Pink dot.

Well, here's a weird one.

I was talking to my boss who, as a student, had worked in a mental hospital, and he said the strangest thing, 'There was a distinct smell to schizophrenia'

And instantly I remembered a distinct smell associated with my son's psychosis. 

In my blog post I'd written: [+]

... It reminds me of school dinners, cooked liver to be precise. It makes my blood run cold. Deep down some bit of me goes into terror when I smell it. I override the primal impulse to run...because I assume I'm feeling what he feels, and I'm not giving in, I keep my head. Nevertheless, I just don't get why there is a particular smell to it. What does that signify?

He continued to explain that there was a urine test that would show a pink dot if a person was psychotic because how a person smells is related to their metabolism,

So, that is interesting, I thought! 

Let's follow it up.

I've found that the pink spot test presents some problems, things are not as simple as I'd hoped! As this paper [+] points out, it is possible that the pink spot is a reaction to the drugs the people have been administered, rather than to an altered chemistry as part of psychosis. 

Another paper in Nature reports on the findings from lumbar punctures. But before I add what their findings were - I can't imagine anything worse that being in a world of terror already and then having someone immobilize you for a lumbar puncture! And the results demonstrate what we already know, chronic stress is very bad news.

Anyway, the conclusion is:

Most biomarkers showed no significant differences, including the dopamine metabolites homovanillic acid and 3,4-dihydroxyphenylacetic acid. These findings suggest that dysregulation of the immune and adrenergic system as well as blood-brain barrier dysfunction are implicated in the pathophysiology of psychotic disorders. [+]

So where did this whole pink spot thing come from?

The pink spot begins its history in 1952.

The hypothesis was based originally on the similarity between the chemical formulae of mescaline and adrenaline. This suggested that schizophrenics might produce abnormal metabolites of adrenaline similar to mescaline in their chemical structure and psychotomimetic properties. An interesting metabolite of mescaline is the compound 3,4-dimethoxyphenylethylamine (D.M.P.E.), a dimethylated derivative of dopamine which Friedhoff and van Winkle first reported as forming a " pink spot " chromatographically in the urine of schizophrenic patients but not in the urine of normal people. [+]

And oh yes!

Are we now into the history of the semi-mythical drug adrenochrome, as in the film Fear and Loathing? Which has unfortunately become part of a Q Anon conspiracy theory? [+]

Nope, not going there!

How about the mythos surrounding DMT - N,N-Dimethyltryptamine which isn't  3,4-dimethoxyphenylethylamine, but it sounds similar!

No.

Back to psychosis and being able to smell it. If I use Google as my guide searching for smell and pychosis I only get results about people worrying that they might smell. 

I put this down to the improved standards of modern hygiene! 

But if we go back to the 60's

Smith and Sines reported the demonstration of an odor present in the sweat of chronic schizophrenic patients which was not present in the sweat of nonschizophrenic patients. They used rats conditioned to the odor as well as a panel of expert odor testers to determine the presence of this odor. [+]

I think there is too much bad science going on here - the treatment drugs of choice in the 60's for  psychosis were  promazine and chlorpromazine, did they cause the distinctive smell? 

Not in my son's case, for sure.

People certainly report that stress and anxiety change how they smell, and psychosis seems to be mostly prolonged and extreme terror, which shuts down reality testing, well whatever!

In writing this I am reminded of why I quit psychology. I saw it as the domain of the insane! I mean psychologists have no excuse for their determined categorizing and medicating of fellow humans. 

I actually left because of 'the kitten carousel'! 

Anyway, the following experiment performed on pidgins gives you some idea of how psychologists get their kicks on rainy afternoons!

Effects of promazine, chlorpromazine, d-amphetamine, and pentobarbital on treadle pressing by pigeons under a signalled shock-postponement schedule. [+]

Curiously it was found that:

The response-rate increases produced by the promazine and the lack of effects on the rates of responding after chlorpromazine were very surprising in the context of the results of these drugs in other species responding under similar schedules to postpone electric shock.

So, perfectly safe for pigeons to continue to operate heavy machinery, as they actually do better when medicated!

But this is not a good idea for rats, squirrel monkeys or beagles, who become unable to care if they get an electric shock or not!

Generally, low doses (I to 4 mg/kg) of chlorpromazine (Bernstein and Cancro, 1962; Clark and Steele, 1963) and hiigher doses of promazine (1.25 to 40 mg/kg) (Niemegeers, Verbruggen, and Janssen, 1969) produce dose-related decreases in responding by rats. Likewise, in squirrel monkeys (Cook and Catania, 1964) and in beagle dogs (Waller and Waller, 1962), chlorpromazine decreases rates of shock-postponement responding in a dose-related manner.