Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data.

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12-17 and their biological parents.

Services to patients with dual diagnoses: findings from Washington's mental health service system.

This study examined how Washington State's (WA) mental health treatment system provided services to patients with substance use disorders or dual diagnoses at several stages of care: crisis commitment, hospitalization, and outpatient treatment. A total of 30 key informants from urban and rural areas were surveyed between February and July 2004 using semi-structured interviews. Key informants represented direct service providers to chief operating officers.

Forecasting recidivism in mentally ill offenders released from prison.

Little research has focused on assessing the risk of mentally ill offenders (MIOs) released from state prisons. Here we report findings for 333 mentally ill offenders released from Washington State prisons. Logistic regression identified sets of variables that forecasted felony and violent reconviction as accurately as state-of-the-art risk assessment instruments.

Racial differences in the criminalization of the mentally ill.

"Criminalization," the hypothesis that mentally ill persons are diverted to the criminal justice system, has been difficult to confirm. The few relevant studies have examined aspects of the mental health or the criminal justice systems, but not both. This study compares state hospital admissions with the admission of mentally ill persons to state prisons.

Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease.

Objective: Two reports have suggested a possible association between a history of sexual trauma and irritable bowel syndrome, but several factors in their study designs limited their generalizability. The authors used a more rigorous methodology to confirm this association.

Method: They administered structured psychiatric and sexual trauma interviews to 28 patients with irritable bowel syndrome and 19 patients with inflammatory bowel disease and compared prevalence rates of sexual victimization in the two groups.

Psychiatric disorders and medical care utilization among people in the general population who report fatigue.

Objective: To study the prevalence of fatigue in the general population and its association with psychiatric disorders, somatization, and medical utilization.

Setting: The public-use data tape from the 1984 National Institute of Mental Health Epidemiologic Catchment Area Study.

Participants: Household sample of 18,571 subjects.

Children on child protective service caseloads: prevalence and nature of serious emotional disturbance.

A multivariate, criterion-referenced approach was used to assess prevalence of serious emotional disturbance among children on protective service case loads. Of 140 recipients of protective services, 72% were statistically indistinguishable from children in Washington State's most intensive mental health treatment programs. School problems, substance abuse, and antisocial behaviors were common in the sample, as were family histories of mental illness or substance abuse.

Medical and psychiatric symptoms in women with childhood sexual abuse.

Although there is increasing awareness of the short-term psychological and social adaptations to childhood sexual abuse, little is known about the long-term effects of such abuse, particularly its effect on subsequent medical utilization and the experience and reporting of physical symptoms. We re-analyzed data from a previous study of 100 women scheduled for diagnostic laparoscopy (50 for chronic pain, 50 for tubal ligation or infertility evaluation) who received structured, physician-administered psychiatric and sexual abuse interviews. Women were regrouped by severity of childhood sexual abuse, and we compared the groups with respect to lifetime psychiatric diagnoses and medically unexplained symptom patterns.

Dissociation in women with chronic pelvic pain.

Objective: The authors' goal was to determine if women with chronic pelvic pain are significantly more likely to use dissociation as a coping mechanism than women without pain.

Method: The subjects were recruited from women who attended a university women's clinic during a 1-month period. Twenty-two women who reported that they had at any time in their lives experienced pelvic pain nearly every day for a period of at least 6 months were included in the study, along with 21 randomly selected women without a history of chronic pelvic pain.

Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study.

The purpose of this investigation is to determine if the high prevalence rates of major depression, panic disorder, and agoraphobia found in tertiary-care studies of irritable bowel syndrome and medically unexplained gastrointestinal symptoms are also found in the general population. Structured psychiatric interviews on 18,571 subjects from the NIMH Epidemiologic Catchment Area (ECA) Study were reviewed for prevalence of gastrointestinal distress symptoms and selected psychiatric disorders. Medically unexplained gastrointestinal symptoms had a high prevalence in the general population (6-25%).

An open trial of nortriptyline in women with chronic pelvic pain.

Although antidepressants have been used in the management of several types of chronic pain there have been no systematic trials of these medications in women with chronic pelvic pain. The authors report on the use of nortriptyline in fourteen women with chronic pelvic pain. Seven women dropped out of the study.

The mentally ill in prisons: a review.

Mentally ill persons who have been charged with crimes present difficult dilemmas for correctional authorities and mental health system administrators. The authors examine the scope of the problem, the legal issues and treatment needs of this population during incarceration, and the obstacles in caring for them after their eventual release from prison. They recommend that mentally ill offenders be afforded the same level of mental health care available to mentally ill residents in other institutions and in the community.