Last week’s movie: Badlands (1973)
The Crazies is a 2010 remake of the 1973 horror film of the same name by George A. Romero. The film takes place in the fictional Iowa town of Ogden Marsh Township, the “friendliest place on Earth,” and portrays an epidemic caused by the Trixie virus. The town sheriff’s attempts to control the water-borne virus is thwarted by the Ogden Marsh Township mayor who, similar to the mayor of 1975 Amity Island (see our post on July 25), decides the “water stays open on.”
THE PSYCHIATRY OF THE CRAZIES (2010)
The Crazies (discriminatory use of the word notwithstanding) serves as an opportunity to review the case formulation of psychosis, rule-out Schizophrenia. Here, we’ll define psychosis by a) negative symptoms (e.g. flat affect) and b) positive symptoms such as delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.
In an initial scene, Rory presents with bizarre speech and behavior when he walks onto a little league field in a catatonic state that is described as appearing drunk. After he’s shot, the medical examiner (ME) orders a blood alcohol level (BAL) and toxicology screen to see if Rory’s behavior is due to the direct physiological effects of a substance. This early scene establishes that consideration of a substance- or medication-induced psychosis is integral in the initial work-up of new-onset psychosis.
Soon after, Bill presents to Judy, his primary care physician (PCP), for evaluation of flat affect, disorganized speech (non sequiturs and perseveration) and behavior. Judy’s treatment plan includes a CT scan of the head. Her formulation is accurate in that one must consider an underlying general medical condition (GMC) as the cause of psychosis before attributing it to mental illness (such as Schizophrenia). Unfortunately, Bill’s bizarre behavior culminates in his setting his house on fire.
Interestingly, both of these cases foreshadow the cause of the zombism depicted in The Crazies. The ME’s provisional diagnosis of a substance-induced psychotic disorder is accurate when it’s discovered that the cause is a weaponized virus (toxin-induced). In a similar context, the discovery of the Trixie virus also allows for the conceptualization of a viral syndrome (i.e. due to a GMC) as the underlying cause. After an incubation period of 48 hours, the virus gradually induces a psychotic state in infected individuals.
The original version of The Crazies (1973) demonstrates a deliverance from the counterculture of the 60’s with its depiction of “normal” people from the “friendliest place on Earth” turned into perpetrators of violence. The zombies therefore are not true zombies, but living people turned zombie-like (Vuckovic, 2011). As such, like all zombie films, its message mirrors the theme of the decade also depicted in Let’s Scare Jessica to Death (1972), Shivers (1975), and Blue Sunshine (1977).
Next week’s movie: Halloween (1978)