A randomized, double-blind, multi-centre, parallel-group study comparing the tolerability and efficacy of moclobemide and dothiepin hydrochloride in depressed patients in general practice.

A randomized, double-blind, multi-centre, parallel-group study compared the tolerability and efficacy of 450 mg of moclobemide and 75-150 mg of dothiepin in the management of depressed patients in general practice. Patients who fulfilled the DSM-III-R criteria for major depressive disorder and who scored 13 or more on the Hamilton Depression Rating Scale were admitted. The trial lasted six weeks. The dose of moclobemide was 150 mg three times daily and that of dothiepin was 75 mg daily for the first two weeks and 150 mg thereafter. Assessments were made at baseline and after one, three and six weeks using the HDRS, the Zung SRS and the CGI. Adverse events and vital signs were monitored at each visit, and laboratory screening tests performed at the beginning and end of the study. Sixty-four general practitioners from four centres recruited 345 patients: 175 received dothiepin and 170 moclobemide; 265 completed six weeks of treatment. Thirty-eight dothiepin-treated patients (22%) and 42 who received moclobemide (25%) dropped out, most commonly because they experienced adverse events. More patients on dothiepin (24) than on moclobemide (16) dropped out for this reason; the incidence of adverse events was 10% higher in the dothiepin-treated group and of "side effects" more than 10% higher, the latter difference being statistically significant. Both treatments resulted in significant improvement; this was greater in the dothiepin-treated group and the difference was statistically significant, although clinically small.

Psychiatric interviewing and clinical skills.

Does the ability of medical students to assess and relate to their patients through the psychiatric interview reflect in traditional academic achievement scores? A previous publication by our group offers data suggesting that certain personality traits of final year medical students have a fundamental importance in determining a successful performance on a psychiatry rotation. As the literature is vague and contradictory about the relationship between the psychiatric interview and clinical performance, a study was developed to determine what outcome variables are associated with the performance of clinical clerks on the Psychiatric Interview. An attempt was made to develop and test a new scale designed to measure the Psychiatric Interview. The Psychiatric Interview Scale was used to measure performance on 33 final year medical students on a 1 month psychiatry rotation at a University of Toronto teaching hospital, and subsequently, as a basis for analysis and training of these students in interviewing. Inter-rater reliability of the Psychiatric Interview Scale was rho = 0.72 and internal reliability was 0.74. Psychiatric Interview Scores were compared with other achievement scores, and with patients' ratings of the students interviews. A significant correlation emerged between the Psychiatric interview scores and final clinical examinations, but surprisingly, there was no relationship between the patients' evaluation of the Psychiatric Interview and the raters' evaluations and a strongly significant negative correlation between patients' ratings and clinical scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Personality and performance in psychiatric education.

An attempt was made in this study to develop a composite profile of personality characteristics of medical students that correlated differentially with successful achievement outcomes in the Psychiatry CLerkship at a University of Toronto teaching hospital. Data on 27 of 33 final year medical students in a psychiatry rotation programme were used to analyse canonical correlations between personality and achievement variables. The findings of the study indicated that success in clinical examinations was significantly correlated (R = 0.64, P less than 0.001) with a personality defined as apprehensive, anxious and less neurotic. Success on oral examinations was significantly correlated (R = 0.37, P less than 0.01) with a personality defined as anxious, more neurotic and extroverted. Success in objective multiple choice tests was not significantly correlated (R = 0.21, P = 0.10) with any particular personality profile, but the direction of the correlations suggested a personality describable as less intelligent (concrete thinking), apprehensive, adjusted and introverted. Although the small sample makes conclusions tentative, the findings are that students' personality differentially affect their examination results.