Hemodialysis in the treatment of a group of schizophrenic patients.
The aim of the study was to examine the possible therapeutic effects of hemodialysis in a group of therapy resistant schizophrenic patients. Eleven patients diagnosed as schizophrenics according to the Feighner and DSM III criteria fulfilled the inclusion and exclusion criteria for the study. One patient was administered active hemodialysis in an open study for about two years. The remaining ten patients entered a double-blind crossover study with active and sham treatment. Seven of these patients completed the full program, four of whom belonged to a large family with a high incidence of schizophrenia. All patients were on antipsychotic medication throughout the study. For the psychopathological evaluations the Comprehensive Psychopathological Rating Scale (CPRS) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30) were used. Samples of blood, urine, cerebrospinal fluid and spent dialysate were obtained for examination. This study did not demonstrate a therapeutic effect of hemodialysis when compared to sham procedure. Although in some patients improvement of the clinical condition was observed, there were only small changes in the nuclear symptoms of schizophrenia. Improvement occurred during the first treatment period irrespective of the type of treatment administered. Possible factors for this improvement, such as method of selection, medication, psychological mechanisms in relation to the treatment or care, and attention provided by the staff are discussed. Many therapy resistant schizophrenic patients had to be rejected because of their poor compliance, unwillingness to participate and difficulties in maintaining an adequate blood access route. The conclusion is, that the results of the present study do not justify the use of hemodialysis in its present form as treatment of schizophrenic patients.
Schulman
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D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006719:Homovanillic Acid / Q000097:blood; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000097:blood; D008297:Male; D008728:Methotrimeprazine / Q000627:therapeutic use; D008995:Monoamine Oxidase / Q000097:blood; D011569:Psychiatric Status Rating Scales; D006435:Renal Dialysis; D012559:Schizophrenia / Q000201:enzymology / Q000235:genetics / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment
D008076:Cholesterol, HDL; D006897:Hydroxyindoleacetic Acid; D008728:Methotrimeprazine; D008995:Monoamine Oxidase; D006719:Homovanillic Acid