Hallucinogenic drug induced states resemble acute endogenous psychoses: results of an empirical study | European Psychiatry | Cambridge Core (original) (raw)
Summary
Clinical evidence suggests that hallucinogenic drug-induced altered states of consciousness (ASCs) and the incipient, acute stages of endogenous psychoses share many common phenomenological features. The aim of our study was to assess hallucinogen-like phenomena in endogenous psychotic patients using standardised methods. We examined 93 endogenous psychotic patients, 50 healthy controls and a small group of drug induced psychotic patients (n = 7) with two ASC self-assessment scales (questionnaire APZ = Abnormer Psychischer Zustand = Altered State of Consciousness [Dittrich et al, 1985]; and questionnaire OAV = Abbreviation of the three subscales: Oceanic Boundlessness/Angst = Dread of Ego Dissolution/Visionary Restructuralisation [Bodmer 1989]). Patients were examined shortly after remission of their last acute psychotic episode and they answered the questionnaires referring to the early phase of this episode. Differences in the questionnaire scores were significant between psychotic patients and controls. Drug induced patients had numerically higher scores than endogenous psychotic patients, however these differences were only significant for the APZ total score and the undifferentiated items of the APZ, but not for the three APZ subscale and the OAV scores. More than 50% of the endogenous psychotic patients answered 26% of the APZ-and 43% of the OAV-items with “yes”. The OAV total score and the OSE (Ozeanische Selbstentgrenzung = oceanic boundlessness) scores of both questionnaires correlated significantly with BPRS Factor 3 (thought disturbance). Our results support the hypothesis that hallucinogen-like experiences represent common phenomena during the acute stages of endogenous psychoses. Remarkably, these phenomena include subjectively pleasant experiences of the OSE dimension. In the routine clinical assessment of endogenous psychotic patients experiences of this dimension may be more easily overlooked than the negative experiences of the AIA dimension (AIA: Angst vor der Ich-Auflösung = dread of ego dissolution).
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Original article
Copyright
Copyright © Elsevier, Paris 1998
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References
American Psychiatric Association, Third Edition — Revised (DSM III R)Diagnostic and Statistical Manual of Mental Disorders Washington, DC: American Psychiatric Association; 1987.Google Scholar
Bodmer, I Konstruktion des Fragebogens OAV zut quantitativen Erfassung auβergewöhnlicher Bewuβtseinszustände (ABZ) Thesis 1989 Institute of Psychology, University of ZurichGoogle Scholar
Bonhoeffer, KDie exogenen Reaktionstypen Archiv für Psychiatrie und Nervenkrankheiten 1917; 58: 58–70CrossRefGoogle Scholar
Bowers, MBFreedman, DX“Psychedelic” experiences in acute psychosis Arch Gen Psychiatry 1966; 15: 240–248CrossRefGoogle Scholar
Conrad, KDie symptomatischen PsychosenKisker, KPMeyer, JEMüller, CStrömgen, ECPsychiatrie der Gegenwart Berlin, Heidelberg, New York: Springer; 1972. 1–70Google Scholar
Dittrich, AÄtiologie-unabhängige Strukturen veränderter Wachbewusstseinszustände Stuttgart: Enke; 1985.Google Scholar
Dittrich, Avon Arx, SStaub, SInternational study on altered states of consciousness (ISASC). Summary of the results German J Psychol 1985; 9: 319–339Google Scholar
Fishman, LGDreams, hallucinogenic drug states, and schizophrenia: a psychological and biological comparison Schizophrenia Bull 1983; 9: 73–94CrossRefGoogle Scholar
Gouzoulis, EHermle, LSass, HPsychedelic experiences at the beginning of acute endogenous psychotic episodes Nervenarzt 1994; 65: 198–201Google Scholar
Heimann, HAusdrucksphänomenologie der Modellpsychosen (Psilocybin) Psychiat Neurol 1961; 141: 69–100CrossRefGoogle Scholar
Hedlund, JLVieweg, BWThe Brief Psychiatric Rating Scale (BPRS): a comprehensive review J Operational Psychiatry 1980; 11: 48–64Google Scholar
Hermle, LFünfgeld, MOepen, GBotsch, HBorchardt, DGouzoulis, Eet al.Mescaline-induced psychopathological, neuropsychological neurometabolic effects in normal subjects. Experimental psychosis as a tool for psychiatric research Biol Psychiatry 1992; 32: 976–99110.1016/0006-3223(92)90059-9CrossRefGoogle ScholarPubMed
Hermle, LGouzoulis, EOepen, GSpitzer, MKovar, K-ABorchardt, Det al.The significance of hallucinogenic research in psychiatry: history and present status Nervenarzt 1993; 64: 562–571Google Scholar
Hollister, LEDrug-induced psychoses and schizophrenic reactions, a critical comparison Ann New York Acad Sci 1962; 96: 80–88CrossRefGoogle ScholarPubMed
Krystal, JHKarper, LPSeibyl, JPFreeman, GKDelaney, RBremmer, JDet al.Subanaesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans Arch Gen Psychiatry 1994; 51: 199–214CrossRefGoogle Scholar
Langeheine, RErwartete Fitwerte für Zufallskonfigurationen in PINDIS Ztschr Sozialpsychol 1980; 11: 38–49Google Scholar
Leuner, HCDie experimentelle Psychose. Ihre Psychopharmakologie, Phänomenologie und Dynamik in Beziehung zur Person Berlin: Springer; 1962.Google Scholar
Lingoes, JCBorg, IProcrustean individual difference scaling J Market Res 1976; 13: 406–407Google Scholar
McCabe, MSFowler, RCCadoret, RJWinokur, GSymptom differences in schizophrenia with good and poor prognosis Am J Psychiatry 1972; 128: 1239–1243CrossRefGoogle ScholarPubMed
Overall, JEGorham, DRBrief Psychiatric Rating ScaleW ECDEU, Assessment Manual for Psychopharmacology Rockville: W ECDEU; 1976. 157–169Google Scholar
Pechnick, RNUngerleider, JTHallucinogensLowinson, JHRuiz, PMillman, RBLangrod, JGSubstance Abuse A comprehensive textbook 3rd ed 1997 Williams and Wilkins Baltimore230–238Google Scholar
Rinkel, MDeshon, HJHyde, RWSolomon, HCExperimental schizophrenia-like symptoms Am J Psychiatry 1952; 108: 572–578CrossRefGoogle ScholarPubMed
Rinkel, MHyde, RWSolomon, HCExperimental psychiatry II: Clinical and physiochemical observations in experimental psychosis Am J Psychiatry 1955; 111: 881–895CrossRefGoogle Scholar
Schroeter-Rosendahl, C Beginnende Schizophrenie und verändertes Wachbewuβtsein Gesunder: ein empirischer Vergleich mittels einer Selbstbeurteilungsskala Thesis 1980 Medical Faculty, University of ZurichGoogle Scholar
Spitzer, MThimm, MHermle, LHolzman, PSchneider, FGouzoulis, Eet al.Increased activation of indirect semantic associations under Psilocybin Biol Psychiatry 1996; 39: 1055–1057CrossRefGoogle ScholarPubMed
Stockings, GTA clinical study of the mescaline psychosis, with special reference to the mechanism of the genesis of schizophrenic and other psychotic states J Mental Sci 1940; 86: 29–47CrossRefGoogle Scholar
Strassman, RJHallucinogenic drugs in psychiatric research and treatment. Perspectives and prospects J Nerv Ment Dis 1995; 183: 127–138CrossRefGoogle ScholarPubMed
Strassman, RJQualls, CRDose-response study of NN-dimethyltryptamine in humans. I. Neuroendocrine, autonomic, and cardiovascular effects Arch Gen Psychiatry 1994; 51: 85–97CrossRefGoogle Scholar
Strassman, RJQualls, CRBerg, LMDifferential tolerance to biological and subjective effects of four closely spaced doses of N,N-dimethyltryptamine in humans Biol Psychiatry 1996; 39: 784–795CrossRefGoogle Scholar
Strassman, RJQualls, CRUhlenhuth, EHKellner, RDoseresponse study of NN-dimethyltryptamine in humans. II. Subjective effects and preliminary results of a new rating scale Arch Gen Psychiatry 1994; 51: 98–108CrossRefGoogle Scholar
Süllwold, LHuber, GSchizophrene Basisstörungen Berlin, Heidelberg, New York: Springer; 1986.CrossRefGoogle Scholar
Vollenweider, FXScharfetter, CLeenders, KLAngst, JDisturbance of serotonergic or glutamatergic neurotransmission results in hyperfrontality as measured by PET and FDG in acute human model psychoses Eur Neuropsychopharmacol 1994 367CrossRefGoogle Scholar
Vollenweider, FXLeenders, KLScharfetter, CAntonin, IAMaguire, PMissimer, Jet al.Metabolic hyperfrontality and psychopathology in the ketamine model of psychosis using positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) Eur Neuropsychopharmacol 1997; 7: 9–24CrossRefGoogle Scholar
Zarroug, E-TAThe frequency of visual hallucinations in schizophrenic patients in Saudi Arabia Br J Psychiatry 1975; 127: 553–555CrossRefGoogle ScholarPubMed