摘要:

New pharmacotherapies for intravenous abuse of opioids and stimulants are needed to control the spread of acquired immunodeficiency syndrome. To facilitate development of these new medications, it is useful to review the neurobiology of these abused drugs from the perspectives of neurotransmitter receptors and synaptic mechanisms in the brain. For the opioid drugs, the roles of the endogenous opioid system and the cyclic adenosine monophosphate second messenger system are reviewed. For the stimulants, the dopaminergic and noradrenergic systems are examined as the basis for reinforcement and withdrawal from chronic stimulant abuse, while the important role of serotonin systems for the stimulant- derived “designer drugs” such as 3,4-methylenedioxymethamphetamine or “ecstasy” is indicated.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Lack of information about the natural history of the premenstrual syndromes may make efforts regarding classification and treatment misguided. Thus, we report a naturalistic and nonintrusive approach to the problem of identification of the premenstrual syndromes, with particular focus on the issue of compliance with 2 months of daily prospective record keeping. Seventy-nine patients presenting for treatment of severe premenstrual symptoms were evaluated with a structured interview, psychological tests, and 2 months of daily prospective ratings of their symptoms. Weekly group follow-up meetings were held to foster compliance with record keeping. The typical woman seeking treatment for premenstrual symptoms in this study was middle-aged, highly educated, highly functioning, living in an urban setting, either married with children and family responsibilites or single and living alone, and supporting herself by a high-level job. She was anxious and depressed with multiple medical and gynecological problems. Despite a highly stressful life, she functioned at a very high level, but had consulted mental health professionals in the past. In general, she did not want medication. Consistent with other reports, only 20% of women seeking treatment for premenstrual symptoms had a premenstrual syndrome prospectively confirmed on the basis of 2 months of daily ratings. However, 81% of those with a prospectively confirmed premenstrual syndrome stated that after the 2-month evaluation period their symptoms no longer interfered with their functioning.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The process of patient change during short-term dynamic therapy was followed in eight patients by repeatedly measuring their appraisal and coping with significant people and issues in their lives. Patients' ratings of their appraisal and their coping with each of these variables were compared to a line of optimal functioning, which describes the ideal appraisal/coping relationship. Two groups of patients were identified who must carry out different corrections on these measures during therapy in order to approximate the optimal functioning line. The appraisal/coping relationship measure appears promising as a way to reflect patient change during therapy.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The most dramatic finding was the very high prevalance of alcohol abuse, using DSMI I I criteria, among men in Seoul, Korea. The prevalence of other psychiatric disorders was lower than in St. Louis, Missouri. With the current biological emphasis in psychiatry, questions may be raised regarding the different prevalence rates of schizophrenia, affective disorders, and even alcoholism.The deficit of the aldehyde dehydrogenase isoenzyme 1 has been hypothesized to reduce the prevalence of alcohol abuse among Asians. Twenty-five percent of Koreans have been found to be deficient in the enzyme, but despite this their prevalance of alcohol abuse is higher than among Americans.Cultural issues are paramount in the much lower prevalence of alcohol abuse among women in Korea.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This paper compares the findings in rural Korea and in the urban capital city of Seoul, Korea. In rural Korea 1966 subjects and in Seoul 3134 subjects were interviewed with the National Institute of Mental Health Diagnostic Interview Schedule. We found that the prevalence of psychiatric disorders, including alcohol dependence, was higher in rural Korea than in the urban setting. Comparing men and women, the prevalence of psychiatric disorders was higher in women. The exception was alcohol abuse/dependence, which was much higher among men, as was antisocial personality disorder. Comparison of prevalence by age groups showed that, in contrast to American studies, there was a tendency for prevalence to increase with increasing age. Alcohol abuse/dependence was much higher in rural Korea compared with St. Louis. Drug abuse/dependence was much higher in St. Louis. Other interesting similarities and differences are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The authors studied 37 male schizophrenics in a county jail psychiatric unit. Subjects were classified as impaired or not according to Luria-Nebraska Neuropsychological Battery criteria. Twelve of the 37 patients were impaired. Violence ratings were made on inpatient behavior and adult criminal records. Impairment status was related to adult history of violence but not inpatient violence. The most violent patients (by criminal record) were from the impaired category.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Seasonal affective disorder (SAD) has been successfully treated with bright light, and morning exposure has been deemed more effective than exposure at other times. Evening treatment may offer a practical advantage, but the optimal duration of exposure has not been established. Six SAD patients were treated at home for 1 week with 2500 lux of light given either from 6 p.m. to 8 p.m. or from 6 p.m. to 10 p.m. using a counterbalanced crossover design with a minimal withdrawal period of 1 week between conditions. Both treatments were effective in reversing SAD symptoms, but neither treatment was superior. These results suggest that evening phototherapy for as little as 2 hours may be a useful and reasonable alternative for the treatment of SAD.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The diagnostic efficiency of the Millon Clinical Multiaxial Inventory (MCMI) was examined with regard to the diagnosis of DSM-III axis II personality disorders by practicing psychiatrists. The MCMI displayed fairly good sensitivity but poor specificity and predictive power regarding the diagnosis of any personality disorder. Two possible explanations were offered: a) axis I psychopathology inflates scores on the MCMI personality disorder scales and causes an overdiagnosis of personality disorders by the test; or b) there is an underrecognition of axis II personality disorders (especially in the context of obvious axis I psychopathology) by the average practicing clinician.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Twelve patients who met DSM-III-R criteria for schizophrenia and had persistent auditory hallucinations completed a diary three times daily for 2 to 3 weeks. Using 5-point equal interval rating scales, nearly all patients were able to record consistently the nature of their hallucinations, the intensity of their delusional beliefs, and the mood and clarity of their thinking. For at least half the patients, there was a statistically significant relationship between the loudness and intrusiveness of hallucinations and the intensity of delusional beliefs; the more intrusive and distressing were the hallucinations, the more anxious and depressed were the patients. The findings suggested that more emphasis might be placed on altering patients' mood in the treatment of persistent hallucinations. The diary approach to research into auditory hallucinations appears promising.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Analyses in 30 patients with a diagnosis of obsessive-compulsive disorder given singleblind placebo over a 2-week period and of 12 of these patients who continued treatment on double-blind placebo for an additional 10 weeks revealed virtual absence of improvement on both clinician and self-rating scales of obsessions, compulsions, phobias, depression, and anxiety. This result would imply that the contribution of the placebo effect to the pharmacotherapy of patients with obsessive-compulsive disorder is negligible although considerable effort and work is still required to reliably identify one of four panic disorder with agoraphobia patients who respond to placebo. The placebo response thus presents a clear distinction between these two phenomenologically complex anxiety disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID