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Thursday, 06.05.2021

John P.M. Court:  Heinz E. Lehmann BPRS Videotapes

            Dr. Heinz Edgar Lehmann (July 17, 1911 – April 7, 1999), a German born psychiatrist, emigrated to Canada in 1937.  In 1954 he was propelled into prominence as the first in North America to publish findings of a replication study on the therapeutic effect of chlorpromazine, and one of first in the world to successfully communicate the drug’s “antipsychotic” effect. Four years later in 1958, he was again first in North America to publish findings of a replication study on the therapeutic effect of imipramine, and one of the first in the world to successfully communicate its “antidepressant” effect. Lehmann's research was instrumental in the birth of neuropsychopharmacology, re-integration of psychiatry with medicine, and the development of neuroscience of which psychiatry is a part. As a clinician and teacher he pioneered a psychiatry in which the biology of the illness, the psychology of the person, and the social situation of the individual were given full and special attention.

            In recognition of his distinguished contributions Lehmann received numerous awards: e.g., in 1957 the Lasker Award, considered America’s leading prize for medical research, and in 1962 the Stratton Award of the American Psychopathological Association.  Then in 1976, Lehmann became an Officer of the Order of Canada.  On October 28, 1998, he joined the distinguished company of William Osler, Norman Bethune, and others when he was inducted into the Canadian Medical Association Hall of Fame.

            The six tapes were prepared in the early 1980s at the Douglas Hall of Douglas Hospital, a large, psychiatric inpatient facility on the outskirts of Montreal (Verdun, Quebec, Canada), the hospital with which Lehmann was affiliated from 1937 until the end of his life. The tapes were prepared for teaching clinical investigators about scoring the Brief Psychiatric Rating Scale (BPRS), an 18-items interval scale, on which each item is scored from 1 to 7 with a score of 1 indicating the absence of the symptom and a score of 7 indicating the presence of the symptom with maximum severity. 

            The BPRS was developed for efficient evaluation of treatment response in clinical psychopharmacology. Its initial version that was published in 1962 consisted of 16 symptom-rating constructs representing distinct aspects of manifest psychopathology. Interest in the use of BPRS for descriptive classification of psychiatric patients, as well as for rapid and efficient assessment of treatment response in selected target populations, prompted the addition in 1966 of two rating constructs to better delineate excited states and organic brain syndromes. That resulted in the form of the instrument used by Lehmann and presented in three pages. 

            In each tape, Lehmann interviews a different subject with the diagnosis of schizophrenia. The interviews are focused on obtaining the necessary information for scoring each item on the scale.   The tapes were prepared for training prospective clinical investigators to assess changes in the course of treatment in multi-center clinical investigations in Europe with potential antipsychotic drugs, during the 1980s and 1990s.

            The Archives of the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario, Canada received the tapes on December 15, 2005, from Dr. Tom Ban, a Hungarian-born, Canadian psychiatrist who had been Lehman's closest collaborator in clinical investigations for more than 20 years.   Ban received the tapes from Dr. Per Bech, director of the psychiatric research unit at Frederiksborg General Hospital in Hillerod, Denmark. It is known that the tapes were used in training clinical investigators, but the studies in which the tapes were actually employed could not be identified.  There are 12 VHS videotapes – six numbered tapes in each of European and PAL (North American) formats.  We recommend that the tapes’ content should be preserved, and they should only be screened, after funding has been obtained for converting them to a digital format.

 

Resources:

 

INHN website/ Archives/ Ban Collection:  inhn.org/archives/ban-collection.html.

INHN website/ Profiles/ Heinz Edgar Lehmann:  inhn.org/profiles/heinz-edgar-lehmann.html.

www.camh.ca/en/education/about/services/camh_library/Documents/foanewsletter_spring2017.pdf - 75k - 2017-03-27.