STH MULTIDISCIPLINARY INTERNATIONAL
Conference of Biological Psychiatry
«Stress and Behavior»
Proceedings of the 9th International Multidisciplinary Conference «Stress and behavior» Saint-Petersburg, Russia, 16-19 May 2005 Editor: Allan V. Kalueff, PhD
CONFERENCE ABSTRACTS
6. GENERAL QUESTIONS:
PSYCHIATRY OF STRESS
EXPERIENCE OF INSTRUMENTAL VERIFICATION OF CLINICAL DIAGNOSIS
J. Zislin, V. Rodionov, S. Raskin, A. Teitelbaum, R. Durst Neurophysiology Laboratory,
Kfar Shaul Mental Health Center, Hadassah Medical School, Hebrew University, Jerusalem; Israel
Event Related potentials (ERP), recorded in the auditory oddball paradigms have long been considered as potential markers of different subtypes of schizophrenia. The instrumental method, developed in the Kfar Shaul Mental Health Center, is a new approach of interpreting ERP based on time locking method (Rodionov et al., 2002, Rodionov, Sohmer, 2004).
Methods and results. We have established ERP markers for normal individuals and male schizophrenic groups. This method enables us to compare individual ERP markers with the groups established. The present study presents two cases in which the ERP markers helped us confirm clinical diagnosis in debate. In the first case, a patient previously diagnosed as borderline personality disorder, was hospitalizes for court appointed evaluation after violating the law. Clinical interviews suggested him as not psychotic, most probably as a malingerer, using psychiatric symptoms for the purpose secondary gain. ERP evaluation clearly pointed him in the group of schizophrenic patient. Re-evaluation and prolongation of clinical observation confirmed the instrumental diagnosis as correct. Treatment with anti-psychotic medications was administered with satisfactory improvement. In the second case we were confronted with a 24 year old Jewish Orthodox Yeshiva student, who arrived at our emergency room with complaints hinting to a psychotic state: no eye contact, strange movement, persecutory ideas and hearing imperative voices. Suspicion of faking clinical psychosis was raised during the clinical evaluation. Thus, three consecutive ERP tests were performed. The result clearly pointed him in the control normal group, confirming our clinical impression of malingering. All «psychotic» symptoms claimed disappeared immediately following confrontation. These two cases are examples of a running research program in the neurophysiological laboratory of our Institute.
Conclusions. We suggest that the new method of the ERP analysis may serve as instrumental verification or marker of clinical diagnosis.
Psychopharmacol. Biol. Narcol. 2005. Vol. 5, N 2. P. 929
Psyhopharmacology & biological narcology
ISSN 1606—8i8i