A diagnostic approach to pain.
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Biomedical subjects
Publications and source records attributed to A A Maltbie.
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Two cased of Capgras syndrome are reported in which platelet monoamine oxidase (MAO) activity is singificantly less than that of 24 psychiatric controls and 39 nonpsychiatric controls. This is the first report of a consistent biochemical abnormality associated with the Capgras phenomenon. Additional evidence is discussed which suggests that psychiatric patients with Capgras syndrome may belong to a discrete group of behavioral disorders characterized by reduced platelet MAO activity.
The literature concerning anniversary reactions is reviewed. Five cases seen by various medical specialists for physical complaints, and subsequently referred for psychiatric evaluation are presented. Each case was felt to represent an anniversary reaction. The necessity of considering the possibility of an anniversary reaction, when the genesis of a complaint is unclear, is emphasized.
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There are now several studies in the literature which document low blood platelet monoamine oxidase (MAO) activity in alcoholics. However, these reports are in disagreement as to the stability of reduced enzyme activity over time. The present study provides evidence that reduced platelet MAO activity in alcoholics is a relatively stable phenomenon, independent of ethanol consumption and proximate factors of the illness which are associated with excessive ethanol consumption.
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The authors suggest that many patients diagnosed as having manic-depressive illness, depressed type, may in fact be experiencing anniversary reactions--time-specific psychological and physiological reactions to a past trauma. They report three cases of cyclic depressive disorder, two of which were first diagnosed as manic-depressive illness, depressed type. Careful, complete interviewing and attention to temporal sequence led to the correct diagnosis of anniversary reaction.
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