Physical features of newborns exposed during pregnancy to anticonvulsant medication and developmental monitoring.

Background: Antiepileptic drug (AED) use during pregnancy can affect the physical features, intelligence, and behavior in the exposed infants and children. Identifying these AED-related effects early makes intervention in childhood possible. To examine the accuracy of the identification of AED effects on the physical features of newborn infants, the written findings in routine physical examinations in medical records can be evaluated.

A brief self-help toolkit intervention for gambling problems: a randomized multisite trial.

Two studies conducted in Massachusetts and Nevada evaluated the efficacy of a self-help toolkit for problem gambling. Individuals concerned about gambling-related problems, in response to public notices and newspaper advertisements, volunteered for a randomized trial of the self-help toolkit, Your First Step to Change: Gambling. Participants were randomly assigned to 1 of 3 conditions: (a) a printed toolkit, (b) the toolkit and a brief guide to the toolkit's content, or (c) assignment to a wait-list condition.

PTSD among a treatment sample of repeat DUI offenders.

Recent studies indicate that posttraumatic stress disorder (PTSD) is one of the most common psychiatric comorbidities among driving-under-the-influence (DUI) offenders in treatment. Investigation of DUI offenders' PTSD and clinical characteristics could have important implications for prevention and treatment. This prospective study examined the demographic and clinical characteristics of repeat DUI offenders with PTSD symptoms at baseline and 1-year follow-up.

Bipolar disorder as a risk factor for repeat DUI behavior.

Background: Bipolar disorder (BD) is more prevalent among people with substance use disorders (SUD) than the general population. SUD among recidivist driving under the influence (DUI) populations are extremely prevalent; not surprisingly, recent evidence suggests that rates of BD also are elevated among DUI offenders. Studies of BD patients with SUD have found high prevalence of other psychiatric disorders and relatively low rate of treatment engagement.

Real limits in the virtual world: self-limiting behavior of Internet gamblers.

The recent expansion of Internet gambling has stimulated debate, policy, and research on this relatively new phenomenon and its potential consequences. The current study focuses on bettors experiencing problems by sampling Internet gamblers who imposed limits on the amount they were allowed to deposit to a betting site. We analyzed the betting transactions over 18 months of all gamblers who subscribed to an online betting site in February, 2005 (N = 47,134), 567 of whom utilized the site's self-limit feature.

Parameters for safer gambling behavior: examining the empirical research.

There have been claims that new gambling technology is hazardous to player health, and that technological interventions can alleviate gambling-related harm. In this paper, we systematically review the empirical research about the nexus between gambling and technology to evaluate the veracity of these claims. We use a public health perspective (i.

The interdependence of behavioral and somatic health: implications for conceptualizing health and measuring treatment outcomes.

Purpose: The interdependence of behavioral and somatic aspects of various health conditions warrants greater emphasis on an integrated care approach.

Theory: We propose that integrated approaches to health and wellness require comprehensive and empirically-valid outcome measures to assess quality of care.

Method: We discuss the transition from independent to integrated treatment approaches and provide examples of new systems for integrated assessment of treatment outcome.

Criminality and continued DUI offense: criminal typologies and recidivism among repeat offenders.

We examined over 20,000 arraignment records to define criminal typologies and post-treatment driving under the influence of alcohol (DUI) convictions for a select cohort of 1,281 repeat DUI offenders who were offered and elected treatment as an alternative to incarceration; we compared this information with a similar data analysis collected 20 years previously. Analyses of 8,600 prior-to-treatment convictions defined four basic crime profiles: only DUI and other substance-related offenses (60%), plus crimes against property (18%), plus crimes against people (8%), plus crimes against both property and people (13%). During the six years after inpatient treatment, 15.

Implementation of a computerized psychiatric assessment tool at a DUI treatment facility: a case example.

Psychiatric comorbidity is common among patients in a variety of treatment settings, yet treatment providers seldom use standardized mental health assessments to identify these problems. Using standardized assessment tools gives practitioners and clients the opportunity to tailor treatment and aftercare efforts to a potential problem, and trains practitioners to provide valid and reliable measurements of mental health. Despite the benefits, there are barriers to implementing formal assessment tools.

Implementation of a consumer-directed approach in behavioral health care: problems and prospects.

Consumer-directed care, a payment system designed to make patients aware of the costs of care, requires treatment seekers to be active participants in their health care. Core components of consumer-directed care, such as higher deductibles and increased decision-making responsibilities, might preclude its easy translation from medical to behavioral health care. Aspects of behavioral disorders will force providers, insurers, and patients to compensate for unique barriers to increasing self-care, such as stigma, neuropsychological complications, and poor self-efficacy.

Missouri casino self-excluders: distributions across time and space.

According to public health research, exposure to casinos is a risk factor for disordered gambling. Consequently, casino self-exclusion programs, which provide gamblers with the opportunity to voluntarily seek limits on their access to gambling venues, can serve as a barometer of the concentration of disordered gambling in an area. This study reports on the distribution, both temporally and geographically, of 6,599 people who applied to exclude themselves from Missouri casinos between November, 1996 and February, 2004.

Obstetric and neonatal outcomes associated with maternal hypothyroid disease.

Objective: We sought to determine whether women with treated hypothyroid disease were more likely than women without thyroid disease to suffer adverse obstetric or neonatal outcomes or to deliver a child with a congenital anomaly.

Methods: Using an institutional database, we identified women with treated hypothyroid disease (n = 482) who delivered a baby at our institution during a 33-month period. We compared the occurrence of adverse obstetric or neonatal outcomes among these women to the occurrence among women without thyroid disease (n = 19,487).

Trends in congenital malformations, 1974-1999: effect of prenatal diagnosis and elective termination.

Objective: To examine trends in congenital malformations, elective terminations for malformations and correlates for the decision to terminate a pregnancy with a malformation.

Methods: All malformed liveborn and stillborn infants and elective terminations for malformations were identified in a large urban tertiary center and general hospital for the years 1974, 1979, 1984, 1989, 1994, and 1999. Nine hundred and fifty-four women with malformed infants, who had always planned to deliver at the hospital, were identified.

Clonazepam use in pregnancy and the risk of malformations.

Background: Clonazepam (Klonopin) is a benzodiazepine that has been used widely to treat seizures and conditions such as panic attacks and anxiety disorder. However, the current findings about its use in pregnancy are derived from limited studies of small sample size. Because it is commonly prescribed during pregnancy, more information about its safety is needed.

Association of rheumatologic disease with preeclampsia.

Objective: To determine whether maternal rheumatologic disease is associated with an increased risk of adverse obstetric or neonatal outcomes.

Methods: Using an institutional database, we identified all women with diagnosed rheumatologic disease (n = 114) who delivered a baby at our institution during a 33-month period. We compared the incidence of adverse obstetric and neonatal outcomes among these women with the incidence among women without rheumatologic diseases (n = 18,534).

Influence of age and tic disorders on obsessive-compulsive disorder in a pediatric sample.

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous disorder with emerging data suggesting that age of onset and/or the presence of tics may define clinically important subgroups.

Objective: This study set out to evaluate the impact of age and tic disorders on the symptom profile in a pediatric sample of patients with OCD ascertained from a specialty clinic.

Methods: Eighty children with OCD (50 boys, 30 girls) were assessed for symptom type, severity, age of onset, presence of a tic disorder, and functional status.

Two-year trends in the use of seclusion and restraint among psychiatrically hospitalized youths.

Objectives: This study examined characteristics associated with the use of seclusion and restraint among 442 psychiatrically hospitalized youths and sought to quantify changing trends in the rates of these modalities of treatment over time after the 1999 implementation of federal regulations and an institutional performance improvement program.

Methods: Demographic and clinical data related to all 5,929 incidents of seclusion and restraint that occurred during 2000 and 2001 at a child and adolescent state psychiatric hospital were analyzed.

Results: The two-year prevalence of use of seclusion was 61 percent and of restraint was 49 percent.