Comparative efficacy of alprazolam, imipramine, and placebo administered once a day in treating depressed patients.

Ninety-eight outpatients with major depressive disorder were treated with alprazolam, imipramine, or placebo in a 6-week, double-blind study. Average doses were 3.67 mg of alprazolam and 167 mg of imipramine, given at bedtime. Fifty percent of patients taking alprazolam, 38.2% taking imipramine, and 17.7% receiving placebo improved their HAM-D scores by more than 50%. Eight patients on imipramine, 6 on alprazolam, and 1 on placebo dropped out because of side effects. The most common side effects for imipramine were tachycardia, constipation, light-headedness, and sedation; common side effects of alprazolam were light-headedness, sedation, and unsteadiness.

The value of interviewing family and friends in assessing life stressors.

A reliability study of a life events questionnaire administered to 117 pairs of respondents indicated that a "significant other" (family member or friend) added approximately 29% new information to that gathered from the patient alone. A validity check of this information with a "knowledgeable" third party confirmed approximately 80% of the events reported by the subjects and significant others. The findings suggest that studies designed to collect information about the occurrence of specific life stressors would obtain more reliable and no less valid data from separate interviews of patients and significant others, and the pooling of the positive responses obtained from these two sources.

Life events and illness: a three year prospective study.

In an investigation of the relation between life events (stressors) and illness, 87 medical students reported on a prospective basis their health and life events history over a three year period. There were a few positive findings, e.g. that subjects who reported more life events during the period also reported more illnesses during that period. Overall, however, the study showed a lack of statistically significant association between life events and illness.

The role of stress as a precipitating factor of psychiatric illness.

Fifty-six psychiatric patients were interviewed to obtain a record of life events preceding admission to hospital, using a modified version of the Schedule of Recent Experiences. Two control groups were studied for comparison: medical and surgical in-patients and a "normal" population studied independently by Myers. Psychiatric patients reported a significantly larger number of events than the medical-surgical patients, who, in turn, reported significantly more events than the "normal" population. There were no significant differences in the specific life event histories between groups.

Genetic determinant of lithium ion metabolism. II. An in vivo study of lithium ion distribution across erythrocyte membranes.

A study was conducted to determine if membrane factors, known to influence the distribution of sodium ion (Na) and potassium ion (K), also influence lithium ion distribution. Two groups of sheep with genetically determined differences in their cation concentrations were administered lithium chloride for ten days. The low red blood cell (RBC) potassium ion sheep (LK) had a greater RBC lithium ion concentration than the high RBC potassium ion sheep (HK). In vitro incubation of erythrocytes with lithium chloride also produced substantially different RBC lithium ion: plasma lithium ion ratios similar to those seen in the vivo study. Distribution of lithium ion was generally similar to that of Na ion. It seems that lithium ion distribution may be controlled by the same genetic factors that regulate Na ion distribution.

Document delivery capabilities of major biomedical libraries in 1968: results of a national survey employing standardized tests.

The standardized Document Delivery Tests (DDT's) developed earlier (Bulletin 56: 241-267, July 1968) were employed to assess the capability of ninety-two medical school libraries for meeting the document needs of biomedical researchers, and the capability of fifteen major resource libraries for filling I-L requests from biomedical libraries. The primary test data are summarized as statistics on the observed availability status of the 300 plus documents in the test samples, and as measures expressing capability as a function of the mean time that would be required for users to obtain test sample documents. A mathematical model is developed in which the virtual capability of a library, as seen by its users, equals the algebraic sum of the basic capability afforded by its holdings; the combined losses attributable to use of its collection, processing, relative inacessibility, and housekeeping problems; and the gain realized by coupling with other resources (I-L borrowing). For a particular library, or group of libraries, empirical values for each of these variables can be calculated easily from the capability measures and the status statistics. Regression equations are derived that provide useful predictions of basic capability from collection size. The most important result of this work is that cost-effectiveness analyses can now be used as practical decision aids in managing a basic library service. A program of periodic surveys and further development of DDT's is recommended as appropriate for the Medical Library Association.

User services offered by medical school libraries in 1968: results of a national survey employing new methodology.

The breadth and depth of services that ninety-two medical school libraries offer to individual users were ascertained by interviewing the heads of these libraries, employing a standardized inventory procedure developed earlier (Bulletin 56:380-403, Oct. 1968). Selected aspects of the descriptive data obtained on services to faculty and to medical students are presented and commented upon. Comparisons with the findings of earlier surveys suggest that increases in the staffs and budgets of medical school libraries over the past two decades have gone largely to supporting a rapidly increasing volume of service, rather than to any striking increase in the breadth and depth of services. To facilitate summarization and comparisions among libraries the descriptive data were weighted and converted to quantitative measures; the weighting scheme was established by a group of five academic medical librarians to reflect the relative values the group assigned to different services. One of these quantitative measures, the percentage score for overall services relative to the optimal library, summarizes a library's services in a single figure. On this measure, medical school libraries ranged from 38 percent to 87 percent; the median overall score was 63 percent. Results of some exploratory analyses are described; these analyses attempted to find explanations for the observed differences among libraries and among geographical regions on the quantitative measures. Present and potential uses of the survey data for managerial and research purposes are discussed. One of the most important of these uses is in establishing and implementing standards-activities which should be carried out by the library profession itself-and recommendations are made for a program of such activities that is appropriate for the Medical Library Association.