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

Obsessive-compulsive disorder is a well-defined clinical syndrome that has been difficult to treat with standard psychotherapies and medications. Data accumulated over the last decade have demonstrated that the disorder is relatively common and frequently coexists with phobia, depression, and alcohol abuse. The authors review current studies of the spectrum of obsessive-compulsive disorder and related disorders that respond to the new serotonergic antidepressants and behavioral therapy. Differential diagnosis, epidemiology and comorbidity, etiology, evaluation, and psychologic and pharmacologic treatments are discussed. Most patients with obsessive-compulsive disorder require long-term treatment with drugs, but behavioral therapy has also been used successfully. Serotonin reuptake inhibitors used in the treatment of depression have been found effective; clomipramine has produced the best results in large-scale tests. The fact that serotonin reuptake inhibitors are effective as both antidepressants and antiobsessional agents suggests common biological factors in disorders that respond to these drugs.
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PMID:Obsessive-compulsive disorder. 151 99

The dependence syndrome concept, developed for alcohol and extended to other abused substances, postulates that its elements form a continuum of severity. Dependence severity should predict treatment success if this concept has predictive validity. Because most studies that examined this aspect of validity used alcoholic populations, we undertook the present 1-year follow-up of 48 opiate addicts to investigate whether dependence severity predicted program retention, treatment compliance, and psychological functioning. We also controlled demography, withdrawal severity, and substance use frequency. The best predictor of program retention was the addicts' rating of substance use frequency. Severity of opiate dependence predicted program retention in White addicts only. For non-White opiate addicts, concurrent depression and cocaine abuse had much greater association with program retention compared to dependence severity.
Am J Drug Alcohol Abuse 1992
PMID:The predictive validity of the dependence syndrome in opiate abusers. 156 12

Chronic alcoholics are all too often not recognized in general practice. Diagnosis is only possible if the doctor assumes potential alcoholism in all his patients. Because of the tendency of the patient and often his family to deny alcohol dependence, diagnosis is only possible by taking psychiatric, somatic and psychosocial aspects into consideration in addition to an independent history. Questionnaires may be helpful. The severity of the dependence on alcohol is not a predictor of success in therapy. In practice, three types of alcoholics may be distinguished: (1) patients with stable social relationships; (2) patients with stable social relationships and severe anxiety or depression with alcohol abuse as an inadequate self medication; (3) patients who are not able to maintain stable relationships. The latter are unlikely to be successfully treated by a family physician. A careful classification of patients according to these simple criteria may reduce the rate of treatment failures. Therapy by the family physician is initiated with an extensive somatic, psychiatric and psychosocial work-up, and maintained by counseling and care. An important factor is close collaboration between physician and social worker. Disulfiram may be a powerful adjunct to the therapy of the family physician if supervised by a trustee. In our departments we work with alcoholics in a joint consultation service involving an internist and a psychiatrist. Two thirds of the patients who consent to supervised disulfiram remain in the program for a year. 3 months after initiation of the treatment, gamma-glutamyltransferase, ASAT, ALAT and MCV are normalized. A follow-up 5 years after treatment indicated the efficacy of this treatment.
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PMID:[What does the alcoholic patient need from his family physician?]. 158 34

As part of a systematic research project on the influence of gender factors on age at onset, symptomatology, and course of schizophrenia, data on gender differences in age at onset and symptomatology of schizophrenia from the WHO Collaborative Study "On Assessment and Reduction of Psychiatric Disability" were compared between seven research centres of three different cultural regions. Results on age at onset of five European centres confirmed the well known fact of an earlier onset in men. The earlier onset in women seen in Khartoum and Ankara could be attributed to patient selection because male/female differences in age at onset and male/female ratios in the various samples covary. In the Islamic centres no relevant gender differences in real age at onset and in symptomatology could be detected as probable causes of earlier hospitalisation of women. Major gender differences in symptomatology were found in the Balkan centres of Sofia and Zagreb with a high prevalence of delusional symptoms in women and depression in men. In Western Europe centres, nuclear schizophrenic symptoms were equally prevalent in either sex, while nonspecific symptoms like irritability and tiredness (more frequent in women) and maladaptive illness behaviours like alcohol abuse and social withdrawal (more frequent in men) differed between the sexes. Explanatory hypotheses and the implications of these results are discussed.
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PMID:Gender differences in schizophrenia in three cultures. Results of the WHO collaborative study on psychiatric disability. 162 Nov 35

This study compared male and female alcoholics in terms of family history of alcoholism, Antisocial Personality (ASP), and depression on the course, consequences, and 1-year treatment outcome. The sample included 266 subjects (197 men and 69 women) who were hospitalized for treatment of alcoholism from three facilities in the greater Hartford area. Female alcoholics reported higher rates of alcoholism among their fathers than men across all diagnostic categories. Both male and female alcoholics who were diagnosed as having ASP reported higher alcoholism among their fathers than those with depression or no other diagnoses. Male alcoholics reported a longer duration of alcohol abuse and a higher number of lifetime alcohol-related problems than women. Subjects with ASP reported more childhood behavior problems, higher levels of alcohol consumption, and more affective and physical disturbances in the month prior to hospitalization whereas no gender differences were found on those variables. ASP alcoholics reported poorer 1-year treatment outcomes than non-ASP alcoholics. Males who were diagnosed as having depression tended to relapse, although the diagnosis of depression tended to modify the rate of relapse among women. The rate of depression was higher among women than men at the 1-year follow-up.
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PMID:Gender comparison of antisocial personality disorder and depression in alcoholism. 166 27

A survey of 989 college students was conducted to investigate risk factors--gender, family history of alcohol abuse, family history of depression and mental illness, childhood hyperactivity, and antisocial personality-associated with alcohol abuse. Two hundred ninety-four subjects (29%) completing the alcohol subscale of the Diagnostic Interview Schedule met lifetime DSM-III criteria for alcohol abuse. Utilizing a loglinear model, expression of childhood and early adolescent deviant behavior, family history of depression, and gender were shown to be significantly associated with alcohol abuse among students.
Am J Drug Alcohol Abuse 1991
PMID:Risk factors associated with alcohol abuse in college students. 174 6

Buprenorphine is a mixed opioid agonist/antagonist which appears to produce less physical dependence and respiratory depression than typical mu-agonist opioids. These effects suggest its use for analgesia for drug abusers. However, buprenorphine may precipitate withdrawal from other opioids. The present case illustrates the utility of buprenorphine and describes a method to transfer a patient from a mu-agonist to buprenorphine without precipitating withdrawal or interrupting analgesia.
Am J Drug Alcohol Abuse 1991
PMID:Buprenorphine for pain relief in a patient with drug abuse. 174 7

The authors review both the preclinical and the clinical evidence for a role of serotonin (5-HT) systems in the regulation of drug-taking behavior. Animal studies show that pharmacologic treatments that enhance 5-HT function, notably selective reuptake inhibitors, reduce the self-administration of a variety of substances of abuse, including ethanol and cocaine. These treatments also tend to suppress consummatory behavior in general. In contrast to the broad spectrum of suppression following 5-HT enhancement, selective antagonists at the 5-HT3 receptor subtype have been reported to reduce ethanol but not cocaine or food intake. Although essentially limited to alcohol abusers, clinical studies seem to support the preclinical findings that a number of 5-HT reuptake inhibitors decrease interest in and intake of alcohol in mild-moderate ethanol-dependent individuals. Furthermore, other serotonergic drugs may show utility in the treatment of alcohol abuse. Another way in which serotonergic medications can be used in treating substance abuse is by the treatment of comorbid psychoactive illness for which such drugs are already known to be effective, e.g., depression and anxiety disorders.
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PMID:Opportunities for treatment of psychoactive substance use disorders with serotonergic medications. 175 60

Thirty alcoholics treated as inpatients were administered the Multi-phasic Questionnaire (MPQ), a short version of MMPI, to study their personality pattern. Results showed highest loading on depression (85%) and lowest on anxiety (3%). A significant correlation was found between scales of psychopathic deviance and hysteria. Age of problem drinking under 35 years and poor PQ level were found to be associated with depression and psychopathic deviance. Clinical diagnosis was corroborated by the findings of the MPQ. The findings of the present study may be utilised to screen adolescents from alcoholic families for preventive measures.
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PMID:Multi-phasic Questionnaire profile of alcoholics and related factors. 179 15

The records of 34 patients who showed evidence of emotional deterioration 6 months or more following traumatic brain injury were compared with a group of patients matched for severity of initial neuropsychiatric impairment who did not show deterioration. The deterioration group was more likely to have been involved in assaults and less likely to have been involved in a motor vehicle accident than the improvement group. The deterioration group was also more likely to have a prior history of alcohol abuse and to have sustained a skull fracture with left parietal lobe injury than the improvement group. Agitation, hostility, apathy, lability of mood, emotional withdrawal, and depression were the symptoms most likely to worsen over time. This deterioration may have been due to premorbid personality characteristics or to the nature of long-term neuronal response to injury.
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PMID:Comparison of patients with and without emotional/behavioral deterioration during the first year after traumatic brain injury. 182 Dec 28


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