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Bliss EL, Clark LD, West CD. 
“Studies of sleep deprivation - relationship to schizophrenia.”. 
Arch.Neurol. Psychiat.. 1959;81:348.
It has been postulated that sleep deprivation may play a critical role in the precipitation of some psychoses. Studies were therefore made in 7 normal subjects who were kept awake for 72 hours. Changes in psychological tests were insignificant but behavioral and subjective alterations were considerable. Feelings of depersonalization, illusions, hallucinations, etc. were common. Adrenocortical activity remained normal. . Four normal subjects were kept awake for 48 hours and then given 0.5 mcg/kg LSD [orally?]. All 4 developed hallucinations. The reaction was as severe or more severe than that made by the same subjects to 1 mcg/kg LSD given previously. Thus, sleep deprivation markedly enhanced the ego-disruptive effect of LSD. . It is thought that sleep deprivation, when combined with isolation and incapacitating anxiety, may be a critical factor in the precipitation of some psychoses.
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