Psychiatric disorder in HIV infection.

OBJECTIVE: This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. METHOD: A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIV+) (79 CDC stage II/III and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version IIIR (DIS-IIIR). RESULTS: Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuse/dependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. CONCLUSIONS: Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men. In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis. The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.

Psychological and social correlates of attrition in a longitudinal study of hazardous waste exposure.

The differences between responders and nonresponders ("re(fuser)s" and "movers") in a follow-up survey of self-reported health effects associated with residing near a hazardous waste site were analyzed in this study. Responders and refusers did not differ with respect to demographic variables when comparison was made with measures from the initial survey; however, movers were more likely than refusers to be younger, to rent their homes, and to have lived in the area for the shortest period. In terms of psychological reactions, movers and refusers reported more intense worries, more stress, and more psychological intrusion about the problem than did responders. There were no differences between the groups with respect to self-reported prevalence of death and cancer, diseases, or symptoms of physical illness. The results indicated that the psychological impact of exposure to a hazardous waste site may be greatest in individuals who are lost to follow-up.

The Children's Depression Scale: assessment of factor structure with data from a normal adolescent population.

This study investigated the reliability and construct validity of the Children's Depression Scale. Data were gathered from an Australian sample of male and female students with a mean age of 14.9 years (N = 202). Factor analysis using principal components was conducted to develop a revised version of the scale. Four factors met the stipulated criteria and accounted for 54% of the variance. The revised subscales, three with five items and one with four items, were shown to have strong construct and face validity and high reliability. Further work on this measure is necessary to refine it for future research.

Suicide and community psychiatric care--a preliminary report.

A preliminary survey of 34 suicides among patients attending community services for the chronically mentally ill revealed a rate of 520 per 100,000 admitted. In contrast to earlier hospital surveys, no risk variables were identified for patients dying by suicide. Thirty-four percent of suicides occurred within one week of the last treatment and 59% within 3 months of service entry. It appears that early and intensive follow-up may be necessary to prevent suicide among patients receiving community psychiatric care.

Assessing school-related stressors and coping mechanisms in adolescents.

Despite a plethora of instruments used to measure stressors and coping mechanisms in adolescents little attention has been paid to issues of reliability and validity. In an endeavour to overcome this problem, a statistical methodology was implemented to develop scales from existing item sets. Items from Kohn and Frazer's (1986) Academic Stress Scale were combined with Strutynski's (1985) list of problems and, together with items from Patterson and McCubbin's (1987) Adolescent Coping Orientation for Problem Experiences, were administered to 1699 secondary school students in Australia. Two scale, the School Stressors Inventory for Adolescents (SSIA) and the Coping Inventory for Adolescents (CIA), were produced with five and four subscales respectively. Both have strong face and factorial construct validity, and high to modest reliability.

Cerebrospinal fluid levels of uric acid in dogs and the effect of allopurinol.

Uric acid (UA) levels in cerebrospinal fluid (CSF) were measured in 15 dogs and the entrance and effect of allopurinol, a specific inhibitor of enzyme xanthine oxidase (XO), in brain were measured by sampling CSF in dogs. Allopurinol was administered intravenously 25 mg/kg every 6 h for 48 h. Drug level as well as UA level in plasma and CSF was measured by high-performance liquid chromatography. A significant concentration of allopurinol was achieved in CSF and a remarkable suppression of CSF UA level was observed at all time points measured. Decrease of UA in CSF level was more pronounced than in plasma, and was not considered secondary to suppression of systemic XO activity. Therefore the regimen employed was proven to be sufficient to suppress XO activity in the subarachnoid space, and drug concentration observed in CSF during this period (5 micrograms/ml) is considered to be in the therapeutic range.