摘要:

Forty follow-up studies of anorexia nervosa and bulimia nervosa are reviewed. Data on recovery, relapse, and crossover are presented in addition to data on mortality, weight, eating behavior, menses, psychological functioning, and psychosexual functioning. Predictors of these outcomes are discussed. Guidelines for future research are suggested to decrease the variability that is created by differences in research methodologies and study designs.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We compared 23 obese subjects meeting DSM-III criteria for bulimia with 47 obese nonbulimic subjects and 47 normal-weight bulimic subjects using structured diagnostic interviews. The obese bulimic subjects were similar to the normal-weight bulimic subjects but different from the nonbulimic obese subjects in exhibiting a high lifetime rate of major affective disorder. However, the obese bulimic subjects were much less likely than the normal-weight bulimic subjects to use self-induced vomiting as a method of purging. These results suggest that obese individuals with bulimic symptoms may constitute a sizable but little-recognized population. Further studies will be required, however, to assess whether the syndrome of bulimia in obesity represents a valid diagnostic entity.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Oral contraceptive (ORC)-related depression and irritability are among the most commonly reported drug-induced psychiatric symptoms. To investigate the etiological role of genetic factors in ORC-related symptoms, we studied questionnaire responses in 715 monozygotic and 416 dizygotic volunteer twin pairs concordant for ORC usage. Biometrical genetic analysis indicated that the liability to ORC-related depression was clearly influenced by genetic but not familial-environmental factors. Similar, but less definitive, results were found for ORC-related irritability. Multivariate genetic analysis indicated that both the genetic and the individual-specific environmental factors that influenced the liability to ORC-related depression and irritability were largely distinct from those that influence baseline levels of psychiatric symptoms. Genes play an important etiological role in ORC-related psychiatric side effects. The genes that influence liability to these side effects appear to differ from those that are etiologically important in baseline psychiatric symptomatology.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The use of emergency room time by medical and psychiatric clinicians evaluating psychiatric patients was studied. The amount of time to the completion of the medical and the psychiatric evaluation and the actual amount of time of the psychiatric evaluation were compared over demographic, admission, diagnostic, and referral factors. Evaluations were completed closer to admission with patients admitted during the day and evening shifts and with patients having more obvious psychiatric problems, i.e., brought involuntarily, with a known psychiatric history, given a psychotic diagnosis in the emergency room, or subsequently sent to a psychiatric hospital. Such factors failed to affect the actual length of the psychiatric evaluation. The multiple time pressures in an emergency room setting appeared to affect when, but not how long, clinicians evaluated psychiatric patients. The time that emergency room clinicians take to begin evaluations of psychiatric patients may reflect important observational data that affect their temporal, diagnostic, and recommended treatment patterns.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The interrelationships among the severity of alcoholism, psychopathology/personality, and the degree of familial alcoholism were examined using the following four familial alcoholism classification schemes, which each differentiated three degrees of familial alcoholism: 1) conventional, compared alcoholics with no, nonparental, and parental alcoholic relatives; 2) lineality, distinguished between subgroups with alcoholism in neither, one, or both sides of their family; 3) generational, compared alcoholics having no, one, or two generations of familial alcoholism; 4) quantitative, credited one point for each first-degree and 1/2 point for each second-degree alcoholic relative.The subjects were 83 male alcoholic Veterans Administration inpatients 50 years of age or under. The Alcohol Use Inventory, various alcohol-related symptoms and behaviors, and laboratory values were used to evaluate the severity/pattern of alcoholism. Psychopathology/personality were measured by the MMPI, the Psychopathic State Inventory, the Mac-Andrew Alcoholism Scale, the Childhood Problem Behaviors Questionnaire, and the percentage of patients with an antisocial personality disorder (ASP) diagnosis.Surprisingly few subgroup differences were revealed in the severity/pattern of alcoholism. Only age at time of treatment and use of nonalcoholic drugs were associated with increasing familial alcoholism. On the other hand, childhood behavior problems, particularly antisocial behavior, and an ASP diagnosis were found to be associated with an increasing degree of familial alcoholism. The diagnosis of ASP was most apparent in the two-generational and bilineal alcoholics, while an increased degree of familial alcoholism was not associated with ASP for the conventional classification. Bilineal familial alcoholics also exhibited an MMPI profile reflective of a characterological disorder. The lineality classification appeared to be the most sensitive and the conventional scheme the least sensitive to differentiations in the variables studied. These findings underline the limitations of dichotomous classifications for the study of familial alcoholism. Two explanations for the high prevalence of ASP in bilineal and two-generational familial alcoholics are discussed—the character spectrum disorder hypothesis vs. the independent transmission of ASP.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

During a 2.5-year follow-up of opioid addicts, we examined psychosocial antecedents and consequences of the onset and remission of cocaine abuse. Patients who never used cocaine were compared with those whose use increased or decreased along several dimensions of treatment outcome including drug abuse, legal, employment, family, social, psychological, and medical problems. Cocaine abuse had a marked impact on almost every outcome area except medical problems. Patients whose cocaine use increased during follow-up had more severe problems than either those whose use decreased or those who never used cocaine. Furthermore, the attainment of cocaine abstinence among abusers was associated with improved psychosocial functioning, whereas the onset of cocaine abuse was associated with increased problem severity. Compared with drug-free and detoxification alone treatments, methadone maintenance may minimize legal complications of cocaine abuse, but otherwise it did not significantly reduce psychosocial morbidity from increasing cocaine abuse. These findings suggest that treatment-seeking opioid addicts are vulnerable to wide-ranging deterioration when they become increasingly involved with cocaine but that with the attainment of abstinence many problem areas improve.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Numerous reports suggest that medical school has adverse psychological effects on medical students, although not all students are affected equally. The authors examined the effects of two social motives, the need for power and the need for intimacy, on measures of well-being and distress obtained throughout the undergraduate years. Medical students high in both power and intimacy motivation were more depressed, neurotic, fatalistic, and self-doubting than were their classmates. These effects began at the end of year 1, peaked in year 2, and disappeared by the end of clerkships. High intimacy-low power students had the highest levels of well-being. These effects were equally true in men and women and both support and render more precise prior role conflict explanations.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Among the various reported neuropsychological effects of electroconvulsive therapy are amnesia, delirium, peripheral neuropathy, headaches, and seizures. A case history is presented that describes a previously unreported neurological sequela: the development of intractable yawning during a course of electroconvulsive therapy. Neuropathophysiological mechanisms possibly relating to this phenomenon are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1988

数据来源: OVID