[Overall results of attempts to treat schizophrenia by hemodialysis. Reflections on the placebo effect in a psychosis].
A review is made of 325 published cases of schizophrenic patients who underwent series of hemodialysis. In 211 cases the series of dialysis were open studies; 49 of these patients (23%) were markedly improved. In 114 other patients the effects of actual and sham dialysis were compared in a double blind experiment. A marked improvement was found in 24 cases (21%). But results of sham and actual hemodialysis did not differ significantly. Hemopurification is therefore not the cause of improvement. The rate of marked improvement is however clearly higher than what one could expect in chronic schizophrenics from a simple placebo effect. The various possible causes for this special effect are discussed. It is proposed that about 20% of schizophrenic patients could favorably react to the strong healing involvement of the psychiatrist, especially when a magic aspect is implied. This should encourage to approach patients not responding to conventional therapy with more optimism and possibly with new methods.
D014150:Antipsychotic Agents / Q000008:administration & dosage; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010919:Placebos; D012075:Remission, Spontaneous; D006435:Renal Dialysis / Q000523:psychology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D012737:Sex Factors
D014150:Antipsychotic Agents; D010919:Placebos
Résultats globaux des essais de traitement de la schizophrénie par hémodialyse. Réflexions sur l'effet placebo dans une psychose.