Effect of Carbon Dioxide on Acrocyanosis in Schizophrenia

Abstract

THE OCCURRENCE of cool blue hands in many patients with schizophrenia is well recognized. According to Olkon,1 cutaneous capillary microscopy over the finger nail fold during life in such instances reveals a decrease in the number of visible capillaries. The capillaries appear pale, bizarrely formed and, in places, irregularly dilated; blood flow through them is irregular and slow. However, the previous work of Schrijver-Hertzberger 2 and the large number of earlier studies discussed in Suckow's 3 exhaustive review strongly suggest that changes such as these are not constantly found in patients with schizophrenia and are not specific to that disease. A number of authors 4 have also found evidence of stasis in blood drawn from the antecubital vein of schizophrenic patients, and Abramson and

The Carotid Body and Schizophrenia

“…He also observed a lowered skin temperature, low blood pressure, and very low pulse in the same patients. Acrocyanosis in schizophrenics, especially of the fingernail folds, has been reported by others (Abramson 1944 andAltschule andSulzbach 1949). At necropsy, a constant finding is a small heart, in which the walls of the auricles are reduced in thickness (Lewis 1923 andShattock 1950).…”

The Carotid Body and Schizophrenia

“…He also observed a lowered skin temperature, low blood pressure, and very low pulse in the same patients. Acrocyanosis in schizophrenics, especially of the fingernail folds, has been reported by others (Abramson 1944 andAltschule andSulzbach 1949). At necropsy, a constant finding is a small heart, in which the walls of the auricles are reduced in thickness (Lewis 1923 andShattock 1950).…”

Differential autonomic responsiveness in the process-reactive classification of schizophrenia.

“…Citing a variety of supporting studies, Angyal, Freeman, and Hoskins (2) and Hoskins (16) characterize schizophrenics, in comparison with normals, as showing reduced physiological responsiveness. However, confirmation of this position has not been obtained in a number of other studies (1,7,26). As suggested by Sands and Rodnick (29) and as illustrated by Malmo, Shagass, and Smith (22), contradictory results in this area are undoubtedly due in part to variations in the types of experimental stimulation and the nature of the physiological measures.…”

“…An investigation by Ficca (8) revealed that neuropsychiatric patients with "unfavorable" ANS patterns of response, in terms of prognosis, produced significantly more "schizophrenic" signs on the Rorschach than patients with "favorable" ANS responses. 1 This research was initiated while the author was on the staff of Veterans Administration Hospital, Battle Creek, Michigan. Grateful acknowledgment is due David W. Merrell for his early collaboration, Harry VanderKamp for providing most of the physiological measures, and Frank Restle for his interest and suggestions.…”

Atypical Antipsychotics Cause an Acute Increase in Cutaneous Hand Blood Flow in Patients with Schizophrenia and Schizoaffective Disorder

“…Early investigators described cool, blue hands (acrocyanosis) in patients with schizophrenia as well as unusual thermoregulatory behaviour [13–15, 53–54]. Subnormal finger temperatures in unmedicated patients, and an increase with phenothiazine medication have also been documented [15,54,55], as have abnormalities in related variables including electrodermal activity (EDA) [16,17,56–61], and core temperature [62]. Notably, Dawson et al found that EDA in schizophrenia patients was increased in the period prior to relapse of symptoms, as well as during the relapse, but not in remission [63].…”

The Carotid Body and Schizophrenia

“…He also observed a lowered skin temperature, low blood pressure, and very low pulse in the same patients. Acrocyanosis in schizophrenics, especially of the fingernail folds, has been reported by others (Abramson 1944 andAltschule andSulzbach 1949). At necropsy, a constant finding is a small heart, in which the walls of the auricles are reduced in thickness (Lewis 1923 andShattock 1950).…”

Differential autonomic responsiveness in the process-reactive classification of schizophrenia.

“…Citing a variety of supporting studies, Angyal, Freeman, and Hoskins (2) and Hoskins (16) characterize schizophrenics, in comparison with normals, as showing reduced physiological responsiveness. However, confirmation of this position has not been obtained in a number of other studies (1,7,26). As suggested by Sands and Rodnick (29) and as illustrated by Malmo, Shagass, and Smith (22), contradictory results in this area are undoubtedly due in part to variations in the types of experimental stimulation and the nature of the physiological measures.…”

“…An investigation by Ficca (8) revealed that neuropsychiatric patients with "unfavorable" ANS patterns of response, in terms of prognosis, produced significantly more "schizophrenic" signs on the Rorschach than patients with "favorable" ANS responses. 1 This research was initiated while the author was on the staff of Veterans Administration Hospital, Battle Creek, Michigan. Grateful acknowledgment is due David W. Merrell for his early collaboration, Harry VanderKamp for providing most of the physiological measures, and Frank Restle for his interest and suggestions.…”

Atypical Antipsychotics Cause an Acute Increase in Cutaneous Hand Blood Flow in Patients with Schizophrenia and Schizoaffective Disorder

“…Early investigators described cool, blue hands (acrocyanosis) in patients with schizophrenia as well as unusual thermoregulatory behaviour [13–15, 53–54]. Subnormal finger temperatures in unmedicated patients, and an increase with phenothiazine medication have also been documented [15,54,55], as have abnormalities in related variables including electrodermal activity (EDA) [16,17,56–61], and core temperature [62]. Notably, Dawson et al found that EDA in schizophrenia patients was increased in the period prior to relapse of symptoms, as well as during the relapse, but not in remission [63].…”

The Carotid Body and Schizophrenia

“…He also observed a lowered skin temperature, low blood pressure, and very low pulse in the same patients. Acrocyanosis in schizophrenics, especially of the fingernail folds, has been reported by others (Abramson 1944 andAltschule andSulzbach 1949). At necropsy, a constant finding is a small heart, in which the walls of the auricles are reduced in thickness (Lewis 1923 andShattock 1950).…”

Differential autonomic responsiveness in the process-reactive classification of schizophrenia.

“…Citing a variety of supporting studies, Angyal, Freeman, and Hoskins (2) and Hoskins (16) characterize schizophrenics, in comparison with normals, as showing reduced physiological responsiveness. However, confirmation of this position has not been obtained in a number of other studies (1,7,26). As suggested by Sands and Rodnick (29) and as illustrated by Malmo, Shagass, and Smith (22), contradictory results in this area are undoubtedly due in part to variations in the types of experimental stimulation and the nature of the physiological measures.…”

“…An investigation by Ficca (8) revealed that neuropsychiatric patients with "unfavorable" ANS patterns of response, in terms of prognosis, produced significantly more "schizophrenic" signs on the Rorschach than patients with "favorable" ANS responses. 1 This research was initiated while the author was on the staff of Veterans Administration Hospital, Battle Creek, Michigan. Grateful acknowledgment is due David W. Merrell for his early collaboration, Harry VanderKamp for providing most of the physiological measures, and Frank Restle for his interest and suggestions.…”

Atypical Antipsychotics Cause an Acute Increase in Cutaneous Hand Blood Flow in Patients with Schizophrenia and Schizoaffective Disorder

“…Early investigators described cool, blue hands (acrocyanosis) in patients with schizophrenia as well as unusual thermoregulatory behaviour [13–15, 53–54]. Subnormal finger temperatures in unmedicated patients, and an increase with phenothiazine medication have also been documented [15,54,55], as have abnormalities in related variables including electrodermal activity (EDA) [16,17,56–61], and core temperature [62]. Notably, Dawson et al found that EDA in schizophrenia patients was increased in the period prior to relapse of symptoms, as well as during the relapse, but not in remission [63].…”