DSM-IV-TR Axes-I and II mental disorders in a representative and referred sample of unemployed youths--results from a psychiatric liaison service in a job centre.

OBJECTIVES: Increased levels of anxiety, depression and alcohol abuse are associated with unemployment. This study compares both DSM-IV-TR Axis-I and Axis-II mental disorders between a representative and a referred sample of unemployed youths aged 16.0 to 24.9. METHODS: One hundred subjects were randomly recruited on the premises of the vocational services centre in the urban region of Essen, Germany (representative sample, RS). One hundred and sixty-five subjects constituting the 'clinical sample' (CS) were preselected and referred by case managers to the on-site psychiatric liaison service. Structured Clinical Interviews for DSM-IV (SCID-I and -II), measures of psychopathology and health service utilization were administered. RESULTS: Ninety-eight percent and 43% of CS and RS subjects fulfilled DSM-IV criteria for mental disorders. Mood-, anxiety- and substance-related disorders were the most common Axis-I disorders in both samples. Personality disorders were diagnosed significantly more frequently in the CS. Despite the more severe psychopathology in subjects with mental disorders from the CS compared to the RS, no differences were found for recent mental health service utilisation. CONCLUSION: Because the sample of unemployed youths referred by case managers was significantly more disturbed in psychiatric terms, such a pre-selection is deemed useful in conjunction with a psychiatric liaison service on the premise of a job centre.

A three-year clinical investigation into efficacy, cycle control and tolerability of a new low-dose monophasic oral contraceptive containing gestodene.

This long-term, open-label multicenter study investigated the clinical efficacy and tolerability of a monophasic oral contraceptive containing 20 micrograms ethinylestradiol and 75 micrograms gestodene. A total of 670 women between the ages of 18 and 45 years received the trial preparation over a 3-year period, giving 19,095 evaluable cycles. Of the 670 participants in the study, 75% completed at least 24 cycles with the trial preparation and 46% remained in the study for the full 3 years. One pregnancy occurred during the study which was considered by the investigator to be the result of misuse of the drug, giving an uncorrected Pearl Index of 0.07. Cycle control with the trial preparation was good, especially in women who did not miss any pills. By cycle 3, only 10.2% of women who had not missed pills reported intermenstrual bleeding (scanty or medium/excessive bleeding) and this decreased to 2.3% by cycle 36. The preparation was well tolerated, with a low incidence of unprompted adverse events. There were no clinically significant changes in mean body weight or blood pressure. Over the 3 years of the study, 10% of women withdrew from the study for reasons related mostly to mild adverse events. Results from this study demonstrate that the trial preparation is a reliable and well-tolerated oral contraceptive that provides good cycle control.

The effect on blood pressure of a monophasic oral contraceptive containing ethinylestradiol and gestodene.

To obtain an overview of the effect of monophasic gestodene on blood pressure and to determine the frequency of "OC elevated BP/hypertension," the results of blood pressure monitoring from four clinical studies of contraceptive efficacy and safety have been retrospectively analyzed. A total of 1930 women took part in the studies, which recorded BP for up to 24 cycles. Analysis of results revealed that 97 women (5.0%) showed an increase in blood pressure from previously normal to elevated values while taking monophasic gestodene, with only 26 (1.35%) fulfilling the criteria of "OC elevated BP/hypertension." Only four women dropped out of the trials due to hypertensive blood pressure values, while 67 women (3.5%) experienced a normalization of previously elevated blood pressure measurements. In conclusion, this analysis has confirmed that gestodene has a negligible effect on blood pressure, with increased BP a relatively rare event.

PIP: Schering AG (manufacturer of a monophasic oral contraceptive [OC] containing 75 mcg gestodene plus 30 mcg ethinyl estradiol) in Berlin, Germany, conducted a retrospective analysis of blood pressure measurements from 4 clinical trials of the contraceptive efficacy and safety of monophasic gestodene to examine gestodene's effect on blood pressure and the incidence of OC-related blood pressure/ hypertension. (OC-related blood pressure/hypertension is defined as: women with neither history of hypertension nor elevated blood pressure before OC use develop increased blood pressure or hypertension that is reversible once OC use ceases.) The clinical trials recorded the blood pressure of 1930 women for up to 24 cycles. Most women (89.9%) experienced no change in their blood pressure during OC use. 97 women (5%) experienced an increase in blood pressure. 26 women (1.35%) had OC-elevated blood pressure/hypertension. Four women left the trials due to hypertension. 67 women (3.5%) who had elevated blood pressure before OC use attained normalization of blood pressure during OC use. These results show that the gestodene-containing OC had an insignificant effect on blood pressure and that elevated blood pressure rarely occurred.

[Clinical analysis of a new triphasic estroprogestational combination with gestodene]. / Analyse clinique d'une nouvelle association estroprogestative triphasique au gestodène.

New steroidal compounds have been recently synthetized and analysed in order to improve the metabolic tolerance of oral contraception. Gestodene, a new progestogen from the 19 nortestosterone series seems to fulfil these conditions. It has also high antigonadotropic effects. The authors report the clinical results of a study with a triphasic combination containing Gestodene. Despite the small doses of hormones, this triphasic combination with Gestodene provides excellent contraceptive efficacy and good cycle control and clinical tolerance.