Factors associated with adolescents receiving drug treatment: findings from the National Household Survey on Drug Abuse.

This article examines factors associated with adolescents receiving treatment for drug-related problems. Data on adolescents (aged 12-17) from the 1995 and 1996 National Household Survey on Drug Abuse (NHSDA, N = 9133) were used. Information was obtained concerning adolescent drug use, smoking, drinking and related problems, as well as sociodemographics.

Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part I: a review.

Objectives: To review the evidence for the safety and efficacy of nonpharmacological and pharmacological treatments for aggression in children and adolescents.

Method: and searches (1990-present) were conducted for double-blind, placebo-controlled studies of atypical antipsychotics for aggression and for literature on the use of other pharmacological agents and psychosocial interventions for aggression. Case reports and adult literature regarding the safety of atypical antipsychotics were used where controlled data for youth were lacking.

Antipsychotics for aggressive adolescents: barriers to best practice.

In adolescents, antipsychotics are most often used to treat complex, comorbid conditions with core disruptive features. However, the literature guiding such practices is limited. Best practice guidelines bridging the gap between the evidence and clinical practice have been developed to promote the appropriate and safe use of antipsychotics in aggressive youths.

"Real world" atypical antipsychotic prescribing practices in public child and adolescent inpatient settings.

This article examines the factors that influence antipsychotic use among youth treated in public inpatient facilities. By combining data from 11 focus groups, a survey of 43 researchers and clinicians, and a chart review of 100 closed patient charts, we investigated the interplay between physicians' and staff members' perceptions of problems related to antipsychotic prescribing, their beliefs concerning optimal approaches, their actual recorded prescribing behaviors, and the discrepancies between their beliefs and their recorded practices. We discovered that antipsychotics are prescribed broadly to treat a variety of conditions, including nonpsychotic disorders among children in public inpatient facilities.

National trends in the use of psychotropic medications by children.

Objectives: Little information exists on national trends in the use of psychotropic medication by children and adolescents. The objective of this report is to compare patterns and predictors of psychotropic medication use by children and adolescents in the United States in 1987 and 1996.

Method: An analysis of medication use data is presented from two nationally representative surveys of the general population focusing on children 18 years of age and younger who used one or more prescribed psychotropic medication during the survey years.

Bupropion treatment for cocaine abuse and adult attention-deficit/hyperactivity disorder.

There are few published studies assessing the efficacy of pharmacologic treatments for attention-deficit hyperactivity disorder (ADHD) among substance abusers seeking treatment. Eleven patients who met DSM-IV diagnostic criteria for cocaine dependence and adult ADHD were entered into a 12-week single-blind trial of divided daily doses of bupropion (BPR). All patients received weekly individual standardized relapse prevention therapy.

The voice DISC-IV with incarcerated male youths: prevalence of disorder.

Objectives: (1) To accurately assess rate of psychiatric disorder in incarcerated juveniles, and (2) to examine the feasibility of using a self-administered, comprehensive structured psychiatric assessment with those youths.

Method: In 1999-2000, 292 recently admitted males in secure placement with New Jersey and Illinois juvenile justice authorities provided self-assessments by means of the Voice Diagnostic Interview Schedule for Children-IV, a comprehensive, computerized diagnostic instrument that presents questions via headphones.

Results: Assessments were well tolerated by youths, staff, and parents; 92% of approached youths agreed.

Pathological gambling: addiction or compulsion?

There is considerable debate about the appropriate conceptualization of pathological gambling and its place in psychiatric nosology. The authors examined the existing research on different areas of pathological gambling to find evidence for a particular model of this disorder. There are 2 dominant models of pathological gambling: as a nonpharmacologic addiction and as an obsessive-compulsive spectrum disorder.

Total energy expenditure as measured by doubly-labeled water in outpatients with bulimia nervosa.

Objective: This study measured total energy expenditure (TEE) in symptomatic outpatient women with bulimia nervosa and normal controls. The study aimed to test the conceptual model of bulimia nervosa as an illness characterized by a physiological state of starvation, despite normal weight.

Method: Total fat and fat-free mass were measured using hydrodensitometry and total energy expenditure was assessed via the doubly-labeled water method, in nine normal weight outpatient females with DSM-III-R bulimia nervosa and ten healthy female controls.

How specific is specific impairment?

Objective: To describe the usefulness of impairment items placed at the end of each diagnostic section of a structured instrument (the Diagnostic Interview Schedule for Children Version 2.3) in an attempt to link impairment to specific diagnoses.

Method: Data from 3 sites of the Methods for the Epidemiology of Child and Adolescent Mental Disorders Study were used to assess the reliability of the specific impairment measures by diagnosis, the extent to which global and specific measures of impairment impact on prevalence rates, the concordance between global and specific impairment, and the degree to which there may be a "halo effect" among specific impairment ratings.

Targeted disruption of the dopamine D(2) and D(3) receptor genes leads to different alterations in the expression of striatal calbindin-D(28k).

The present study used mice deficient for dopamine D(2) and D(3) receptors to test whether the expression of these two members of the D(2) class of receptors is essential for the normal expression of three markers that characterize the neurochemical differentiation of the striatum: the calcium-binding protein calbindin, tyrosine hydroxylase and acetylcholinesterase. Results from these experiments revealed that the expression of striatal tyrosine hydroxylase (the rate-limiting enzyme of dopamine synthesis) and acetylcholinesterase is unaffected even by the combined knockout of D(2) and D(3) receptors. However, D(2) and D(3) receptor knockouts differently affect the striatal expression of calbindin-D(28k) immunoreactivity.

Withdrawal and tolerance: prognostic significance in DSM-IV alcohol dependence.

Objective: The clinical and research importance of tolerance and/or withdrawal in the diagnosis of substance dependence has been identified as a key area needing clarification. Earlier longitudinal studies did not identify whether diagnoses of alcohol dependence were current or lifetime. In this study, the prognostic significance of the DSM-IV physiological specifier was investigated among cases of alcohol dependence current at the baseline interview.

Pergolide mesylate for cocaine abuse: a controlled preliminary trial.

A small, controlled study was conducted to assess whether pergolide mesylate has clinical promise as a treatment for cocaine abuse prior to embarking on a larger, randomized, double-blind, controlled trial. Fourteen individuals were placed on placebo for 2 weeks, followed by a 24-week single-blind study in which they were placed on pergolide for 12 weeks, followed by placebo for 12 weeks. Another 14 patients received single-blind placebo for two weeks and then were randomized into a 24-week double-blind, placebo-controlled, multiple baseline design.

Use of standardized patients to evaluate the physicians in residence program: a substance abuse training approach.

The purpose of this study was to evaluate the efficacy of the Physician in Residence (PIR) program at the Hazelden Residential Program of New York City as a substance abuse training approach using standardized patients (SP) and self-report ratings. Using an objective rating scale, two experienced drug counselors evaluated four videotaped interviews carried out by housestaff pre- and post-enrollment in the PIR program. In addition, housestaff completed self-report ratings regarding their knowledge, attitudes, and skills of substance abuse.

Practice patterns of international and U.S. medical graduate psychiatrists.

Objective: The practice patterns of international medical graduate (IMG) and U.S. medical graduate (USMG) psychiatrists were compared.

Witnessed community violence and antisocial behavior in high-risk, urban boys.

Examined the longitudinal relation between children's self-report of witnessing community violence, family environment, and parent report of child antisocial behavior in a sample of 6- to 10-year-old urban American boys (N = 97) at familial risk for antisocial behavior. Boys reported high rates of lifetime exposure to community violence. Boys' reports of witnessing community violence were significantly positively related to changes over 15 months in child antisocial behavior, even after controlling for the possible effects of 3 aspects of parent-child interactions shown previously to be related to problematic child behavior.

Long-term course of acute brief psychosis in a developing country setting.

Background: This study in North India compared acute brief psychosis--defined by acute onset, brief duration and no early relapse--with other remitting psychoses, over a 12-year course and outcome.

Method: In a cohort of incident psychoses, we identified 20 cases of acute brief psychosis and a comparison group of 43 other remitting psychoses based on two-year follow-up. Seventeen people (85%) in the acute brief psychosis group and 36 (84%) in the comparison group were reassessed at five, seven and 12 years after onset, and were rediagnosed using ICD-10 criteria.

Methylphenidate treatment for cocaine abusers with adult attention-deficit/hyperactivity disorder: a pilot study.

Background: Attention-deficit/hyperactivity disorder (ADHD) is common among cocaine abusers seeking treatment. This open trial was carried out to assess the efficacy of sustained-release methylphenidate for the treatment of cocaine abuse among individuals with ADHD.

Method: Twelve patients who met DSM-IV diagnostic criteria for adult ADHD and cocaine dependence were entered into a 12-week trial of divided daily doses of sustained-release methylphenidate ranging from 40 to 80 mg.

A protocol to switch high-dose, methadone-maintained subjects to buprenorphine.

Buprenorphine (BUP) is an alternative to methadone (METH) maintenance. However, there are few studies on the switching of patients from METH to BUP. Eighteen volunteers who had been maintained on METH for 1-19 years were recruited for a residential cocaine self-administration study.

Mental disorders in public, private nonprofit, and proprietary general hospitals.

Objective: The authors' goal was to assess the effects of facility ownership on the characteristics of psychiatric inpatients treated in public, private nonprofit, or proprietary general hospitals.

Method: Data from the 1993 National Hospital Discharge Survey were analyzed to determine the number, sociodemographic and diagnostic composition, and treatment characteristics of patients with primary mental disorders discharged from public, private nonprofit, and proprietary general hospitals.

Results: An estimated 1.

Parenting predictors of early conduct problems in urban, high-risk boys.

Objective: As part of a larger, prospective study, the authors examined concurrent and prospective relations among parenting and child antisocial behavior in inner-city boys at high risk for delinquent behavior.

Method: One hundred twenty-six younger brothers (aged 6 to 10 years) of convicted delinquents in New York City and their parents were assessed; 15 months later 112 boys were reassessed. Demographics, parenting, and child diagnosis were examined as they relate to child externalizing behavior problems.

Psychiatric Research Interview for Substance and Mental Disorders (PRISM): reliability for substance abusers.

Objective: The purpose of this study was to investigate the reliability of a new semistructured diagnostic interview, the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), for substance-abusing patients. The reliability of psychiatric diagnoses for individuals who drink heavily or use drugs has been shown to be problematic. The PRISM was designed to improve the reliability for such individuals.

Cerebral metabolic topography in unilateral temporal lobe epilepsy.

Objective: Fluorodeoxyglucose positron emission tomography (FDG-PET) studies of temporal lobe epilepsy (TLE) generally report interictal hypometabolism in the vicinity of the seizure focus. Yet, other evidence suggests that interictal metabolic abnormalities might extend to remote brain areas. We used FDG-PET to evaluate metabolism in selected regions distant from the focus in TLE.

No relation between risk of schizophrenia and prenatal exposure to influenza in Holland.

The authors compared the risk of schizophrenia in Dutch birth cohorts that were or were not exposed during the second trimester of gestation to the 1957 A2 influenza epidemic. Exposed birth cohorts did not have a higher risk of schizophrenia. These findings suggest that, in some populations, there is no relation between prenatal exposure to influenza and risk of schizophrenia.

G. C. Lichtenberg: dreams, jokes, and the unconscious in eighteenth-century Germany.

The German physicist and writer Lichtenberg (1742-1799) was well known during the nineteenth century as a humorist, thinker, and psychologist. He was also a favorite author of Freud, who read him beginning in his teens, quoted him frequently, and called him a "remarkable psychologist." Despite this, he has been ignored by psychoanalysts and historians of psychiatry alike, and most of his writing is still unavailable in English.