Endocrinological Study of Atypical Psychosis

Abstract

Summary Somatic aspects of atypical psychosis were investigated in terms of the endocrine and autonomic nervous functions. (1) Three female cases of atypical psychosis who showed marked phasic variations in their clinical symptoms in correlation with their menstrual cycles were chosen for the laboratory work. Three schizophrenic and one normal subjects were studied simultaneously as controls. (2) Estimations of i) estrogens, ii) pregnandiol, iii) urinary 17‐hydroxycorticoids, iv) 17‐ketosteroids, v) circulating eosinophile count, vi) basal metabolic rate and vii) static autonomic nervous function were made every day or every other day continuously for periods ranging from two months to half a year on each of the above 7 subjects. The laboratory findings thus obtained were carefully checked as to correlation with changes in the patients' psychic symptoms. (3) There were observed such remarkable changes in the endocrine and autonomic nervous functions as i) reduction in urinary estrogen and pregnandiol, which was suggestive of non‐ovulatory menstruation, ii) marked increase in amount and in degree of fluctuations of 17‐OHCS and 17‐KS outputs in urine with corresponding decrease in circulating eosinophile count, which indicated hyperactivity as well as instability of adrenocortical function, iii) increase in basal metabolic rate and iv) sympathetic predominance in autonomic nervous activity. (4) These abnormalities in bodily functions, however, were found to be not confined or specific to the cases of atypical psychosis. Actually, the same results were observed in the schizophrenic subjects when their psychic symptoms became worse. These abnormal findings, therefore, seemed to correspond to, or to be the sequences of, the changes in psychic state of the subjects examined. (5) The results of the present study are essentially in line with those of the series “psychophysiological studies of emotion” which have been under way in the authors' laboratory since 1953.

A Study of Cycloid Psychoses

“…As mentioned above 46 episodes in his series showed a spontaneous remission. Japanese authors, who use an operational definition of atypical psychosis very similar to our own, have for a long time found evidence of the occurrence of endocrinological disturbances in patients suffering from atypical psychoses (Inoue ( 1959), Yamashita et al (1962), Hatotani e t al. (1962), Wada et al (1963), Hatotani ( 197 3)).…”