The present study replicates that of De Freitas and Schwartz (1979), using more typical chronic patients (on open wards rather than locked wards), and monitoring coffee intake with serum caffeine levels. The serum caffeine levels observed indicate that caffeine can be effectively manipulated on an open ward by switching the type of coffee served. Contrary to our predictions, no significant improvements in patients' behavior occurred when decaffeinated coffee was first introduced, nor was there any deterioration when regular coffee was reinstated. Only after decaffeinated coffee was introduced for the second time did any of the predicted changes occur; however, the improvements were few in number and may be accounted for by the considerable effect of time per se across all time periods. Although the findings cannot be generalized to all psychiatric patients, the results do not support recent calls for a switch to decaffeinated coffee for this population of inpatients (i.e., chronic schizophrenic patients on high doses of neuroleptics who drink large amounts of coffee).
Twenty male chronic schizophrenics suffering from self-induced water intoxication were administered a 15 item questionnaire to assess their understanding of and attitudes toward drinking fluids. Eighty-five percent stated they drank excessive amounts of fluids in order to feel better. These findings have implications for the treatment of patients with this disorder.
The authors describe intoxicationrelated behavior patterns observed among 89 chronic schizophrenic inpatients over a 5-year period. These include caffeine intoxication, water intoxication, antihistamine intoxication, nicotine withdrawal, voluntary hypei'venUlation, and ingestion of deodorants and aerosols. Affected patients tended to abuse multiple substances in the hospital, to have generalized polydipsia, and to have histories of drug or alcohol abuse before hospitalization. Periodic intoxication in this population may be an important contributor to the refractoriness of their psychotic symptoms.
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