摘要:

While the prognostic significance of eomorbid psychopathology and dependence severity has been demonstrated with opiate addicts and alcoholics, no previous reports have examined those issues in cocaine abusers. We reinterviewed 94 cocaine abusers 1 year after they sought treatment to assess predictors of treatment retention and outcome. Results suggested that: a) Many cocaine abusers did comparatively well; fully a third reported complete abstinence during the 12 months preceding the follow-up interview. b) Throe variables emerged as consistent predictors across several outcome domains: severity of drug use, poorer psychiatric functioning, and presence of concurrent alcoholism. c) The data supported a unidimensional model of outcome for cocaine abuse that emphasized reduction in level of substance use. However, abstinence was not strongly associated with improved functioning in all outcome areas. d) Variables associated with longer retention in treatment also tended to predict poorer outcome.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In contrast to suicide in depression, suicide associated with alcoholism and substance dependence may be preceded more often by interpersonal loss and conflict6 weeksprior to death. We used psychological autopsy methodology in an effort to clarify and extend these findings using a more comprehensive typology of interpersonal stressors. Subjects included 57 suicide victims with diagnoses of alcohol/substance dependence (A/SD:N= 30) and mood/anxiety disorders (M/AD;N= 27). Consistent with previous studies, a substantial majority of the A/SD suicide victims were confronted with interpersonal stressors in the 6 weeks prior to death. Our investigation extends previous findings by indicating that a) A/SD suicide victims are confronted with a broader range of interpersonal stressors than M/AD suicide completers and b) the types of interpersonal stressors experienced by A/SD subjects in the weeks prior to suicide involve conflicts/arguments and attachment disruptions.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Faced with many patients with comorbid severe mental illness and substance use disorders, a university-affiliated, inner-city community mental health center and a psychosocial rehabilitation center initiated this clinical trial assessing a program to care for these patients. Fifty-four patients, age 18 to 10, with either schizophrenia or major affective disorder and a substance use disorder were randomly assigned to usual community mental health center and rehabilitation services with or without an innovative group and intensive case management program. One-year follow-ups detected no significant advantages on patient outcomes for adding the innovative program to usual services. Failure to engage patients in the experimental program posed a major and enduring barrier to treatment, despite intensive case management. Future efforts must give greater consideration to effective engagement techniques and patients' readiness for active treatment.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study examined the specificity of vegetative and psychological symptoms of depression among 66 patients with acute traumatic brain injury followed over 1 year. The median frequencies of vegetative and psychological symptoms among patients with depressed mood were 3 and 3. These frequencies were three times the respective rates among nondepressed patients. Although change in self-attitude and subjective anergia distinguished depressed from nondepressed patients throughout the 1-year follow-up, some symptoms, such as early awakening and difficulty concentrating, distinguished groups only after 6 months. If diagnostic criteria for major depression were modified to include onlyspecificsymptoms of depression, the standard (i.e., unmodified) DSM-III-R still had a 100% sensitivity and 94% specificity at the initial evaluation and 80% and 100%, respectively, at 1 year. There were almost no patients with depressive symptoms without a depressed mood (i.e., “masked” depressions). These findings suggest that DSM-III-R criteria for major depression are useful, oven in an acute head-injured population, but also suggest that the nature of posttraumatic brain injury depressive disorder may change over time.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A series of 309 admissions to a stroke unit was examined for anxiety symptoms. Patients were diagnosed with DSM-III-R generalized anxiety disorder (CAD) symptom criteria. They were divided into groups of no anxiety (59.2%), worried but not fulfilling GAD criteria (13.9%), and GAD (26.9%). Patients were then divided into depressed and nondepressed groups based on the existence of DSM-III major or minor (dysthymic) depression. These groups were not significantly different in their background characteristics, family or personal psychiatric history, social support or the severity of physical impairment. Anxiety plus depression was associated with left, cortical lesions, whereas anxiety alone was associated with light hemisphere lesions. Patients with worry had anterior and patients with GAD had posterior right hemisphere lesions. These findings suggest that anxiety disorder (independent of depression) is not related to background characteristics or to severity of impairment but is, in part, influenced by the brain structures that are injured.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Deficits in executive, frontally mediated attention processes have been observed in substance abusers. A significant rate of childhood histories of attention deficit hyperactivity disorder has also been reported in this population, creating the question of whether attention problems predated addiction or were secondary to neurological drug or alcohol effects in pathological gamblers. To address this issue, the current study compared 33 non-substance-abusing pathological gamblers with 33 nonaddicted controls on nine attention measures and childhood behavior questionnaires. Gamblers performed significantly worse than controls on higher order attention measures and reported more childhood behaviors consistent with attention deficits. Results suggest attention deficits may be a risk factor for development, of addictive disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study's purpose was a) to determine the prevalence of DSM-III-R disorders in newly arrived ethnic Vietnamese and ethnic Chinese refugees from Vietnam and b) to determine the correlates of DSM-III-R disorders. A Vietnamese-speaking psychiatrist administered translated sections of the Structured Clinical Interview for DSM-III-R to 201 Vietnamese new arrivals undergoing mandatory health screening. Overall, 18.4% had one or more current disorders: 8.5% had adjustment disorder and 5.5% had major depression. Ethnic Vietnamese, compared with ethnic Chinese, had significantly (p< .05) higher rates of current posttraumatic stress disorder and generalized anxiety disorder. Ethnic differences in psychopathology were largely explained by the fact that ethnic Vietnamese refugees had experienced more traumatic events and separation from family. After adjusting for ethnicity, refugees who reported traumatic events, refugees who were married, and veterans were significantly (p< .05) more likely to have one or more psychiatric disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The magnitude of depressive morbidity as well as its significant sociodemographic and disease-related correlates were investigated in a sample of 180 adult diabetic patients attending an outpatient clinic in ‘Zagreb, Croatia (formerly Yugoslavia) in 1989. Results using the Zung Self-Rating Depression Scale yielded a prevalence rate of 60.5% with 10% manifesting severe levels of depressive symptoms. Significant correlates of higher symptoms included older age, female gender, unmarried status, less education, the presence of diabetic complications, longer duration of the disease, more demanding diabetic regimens, and poorer adherence to the regimen. The lowest coefficient was for level of glycosylated hemoglobin (r= .04), indicating a weak relationship between diabetic control and depressive symptoms. Findings are discussed in relation to other epidemiological surveys of depression and to the deteriorating economic and political situation in Croatia. The implications of untreated depression for diabetic self-care are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The use of specified diagnostic criteria is part of routine psychiatric practice and research. However, there is evidence that the same criteria may be interpreted and applied differently at different research centers. The next, question is whether it is possible to detect these systematic inter center differences in diagnostic practices. An inexpensive, nonlaborious, standardized method is needed that can easily be used at any site. In the present report, we demonstrate how self-report questionnaires can provide a method of detecting systematic differences in the application of contemporary diagnostic criteria. Sixty consecutively admitted inpatients with nonpsychotic major depressive disorder were interviewed with standardized schedules and diagnosed according to two interpretations of the Research Diagnostic Criteria (RDC) and DSM-III endogenous/melancholia criteria. The patients also completed the Inventory to Diagnose Depression, a self-report scale designed to diagnose major depression and subtype patients according to RDC and DSM-III endogenous/melancholia criteria. The interview to self-report, ratio for diagnosing endogenous depression and melancholia was associated with diagnosticians' interpretation of the criteria. A broader application of the criteria resulted in a higher ratio. A paper-and-pencil questionnaire could be useful in detecting systematic interinvestigator differences in the broadness or narrowness with which criteria are applied. The advantage of a sell-report scale is that it is free from systematic biases and tendencies of clinician raters. Of course, ratings on questionnaires are not free of bias; however, it is less likely that differences between samples will reflect asystematicvariation in response set.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID