Syringes for Schizophrenics?

Behind every psychoanalyst stands the man with the syringe, said Freud. Last week, at the annual meeting of the American Psychiatric Association in Chicago, the syringe-wielders held the spotlight. The momentous goal toward which they were advancing: chemical treatment of schizophrenia and other mental disorders.

Attention centered first on Dr. Stig Akerfeldt, a boyish (27), blond biochemist from Stockholm's famed Nobel Institute, who had reported that when a certain chemical is added to a sample of blood serum, it will turn a bright red if the subject has schizophrenia or other severe mental illness. Akerfeldt's method has been touted as a "test" for schizophrenia. It is far from being that, since it also gives a red reaction with patients suffering from various infections, cancer, disorders of the liver, or even with women in the later months of pregnancy. But Akerfeldt's work may be a step forward.

Red Reaction. It has been known for more than 20 years that there are differences between the metabolism of schizophrenics and that of normal people, and some of these elusive differences show up in the blood. The trouble has been that when one group of researchers has reported a detectable difference, other groups have not been able to confirm it.

Researcher Akerfeldt is clearly over that hurdle: in a jampacked meeting last week U.S. researchers said that they had duplicated his method with minor variations, adding a chemical called DPP (for N,N-dimethyl-p-phenylene diamine) to serum specimens and getting the red reaction from patients with serious mental illnesses and some other diseases. (One notable exception: patients who have had schizophrenia a long time.) Most promising positive use: the reaction seems to be clearest in children, whose emotional disorders are especially hard to diagnose--and who are not likely to have such misleading conditions as malaria or pregnancy. In any patient, old or young, other techniques must be used for diagnosis.

More important than whether the reaction can be used as a test is the question of why it occurs at all. On this, Biochemist Akerfeldt shed some new light. What Akerfeldt's DPP reacts to is a copper-containing enzyme, ceruloplasmin, present in the blood. It had been assumed that there must be more of this enzyme in schizophrenic than in normal blood. Not so, said Akerfeldt: the reaction measures not the amount but the activity of ceruloplasmin, and this activity depends at least to some extent on the presence of a second substance which he has not identified and calls simply "K.2." There seems to be a lot of K2 in schizophrenics' blood.

From Bovine Brains. Most controversial of the biochemists' reports came from Tulane University's Dr. Robert Heath, who is both an analyst and a man with a syringe. For the first time, Dr. Heath spelled out his theory of the nature of schizophrenia, at which he had only hinted previously (TIME, May 14, 1956). He and his colleagues believe that schizophrenia is a "genetically determined metabolic disease"--i.e., a disorder of body chemistry which reflects a defect in the inherited genes. He relegated emotional stress, generally regarded as a major cause of the illness, to a minor role. Psychiatrist Heath also suggested that schizophrenia is far commoner than usually recognized, and that "the overwhelming majority of patients reporting to the psychiatrist for treatment are probably suffering to some degree from this disease." (At least half of all mental patients are now recognized as schizophrenics.)

What to do about it? Dr. Heath startled his colleagues last year by reporting that he had consistently extracted from the blood serum of schizophrenics a substance, which he has dubbed taraxein, that causes symptoms similar to schizophrenia when injected into normal volunteers. To make sure that taraxein really exists in schizophrenics' blood and is not merely a byproduct of laboratory processing of the serum, Heath took half a pint of blood from patients, removed the cells, and directly injected the serum into volunteers. They promptly developed what looked like mild, temporary, schizophrenic symptoms. With similar blood from normal subjects there was no such reaction. Ergo, argued Heath, taraxein (whatever it is) is real, and appears naturally in schizophrenics.

Discussing treatment of the disease, Heath turned his back dramatically on his own analytic training, declared that conventional psychiatric treatment based on analytic principles is wrong for schizophrenics--by increasing the stress to which they are subject, it can make their condition worse. He said that his laboratories had extracted something from the brains of cattle which he had tried in schizophrenic patients. What the substance is, Experimenter Heath did not claim to know: he gets it from the "septal region" (part of the midbrain. in front of the hypothalamus) of bovine brains. One test: Heath & Co. shot taraxein into two monkeys, noted behavior changes which reminded them of schizophrenia, then gave a shot of the beef-brain extract. The monkeys promptly returned to normal, apish antics.

Between the Lines. With this report, Heath got himself way out on a limb which critical convention colleagues were anxious to saw off. Snapped Cleveland's Dr. Douglas D. Bond: "No group of psychiatrists need be told that the easiest people to deceive are ourselves." In this atmosphere. Heath was careful not to disclose anything about the beef extract's effects, if any. on the mental symptoms of human patients. One trouble, he conceded, was that his extracts did not always turn out the same, might have varying potency, or none. But something could be 'read between the lines of his report. One patient has had the beef-brain-extract injections for as long as 18 months, and another for eight months, so, while it may be relatively safe, it is no prompt cure.

From all the syringe-wielders' needlework exhibited at the conference, there was no outline of such a cure--only research strands from which researchers may painstakingly build a pattern.

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