PUPILLARY REACTIVITY AS A MEASURE OF ADRENERGIC-CHOLINERGIC MECHANISMS IN THE STUDY OF PSYCHOTIC BEHAVIOR

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Abstract
Measurements of pupillary reactivity were employed to test hypotheses deduced from a general theory of the interaction of adrenergic and cholinergic mechanisms in psychiatric disorders. Accepting the requirement of a maximal generalized sympathetic response for effective adjustment to emergency or threatening situations, it was then shown that an adequate response to stress consisted of an increased adrenergic outflow and a concomitant decrease in the level of cholinergic activity. The disordered responses to stress which characterize the functional psychoses were demonstrated to represent significant departures from the adrenergic increase and cholinergic decrease typifying the effective, normally adjusting individual during stress. Experiments confirmed the existence of specific patterns of discrete adrenergic-cholinergic interaction that significantly differentiated psychiatric patients from normal, healthy people. The patterns of disordered responsiveness to stress demonstrated an impairment of function of either the adrenergic or cholinergic mechanism or both. It is suggested that the results of the experiments provide a rational basis for chemotherapy with the so-called functionally psychotic patient population.