Attitudes toward DSM-IV dissociative disorders diagnoses among board-certified American psychiatrists.

OBJECTIVE: The authors assessed the opinions of American psychiatrists regarding the diagnostic status and scientific validity of the DSM-IV categories of dissociative amnesia and dissociative identity disorder. METHOD: A one-page questionnaire was mailed to a random national sample of 367 board-certified American psychiatrists. RESULTS: Three hundred one responses were received-a rate of 82%. Only about one-third of respondents replied that dissociative amnesia and dissociative identity disorder should be included without reservations in DSM-IV; a larger proportion replied that these categories should be included only as proposed diagnoses. Only about one-quarter of respondents felt that diagnoses of dissociative amnesia and dissociative identity disorder were supported by strong evidence of scientific validity. CONCLUSIONS: Among board-certified American psychiatrists, there currently appears to be little consensus regarding the diagnostic status or scientific validity of dissociative amnesia and dissociative identity disorder.

Drug use history and criminal behavior among 133 incarcerated men.

The present study investigated the relationship between crime and substance abuse in a sample of 133 consecutively evaluated male prisoners. Using the Structured Clinical Interview for DSM-III-R, we assessed the prevalence of various forms of substance abuse in this population and attempted to judge whether substance abuse played a role in the index crime which has led to the present incarceration. In addition, we assessed whether there was a relationship between the nature of substance dependence and the type of crime committed, whether sexual, violent, or non-violent. Among the 133 prisoners, 95% obtained a diagnosis of dependence on one or more substances. Fifty-eight percent of the inmates reported that they were acutely intoxicated with one or more substances at the time they committed the index crime and an additional 6% were withdrawing from a substance at the time of the crime. There was no significant correlation between the type of substance abuse diagnosis and the type of crime committed. Similarly, there was no significant correlation between the number of individuals who reported they were intoxicated at the time of the offense and the type of crime committed.

Changes in lipoprotein-lipid levels in normal men following administration of increasing doses of testosterone cypionate.

OBJECTIVE: The objective of this study was to examine the relationship between anabolic--androgenic steroids and lipoprotein levels in men receiving weekly injections of gradually escalating doses of up to 600 mg/week of testosterone cypionate. DESIGN: The design was a placebo-controlled, double-blind, 24-week cross-over design in which subjects were randomized to one of two treatment sequences: (a) weekly testosterone cypionate injections for 6 weeks, no treatment for 6 weeks, weekly placebo injections for 6 weeks, and then again no treatment for 6 weeks; or (b) placebo, no treatment, testosterone, and then no treatment, with each interval also lasting 6 weeks as in the first sequence. SETTING: The setting was a private hospital. PARTICIPANTS: Participants were normal male volunteers. INTERVENTIONS: Testosterone cypionate injections were given in gradually increasing doses of 150 mg/week for 2 weeks, 300 mg/week for 2 weeks, and 600 mg/week for 2 weeks. Eight subjects received testosterone injections during the first injection phase and placebo during the second injection phase, and the remaining eight subjects received placebo first and testosterone second. RESULTS: We found a 21% depression of high-density lipoprotein cholesterol (HDL-C) levels following the first 300-mg testosterone dose. This depression remained unchanged after the two 600-mg doses. In contrast, we did not find any changes in low-density lipoprotein or total cholesterol levels at any of the time points studied. Subjects' total cholesterol/HDL-C ratios were significantly elevated during testosterone administration and even 4 weeks following the last injection. CONCLUSION: Our findings suggest that testosterone cypionate adversely affects cholesterol fractions, that this effect reaches its full magnitude even at very modestly supraphysiologic doses, and that this effect persists for several weeks after discontinuation of the drug.

Increased aggressive responding in male volunteers following the administration of gradually increasing doses of testosterone cypionate.

The present study assessed the effects of supraphysiologic doses of testosterone on aggressive responding in a controlled laboratory setting. Eight male subjects received gradually increasing doses of testosterone cypionate (150 mg/week for two weeks, 300 mg/week for two weeks, and 600 mg/week for two weeks) or placebo using a double-blind, randomized, cross-over design. Subjects were tested both before and after the series of injections. During the experimental session subjects could press a button to accumulate points exchangeable for money (non-aggressive response) or press another button to subtract points from a fictitious opponent (aggressive response). Aggressive responding was instigated by subtracting points from the subject which was attributable to the fictitious opponent. Testosterone administration resulted in a significantly higher number of aggressive responding compared to placebo.