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Intensive Cortisone Therapy in Schizophrenia

Bethlem Royal and Maudsley Hospitals

G. M. King, M.R.C.S., L.R.C.P., Physician Superintendent

St. Cadoc's Hospital, Caerleon

ABSTRACT

1. The paper describes a controlled investigation of the therapeutic effects of Cortisone given in high dosage over a period of three weeks.
   
2. The experimental group consisted of 18 schizophrenic patients comprising nine pairs matched after detailed clinical analysis for age, sex, clinical status, duration of illness and previous treatment.
   
3. The experiment was carried out as a double blind trial, neither doctors making clinical assessments nor nurses knew when active or inert injections were being given. All patients were given inert injections for the first week during which all tests were carried out. Inert injections were continued in the control series for three weeks and Cortisone given to the other series. Finally inert injections were given to both groups.
   
4. Psychiatric rating scales, psychological tests of personal tempo and persistence and physiological tests such as blood-pressure and water balance records, electro-encephalography and electrocardiography were carried out before, during and after the period of clinical trial.
   
5. No significant clinical improvement was noted in patients receiving Cortisone therapy or in the control series. One female patient showed a temporary exacerbation of symptoms, returning to her previous state after termination of Cortisone.
   
6. No significant changes occurred in psychological tests for personal tempo and persistence. In eight of the nine patients marked side effects occurred consisting of water retention, sudden increase in weight, oedema, and in four patients a marked bradycardia developed. No changes in electroencephalograph recordings were noted during Cortisone administration.
   
7. The results of the investigations lend no support to the claims that Cortisone given in high dosage for a relatively long period has any beneficial therapeutic effect in chronic schizophrenia.