Is a history of alcohol problems or of psychiatric disorder associated with attrition at 11-year follow-up?

Although rarely available, detailed analyses of attrition in psychiatric surveys are important because surveys of this type might be more vulnerable to follow-up losses. In this report the demographic characteristics, as well as history of alcohol problems and psychiatric disorders of responders were compared to nonresponders in an 11-year follow-up study. Data revealed few differences between responders and nonresponders. Men, those less educated, and low users of medical care were more likely to be nonresponders, as were those reporting driving trouble when drinking or a history of barbiturate abuse or dependence. A history of other psychiatric disorders was not associated with nonresponse. Refusal conversion did not change the findings; those who were converted (25% of initial refusals) had demographic characteristics, symptoms of alcohol abuse, and psychiatric histories comparable to those who resisted conversion. These findings suggest that efforts to convert refusals to responders might not be necessary. The results also support community psychiatric research by providing evidence that those with a history of psychiatric disorder are not more difficult to recruit than their unaffected counterparts.

DSM-IV field trial: testing a new proposal for somatization disorder.

OBJECTIVE: The purpose of this study was to evaluate for APA a proposed strategy to diagnose somatization disorder for possible inclusion in DSM-IV. METHOD: Five sites--Washington University, University of Kansas, University of Iowa, University of Arkansas, and Mount Sinai Medical Center in New York--participated in a collaborative field trial. Female subjects (N = 353) were recruited from several different services (psychiatry, internal medicine, and family practice) and were evaluated for the presence or absence of the disorder. This assessment was performed with a new instrument constructed by combining all the criteria for somatization disorder from the proposed criteria for DSM-IV, DSM-III, DSM-III-R, Perley-Guze, and proposed criteria for ICD-10. RESULTS: A high level of concordance was found between the proposed diagnostic strategy for DSM-IV and the current criteria (DSM-III-R), as well as the earlier criteria (Perley-Guze and DSM-III). The ICD-10 criteria agreed poorly with all other criteria sets. The level of experience of the rater (expert versus novice) with the earlier (Perley-Guze, DSM-III) and current (DSM-III-R) criteria did not influence the identification of cases by use of DSM-IV criteria. No racial effect was introduced by any of the criteria sets. CONCLUSIONS: The strategy for DSM-IV is an accurate and simpler method of diagnosing somatization disorder that does not require special expertise for proper use.

Psychosocial consequences of sterilization: a review of the literature and preliminary findings.

Tubal ligation continues as a frequently used method of birth control. Nonetheless, psychosocial consequences, sexual satisfaction, and later regret regarding the procedure and the loss of childbearing potential remain as concerns. This is particularly true for the population of childless women requesting the procedure. The authors review all available recent literature on regret, psychosocial correlates, and sexual satisfaction related to tubal sterilization, with particular attention to the literature on childless women. They also present preliminary findings from a prospective controlled 5-year follow-up study of sterilization in childless women.

Briquet's syndrome, dissociation, and abuse.

OBJECTIVE: To help clarify the complex association between childhood abuse and adult psychopathology, the authors examined the relationship among abuse, Briquet's syndrome (somatization disorder), and dissociative symptoms. METHOD: Ninety-nine female psychiatric clinic outpatients with a history of somatic complaints were assessed for Briquet's syndrome, dissociative symptoms, adult and childhood sexual abuse, childhood physical abuse, and childhood emotional abuse. RESULTS: Women with high dissociation scores and many somatic symptoms were more likely to report abuse than were subjects with low dissociation scores or with few somatic complaints. CONCLUSIONS: Briquet's syndrome, dissociation, and abuse are significantly associated. Awareness of this association may have a significant effect on the treatment of psychiatric patients.

A calendar savant with autism and Tourette syndrome. Response to treatment and thoughts on the interrelationships of these conditions.

A case of a calendar savant with infantile autism and Tourette syndrome is presented. Pharmacotherapy and comorbidity issues are discussed in terms of the interrelationships of these conditions and obsessive-compulsive disorder.

Psychiatric correlates of incest in childhood.

OBJECTIVE: The purpose of the study was to describe more precisely the type of psychiatric illness associated with incest during childhood. METHOD: The Diagnostic Interview Schedule was administered to 52 adult women who had been victims of incest during childhood and to 23 age- and race-matched comparison subjects from local self-help agencies. RESULTS: The prevalence of 19 psychiatric disorders was higher in the incest group than base population rates. Rates of anxiety disorders (panic disorder, agoraphobia, social and simple phobia), major depression, and alcohol abuse and dependence were significantly higher in the incest group than in the comparison group. More severe types of incestuous abuse were associated with a higher risk for the development of psychiatric disorders. CONCLUSIONS: There was an association between incest and psychiatric disorders in this community-based treatment population. All patients, especially those who present with these specific psychiatric disorders, should be queried about childhood sexual abuse during the history.