Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-28T05:26:51.318Z Has data issue: false hasContentIssue false

The Positive Correlation between Insulin Resistance and Duration of Hospitalization in Untreated Schizophrenia

Published online by Cambridge University Press:  29 January 2018

Werner H. Schimmelbusch
Affiliation:
Yale Psychiatric Institute, New Haven, Connecticut∗
Peter S. Mueller
Affiliation:
Dept. Psychiatry, Yale University, New Haven, Connecticut
Jack Sheps
Affiliation:
Dept. Psychiatry, Yale University, New Haven, Connecticut

Extract

Various abnormalities have been demonstrated in schizophrenic patients in response to injected insulin. Thomas et al. (22), Harris (8), Freeman et al. (7), Mayer-Gross (10), and Braceland et al. (4) have shown a delayed or decreased response of blood glucose to insulin in schizophrenic patients. Meduna and McCulloch (11) observed that those schizophrenic patients who suffered from confusion and clouding of the sensorium particularly displayed a delayed or decreased response to injected insulin as well as a urinary hyperglycaemic factor and decreased tolerance to oral and intravenous glucose. Subsequent studies by Mueller (12, 13) demonstrated a rise or lack of fall in the plasma free fatty acids (FFA) following the administration of insulin intramuscularly or intravenously in chronic schizophrenic patients. Van Sickle et al. (23) confirmed these findings of insulin resistance in chronic schizophrenia and noted that this low FFA response was neither related to an abnormal release of, nor response to, epinephrine.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1971 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Beroen, J. R., Mittag, T. W., Frohman, C.E., Arthur, R. E., Warner, K. A., Gornspoon, L., and Freeman, H. (1968). ‘Plasma factors in schizophrenia.’ Arch. gen. Psychiat. (Chic.), 18, 471–6.Google Scholar
2 Bergsman, A. (1959). ‘The urinary excretion of adrenaline and noradrenaline in some mental diseases.’ Acta psychiat. Scand., 34, 1107 (suppl. 133).Google Scholar
3 Boden, G., and Soeldner, J. S. (1967). ‘A sensitive double antibody radioimmunoassay for human growth hormone: Levels of serum human growth hormone following rapid tolbutamide infusion.’ Diabetologia, 3, 413–21.Google Scholar
4 Braceland, F. J., Meduna, L. J., and Vaichulis, J. A. (1945). ‘Delayed action of insulin in schizophrenia.’ Amer. J. Psychiat., 102, 108110.Google Scholar
5 Fales, F. W., Russell, J. A., and Fain, J. N. (1961). ‘Some applications and limitations of the enzymic, reducing, and anthrone methods for estimating sugars.’ Clin. Chem., 7, 389403.Google Scholar
6 Frantz, A. G., and Rabkin, M. T. (1964). ‘Human growth hormone: Clinical measurement, response to hypoglycemia and suppression by corticosteroids.’ N. Eng. J. Med., 271, 1375–81.CrossRefGoogle ScholarPubMed
7 Freeman, H., Looney, J. M., Hoskins, R. G., and Dyer, C. G. (1943). ‘Results of insulin and epinephrine tolerance tests in schizophrenic patients and in normal subjects.’ Arch. Neurol. Psychiat., 49, 195203.CrossRefGoogle Scholar
8 Harris, M. M. (1942). ‘Insulin sensitivity of patients with mental disease: Factors in their serum affecting action of insulin.’ Arch. Neurol. Psychiat., 48, 761–73.CrossRefGoogle Scholar
9 Klerman, G. L., Davidson, E. M., and Kayce, M. M. (1964). ‘Factors influencing the clinical responses of schizophrenic patients to phenothiazine drugs and to placebo.’ Psychiat. Res. Rep. Amer. psychiat. Ass., 19, 97113.Google ScholarPubMed
10 Mayer-Gross, W. (1952). ‘The diagnostic significance of certain tests of carbohydrate metabolism in psychiatric patients and the question of oneirophrenia.’ J. ment. Sci., 98, 683–6.Google Scholar
11 Meduna, L. J., and McCulloch, W. S. (1945). ‘The modern concept of schizophrenia.’ Med. Clin. N. Amer., 29, 147–64.Google Scholar
12 Mueller, P. S. (1962). ‘Plasma free fatty acid response to insulin in schizophrenia.’ Arch. gen. Psychiat. (Chic.), 7, 140–6.CrossRefGoogle ScholarPubMed
13 Mueller, P. S. (1962). ‘Plasma free fatty acid concentrations (FFA) in chronic schizophrenia before and after insulin stimulation.’ J. psychiat. Res., 1, 106–15.Google Scholar
14 Mueller, P. S., Heninger, G. R., and McDonald, R. K. (1969). ‘The insulin tolerance test in depression.’ Arch. gen. Psychiat. (Chic.), 21, 587–94.Google Scholar
15 Mueller, P. S., Heninger, G. R., and McDonald, R. K. (1969). ‘Studies on glucose utilization and insulin sensitivity in affective disorders.’ In: Proceedings of the NIMH Workshop on Recent Advances in the Psychobiology of the Depressive Illnesses, Wash. D.C. Gov. Printing Off., in press.Google Scholar
16 Mueller, P. S. and Watkins, D. M. (1961). ‘Plasma unesterified fatty acid concentrations in neoplastic disease.’ J. Lab. clin. Med., 57, 95108.Google Scholar
17 Niswander, G. D., Haselrud, G. M., and Mitchell, G. (1963). ‘Differences in longevity of released and retained schizophrenic patients.’ Dis. nerv. Syst., 24, 610.Google Scholar
18 Niswander, G. D., Haselrud, G. M., and Mitchell, G. (1963). ‘Changes in cause of death of schizophrenic patients.’ Arch. gen. Psychiat. (Chic.), 9, 229–34.Google Scholar
19 Powell, G. F., Brasel, J. A., Raiti, S., and Blizzard, R. M. (1967). ‘Emotional deprivation and growth retardation simulating idiopathic hypopituitarism. II. Endocrinologic evaluation of the syndrome.’ N. Eng. J. Med., 276, 1279–83.Google Scholar
20 Sachar, E. J., Harmatz, J., Beroen, H., and Cohler, J. (1966). ‘Corticosteroid responses to milieu therapy of chronic schizophrenics.’ Arch. gen. Psychiat. (Chic.), 7, 310–19.Google Scholar
21 Soeldner, J. S., and Slone, D. (1965). ‘Critical variables in the radioimmunoassay of serum insulin using the double antibody technic’ Diabetes, 14, 771–9.CrossRefGoogle ScholarPubMed
22 Thomas, J. C., Gilsenan, B., and Hewitt, E. J. C. (1939). ‘Insulin shock therapy: I. Carbohydrate metabolism in schizophrenia. (Preliminary observations.)’ J. ment. Sci., 85, 696706.Google Scholar
23 Van Sickle, G. R., McCluer, H. R., Kistler, C. R., and Beesch, N. F. (1966). ‘Epinephrine and insulin effects: I. Glucose and plasma free fatty acid.’ Arch. gen. Psychiat. (Chic.), 14, 284–6.Google Scholar
24 Waalas, O., Waalas, E., Sovik, O., Alersten, A. R., and Lingjaerde, O. (1965). ‘Metabolic effects on the isolated rat diaphragm of serum prealbumin fraction from schizophrenic and other psychotic patients.’ Confin, neurol. (Basel), 25, 175–82.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.