Schizotypal personality disorder in an outpatient population: incidence and clinical characteristics.

The incidence and clinical characteristics of DSM-III Schizotypal Personality Disorder (SPD) were explored in a series of 76 consecutive outpatients. Ten patients (13.2%) met DSM-III criteria for SPD. Patients with SPD were significantly more likely to receive a diagnosis of drug abuse or dependence and tended to exhibit a higher rate of major affective disorders than did the non-SPD group. Patients with SPD were rated as significantly more severely disturbed than non-SPD patients on the Global Assessment Scale for the current episode and the worst lifetime episode of disorder. In addition, SPD patients were significantly more likely to have histories of psychiatric hospitalization and attempted suicide and first received treatment at a significantly younger age than did non-SPD patients. These results indicate that SPD is relatively common in outpatient settings and is associated with particularly severe psychopathology.

Self-reported depression in adolescent cancer patients.

The prevalence of depression was studied, using the Beck Depression Inventory (BDI) and Schedule for Affective Disorders and Schizophrenia (SADS), in a sample of 30 adolescent cancer patients. BDI scores revealed that 26 patients (87%) were not depressed, 4 (13%) were moderately depressed and no one had severe depression. Similarly, SADS data indicated no history of depression in 75% of the sample, and histories of minor and major depression in 14 and 10% of the sample, respectively. Females scored significantly higher (p less than .05) than males on BDI physical, but not psychological, items. The average response to BDI physical items was significantly greater (p less than .05) than to psychological items, suggesting that somatic symptoms are more salient than psychological symptoms of depression among adolescent cancer patients. Overall, however, as compared with norms, the rate of major depression among adolescent cancer patients is not greater than that for the population at large. These data do not exclude the possibility of masked symptoms, which only under stringent conditions will become obvious.

The role of parent-adolescent concordance in compliance with cancer chemotherapy.

In an attempt to examine factors affecting compliance with orally administered chemotherapy agents, we have examined the relation of agreement of parents and their adolescent children on various treatment-related issues and compliance with cancer chemotherapy. In a longitudinal study, 16 parent/cancer patient pairs were interviewed regarding their knowledge and understanding of illness, medications, and treatment, and their medication compliance. Adolescent responses matched closely those of parents on topics pertaining to medication dose, frequency, number, and purpose. Age was positively correlated with agreement for medication instructions. Disagreements were more commonly found in patients under 17 years of age. Compliance was greater when parents and patients agreed on who was responsible for medication administration, and on their understanding of medication instructions, number, and effectiveness. Treatment of the adolescent oncology patient should include consideration of psychosocial developmental factors, encourage parent-child communication, and place less reliance on self-administered therapy.

Discriminant validity of the General Behavior Inventory: an outpatient study.

Recent studies have provided strong support for the convergent validity of the General Behavior Inventory (GBI), a case identification inventory for chronic subsyndromal affective disorders (cyclothymia and dysthymia). Fewer data are available, however, on the ability of the GBI to distinguish chronic subsyndromal affective disorders from other forms of psychopathology. In order to address this issue, outpatients with cyclothymia (n = 9), dysthymia (n = 26), nonchronic major depression (n = 16), and nonaffective psychiatric disorders (n = 30) were compared on the GBI. Diagnoses were derived blind to GBI scores using structured diagnostic interviews and DSM-III criteria. The inventory significantly discriminated cyclothymes and dysthymes from patients with nonchronic major depressions and nonaffective disorders. Using the cutoff score that maximized GBI-diagnosis concordance, the inventory correctly classified 88% of the sample. All of the cyclothymes, 92% of the dysthymes, 87% of the patients with nonaffective psychiatric disorders, and 75% of the nonchronic major depressives were correctly classified by the inventory. These data provide strong support for the discriminant validity of the GBI.