Estrogen therapy and aggressive behavior in elderly patients with moderate-to-severe dementia: results from a short-term, randomized, double-blind trial.

The authors used a randomized, double-blind, placebo-controlled clinical trial study design to investigate the efficacy and safety of short-term estrogen therapy in decreasing aggressive behaviors in elderly patients with moderate-to-severe dementia. Estrogen therapy was associated with lower total aggression scores (P<0.030) and with decreased frequency of physical aggression (P<0.019) over the 4-week trial. Verbally aggressive behaviors were decreased relative to control subjects, although this effect was not statistically significant. No drug-vs.-placebo differences were found for resistive, sexual, or self-directed aggressive behaviors. No adverse effects from the estrogen were observed during the course of the study.

Diagnostic patterns of social phobia. Comparison in Tokyo and Hawaii.

A comparison was made of the diagnosis of social phobia by Japanese psychiatrists in Tokyo and American psychiatrists in Hawaii. A brief segment of videotaped interviews and written case histories of four Japanese patients from Tokyo and two Japanese-American patients from Hawaii, who were clinically diagnosed with social phobia, were presented to the clinicians for their diagnosis. Japanese psychiatrists tended to diagnose social phobia congruently for the Japanese cases but not for the Japanese-American cases. American psychiatrists tended to diagnose various categories including anxiety disorder and avoidant personality disorder, in addition to social phobia, disregarding the ethnic background of the patients. This illustrates that the diagnostic pattern for social phobia varied considerably between psychiatrists of these two countries. The reasons considered are the patient's cardinal symptom manifestation, style of problems presentation, as well as the clinician's professional orientation and familiarity to this particular disorder.