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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because alcoholism is a highly heritable condition, children of alcoholics, especially sons, are at much higher risk than the general population for developing the disorder. Furthermore, secular trends are apparent for both sons and daughters of alcoholics, such that alcoholism has become more prevalent over time, increasing the morbid risk in offspring of alcoholics. Increases in prevalence of disorders known to be associated with alcoholism, such as conduct disorder, depression, and drug abuse, have also been found in younger cohorts, as well. At the genetic level, alcoholism appears to be heterogeneous, raising the possibility that alcoholism may be a product of numerous different kinds of gene-environment interactions. Further advances in our understanding of alcoholism will come from molecular genetic studies and longitudinal studies of high-risk populations.
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PMID:Epidemiological perspectives on children of alcoholics. 175 88

In this article, we present data obtained with the psychosocial interview instrument, HEADSS (Home, Education, Activities, Drug use and abuse, Sexual behavior, Suicidality and depression) that was administered to High Risk Youth Clinic clients at their initial visits during a 1-year period. Of the 1,015 new patients, 63% were homeless/runaway youths and 37% were living with their families. Utilizing the HEADSS interview instrument, we compared homeless/runaway youths to nonhomeless youths in a number of areas, including risks for human immunodeficiency virus (HIV) infection. Our results showed that homeless teens tended to be younger, female, and white compared to their nonhomeless counterparts. They were more likely to have dropped out of school and were far more likely to be depressed and actively suicidal. They demonstrated all forms of drug abuse. They engaged in first sexual intercourse at an earlier age, and experienced a higher incidence of sexual abuse and prostitution. They were 6 times more likely to be at risk for HIV infection.
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PMID:HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. 177 92

All initial visits (n = 620) of runaway/homeless youths to an outpatient medical clinic over a 12-month period (July 1988-June 1989) were analyzed. Of these visits, 467 made by youth not involved in prostitution were compared with 153 visits by youth who were involved. According to the data from an adolescent risk profile interview, homeless youth involved in prostitution are at greater risk for a wide variety of medical problems and health-compromising behaviors, including drug abuse, suicide, and depression. The implications for public health and social policy are discussed.
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PMID:A risk profile comparison of homeless youth involved in prostitution and homeless youth not involved. 177 93

This paper explores the contribution of unconscious and experiential factors in accounting for the high rates of depression, alcohol and drug abuse and suicide within the medical profession. The first part of the paper reviews the literature on motivations to study medicine and proposes that, for some doctors, a component of their decision is a response to unconscious drives to compensate for childhood experiences of parental impotence, or emotional neglect. The second part of the paper utilizes the theoretical framework of Kohut to argue that these childhood experiences may also result in the development of a narcissistic disturbance, and a vulnerable self-esteem. A model is outlined of how this may contribute to the development of emotional distress and psychiatric illness through the creation of a state of dependence on patients, emotional detachment and the denial of personal vulnerability. It is proposed that preventative strategies will need to include changing the emotionally 'abusive' nature of medical education, which tends to exacerbate this process.
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PMID:Predisposition to emotional distress and psychiatric illness amongst doctors: the role of unconscious and experiential factors. 178 25

In an interdisciplinary study starting 2.5 years ago patients with various symptoms, which they associate with amalgam fillings, were examined. According to the first results of this study with 50 patients, the Hg-concentration in urine does correlate with the amount of amalgam fillings before and after taking DMPS (2,3-Dimercapto-1-propane-sulfonic-acid), but with a maximum of 66.4 micrograms Hg (24 h urine) the amounts of mobilization measured were significantly below toxicologically critical limits. Only in 3 patients did the individual immunological values (CD4/8 ratio, antinuclear antibodies) by far exceed standard values. In one case an allergy to amalgam is suspected. 40% of the patients showed a pathological psychiatric status (neurosis, depression, etc.). Another quarter had psychological problems like alcoholism or drug abuse. There is no reason at the moment to reject amalgam as filling material either because of the measured Hg-concentrations or because of any immunological or allergological findings.
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PMID:[Adverse side effects of amalgam? An interdisciplinary study]. 181 25

This paper reviews psychologic aspects of sexual abuse in female adolescents. It documents that sexual abuse is widespread, occurring at an alarming rate at all socioeconomic levels of society. It is perpetrated principally by adult men in the victim's family. Often its effects are tragic. Adolescent female sexual abuse victims are at high risk for subsequent acting out behavior, sexual promiscuity, physical and sexual abuse, anxiety, depression, low self-esteem, alcohol and drug abuse or dependence, chronic sleep disturbance, dissociative disorders, eating disorders, emotional numbing, dissociation, guilt, shame, hyperalertness, suicidal ideation, and multiple associated psychiatric disorders. Although it may appear at a surface level that sexual abuse victims recover from such abuse, follow-up studies suggest that many remain disabled long after the abuse has ended. Health care professionals should be especially cognizant of the magnitude of the impact of sexual abuse on adolescent girls and recognize the need of these patients for psychologic and medical services.
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PMID:Psychologic aspects of sexual abuse in adolescence. 181 20

Children with conduct disorder have long been known to be at high risk for developing externalizing disorders, alcohol and drug abuse, and antisocial personality. Relationships of conduct disorder to other adult psychiatric disorders, on the other hand, have not been definitively shown. Taking advantage of the large community sample (N = 19,482) interviewed in the NIMH Epidemiologic Catchment Area Program, the authors examined the effects of childhood conduct problems on ten DSM-III psychiatric disorders: somatization, phobia, panic, obsessive-compulsive, depression, mania, alcohol use disorder, drug use disorder, schizophrenia and antisocial personality. Each of the ten adult disorders showed an increase in prevalence with an increasing number of conduct problems, although effects were stronger for externalizing disorders. The predictive power of conduct problems was similar for males and females. The effect of conduct problems on nonexternalizing disorders was found to be largely mediated through externalizing disorders, particularly for men but direct effects also occurred for both sexes. These findings raise questions about the conventional view of psychiatric disorders as divisible into externalizing and internalizing disorders. They also suggest that the increasing rates of conduct problems in younger cohorts may be responsible in part for the rising rates of other disorders. Thus, prevention of and early intervention with conduct disorder may hold promise for reducing rates of a broad range of disorders.
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PMID:Adult disorders predicted by childhood conduct problems: results from the NIMH Epidemiologic Catchment Area project. 185 46

The Millon Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuse, Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.
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PMID:An MCMI-II item-level component analysis: personality and clinical factors. 195 78

There are increasing numbers of reports on the tobacco smoking and ingestion of abused drugs (e.g. morphine, cocaine) by pregnant women and the effects of the substances on the developing fetus and newborn infant. The passage of drugs and chemicals from the mother to the fetus is influenced by the placental transport and metabolism of the substances. Further, these drugs and chemicals affect the nutrient transport systems in the placenta. The three major drugs of abuse-nicotine, morphine and cocaine-depress both active amino-acid uptake by human placental villi and transplacental amino-acid transport by reason of the drugs' influence on placental cholinergic and opiate systems. Part of this depression (10-16%) is not reversible. Nicotine blocks the cholinergic receptor and thus blocks acetylcholine (ACh)-facilitated amino-acid transport. Morphine stimulates opiate kappa receptors and depresses ACh release. Cocaine blocks Ca2+ influx and thus blocks ACh release. ACh causes dilation of blood vessels and maintains placental blood flow by the activation of endothelial muscarinic receptors. By interfering with ACh release and placental blood flow, the three drugs of abuse may depress the diffusion of amino acids and other nutrients from the trophoblast into the placental circulation. Three regulatory systems are delineated for amino-acid uptake by the placenta: placental ACh, phospholipid N-methyltransferase, and the gammaglutamyl cycle. These systems operate in concert with one another and are dependent on cellular formation of adenosine 5'-triphosphate (ATP). Placental hypoxia induced by carbon monoxide and other tobacco gases depresses the energy-dependent processes and thus the ATP levels of placental cells. Maternal tobacco smoking and drug abuse cause placental insufficiencies for amino-acid transport, which may partially explain the fetal intrauterine growth retardation caused by these substances. Part of the amino-acid deficits may be compensated for by the induction of new amino-acid transport systems. Specific receptors or drug-binding proteins for the three drugs of abuse are present in the placenta. A DNA adduct selective for maternal smoking has been demonstrated in the placenta. DNA adducts selective for cocaine, morphine and other environmental chemicals have yet to be demonstrated ins the placenta.
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PMID:Placental toxicology: tobacco smoke, abused drugs, multiple chemical interactions, and placental function. 195 23

Previous research has documented high rates of major depression and antisocial personality in opiate addicts. This study was designed to investigate the relationship of dual diagnosis in opiate-addicted probands to family history of psychiatric disorders and substance use disorders in biological relatives. Psychiatric disorders and substance use disorders were evaluated using direct interview and family history in a sample of 877 first-degree relatives of 201 opiate addicts and 360 relatives of 82 normal controls. Results indicate that (1) compared with relatives of normal subjects, opiate addicts' relatives had substantially higher rates of alcoholism, drug abuse, depression, and antisocial personality; (2) relatives of depressed opiate-addicted probands had elevated rates of major depression and anxiety disorders but not of other disorders, suggesting the validity of subtyping opiate addicts by the presence or absence of major depression; and (3) in contrast, relatives of antisocial opiate addicts had rates of disorders that were not significantly different from those of relatives of opiate addicts without antisocial personality. Implications of these findings for the classification and treatment of substance abuse are discussed.
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PMID:Psychiatric disorders in relatives of probands with opiate addiction. 198 60


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