Psychosomatic Medicine 23:508-519 (1961)
© 1961 American Psychosomatic Society

A Comparison of Hypertensive and Hypotensive Schizophrenics

¹ Now Professor of Psychiatry, Psychiatric Institute, University of Maryland School of Medicine, Baltimore 1, Md.; Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, La.
² Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, La.

Seven hundred and sixty-six institutionalized patients were screened for evidence of hypertension and hypotension. In 515 schizophrenic patients, the incidence of hypertension was comparable to that expected in the normal population, 4.6 per cent; this was also true of the nonschizophrenic patients (5.2 per cent). The incidence of hypotension in the schizophrenic group, 16.7 per cent, was three times that expected in the normal population and similarly high in the nonschizophrenic group, 18.7 per cent. This suggests that the previously reported higher incidence of hypotension in schizophrenia may be an artifact of institutionalization.

Twelve randomly selected hypertensive and 12 similarly selected hypotensive patients were studied intensively, both psychiatrically and physiologically, to see whether there were identifiable factors differentiating the two groups that might justify classification in terms of a facilitatory schizophrenic group and an inhibitory one.

In both hypertensive and hypotensive groups, the variations in blood pressure were wide, all but 1 of the patients attaining a normal range on at least one measurement.

In over half of the patients, such a differentiation could be made on the basis of brief evaluation of mental status alone, while a longitudinal study suggested that 23 of 24 patients could be predicted to have been hypertensive or hypotensive and that the blood pressure correlated well with the concept of facilitatory or inhibitory schizophrenia. With the possible exception of a fall in blood pressure after epinephrine in the hypotensive group, other physiological tests did not differentiate the group, nor did psychomotor tests.

Such a separation into a facilitatory schizophrenia and an inhibitory schizophrenia, as determined by the blood pressure, is probably too simplified a criterion, as has been suggested by other data since this study was initiated.