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Headache in a psychiatric population
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strategy is reported. The authors describe a pain measurement technique that consists of: (1) a modified signal detection theory procedure; and (2) evoked potential measures of pain response. An altered pain perception in schizophrenics was demonstrated. The results from a small sample of schizophrenic patients treated with the narcotic antagonist naloxone is discussed as well. Both signal detection analysis of self-reported pain and evoked potential amplitude/intensity functions reflected significantly increased pain and sensitivity in schizophrenics. The evoked potentials of normals administered morphine were similar to those of unmedicated schizophrenic patients thus suggesting a role for endorphins in schizophrenia.
PSYCHIATRY Amitriptyline versus placebo in postherpetic neuralgia. - C.P. Watson, R.J. Evans. K. Reed, H. Merskey, L. Goldsmith and J. Warsh (Suite 507. 3025 Hurontario Street, Mississauga, Ont. L5A 2H1, Canada). Neurology (Minneap.). 32 (1982) 671-673. To study the effects of amitriptyline in treating postherpetic neuralgia. 24 patients were randomly assigned to either drug or placebo in a double-blind crossover study. Good to excellent pain relief was found in 16 of 24 patients (P I 0.00 1). An antidepressant effect was not found in most patients (P > 0.05). The median dose of amitriptyline was 75 mg. The median blood level was 65 ng/ml and of nortriptyline 30 ng/ml. Good responses were maintained in 12 of 22 patients. Amitryptiline is useful in treating postherpetic neuralgia and may not act solely as an antidepressant. Headache in a psychiatric population. - C. Philips and M. Hunter (Maudsley Hospital, Denmark Hill. London SE5, Great Britain). J. nerv. ment. Dis.. 170 (1982) 34-40. The frequency and quality of headaches reported by 300 psychiatric patients were analyzed and compared to findings drawn from a general practice sample. Migraine and tension headaches were commonly reported and were found to be considerably more severe and frequent among psychiatric patients than among those patients attending a general practice. However, few of the psychiatric patients regarded their headaches as a major problem. Those who were headache sufferers had significantly higher scores on a psychometric assessment of neurotic tendency and were more frequently diagnosed as suffering from neuroses than were those patients who reported few or no headaches. There was no association between headache and the diagnosis of depression, but psychometric scores on depression were significantly higher among the headache cases. The scale may have been reflecting general psychiatric distress rather than depression as such. The possibility that headaches contribute significantly to psychiatric distress. and are not merely a symptom of such distress. is considered. The psychophysiological etiology of muscle-contraction headache. Cuevas and L.R. Gannon (Dept. of Psychology, Southern Illinois dale, Ill. 62901, U.S.A.). Headache, 22 (1982) 122-132.
S.T. Haynes, J. Univ., Carbon-
strategy is reported. The authors describe a pain measurement technique that consists of: (1) a modified signal detection theory procedure; and (2) evoked potential measures of pain response. An altered pain perception in schizophrenics was demonstrated. The results from a small sample of schizophrenic patients treated with the narcotic antagonist naloxone is discussed as well. Both signal detection analysis of self-reported pain and evoked potential amplitude/intensity functions reflected significantly increased pain and sensitivity in schizophrenics. The evoked potentials of normals administered morphine were similar to those of unmedicated schizophrenic patients thus suggesting a role for endorphins in schizophrenia.
PSYCHIATRY Amitriptyline versus placebo in postherpetic neuralgia. - C.P. Watson, R.J. Evans. K. Reed, H. Merskey, L. Goldsmith and J. Warsh (Suite 507. 3025 Hurontario Street, Mississauga, Ont. L5A 2H1, Canada). Neurology (Minneap.). 32 (1982) 671-673. To study the effects of amitriptyline in treating postherpetic neuralgia. 24 patients were randomly assigned to either drug or placebo in a double-blind crossover study. Good to excellent pain relief was found in 16 of 24 patients (P I 0.00 1). An antidepressant effect was not found in most patients (P > 0.05). The median dose of amitriptyline was 75 mg. The median blood level was 65 ng/ml and of nortriptyline 30 ng/ml. Good responses were maintained in 12 of 22 patients. Amitryptiline is useful in treating postherpetic neuralgia and may not act solely as an antidepressant. Headache in a psychiatric population. - C. Philips and M. Hunter (Maudsley Hospital, Denmark Hill. London SE5, Great Britain). J. nerv. ment. Dis.. 170 (1982) 34-40. The frequency and quality of headaches reported by 300 psychiatric patients were analyzed and compared to findings drawn from a general practice sample. Migraine and tension headaches were commonly reported and were found to be considerably more severe and frequent among psychiatric patients than among those patients attending a general practice. However, few of the psychiatric patients regarded their headaches as a major problem. Those who were headache sufferers had significantly higher scores on a psychometric assessment of neurotic tendency and were more frequently diagnosed as suffering from neuroses than were those patients who reported few or no headaches. There was no association between headache and the diagnosis of depression, but psychometric scores on depression were significantly higher among the headache cases. The scale may have been reflecting general psychiatric distress rather than depression as such. The possibility that headaches contribute significantly to psychiatric distress. and are not merely a symptom of such distress. is considered. The psychophysiological etiology of muscle-contraction headache. Cuevas and L.R. Gannon (Dept. of Psychology, Southern Illinois dale, Ill. 62901, U.S.A.). Headache, 22 (1982) 122-132.
S.T. Haynes, J. Univ., Carbon-