Vocational rehabilitation outcomes of veterans with substance use disorders in a partial hospitalization program.

The authors examined factors that influenced the employment rates of 529 veterans with severe alcohol and other substance use disorders who were being treated at an addictions partial hospitalization program. The employment rate was significantly higher for veterans who completed the hospitalization program, participated in a Veterans Industries work-for-pay program, and received drug-free supportive housing.

Some selected psychological and social characteristics of veteran psychiatric inpatients without stable housing.

In this study were compared scores on selected MMPI subscales and demographic variables from 58 veterans with stable housing and 54 veterans without stable housing. Both groups were selected from the same inpatient psychiatric treatment program at the Houston VA Medical Center. The MMPI was administered and a number of demographic variables were collected from patients' archival computerized records. Comparison of MMPI scores indicated that patients without housing had marginally significantly higher scores on the clinical research subscale PD4A (Social Alienation). They were also significantly less likely to be married or employed. Logistic regression analysis indicated that, when multiple predictors were considered, marital status was the only significant risk factor for absence of stable housing. Results underscore the relevance of social services to treatment, discharge, and rehabilitation planning when working with veterans without stable housing.

Some outcome predictors for use in vocational rehabilitation planning.

This study examined some predictor variables for positive outcome with a state vocational rehabilitation agency. Referrals to the agency from VA Counseling Psychology were analyzed to develop guidelines for identifying clients with good probability for positive outcome in their vocational rehabilitation planning. All subjects had a history of substance-abuse treatment at the Houston VA Medical Center. Analyses suggested a number of factors are relevant when assessing potential for successful vocational rehabilitation. Provision of drug-free housing, recent work history, and discharge status from a substance-abuse program were identified as relevant factors.

Platelet MAO concentration and molecular activity: II. Comparison of normal and schizophrenic populations.

Platelet monoamine oxidase (MAO B) in 59 normal and 57 RDC-diagnosed medicated and unmedicated schizophrenic subjects was analyzed for whole platelet and extracted activities, specific concentration, and molecular activity. A novel radioimmunoassay using a monoclonal antibody elicited to human platelet MAO was used. Female schizophrenics showed no differences from female normals in MAO measures; however, these data could not be clearly evaluated because of confounding effects of age and drugs. Male schizophrenics treated with neuroleptics expressed significantly reduced whole platelet MAO activity, compared to untreated male patients. Compared with normal males, male schizophrenics showed significantly lowered molecular activities, along with elevated specific concentrations, which did not appear to be explained solely by drug usage. Additional mechanisms explaining the diminished molecular activity in male schizophrenics may be the presence of an endogenous irreversible inhibitor or a genetically determined, possibly structural, variant of MAO B.

Platelet MAO concentration and molecular activity: I. New methods using an MAO B-specific monoclonal antibody in a radioimmunoassay.

New methods for determination of specific concentration and molecular activity of monoamine oxidase (MAO) in platelets are described and evaluated in parallel with specific activity measures, performed in whole platelets and platelet extracts. Platelet MAO specific concentration is determined in platelet extracts by a radioimmunoassay, using a monoclonal antibody that recognizes human MAO B, the form that occurs in platelets, but not MAO A. All four platelet MAO measures are found to be reliable and stable, and thus are suitable for long-term comparisons of normal and clinical populations, such as those reported in Part II of this report. The new measures of enzyme concentration and molecular activity make available important information about the state of MAO B molecules in a given individual that reflects the genetic expression and control of the enzyme.

Reliability and validity of emotional blunting as a criterion for diagnosis of schizophrenia.

The authors tested the usefulness of emotional blunting as a criterion for the diagnosis of schizophrenia on 130 patients with Research Diagnostic Criteria (RDC), diagnoses of schizophrenia, schizoaffective disorder, and affective disorder, using both a scale devised by Abrams and Taylor and a global item from the Schedule for Affective Disorders and Schizophrenia. Reliability for both measures was very high. The results did not support the use of emotional blunting as a value criterion for the RDC diagnosis of schizophrenia, although it may be useful in differentiating subtypes of schizophrenia and as an exclusion criterion for affective disorders. There was no advantage in using a scale rather than a single rating measure for assigning diagnoses.

Phencyclidine intoxication: assessment of possible antidotes.

Phencyclidine (PCP), a widely abused drug currently, has multiple pharmacological actions, including psychotomimetic [1], anesthetic [2], sympathomimetic [2], anticholinergic [3-7], and dopaminergic [8-10]. Similarly, PCP intoxication in man can present with diverse symptoms: schizophrenia-like delusions and hallucinations; mania; violence, dyskinetic, catatonic, or stereotyped movements; hypertension; and coma [11, 12]. There is general agreement that the treatment of PCP intoxication includes support of vital functions and acidification of the urine [13]. However, there is no known specific antidote for PCP toxicity. Although diazepam [13], haloperidol [14, 15], and chlorpromazine [16] have been reported to improve the agitation and psychotic symptoms caused by PCP, the therapeutic efficacy of these agents has rarely been documented with objective clinical measures. Recently we found that intramuscular physostigmine and haloperidol [17, 18] improved several symptoms of acute PCP intoxication as measured by the Brief Psychiatric Rating Scale (BPRS) [19].