Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-26T14:38:11.841Z Has data issue: false hasContentIssue false

Part 2. Improvement criteria in drug trials with neurotic patients

Published online by Cambridge University Press:  09 July 2009

Robert Kellner
Affiliation:
Department of Psychiatry, University of Liverpool

Synopsis

Based on the available research evidence, several rating and self-rating methods are recommended which appear to be suitable for the measurement of changes in distress in drug trials with neurotic patients.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1972

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abruzzi, W. A. (1964). A long release dose form of pentobarbital Compared with meprobamate in the management of anxiety States. Clinical Mediane, 71, 12311234.Google Scholar
Armiger, B. (1968). Pain perception and reaction: response to carisoprodol and meprobamate. Doctoral dissertation thesis. St. John's University.Google Scholar
Ball, J. R. B., and Kiloh, L. G. (1959). A controlled trial of imipramine in treatment of depressive states. British Medical Journal, 2, 10521055.Google Scholar
Barker, J. C., Jan, I. A., and Enoch, M. D. (1965). A controlled trial of mebanazine (‘Actomol’) in depression. British Journal of Psychiatry, 111, 10951100.Google Scholar
Bartholomew, A. A. (1962). An evaluation of tranylcypromine (Parnate) in the treatment of depression. Medical Journal of Austratia, 1, 655662.Google Scholar
Bates, T. J. N., and Douglas, A. D. McL. (1961). A comparative trial of four mono-amine oxidase inhibitors on chronic depressives. Journal of Mental Science, 107, 538546.Google Scholar
Battle, C. C., Imber, S. D., Hoehn-Saric, R., Stone, A. R., Nash, E. R., and Frank, J. D. (1966). Target complaints as criteria of improvement. American Journal of Psychotherapy, 20, 184192.Google Scholar
Batterman, R. C., Mouratoff, G. J., and Kaufman, J. E. (1963). Comparative treatment of the psychoneurotic reactive-type anxiety state with fluphenazine and chlordiazepoxide. Journal of New Drugs, 3, 297301.Google Scholar
Brick, H., Doub, W. H., and Perdue, W. C. (1962). Effects of amitriptyline on depressive and anxiety states in penitentiary inmates. Diseases of the Nervous System, 23, 572578.Google Scholar
Brick, H., Doub, W. H. Jr., and Perdue, W. C. (1965). A comparison of the effects of amitriptyline and protriptyline on anxiety and depressive States in female prisoners. International Journal of Neuropsychiatry, 1, 325336.Google Scholar
Brill, N. Q., Koegler, R. R., Epstein, L. J., and Forgy, E. W. (1964). Controlled study of psychiatric outpatient treatment. Archives of General Psychiatry, 10, 581595.Google Scholar
Browne, M. W., Kreeger, L. C., and Kazamias, N. G. (1963). A clinical trial of amitriptyline in depressive patients. British Journal of Psychiatry, 109, 692694.Google Scholar
Byrne, D. (1964). Assessing Personality Variables and their Alteration in Personality Change. Edited by Worchel, P. and Byrne, D.. Wiley: New York.Google Scholar
Capstick, N. S., Corbett, M. F., Pare, C. M. B., Pryce, I. G., and Rees, L. W. (1965). A comparative trial of diazepam (Valium) and amylobarbitone. British Journal of Psychiatry, 111, 517519.Google Scholar
Cattell, R. B., King, J. E., and Schuettler, A. K. (1954). IPAT Contact Personality Factor Test. Institute for Personality and Ability Testing, Champaign, Illinois.Google Scholar
Cattell, R. B., and Scheier, I. H. (1957). The IPAT Anxiety Scale. Institute for Personality and Ability Testing: Champaign, Illinois.Google Scholar
Chieffi, M. (1965). A two-part, double-blind study of the antineurotic action of tybamate. Diseases of the Nervous System, 26, 369374.Google Scholar
Claghorn, J. L., and Kellner, R. (1971). When is a tranquilizer an antidepressant? Current Therapeutic Research, 13, 575579.Google Scholar
Clyde, D. J. (1960). Self-ratings. In Drugs and Behavior. Edited by Uhr, L., and Miller, J. G.. Wiley: New York.Google Scholar
Clyde, D. J. (1963). Manual for the Clyde Mood Scale. Biometric Laboratory: Miami, Florida.Google Scholar
Coleman, E. L., Nelson, S. E., Olson, F. P., Raths, O. N., and Wiener, D. N. (1958). A controlled study of the use of meprobamate. Journal of Clinical Experimental Psychopathology and Quarterly Review of Psychiatry and Neurology, 19, 323329.Google Scholar
Collard, J., and Kerf, J. (1962). Étude comparative biaveugle du chlordiazepoxide du meprobamate et d'un placebo. Annales Medico Psychologiques, 120, 921934.Google Scholar
Cronbach, L. J. (1946). Response sets and test validity Educational and Psychological Measurement, 6, 475494.Google Scholar
Cronbach, L. J. (1950). Further evidence on response sets and test design. Educational and Psychological Measurement, 10, 331.Google Scholar
Cronbach, L. J., and Meehl, P. E. (1956). Construct validity in psychological tests. In Minnesota Studies in the Philosophy of Science, pp. 174204. Vol. 1. The Foundations of Science and the Concepts of Psychology and Psychoanalysis. Edited by Feigl, H. and Scriven, M.. University of Minnesota Press: Minneapolis.Google Scholar
Crown, S., and Crisp, A. H. (1966). A short clinical diagnostic self-rating scale for psychoneurotic patients. British Journal of Psychiatry, 112, 917923.Google Scholar
Daneman, E. A. (1964). Double blind study with diazepam, chlordiazepoxide and placebo in the treatment of psychoneurotic anxiety. Journal of the Medical Association of Georgia, 53, 5558.Google Scholar
Davies, D. L., and Shepherd, M. (1955). Reserpine in the treatment of anxious and depressed patients. Lancet, 2, 117120.Google Scholar
Davison, K. (1963). Evaluation of a new tranquillizer—benzquinamide (P2647) by a sequential method. British Journal of Psychiatry, 109, 539543.Google Scholar
Dickel, H. A., Dixon, H. H., Shanklin, J. G., and Dixon, H. H. Jr. (1962). A clinical double-blind comparison of Librium, meprobamate, and phenobarbital. Psychosomatics, 3, 129133.Google Scholar
Eysenck, H. J. (1959). Manual of the Maudsley Personality Inventory. University of London Press: London.Google Scholar
Eysenck, H. J., and Eysenck, S. B. G. (1964). Manual of the Eysenck Personality Invenlory, University of London Press: London.Google Scholar
Folkson, A. (1957). Use of meprobamate in tension states. Journal of Mental Science, 103, 860863.Google Scholar
Forbes, H. S., and Earle, B. V. (1957). Benactyzine in psychoneurosis. British Medical Journal, 1, 226.Google Scholar
Frank, J. D., Gliedman, L. H., Imber, S. D., Nash, E. H., and Stone, A. R. (1957). Why patients leave psychotherapy. AMA Archives of Neurology and Psychiatry, 77, 283299.Google Scholar
Frank, J. D., Nash, E. H., Stone, A. R., and Imber, S. D. (1963). Immediate and long-term symptomatic course of psychiatric outpatients. American Journal of Psychiatry, 120, 429–139.Google Scholar
General Practitioner Clinical Trials (1964a). Methylpentynol compared with phenobarbitone in anxiety. Practitioner, 192, 273275.Google Scholar
General Practitioner Clinical Trials (1964b). A dexamphetamine-barbiturate combination in anxiety-depressive states. Practitioner, 192, 275278.Google Scholar
General Practitioner Clinical Trials (1965). Chlordiazepoxide in anxiety states. 1. Short-term study. Practitioner, 195, 689691.Google Scholar
General Practitioner Clinical Trials (1966). A trial of Neulactil (pericyazine) in anxiety neurosis in general practice. Medical Proceedings, Mediese Bydraes, 12, 343347.Google Scholar
Giel, R., Knox, R. S., and Carstairs, G. M. (1964). A five-year follow-up of 100 neurotic outpatients. British Medical Journal, 2, 160163.Google Scholar
Glaser, E. M., and Whittow, G. C. (1954). Experimental errors in clinical trials. Clinical Science, 13, 199210.Google Scholar
Glick, B. S. (1964). Double-blind study of tranylcypromine and phenelzine in depression. Diseases of the Nervous System, 25, 617619.Google Scholar
Gliedman, L. H., Nash, E. H., Imber, S. D., Stone, A. R., and Frank, J. D. (1958). Reduction of symptoms by pharmacologically inert substances and by short-term psychotherapy. AMA Archives of Neurology and Psychiatry, 79, 345351.Google Scholar
Goldstein, B. J., and Weiner, D. (1970). Clinical evaluation of a new antianxiety agent BA-30803. Journal of Clinical Pharmacology, 10, 1923.Google Scholar
Gore, C. P., and McComisky, J. G. (1961). A study of the comparative effectiveness of Librium, amylobarbitone and a placebo in the treatment of tension and anxiety states. In Proceedings, Third World Congress of Psychiatry, Montreal, 1961. Vol. 2, pp. 979982. University of Toronto Press: Toronto, 1962.Google Scholar
Gottfries, C. G. (1963). Clinical trial with the monoamino oxidase inhibitor tranylcypromine on a psychiatric clientele. Acta Psychiatrica Scandinavica, 39, 463472.Google Scholar
Greenblatt, M., Grosser, G. H., and Wechsler, H. (1962). A comparative study of selected antidepressant medications and EST. American Journal of Psychiatry, 119, 144153.Google Scholar
Grosser, H. H., and Ryan, E. (1965). Drug treatment of anxiety: A controlled study of omipramol and chlordiazepoxide. British Journal of Psychiatry, 3, 134141.Google Scholar
Guilford, J. P. (1954). Psychometric Methods. 2nd edn.McGraw-Hill: London.Google Scholar
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 5055.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.Google Scholar
Hare, E. H. (1955). The effects of mephenesin in neurotic anxiety. Journal of Mental Science, 101, 172174.Google Scholar
Hargreaves, G. R., Hamilton, M., and Roberts, J. M. (1958). Treatment of anxiety states. II. Clinical trial of benactyzine in anxiety states. Journal of Mental Science, 104, 10561061.Google Scholar
Hankoff, L. D., Rudorfer, L., and Paley, H. M. (1962a). The psychiatric use of Pyrbenzindole: A double blind outpatient study. Journal of New Drugs, 2, 167172.Google Scholar
Hankoff, L. D., Rudorfer, L., and Paley, H. M. (1962b). A reference study of alaraxics: A two-week double blind outpatient evaluation. Journal of New Drugs, 2, 173178.Google Scholar
Hathaway, S. R. (1948). Some considerations relative to nondirective counseling as therapy. Journal of Clinical Psychology, 4, 226231.Google Scholar
Hathaway, S. R., and McKinley, J. C. (1951). Minnesota Multiphasic Personality Invenlory. The Psychological Corporation: New York.Google Scholar
Heller, G. C., Walton, D., and Black, D. A. (1957). Meprobamate in the treatment of tension states. Journal of Mental Science, 103, 581588.Google Scholar
Hertz, M. (1958). Effekten af Restenil (Meprobamat). Ugeskrift for Lager, 120, 335342.Google Scholar
Heseltine, W. W. (1961). Controlled trial of fluphenazine. In Fluphenazine in Anxiety and Tension, pp. 5275. Edited by Heseltine, W. W.. Charles Birchall: Liverpool.Google Scholar
Hinton, J. M. (1958). A controlled trial of meprobamate in anxious outpatients. Journal of Neurology, Neurosurgery and Psychiatry, 21, 301304.Google Scholar
Hinton, J. M. (1959). A comparison of perphenazine (‘Fentazin’), sodium amylobarbitone, and a placebo in anxious and depressed outpatients. Journal of Mental Science, 105, 872877.Google Scholar
Hoehn-Saric, R., Frank, J. D., Imber, S. D., Nash, E. H., Stone, A. R., and Battle, C. C. (1964). Systematic preparation of patients for psychotherapy—1. Effects on therapy behaviour and outcome. Journal of Psychiatric Research, 2, 267281.Google Scholar
Hollister, L. E., Stannard, A. N., and Drake, C. F. (1956). Treatment of anxious patients with drugs. Diseuses of the Nervous System, 17, 289293.Google Scholar
Honigfeld, G. (1964a). Non-specific factors in treatment: 1. Review of placebo reactions and placebo reactors. Diseuses of the Nervous System, 25, 143156.Google Scholar
Honigfeld, G. (1964b). Non-specific factors in treatment: 2. Review of social-psychological factors. Diseases of the Nervous System, 25, 225239.Google Scholar
Jenner, F. A., Kerry, R. J., and Parkin, D. (1961a). A controlled trial of methaminodiazepoxide (chlordiazepoxide. ‘Librium’) in the treatment of anxiety in neurotic patients. Journal of Mental Science, 107, 575582.Google Scholar
Jenner, F. A., Kerry, R. J., and Parkin, D. (1961b). A controlled comparison of methaminodiazepoxide (chlordiazepoxide, ‘Librium’) and amylobarbitone in the treatment of anxiety in neurotic patients. Journal of Mental Science, 107, 583589.Google Scholar
Jenson, E., Kristjansen, P., and Paerregaard, G. (1957). Meprobamats virkning på neurotiske og senile patienter. Nordisk Medicin, 58, 16141617.Google Scholar
Johnson, D. T. (1968). Effects of interview stress on measures of state and trait anxiety. Journal of Abnormal Psychulogy, 73, 245251.Google Scholar
Johnson, D. T., and Spielberger, C. D. (1968). The effects of relaxation training and the passage of time on measures of state- and trait-anxiety. Journal of Clinical Psychology, 24, 2023.Google Scholar
Johnstone, E. E., and Claghorn, J. L. (1968). Doxepin vs chlordiazepoxide. A controlled comparison in neurotic outpatients. Current Therapeutic Research, 10, 514519.Google Scholar
Kellner, R. (1967a). The assessment of changes in the symptoms of neurotic adults. Ph.D. thesis, University of Liverpool. (b) p. 370; (c) p. 373; (d) p. 378; (e) p. 395; (f) p. 386; (g) p. 397; (h) pp. 252, 344.Google Scholar
Kellner, R. (1967b). The evidence in favour of psychotherapy. British Journal of Medical Psychology, 40, 341358.Google Scholar
Kellner, R. (1970a). Drugs, diagnoses, and outcome of drug trials with neurotic patients: A survey. Journal of Nervous and Mental Diseuse, 151, 8596.Google Scholar
Kellner, R. (1970b). The design of drug trials with neurotic patients. Behavioral Neuropsychititry, 2, 1219.Google Scholar
Kellner, R., and Claghorn, J. L. (1970). A controlled trial of benzoctamine (Ba-30803) in neurotic anxiety. Journal of Clinical Pharmacology, 10, 342348.Google Scholar
Kellner, R., Kelly, A. V., and Sheffield, B. F. (1968). The assessment of changes in anxiety in a drug trial: A comparison of methods. British Journal of Psychiatry, 114, 863869.Google Scholar
Kellner, R., and Sheffield, B. F. (1967a). Abridged Manual of the Symptom Rating Test. Department of Psychiatry, University of Liverpool.Google Scholar
Kellner, R., and Sheffield, B. F. (1967b). Symptom Rating Test scores in neurotics and normals. British Journal of Psychiatry, 113, 525526.Google Scholar
Kellner, R., and Sheffield, B. F. (1968). The use of self-rating scales in a single-patient multiple crossover trial. British Journal of Psychiatry, 114, 193196.Google Scholar
Kellner, R., and Sheffield, B. F. (1969). A crossover trial of chlordiazepoxide-with-amitriptyline and amitriptyline alone. British Journal of Clinical Practice, 23, 459461.Google Scholar
Kellner, R., and Sheffield, B. F. (1971). The relief of distress following attendance at a clinic. British Journal of Psychiatry, 118, 195198.Google Scholar
Kellner, R., and Sheffield, B. F. (1972). A self-rating scale of neurotic distress. (Awaiting publication.)Google Scholar
Kelly, D., Brown, C. C., and Shaffer, J. W. (1969). A controlled physiological, clinical and psychological evaluation of chlordiazepoxide. British Journal of Psychiatry, 115, 13871392.Google Scholar
Kerry, R. J., and Jenner, F. A. (1962). A double blind crossover comparison of diazepam (Valium, R05–2807) with chlordiazepoxide (Librium) in the treatment of neurotic anxiety. Psychopharmacologia, 3, 302306.Google Scholar
Knowles, J. B. (1963). Rating methods and measurement of behaviour. In Methods of Psychiatric Research, pp. 7484. Edited by Sainsbury, P., and Kreitman, N.. Oxford University Press: London.Google Scholar
Koteen, H. (1957). Use of a ‘double-blind’ study investigating the clinical merits of a new tranquilizing agent. Annals of Internal Medicine, 47, 978989.Google Scholar
Lader, M. H., and Wing, L. (1966). Physiological Measures, Sedative Drugs, and Morbid Anxiety, p. 89. Oxford University Press: London.Google Scholar
Le Gassicke, J., Boyd, W. D., and McPherson, F. M. (1964). A controlled outpatient trial with fencamfamin. British Journal of Psychiatry, 110, 267269.Google Scholar
Le Gassicke, J., and McPherson, F. M. (1965). A sequential trial of Wy 3498 (Oxazepam). British Journal of Psychiatry, 3, 521525.Google Scholar
Lehmann, H. E. (1960). he place and purpose of objective methods in psychopharmacology. In Drugs and Beliavior, pp. 107127. Edited by Uhr, L. and Miller, J. G.. Wiley: New York.Google Scholar
Lipman, R. S., Cole, J. O., Park, L. C., and Rickels, K. (1965). Sensitivity of symptom and nonsymptom-focused criteria of outpatient drug efficacy. American Journal of Psychiatry, 122, 2427.Google Scholar
Lipman, R. S., Covi, L., Rickels, K., Uhlenhuth, E. H., and Lazar, R. (1968). Selected measures in out-patient evaluation. In Psychopharmacology: A Review of Progress, 1957–1967, pp. 249254. Edited by Efron, D. H.. U.S. Govt. Printing Office: Washington.Google Scholar
Lipman, R. S., Rickels, K., Covi, L., Derogatis, L. R., and Uhlenhuth, E. H. (1969). Factors of symptom distress. Doctor ratings of anxious neurotic outpalients. Archives of General Psychiatry, 21, 328338.Google Scholar
Lorr, M., McNair, D. M., and Weinstein, G. J. (1963). Early effects of chlordiazepoxide (Librium) used with psychotherapy. Journal of Psychiatric Research, 1, 257270.Google Scholar
Lorr, M., McNair, D. M., Weinstein, G. J., Michaux, W. W., and Raskin, A. (1961). Meprobamate and chlorpromazine in psychotherapy. Archives of General Psychiatry, 4, 381389.Google Scholar
Maggs, R., and Neville, R. (1964). Chlordiazepoxide (Librium). A clinical trial of ils use in controlling symptoms of anxiety. British Journal of Psychiatry, 110, 540543.Google Scholar
Mårtens, S. (1960). Clinical trial of emylcamate, a new internuncial blocking tranquilizer. A double-blind study in alcoholic outpatients. Quarterly Journal of Studies on Alcohol, 21, 223232.Google Scholar
May, A. R. (1961). Drug treatment of neurotic symptoms with a combination of trifluoperazine and anylobarbitone (Amylozine). Medical Press, 245, 269272.Google Scholar
May, A. R., Whiteley, J. S., and Gradwell, B. G. (1959). Trifluoperazine (Stelazine) in psychoneuroses. A clinical assessment. Journal of Mental Science, 105, 10591063.Google Scholar
McDowall, A., Owen, S., and Robin, A. A. (1966). A controlled comparison of diazepam and amylobarbitone in anxiety States. British Journal of Psychiatry, 112, 629631.Google Scholar
McLaughlin, B., Rickels, K., Abidi, M., and Toro, R. (1969). Meprobamate-benactyzine (Deprol) and placebo in two depressed outpatient populations. Psychosomatics, 10, 7381.Google Scholar
Meath, J. A., Feldberg, T. M., Rosenthal, D., and Frank, J. D. (1956). Comparison of Reserpine and placebo in treatment of psychiatric outpatients. Archives of Neurology and Psychiatry, 76, 207214.Google Scholar
Middlefell, R., and Edwards, K. C. S. (1959). Hydroxyzine (Atarax) in the relief of tension associated with anxiety neurosis and mild depressive States. Journal of Mental Science, 105, 792794.Google Scholar
Mock, J. E., Rickels, K., and Yee, R. (1965). A clinical evaluation of hydroxyzine and placebo in anxious psychiatric outpatients. International Journal of Neuropsychialry, 1, 168172.Google Scholar
Mooney, R. L., and Gordon, L. V. (1950). Mooney Problem Check List, 1950 Revision. Psychological Corporation: New York.Google Scholar
Moriarty, J. D. (1960). Drug therapy versus psychotherapy. Journal of Neuropsychiatry, 2, 8285.Google Scholar
Nesselhof, W., Gallant, D. M., and Bishop, M. P. (1965). A double-blind comparison of Wy-3498, diazepam and placebo in psychiatric outpatients. American Journal of Psychiatry, 121, 809811.Google Scholar
Nodine, J. H., Siegler, P. E., Bodi, T., Mapp, Y., and Dykyj, R. (1965). A variable dose phase 3, human bioassay of nortriptyline. American Journal of Medical Sciences, 250, 443447.Google Scholar
Overall, J. E. and Gorham, D. R. (1962). The brief psychiatric rating scale. Psychological Reports, 10, 799812.Google Scholar
Osgood, C. E., Suci, G. J., and Tannenbaum, P. H. (1957). The Measurement of Meaning. University of Illinois Press: Urbana, Illinois.Google Scholar
Park, L. C., Uhlenhuth, E. H., Lipman, R. S., Rickels, K., and Fisher, S. (1965). A comparison of doctor and patient improvement ratings in a drug (meprobamate) trial. British Journal of Psychiatry, 111, 535540.Google Scholar
Parloff, M. B., Kelman, H. C., and Frank, J. D. (1954). Comfort, effectiveness, and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry, 111, 343351.Google Scholar
Phillips, J. P. N. (1963). Scaling and Personal questionnaires. Nature, 200, 13471348.Google Scholar
Phillips, J. P. N. (1964). Techniques for scaling the symptoms of an individual psychiatric patient. Journal of Psycliosomatic Research, 8, 255271.Google Scholar
Phillips, J. P. N. (1966). On a certain type of partial higher-ordered metric scaling. British Journal of Mathematical and Statistical Psychology, 19, 7786.Google Scholar
Raab, E., Rickels, K., and Moore, E. (1964). A double-blind evaluation of tybamate in anxious neurotic medical clinic patients. American Journal of Psychiatry, 120, 10051007.Google Scholar
Raymond, M. J., and Lucas, C. J. (1956). Benactyzine in psychoneurosis. British Medical Journal, 1, 952954.Google Scholar
Raymond, M. J., Lucas, C. J., Beesley, M. L., O'Connell, B. A., and Roberts, J. A. F. (1957). A trial of five tranquillizing drugs in psychoneurosis. British Medical Journal, 2, 6366.Google Scholar
Rees, W. L., and Lambert, C. (1955). The value and limitations of chlorpromazine in the treatment of anxiety states. Journal of Mental Science, 101, 834840.Google Scholar
Reeves, J. E. (1960). Thioridazine (Mellaril) in general office practice. Arizona Medicine, 17, 9092.Google Scholar
Reynolds, E., Joyce, C. R. B., Swift, J. L., Tolley, P. H., and Weatherall, M. (1965). Psychological and clinical investigation of the treatment of anxious outpatients with three barbiturates and placebo. British Journal of Psychiatry, 111, 8495.Google Scholar
Richmond, P. W., and Roberts, A. H. (1964). A comparative trial of imipramine, amitriptyline, isocarboxazid and tranylcypromine in outpatient depressive illness. British Journal of Psychiatry, 110, 846850.Google Scholar
Rickels, K., Boren, R., and Stuart, H. M. (1964). Controlled psychopharmacological research in general practice. Journal of New Drugs, 4, 138147.Google Scholar
Rickels, K., Clark, T. W., Ewing, J. H., Klingensmith, W. C., Morris, H. M., and Smock, C. D. (1959). Evaluation of tranquilizing drugs in medical outpatients. Journal of the American Medical Association, 171, 16491656.Google Scholar
Rickels, K., and Downing, R. W. (1967). Drug- and placebotreated neurotic outpatients. Pretreatment levels of manifest anxiety, clinical improvement, and side reactions. Archives of General Psychiatry, 16, 369372.Google Scholar
Rickels, K., Gordon, P. E., Meckelnburg, R., Sablosky, L., Whalen, E. M., and Dion, H. S. (1968). Iprindole in neurotic depressed general practice patients: A controlled study. Psychosomatics, 9, 208214.Google Scholar
Rickels, K., Gordon, P. E., Jenkins, B. W., Perloff, M., Sachs, T., and Stepansky, W. (1970). Drug treatment in depressive illness: amitriptyline and chlordiazepoxide in two neurotic populations. Diseases of the Nervous System, 31, 3042.Google Scholar
Rickels, K., Jenkins, B. W., Zamostien, B., Raab, E., and Kanther, M. (1967). Pharmacotherapy in neurotic depression: differential population responses. Journal of Nervous and Mental Diseases, 145, 475485.Google Scholar
Rickels, K., Raab, E., and Carranza, J. (1965). Doctor medication guesses: an indicator of clinical improvement in double-blind studies. Journal of New Drugs, 5, 6771.Google Scholar
Rickels, K., Raab, E., De Silverio, R., and Etemad, B. (1967). Drug treatment in depression: Antidepressant or tranquilizer? Journal of the American Medical Association, 201, 675681.Google Scholar
Rickels, K., and Snow, L. (1964). Meprobamate and phenobarbital sodium in anxious neurotic psychiatric and medical clinic outpatients. Psychopharmacologia, 5, 339348.Google Scholar
Rickels, K., Snow, L., Baumm, C., and Mock, J. (1963). Controlled evaluations of several tranquilizing agents in anxious neurotic outpatients. American Journal of Psychiatry, 119, 10931094.Google Scholar
Roberts, J. M., and Hamilton, M. (1958). Treatment of anxiety states. I. The effects of suggestion on the symptoms of anxiety states. Journal of Mental Science, 104, 10521055.Google Scholar
Robin, A. A. (1959). Pecazine (‘Pacatal’) Compared with amylobarbilone sodium in anxiety states. Journalof Mental Science, 105, 10641069.Google Scholar
Robin, A. A., Cronin, D. P., and Scotton, L. (1961). Clinical studies of a new barbiturate (nealbarbilone). Journal of Mental Science, 107, 8389.Google Scholar
Robin, A. A., and Enoch, M. D. (1964). A validation study of nealbarbitone. British Journal of Psychiatry, 110, 855858.Google Scholar
Robinson, J. T., Davies, L. S., Knowles, J., and Kreitman, N. (1965). A controlled trial of pericyazine in the treatmenl of anxiety states. Proceedings of the Leeds Symposium on Behavioural Disorders, pp. 221227. Edited by Jenner, F. A.. May and Baker: Dagenham, Essex.Google Scholar
Robinson, J. T., Davies, L. S., Kreitman, N., and Knowles, J. B. (1965). A double-blind trial of oxypertine for anxiety neurosis. British Journal of Psychiatry, 111, 527529.Google Scholar
Rose, J. T., Leahy, M. R., and Plowman, R. (1963). A comparison of phenoxypropazine and amitriptyline in depression. American Journal of Psychiatry, 120, 393395.Google Scholar
Roulet, N., Alvarez, R. R., Duffy, J. P., Lenkoski, L. D., and Bidder, T. G. (1962). Imipramine in depression: A controlled study. American Journal of Psychiatry, 119, 427431.Google Scholar
Sainsbury, P., and Lucas, C. J. (1959). Sequential methods applied to the study of prochlorperazine. British Medical Journal, 2, 737740.Google Scholar
Schofield, W. (1950). Changes in responses to the Minnesota Multiphasic Inventory following certain therapies. Psychological Monographs, 64, No. 5.Google Scholar
Schofield, W. (1953). A further study of the effects of therapies on M MPI responses. Journal of Abnormal and Social Psychology, 48, 6777.Google Scholar
Scott, P. A. L. (1955). A controlled study of the effect of mephenesin on psychiatric outpatients. Journal of Mental Science, 101, 163171.Google Scholar
Seager, C. P., and Leitch, A. (1956). Benactyzine in psycho-neurosis. A controlled clinical trial in hospital patients. British Medical Journal, 2, 14071409.Google Scholar
Shapiro, M. B. (1961). The Personal Questionnaire. A method of measuring changes in symptoms of an individual psychiatric patient. Institute of Psychiatry: London.Google Scholar
Sheffield, B. F., and Kellner, R. (1970). The temporal stability of self-ratings of neurotic symptoms. British Journal of Social and Clinical Psychology, 9, 4653.Google Scholar
Smith, M. E., and Chassan, J. B. (1964). Comparisons of diazepam, chlorpromazine, and trifluoperazine in a double-blind clinical investigation. Journal of Neuropsychiatry, 5, 593600.Google Scholar
Snaith, R. P., Goodman, M. J., and Holman, R. M. (1965). The control of manifest anxiety in dermatological patients: A comparison between sodium amylobarbitone and pericyazine. In Proceedings of the Leeds Symposium on Behavioural Disorders, pp. 262270. Edited by Jenner, F. A.. May and Baker: Dagenham, Essex.Google Scholar
Spear, F. G., Hall, P., and Stirland, J. D. (1964). A comparison of subjective responses to imipramine and tranylcypromine. British Journal of Psychiatry, 110, 5355.Google Scholar
Splitter, S. R. (1964). A new psychotropic drug: evaluation of tybamate in the treatment of anxiety and tension states. Psychosomatics, 5, 292294.Google Scholar
Straker, M., Davanloo, H., and Moll, A. (1966). A double-blind comparison of a new antidepressant protriptyline, with imipramine and amitriptyline. Canadian Medical Association Journal, 94, 12201222.Google Scholar
Strupp, H. H., and Bergin, A. E. (1969). Some empirical and conceptual bases for coordinated research in psycho-therapy. A critical review of issues, trends, and evidence. Vanderbilt University.Google Scholar
Taylor, J. A. (1953). A personality scale of manifest anxiety. Journal of Abnormal and Social Psychology, 48, 285290.Google Scholar
Tobin, J. M., Lorenz, A. A., Brousseau, E. R., and Conner, W. R. (1964). Clinical evaluation of oxazepam for the management of anxiety. Diseases of the Nervous System, 25, 689696.Google Scholar
Uhlenhuth, E. H., Canter, A., Neustadt, J. O., and Payson, H. E. (1959). The symptomatic relief of anxiety with meprobamate, phenobarbital and placebo. American Journal of Psychiatry, 115, 905910.Google Scholar
Uhlenhuth, E. H., and Park, L. C. (1964). The influence of medication (imipramine) and doctor in relieving depressed psychoneurotic outpatients. Journal of Psychiatric Research, 2, 101122.Google Scholar
Uhlenhuth, E. H., Rickels, K., Fisher, S., Park, L. C., Lipman, R. S., and Mock, J. (1966). Drug, doctor's verbal attitude and clinic setting in the symptomatic response to pharmacotherapy. Psychopharmacologia, 9, 392418.Google Scholar
Uhr, L., Pollard, J. C., and Miller, J. G. (1959). Behavioral effects of chronic administration of psychoactive drugs to anxious patients. Psychopharmacologia, 1, 150168.Google Scholar
Vazuka, F. A., and McLaughlin, B. E. (1965). Chemotherapy of symptoms of chronic anxiety states and other neurotic disorders. Psychosomatics, 6, 7378.Google Scholar
Vilkin, I. M. (1964). Comparative chemotherapeutic trial in treatment of chronic borderline patients. American Journal of Psychiatry, 120, 1004.Google Scholar
Wallace, H. E. R., and Whyte, M. B. H. (1959). Natural history of the psychoneuroses. British Medical Journal, 1, 144149.Google Scholar
West, R. O. (1965). A double-blind study in a group of patients with anxiety and depression. Psychosomatics, 6, 374376.Google Scholar
West, E. D., and da Fonseca, A. F. (1956). Conlrolled trial of meprobamate. British Medical Journal, 2, 12061209.Google Scholar
Wheatley, D. P. (1965). A trial of pericyazine in anxiety in general practice. In Proceedings of the Leeds Symposium on Behavioural Disorders, pp. 211220. Edited by Jenner, F. A.. May and Baker: Dagenham, Essex.Google Scholar
Winkelman, N. W. (1965). Three evaluations of a monoamine oxidase inhibitor and phenothiazine combination. Diseases of the Nervous System, 26, 160164.Google Scholar
Wittenborn, J. R., Plante, M., Burgess, Frances, and Maurer, Helen (1962). A comparison of imipramine, electroconvulsive therapy and placebo in the treatment of depressions. Journal of Nervous and Mental Diseases, 135, 131137.Google Scholar
Wittenborn, J. R. (1955). Wittenborn Psychiatric Rating Scales. Psychological Corporation: New York.Google Scholar
Zuckerman, M. (1960). The development of an Affect Adjective Check List for the measurement of anxiety. Journal of Consulting Psychology, 24, 457462.Google Scholar
Zuckerman, M., and Lubin, B. (1965). Manual of the Multiple Affect Adjective Check List. Educational and Industrial Testing Service: San Diego, California.Google Scholar
Zuckerman, M., and Lubin, B. (1968). Bibliography for the Multiple Affect Adjective Check List. Educational and Industrial Testing Service: San Diego, California.Google Scholar
Zukin, P., Arnold, De Vere, G., and Kessler, C. R. (1959). Comparative effects of phenaglycodol and meprobamate on anxiety reactions. Journal of Nervous and Mental Diseases, 129, 193195.Google Scholar
Zung, W. W. K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 6370.Google Scholar
Zung, W. W. K., Richards, C. B., and Short, M. J. (1965). Self-rating depression scale in an outpatient clinic. Archives of General Psychiatry, 13, 508515.Google Scholar