Arch Gen Psychiat
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A survey evaluated the lifetime and current prevalence of mental disorders in 501 patients seeking assistance with alcohol and other drug problems at an addiction research and treatment facility. Information was gathered using the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and computer diagnoses were generated according to DSM-III criteria. Four fifths (78%) of the sample had a DIS lifetime psychiatric disorder in addition to substance use, and two thirds (65%) had a current DIS mental disorder. ⋯ Patients who abused both alcohol and other drugs were the most psychiatrically impaired. Patients with DIS psychiatric disorders had more severe alcohol and other drug problems. Barbiturate/sedative/hypnotic, amphetamine, and alcohol abusers were the most likely to have a DIS mental disorder.
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We studied the six-month prevalence of four child psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization) and patterns of service utilization for mental health and social services, ambulatory medical care and special education by different regions of Ontario, urban-rural residence, and age and sex groupings. Among children 4 to 16 years of age, the overall six-month prevalence rate of one or more of these disorders was 18.1%. The prevalences of hyperactivity and one or more disorders were significantly higher in urban areas than rural areas. ⋯ Over 50% of the children in the province had received ambulatory medical care in the last six months. Over 15% of the children in the province had received special education services at some time thus far in their school careers. Implications of these findings, especially for the provision of child mental health services, are discussed.
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Randomized Controlled Trial Clinical Trial
Adjunctive imipramine in the treatment of postpsychotic depression. A controlled trial.
The efficacy of adjunctive imipramine hydrochloride treatment for syndromally defined postpsychotic depression was assessed in a six-week, double-blind, placebo-controlled study. All patients had been diagnosed as having schizophrenia or schizoaffective disorder, all were receiving stable doses of fluphenazine decanoate, and all had received benztropine mesylate in an attempt to rule out neuroleptic-induced akinesia. ⋯ There were no significant differences in outcome psychosis ratings or side effects. This study indicates the existence of an identifiable syndrome of secondary depression in this patient group that is likely to respond favorably to treatment with adjunctive imipramine.
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Comparative Study
Comparative studies of thought disorders. II. Schizoaffective disorder.
We examined thought disorder in 22 patients with schizoaffective disorder (12 schizoaffective-manic and ten schizoaffective-depressed) using Research Diagnostic Criteria. The Thought Disorder Index was used to tag 22 categories of thought disorder that ranged from mild to severe. Qualitative patterns in the thought disorder of schizoaffective patients were compared with those of 20 manic and 43 schizophrenic patients. ⋯ The schizoaffective-manic patients, like the schizophrenic patients, produced a high number of responses in the categories of idiosyncratic verbalizations, autistic thinking, and confusion. Unlike the manic patients, schizoaffective-depressed patients generally produced a few absurd and idiosyncratic responses in a setting of constricted output. The data strongly suggest that the thinking disorders of schizoaffective patients are like those of the schizophrenic patients.