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September 1966

Corticosteroid Responses to Milieu Therapy of Chronic Schizophrenics

Author Affiliations

From the Psychoendocrine Laboratory and the Clinical Research Center, Massachusetts Mental Health Center, and the Department of Psychiatry, Harvard Medical School, Boston (Dr. Sachar). Dr. Cohler is currently with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York.

Arch Gen Psychiatry. 1966;15(3):310-319. doi:10.1001/archpsyc.1966.01730150086013

OVER the past two decades, it has been well established in both animals and man that emotional distress can stimulate adrenal cortical activity through neuroendocrine pathways. In man, however, emotional distress is regarded as being closely regulated by ego defenses (in a manner perhaps analogous to a buffer system). It appears useful, then, to study both the dimensions of affect state and ego defensive functions as a system, in psychoendocrine investigations in man.

This paper will report on corticosteroid excretion in four chronic schizophrenic men during a year's course of intensive milieu therapy. Changes in affect state and in corticosteroid excretion will be related to alterations in the psychosocial equilibrium maintained by these chronic patients.

The present study grows out of previous work by Sachar et al1,3,4 which described changes in corticosteroid excretion in acutely schizophrenic men as they moved through clinical phases in their

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