Employment outcomes in family-aided assertive community treatment.

Family-aided assertive community treatment (FACT) was enhanced by adding vocational specialists to help persons with severe mental illness obtain competitive employment. Results were then tested against those of conventional vocational rehabilitation (CVR). The FACT cohort demonstrated significantly better employment rates than did the CVR, while negative symptoms declined in the former and increased in the latter. No evidence was found that competitive work presented a significant risk for relapse.

A comparison of two levels of family-aided assertive community treatment.

OBJECTIVE: The study examined differences in outcomes for patients with schizophrenic disorders who were receiving assertive community treatment based on whether their families were involved in their treatment more intensively in psychoeducational multifamily groups or episodically in crisis family intervention. METHODS: Sixty-eight individuals who met DSM-III-R criteria for schizophrenic disorders and who had at least one other major complicating factor were randomly assigned to the two treatment conditions, and clinical and functional outcomes over a 24-month follow-up period were compared. RESULTS: Both groups had significant reductions in rehospitalization rates and symptom levels and increased participation in treatment. Patients in multifamily group treatment had higher employment rates during the study. Otherwise, few significant differences in the major outcome variables were found. In both treatment conditions family members reported significant improvements in their objective and subjective burden; in friction, dissatisfaction, and overinvolvement with the patient; and in the patient's functioning. CONCLUSIONS: The results suggest that systematic family involvement enhances the rehabilitation and family-related outcomes of assertive community treatment. Patients in multifamily group treatment had better employment outcomes.

Testosterone-binding globulins in human plasma: studies on sex distribution and specificity.

When human plasma is mixed with testosterone-(3)H and subjected to electrophoresis on paper in glycine acetate buffer at pH 8.6, at least two proteins other than albumin bind the testosterone. In normal women 80.5 +/- 1.9% (SEM) of the recovered radioactivity migrates with the beta-globulins, 7.3 +/- 0.80% with the inter-alpha-globulins, and 4.3 +/- 0.40% with albumin. In normal men the percentages are 69.3 +/- 3.0%, 14.3 +/- 1.6%, and 6.2 +/- 1.1%, respectively. These differences between men and women in binding among the beta-globulins and inter-alpha-globulins are statistically significant (P < 0.001). The highest percentages of radioactivity associated with the beta-globulins are seen in infants of both sexes, men receiving diethylstillbestrol, and pregnant women. These same subjects have the lowest percentages of radioactivity associated with the inter-alpha-globulins. Experiments with carrier testosterone indicate that at least some of the differences between the normal men and women and infants can be explained by differences in the concentration of endogenous testosterone. This factor alone, however, cannot explain the increased binding among the beta-globulins in the men receiving diethylstilbestrol or in the pregnant females. In this system estrone, estradiol, dehydroisoandrosterone, androsterone, 17alpha-hydroxyprogesterone, and 19-nortestosterone compete with testosterone for binding sites on the proteins. None is as potent as testosterone itself.