National field trial of the DSM-III-R diagnostic criteria for self-defeating personality disorder.

A national field trial of the criteria for self-defeating personality disorder was conducted in 1986. Among psychiatrists with a special interest in personality disorders there was a lack of consensus as to the need for the category in DSM-III-R. Although the diagnosis was more commonly made for female patients, the disorder was by no means rare in male patients.

Human polyclonal and monoclonal IgG and IgM complement 3 nephritic factors: evidence for idiotypic commonality.

Complement 3 nephritic factors (C3NeF) were isolated from the sera of patients with membranoproliferative glomerulonephritis (MPGN) and the supernatants of pokeweed mitogen-stimulated mononuclear cells from patients with MPGN. Three human monoclonal C3NeF antibodies (two IgGs, CK and PH, and one IgM, K3C4) were established. Using an exhaustive series of affinity columns, we isolated anti-C3NeF idiotypic antibodies (anti-IdNeF) (three from normal and two from patient sera).

Psychotic disorders in DSM-III-R.

The authors review the important changes in the three sections of DSM-III-R that include only psychotic disorders (schizophrenia, delusional disorder, and psychotic disorders not elsewhere classified), outline the rationale for these changes, and, where available, review their empirical basis. In addition, they review two proposed changes that were not incorporated into DSM-III-R. They conclude by calling for an increasingly rigorous and data-based process of nosologic revision.

Self-defeating personality disorder and DSM-III-R: development of the diagnostic criteria.

One of the major controversies during the development of DSM-III-R was the possible inclusion of self-defeating personality disorder. The authors review the clinical literature that serves as the conceptual basis for this diagnosis. The development of the diagnostic criteria is described, including the rationale for specific criteria and the objections raised by opponents of the category.

Late luteal phase dysphoric disorder and DSM-III-R.

Text and diagnostic criteria for a new category, late luteal phase dysphoric disorder, appear in appendix A of DSM-III-R: "Proposed Diagnostic Categories Needing Further Study." The inclusion of this category in the manual was perhaps the most controversial aspect of the revision of DSM-III. In this paper the authors describe the work of the advisory committee that first proposed the category, the rationale for the category's inclusion in the manual, and the many issues that were the focus of heated debates.

A comparison of clinical and self-report diagnoses of DSM-III personality disorders in 552 patients.

This report examines the relationship between clinicians' diagnoses of personality disorder and self-report diagnoses of personality disorder obtained from the Personality Diagnostic Questionnaire (PDQ). The results from 552 patients showed general lack of agreement between clinical and self-report diagnoses of DSM-III personality diagnoses. The best agreement obtained was for Borderline Personality Disorder: k = 0.

Melancholia: from DSM-III to DSM-III-R.

On July 26, 1985, an ad hoc committee appointed by the APA Work Group to Revise DSM-III met and reviewed the research on the validity of the DSM-III criteria for melancholia. In this paper the proceedings of the meeting are related. After reviewing studies of the validity of the DSM-III melancholia criteria, the authors describe the committee's discussion of alternative proposals for DSM-III-R and the process of developing the new DSM-III-R criteria.

DSM-III-R criteria for posttraumatic stress disorder.

The authors describe the changes in DSM-III criteria for posttraumatic stress disorder (PTSD) that have been included in DSM-III-R. DSM-III-R includes specification of generic characteristics of traumatic stressors, clearer organization of symptoms around three dimensions of stress response (reexperiencing, avoidance and numbing, and physiological arousal), inclusion of symptoms specific to children, and specification of onset and duration of the disorder. The importance of these changes in the evolution of the diagnosis of PTSD is discussed.

Having a dream. A research strategy for DSM-IV.

Psychiatric research has had a major impact on both DSM-III and its revision (DSM-III-R). We propose a strategy to maximize the impact of psychiatric research on DSM-IV. This strategy is an elaboration of a study design that was particularly helpful in developing criteria for several of the problematic diagnostic categories of DSM-II-R.

The DSM-III-R personality disorders: an overview.

The revision of DSM-III (DSM-III-R) includes substantial changes in the axis II personality disorders. The authors present and critically review these revisions and suggest directions for further research. The issues discussed include the multiaxial system, the use of a categorical rather than a dimensional format, the change from monothetic to polythetic criteria sets, the reduction in overlap among criteria sets, the decrease in the amount of unnecessary inferential clinical judgment required to make diagnoses, and the addition of two new personality disorders in an appendix.

Revised diagnostic criteria and a new structured interview for diagnosing anxiety disorders.

In recent years there has been a growing interest in the diagnosis and treatment of Anxiety Disorders. A fundamental assumption of the newer treatments is the identification of specific subtypes of Anxiety Disorders. Although the DSM-III classification of Anxiety Disorders is widely accepted, research experience since its publication in 1980 has identified many problems with the classification and diagnostic criteria for the individual Anxiety Disorders.

Treatment of human immunodeficiency virus-related polyneuropathy with 3'-azido-2',3'-dideoxythymidine.

A 72-year-old woman with human immunodeficiency virus (HIV)-related axonal polyradiculoneuropathy of the lower extremities was treated with 3'-azido-2',3'-dideoxythymidine (AZT), 250 mg every 4 hours. Before therapy she had rapidly progressive weakness in both legs and when treatment began she could move only her toes. Six weeks after therapy, there was mild improvement in her strength, which peaked 2 months later.

On the origin and control of C3NeF.

Nephritic factors are a relatively recent addition to the growing list of autoantibodies. C3NeF was the first of these to be described and acts by stabilizing the alternative pathway C3/C5 convertase. IgG and IgM C3NeF as well as anti-idiotypic antibody to C3NeF, may be found in normal individuals at all ages.

Maturation of hagfish gland thread cells: composition and characterization of intermediate filament polypeptides.

Previous studies with the hagfish, a primitive vertebrate, have shown that the gland thread cells (GTCs) each contain a single thread (approximately 60 cm long in average-sized cells) in the form of a concisely coiled cytoskeletal entity destined for export by holocrine secretion. The thread in relatively immature GTCs consists almost entirely of intermediate filaments (IFs) bundled in parallel alignment with far fewer microtubules (MTs). The three thread polypeptides described earlier (alpha, basic; beta, acidic; gamma, most acidic; each with a Mr of 63-64 kD) are now further evaluated with respect to in vitro assembly, cross-reactivity with IF polypeptides from higher vertebrates, and peptide sequence homology with known IF polypeptides.

Substance-use disorders in DSM-III-R. Evidence for the dependence syndrome across different psychoactive substances.

Using the newly revised DSM-III-R criteria for substance-abuse diagnoses, we examined dependence syndrome elements among 83 psychiatric patients. The sample included 14 with no history of substance abuse. The remainder abused alcohol (52), sedatives (31), hallucinogens (12), stimulants (33), cannabis (44), cocaine (52), or opiates (47).

MR and CT appearance of ruptured intracranial dermoid tumors.

Intracranial dermoid tumors have characteristic MR and CT appearances. Rupture of an intracranial dermoid produces a dramatic MR and CT appearance. Two cases of ruptured intracranial dermoid tumors are presented, one with rupture into the subarachnoid space, another with rupture into the ventricles.