Intensive outpatient treatment of persons with mental retardation and psychiatric disorder: a preliminary study.

The impact of intensive outpatient mental health interventions (in a dual diagnosis clinic) on the hospitalization rate and length of stay was examined for 28 adults with mental retardation and severe psychiatric disorder. They were selected on the basis of frequent use of mental, medical, and social services. Charts were reviewed for the 12-month periods before and after referral to the program to compare service utilization.

Psychosocial predictors of high-risk patients undergoing orthognathic surgery.

The purpose of this analysis was to identify a set of predictor variables that are prospectively related to postsurgical outcomes. Specifically, psychosocial characteristics were sought to predict postsurgical outcomes. The 5 Revised Symptom Checklist-90 (SCL-90-R) scales, the neuroticism score of the Eysenck Personality Inventory (EPI), the psychosocial domain score from the Sickness Impact Profile (SIP), and 4 scales from the Oral Health Status Questionnaire (OHSQ) were used as the predictors.

Do health professionals' attitudes interfere with the treatment of depression?

Might the attitudes of health care professionals help to explain why most persons with a depressive disorder do not receive adequate care? To assess this question, the authors surveyed the faculty and staff of a midwestern university. One hundred percent of the social workers who responded found psychotherapy or counseling to be extremely or quite effective in treating persons with a major depressive episode, compared to 55% of the psychologists and 31% of the psychiatrists. For medication, the corresponding figures were 88% of psychiatrists, 64% of psychologists, and 46% of social workers.

Measuring inhibitory control in children.

The Stop Signal Task is a measure of inhibitory control in which subjects must press a button in response to a stimulus. On certain trials, the subject receives a second stimulus (the Stop Signal) after the primary stimulus and must withhold his/her response during those trials. The onset of the Stop Signal is varied, sometimes coming immediately after the primary stimulus (inhibition is easy); at other times, the Stop Signal arrives quite late, making inhibition difficult.

Solitary drinking, social isolation, and escape drinking motives as predictors of high quantity drinking, among Anglo, African American and Mexican American males.

This paper addresses the phenomenon of 'solitary drinking', considering whether Anglo, African American and Mexican American male regular drinkers differ in the propensity to drink in solitary contexts and whether such differences may help to explain observed ethnic variation in patterns of heavy drinking. Further, the paper considers whether apparent relationships between solitary drinking and drinking patterns are explained by individual personality characteristics such as social isolation and/or by endorsement of 'escape drinking' motives. Data were analysed from a random community sample of 481 adult male regular drinkers in San Antonio, Texas, USA.

Influence of depression on cognitive functioning in Fragile X females.

We sought to determine the frequency of a history of major depression in women with Fragile X syndrome. In addition, we attempted to disentangle the cognitive effects of major depression from those of Fragile X syndrome. Thirty-seven mothers of developmentally delayed children (Fragile X syndrome: n = 18; comparison group n = 19), matched for age, educational level, and socioeconomic status, were administered psychiatric and neuropsychological measures.

Ethnic matching of caseworker and patient in methadone maintenance.

The relation of ethnic matching of caseworker and patient to treatment outcomes was evaluated in a cohort of 610 opioid users admitted to methadone maintenance. At admission, the subjects were assigned to caseworkers in rotation. Thirty-seven percent of the Anglo subjects, 11% of the African-American subjects, and 60% of the Hispanic subjects were matched with caseworkers of their own ethnic group.

Dosing strategies and time course of response to antimanic drugs.

Mania is one of the few emergent conditions in psychiatry. Vigorous treatment, aimed at achieving symptom control as promptly as possible while avoiding adverse effects, is therefore important. Strategies to accomplish this aim are possible, but differ for each of the three antimanic drugs principally employed.

Compulsory supervision and methadone maintenance.

Treatment outcomes of 296 subjects admitted to methadone maintenance while on probation or parole are compared to those of 314 subjects admitted without such compulsory supervision. Equivalent treatment services were offered to both groups. The pretreatment differences between groups were small except for time incarcerated.

Rapid admission and retention on methadone.

An open clinical trial was conducted to compare the effects of rapid (1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outcomes. One hundred eighty-six illicit opioid users eligible for methadone maintenance were randomly assigned to rapid admission or slow admission, with 93 subjects assigned to each group. The random assignment produced two groups that were similar on 22 personal variables.

Clonidine plus haloperidol in the treatment of schizophrenia/psychosis.

Because of the evidence for increased norepinephrine (NE) production in psychotic patients, we studied the effects of combining the alpha 2-adrenergic agonist clonidine with haloperidol for the treatment of schizophrenic psychosis. Twelve hospitalized schizophrenic patients were taken off their antipsychotic medication for 2 to 4 weeks before double-blind treatment with haloperidol (20 mg/day) combined with either clonidine or placebo. The group receiving clonidine was significantly more improved on the thought disorder subscale of the Brief Psychiatric Rating Scale (p = 0.

Reliability of two brief questionnaires for drug abuse treatment evaluation.

The authors report the inter-interviewer reliability of two brief questionnaires developed to measure the effects of innovations in methadone maintenance. The instruments were designed to answer the research questions, but to intrude only minimally into the clinical assessment and treatment processes. The Initial Interview, completed at the time of admission, yielded information on 23 variables, and the Followup Interview, completed as soon as possible after the first anniversary of admission, yielded information on 20 variables.

Obtaining follow-up interviews for treatment evaluation.

Studies of the outcomes of substance abuse treatment are often handicapped because of subjects lost to follow-up. While follow-up data may be obtained from several sources, the follow-up interview often serves as the principal source of data. Difficulties are regularly encountered in locating and interviewing subjects not in treatment.

Urinary catecholamines in attention-deficit hyperactivity disorder with and without comorbid anxiety.

Objective: To determine whether there are differences in noradrenergic or adrenergic functioning in children with attention-deficit hyperactivity disorder (ADHD) with and without anxiety.

Method: ADHD children with and without a comorbid overanxious (ANX) disorder were compared to each other and to normal controls in terms of 2-hour urinary excretion of norepinephrine (NE), epinephrine (EPI), and their metabolites. All subjects performed a fixed series of mentally stressful tasks during the collection period.

Adrenomedullary function in depressed patients.

In this paper from the Collaborative Depression Study (CDS)--Biological, a set of data analyses are presented which indicate that depressed states and perhaps depressed mood are associated with a greater activation of the adrenomedullary system than the sympathetic nervous system [as measured by norepinephrine (NE) and normetanephrine excretion]. For the most part this finding of predominant activation of the adrenomedullary system is seen in unipolar and not bipolar patients.

Adult children of alcoholic or mentally ill parents: alcohol consumption and psychological distress in a tri-ethnic community study.

Data from a racially and ethnically heterogeneous random community sample of 1,784 adults were used to compare effects of reported parental alcoholism, parental mental illness, both alcoholism and mental illness, or no parental pathology. No parental history differences were observed among males with regard to psychological distress (depression, anxiety, and somatization) or drinking patterns (drinking, quantity, frequency, or total weekly consumption). Among females, the parental-mental-illness-only group consistently reported more problems than did the no-pathology group on depression, anxiety, somatization, and drinking quantity, even after statistical controls for demographic factors, social desirability, and possible coping resources such as fatalism, religiosity, and self-esteem.

Illicit drug injectors in three Texas cities.

In three Texas cities illicit drug injectors not in treatment were located by outreach and interviewed with a standard questionnaire. In all the cities the drug injectors were predominantly undereducated and unemployed young men from minority groups. In Dallas and Houston most were Black, while in San Antonio most were Hispanic.

Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects.

Objective: Executive deficits have traditionally been associated with frontal lobe brain damage. They are relevant to a variety of disabling mental conditions, including schizophrenia and Alzheimer's disease. To measure these deficits, the authors developed the Executive Interview, a 25-item, 15-minute interview.

Acute effects of neuroleptics on unmedicated schizophrenic patients and controls.

Acute administration of haloperidol (0.2 mg/kg) produced many more side effects in normal controls than in unmedicated schizophrenic patients. Prior to the neuroleptic challenge, both groups were on the peripheral monoamine oxidase inhibitor, debrisoquin, for at least 1 week, in order to enhance the relative contribution of CNS catecholamine metabolites to those measured in both plasma and urine.

Life stressors, drinking patterns, and depressive symptomatology: ethnicity and stress-buffer effects of alcohol.

This paper seeks to extend previous research on stress buffer effects of alcohol use using data from a tri-ethnic community sample of 1,784 respondents. Differences in buffer effects between Anglos, Blacks, and Mexican Americans are examined to explore possible racial/ethnic variation in the role or function of alcohol vis-à-vis life stress and depressive symptoms. Both acute life events and chronic financial stress are examined to clarify the conditions under which buffer effects are most and least salient in these groups.