NEUROPSYCHOLOGICAL OBSERVATIONS WITH PSYCHOSIS AND SOMATIC TREATMENT

Abstract

Observations with extensive neuropsychological testing of psychotic patients before and after somatic therapy are described in this paper. Complete test results were obtained in 45 patients when drug-free during acute psychotic episodes and again after treatment with either phenothiazines, lithium, or unilateral electroconvulsive treatment. Results of the test battery prior to somatic treatment generally did not suggest diffuse or localized central nervous system (CNS) impairment. With few exceptions, test scores were within nonbrain-damaged values despite the presence of severe psychotic symptoms with apparent disruption of mentation, perception, and cognitive functions. Performance on the test battery remained within normal ranges after somatic treatment without impairment in tests of dominant, or bilateral hemispheric functions, even in the patients receiving convulsive treatment on the right or left side of the head. There were improved retest scores on some battery items which varied according to treatment modality and diagnosis. There was no indication of preferential influences upon uni- or bilateral hemispheric functions. This investigation established that extensive neuropsychological investigations of psychotic patients were feasible and that clinical disturbances resembling organic disruptions of brain function were not associated with neuropsychological indications of brain damage. Further somatic therapies known to alter and interfere with certain CNS functions did not impair neuropsychological test performance. Moreover, differential patterns of test scores and changes with treatment discriminated between the three kinds of somatic therapy and clinical diagnosis.