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Concrete cross-sectional studies of the organic brain syndrome, carried out periodically, attempt to establish for the parameters evaluation of substrate damage--and different noopsychopathological rating-scales for the measurement of brain capacity impairment. Beyond the level of the purely correlative-statistical point of view of the relationship between parameter and score changes, demanding for a quantitative model which could provide not only a description, but also an explanation for such a relationship. The fact that there can only be a question here of a "quantitative causality" embracing non-specificity of toxic substances and relative to acute and chronic diffuse organic brain syndromes. It results, that quantitative causality meets the requirements of an exponential function model and that one can validate such models through correlative-statistical methods. This has already been carried out by Ball and Taylor.

Patients resistant to therapy with lithium or lithium plus tricyclic antidepressants were included in our study. They had shown no curtailment of depression, no lessening of the depth of depression nor any improvement in the manic symptoms. Therapeutic medication with lithium, lithium plus tricyclics, neuroleptics and/or tranquilizer had been tried out for at last three years and the episodes of the manic-depressive illness were documented over this period. The diagnosis in the case of these patients was manic-depressive illness, type bipolar I or II. We report one case covering three years of treatment showing the following trend: Psychopathology did not change after quitting anciliary medication and tricyclic antidepressants while lithium intake was continued. A low-dose MAO inhibitor (tranylcypromine 13.7 mg/die) in addition to lithium led to shortened and less pronounced depressive and manic episodes and more prolonged normorhythmic periods. This trend emerged with even greater clarity during the course of the study.

All long-term patients with the diagnosis "paraphrenia systematica" out of one region were included in this study. 53 patients were treated in an in-patient psychiatric unit between 1979 and 1981 and were available in this study. Parenteral Fluphenacin-Decanoate (25-75 mg monthly) was given. Before, during and after Fluphenacin (each schedule lasting for at least 20 weeks) psychopathological and social evaluations were done. We used quantitative scales: NGI (Nurses Global Impressions) and BPRS (Brief psychiatric Rating Scale). Good Socialization showed a striking correlation to parenteral Fluphenacin-treatment. Differences in the present state psychopathology were not able to explain the social difference. During parenteral treatment 49 patients switched from badly socialized (NGI: more than 12 points) to well socialized (NGI less than 7 points). 18 patients stopped parenteral neuroleptic treatment for various reasons. 13 Patients out of this group had to be readmitted to the psychiatric hospital, while those staying on their parenteral neuroleptic drug-treatment stayed well socialized.