In this placebo-controlled crossover study nicotinic acid, in a fixed dosage of 3000 mg. a day, produced statistically significant improvement in chronic hospitalized schizophrenic patients. We were able to reproduce the clinical observations and the results of previous workers; that is, the exacerbation of psychopathological symptoms by the combined administration of methionine and tranylcypromine. Nicotinic acid failed to prevent by prior administration or to relieve by subsequent administration, the methionine-tranylcypromine-induced exacerbation of psychopathology. This might have been due to the inadequate dosage of nicotinic acid given but the possibility of a toxic psychosis due to the metabolite, methionine sulfoximine, must be seriously considered.

Magnetic resonance imaging (MRI) of the brains of 32 patients who met the DSM-III criteria for obsessive-compulsive disorder and of 14 normal subjects frequently revealed abnormalities, but none was specific to obsessive-compulsive disorder. Spin-lattice relaxation time (T1) for right frontal white matter was prolonged in the patients compared to the control subjects, and the patients had greater right-minus-left T1 differences for frontal white matter. Right-minus-left T1 differences in the orbital frontal cortex were strongly correlated with symptom severity in the unmedicated patients and in the patients with family histories of obsessive-compulsive disorder.

The results of a psychophysiological (conditioning) analysis of chronic schizophrenia are presented, and a relationship between the level of psychophysiological performance and differential drug withdrawal effects is revealed. Regression from a higher to a lower level of organization, for example, from integrational to skeletomuscular or from skeletomuscular to autonomic functional systems, and dissociation within a functional system or between the different functional systems tested, were shown to be prevalent in schizophrenic patients.

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