seen in normals under stress. The patients subsequently recovered along two separate clinical pathways, which were associated with distinctive changes in adrenal cortical activity. The findings suggest neuroendocrine differences between psychotic and neurotic anxiety.
