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In a literary synopsis we inform about eating addiction or binges already known in antiquity and differentiated as bulimos (fames bovina) respectively as kynorexia (fames canina), partially in a still true description. The syndrome, occurring increasingly since one decade, consists of periodically pathological and excessive devouring of food, mostly consecutive restrictive diet and/or vomiting, use of laxatives, depressivity, experience of shame and guilt s.o. At a prevalency of 5% of the (psychiatric) patients mainly women (95%) are concerned, showing a postpubertary begin of disease. In spite of certain connexions to the anorexia nervosa we have to define the bulimia as its counterpart. The different etiological conceptions suppose an epilepsy-like disorder, an attachment to the (endogenic) depression or the presumption of neuro-endocrine events. Largely it is applied to intra- and interpsychical neurotic conflictuality, though actually behavioristical aspects seem to be preferred. The therapeutic intentions comprise anticonvulsives and antidepressives in view of medicamentous treatment; the psychical treatment comprises psychoanalysis, outpatient and inpatient clinical psychotherapy and all actually usual methods up to self-help groups.
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PMID:[Bulimia]. 389 7

Recent clinical observations and psychiatric diagnostic findings of drug-dependent individuals suggest that they are predisposed to addiction because they suffer with painful affect states and related psychiatric disorders. The drugs that addicts select are not chosen randomly. Their drug of choice is the result of an interaction between the psychopharmacologic action of the drug and the dominant painful feelings with which they struggle. Narcotic addicts prefer opiates because of their powerful muting action on the disorganizing and threatening affects of rage and aggression. Cocaine has its appeal because of its ability to relieve distress associated with depression, hypomania, and hyperactivity.
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PMID:The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. 2349 64

The propriety of narcotic usage at the Hadassah Hospital has been studied in 35 cancer patients and 70 post-operative patients. Eighty-three per cent of the cancer patients and 66% of the surgical patients remained in moderate to severe distress in spite of the analgesic therapy. Insomnia and anxiety, plus depression in the cancer patients, were the major results of uncontrolled pain. The inadequacy of the treatment was attributed to the incorrect selection of medication, usage "as needed' policy and smaller daily doses than advocated. This resulted mainly because of exaggeration of the risk of tolerance and addiction by both patients and personnel.
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PMID:The propriety of narcotic usage in hospitalized patients. 395 14

The empirical validity of the MacAndrew Scale was investigated in 200 adolescent males convicted of misdemeanor offenses who were classified according to their pattern of alcohol intoxication. Classification results were comparable to those from studies of adult men--true positive = 80%, false negative = 20%, true negative = 81% and false positive = 19%. An empirical cluster analysis of factor scores from the California Psychological Inventory yielded 14 personality types. About 56% of these cases resembled two character orientations (Emotional Extraversion or Emotional Introversion) that were hypothesized by MacAndrew to mediate addiction-proneness among males. However, 38.7% of these subjects were not alcohol misusers. The hypothesis that Emotional Introverts tend to be classified as false negatives was not supported--true positive = 79% and false negative = 21%. Although MacAndrew's formulation of two character orientations has heuristic value, the present study found alcohol misuse among adolescents with other personality characteristics. Studies of nonoffender adolescent males were recommended to clarify the MacAndrew Scale's sensitivity to the character orientation Emotional Introvert. Consistent with earlier research, the present study found no evidence of high levels of emotional tension in the form of anxiety or depression among adolescent alcohol misusers.
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PMID:Construct validity of the MacAndrew Scale: secondary psychopathic and dysthymic-neurotic character orientations among adolescent male misdemeanor offenders. 399 Feb 98

Application of personal construct theory to addicts in treatment led to a series of hypotheses about their psychological reactions and how these might differ with differences in their histories. Their scores on a set of content analysis scales were compared with those of a relatively non-stressed group and a relatively stressed group matched for sex and age. The chief element in the pattern of experiential elements which was identified was uncertainty. Addicts also expressed more anxiety, depression and anger (directly and indirectly) and reported fewer social interactions than the non-stressed group; however, for most of these elements they were similar to the similarly stressed group of young people with whom they were compared. The pattern of experience of addiction was found to vary according to the employment, addiction and criminal histories of the addicts, their treatment histories as represented by their counsellors' assessments of them and the social supports available to them.
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PMID:The addiction experience as a function of the addict's history. 400 73

The Beck Depression Inventory (BDI) was self-administered to 105 outpatient alcoholics and 211 methadone maintenance patients seeking treatment at a large community mental health center to determine whether or not specific depressive symptoms differentiated the groups. Canonical correlations were first calculated between the set of 21 BDI items and the patients' demographic characteristics of sex, race and age to ascertain if these characteristics should be controlled before making comparisons between the two types of substance abusers. Age and sex were significantly related to self-reported depressive symptomatology and were entered first into a stepwise discriminant analysis with the 21 BDI items followed by type of substance abuse. Four symptoms contributed at least 5% to the overall discrimination between the alcoholics and the heroin addicts; these were sense of failure, weight loss, somatic preoccupation, and loss of libido. The alcoholics described themselves as feeling more like failures and having more somatic preoccupation than the heroin addicts, whereas the heroin addicts reported more weight loss and loss of libido. To estimate the efficiency with which these four symptoms could differentiate between the alcoholics and heroin addicts, discriminant classification analysis was employed; 69.3% of the substance abusers were correctly assigned to their type of addiction. The results were discussed as supporting the contention that alcoholics and heroin addicts may display different depressive symptoms.
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PMID:Depressive symptoms differentiating between heroin addicts and alcoholics. 401 71

With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Twenty-three cocaine-using women enrolled in a comprehensive perinatal-addiction program were divided into two groups: those using cocaine only and those using cocaine plus narcotics. These two groups were compared with a group of women who had used narcotics in the past and were maintained on methadone during pregnancy, and with a group of drug-free women. All four groups were similar in maternal age, socioeconomic status, number of pregnancies, and cigarette, marijuana, and alcohol use. Their medical histories indicated that the cocaine-using women had a significantly higher rate of spontaneous abortion than the women in the other two groups. In the pregnancies under study, four cocaine-using women had onset of labor with abruptio placentae immediately after intravenous self-injection of cocaine. Neonatal gestational age, birth weight, length, and head circumference were not affected by cocaine use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of interactive behavior and a poor organizational response to environmental stimuli (state organization). These preliminary observations suggest that cocaine influences the outcome of pregnancy as well as the neurologic behavior of the newborn, but a full assessment will require a larger number of pregnancies and longer follow-up.
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PMID:Cocaine use in pregnancy. 402 59

Recent psychiatric literature is reviewed to demonstrate the general state of clinical psychiatry. The advent of chemical therapies requires that psychiatrists receive comprehensive training in organic and dynamic approaches. Consultative collaboration between psychiatrists and physicians is encouraged though there is also a conspicuous need for physician training in consultative techniques and referrals. Diagnostic classifications by the psychiatrist are discussed. Rehabilitation methods in the community and family require more research and awareness on the part of psychiatrists. The manifold variety of investigations, studies, treatments, and rehabilitation of schizophrenics is discussed at length and the often contradictory conclusions are noted. The scope of analysis and treatment of depression is reviewed and certain etiological hypotheses associated backgrounds and depression are shown to be invalid. Suicide and its prognostication is covered as well as narcotic addiction and other disorders such as hyperphagia, anorexia, and dystonia musculorum deformans. 1 study is cited, based on an investigation of 120 children born as a result of the mothers being refused an abortion, suggesting that early rejection rather than early bereavement contributes to a higher risk of psychiatric difficulties in later life.
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PMID:Clinical psychiatry. 488 Jan 69

The general public feels that cocaine is not particularly dangerous because it does not produce a well defined physical dependency and abstinence syndrome. However, when addiction is defined as compulsion, loss of control and continued use in spite of adverse consequences, cocaine drug hunger can be seen as an agent of addictive disease. Withdrawal from cocaine dependence usually involves depression, anxiety and lethargy. These usually clear within a week, leaving only the "drug hunger" to contend with. Medication is rarely needed. When cocaine is the primary addiction, after withdrawal the most effective treatment is group therapy with other recovering cocaine abusers. We incorporate the principles of recovery and define positive and constructive alternatives in dealing with cocaine hunger. Recovery programs should be flexible and involve individual and family education on recovery and the nature of addictive disease. Exercise that produces cardiopulmonary stimulation is a helpful means of reducing drug hunger and anxiety during recovery therapy.
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PMID:Diagnostic, treatment and aftercare approaches to cocaine abuse. 610 Jan 90

The action of bromazepam was assessed in 30 patients whose dominant symptom was anxiety in clinical presentations of neurosis, depression, drug-addiction or alcoholism, senile dementia or oligophrenia. The doses administered ranged from 6 to 12 mg/day and in some cases from 18 to 36 mg/day. Distinct improvement was noted in 20 patients, the effects of the drug on anxiety being manifested within 2 to 3 days. The somatic symptoms of anxiety and sleep disturbances were also improved. However, depressive and psychotic symptoms remained unchanged and it was necessary to combine diazepam with other drugs. Side-effects consisted of daytime somnolence in 2 cases and feeling of dizziness in 3 cases.
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PMID:[The action of bromazepam on anxiety (author's transl)]. 612 47


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