How are we doing? A statewide survey of community adjustment among people with serious mental illness receiving intensive outpatient services.

Although mental health consumers often prefer community living, the factors influencing community outcomes are not well understood. In order to address this issue in Connecticut, the Department of Mental Health and Addiction Services (DMHAS) commissioned a statewide study of 6,800 clients receiving the most intensive community-based mental health services funded by the state. DMHAS clinicians provided the ratings for their clients on a variety of variables including demographics, diagnosis, clinical stability, current psychotic symptomology, adherence to prescribed medications, substance abuse, history of violent crime, community trouble-making or victimization, likelihood of threatening behavior, frequency of social contacts, and difficulty in adjusting to life in the community. Also, the total length of stay and total number of admissions during a two year period were taken from the statewide management information system for each client in the study. Descriptive data analysis included frequencies and means to describe the demographic, the diagnostic, and the clinical profile of the DMHAS clients. A stepwise hierarchical multiple regression analysis (MRA) was performed to determine what factors predict a composite score of overall functioning, community adjustment, and psychiatric impairment. Clients with better composite scores were those who had a prescription for medications, adhered more to their medication regimen, perceived to be less threatening, and had more frequent social interactions. Implications of these findings for outpatient treatment are discussed.

Prefrontal levels of 5-HIAA, but not dopamine, predict alcohol consumption in male Wistar rats following 6-OHDA lesions.

To examine the effects of dopamine (DA) on alcohol consumption, male Wistar rats were subjected either to 6-OHDA lesions of the frontal cortex (MPFC) or to a sham lesion/no lesion. Following surgery, rats were trained to drink alcohol on a sucrose-fading paradigm over the course of 6 weeks, at the completion of which they consumed a solution of 3% sucrose/10% alcohol. Daily consumption of alcohol was computed for each rat. Animals were sacrificed and the MPFC, nucleus accumbens (NA), and ventral tegmentum (VTA) were removed. Levels of DA and its metabolites (i.e., HVA and DOPAC), norepinephrine (NE), and serotonin (5-HT) and its metabolite (i.e., 5-HIAA) were measured for each brain region using HPLC with electrochemical detection. Post hoc analyses were run examining the relationship of DA and its metabolites, 5-HT and its metabolite (5-HIAA), and norepinephrine (NE) in the MPFC, NA, and VTA with alcohol consumption. The 6-OHDA lesions depleted DA to 74.5% of control levels in the MPFC, but did not significantly affect alcohol consumption. Post hoc analyses found that the "high" alcohol consumption group had significantly reduced levels of MPFC 5-HIAA in comparison to the "low" consumption group, but that there was no relationship of 5-HIAA levels in the VTA or NA to alcohol consumption. These findings suggest that MPFC DA is not critically involved in the regulation of alcohol consumption. They further suggest that MPFC serotonergic systems may play an important role in the regulation of alcohol consumption, although future experimentation directly manipulating 5-HT systems in the MPFC will be required to fully assess these findings.

Effect of ethanol on maternal and offspring characteristics: comparison of three liquid diet formulations fed during gestation.

Maternal blood alcohol levels, weight gain during pregnancy, parturition time, perinatal mortality, and postnatal growth of offspring were compared in groups of pregnant rats fed one of three ethanol-containing liquid diets (Kahn's formula = BSA diet, Revised Wiener's = RA6 diet, and Lieber-DeCarli's high protein 82C diet = LDA diet). The three ethanol diets all contained the same amount of ethanol-derived energy (36% of total energy), but differed in the amount of energy contributed by protein (17, 30, and 25%), fat (36, 24, and 13%), and carbohydrate (12, 10, and 27%), respectively. The experimental design also included dams that were pair-fed isocaloric ethanol-free versions of the three ethanol diets (designated BSP, RP6, and LDA, respectively) and a group of dams fed a pelleted casein-based solid diet (PC diet). All experimental diets were fed ad libitum from gestational day 7 to delivery. The effect of ethanol exposure in utero was most severe in mothers and offspring fed the BSA diet. The feed efficiency ratio (maternal weight gain/total dietary energy consumed) of this low-protein ethanol diet was less than that of RA6 or LDA diets. The feed efficiency ratio calculated for RA6 and LDA diets was not different from that of PC diet. Compared with rats fed RA6 and LDA diets, the rats that were fed BSA diet exhibited deficient maternal weight gain, greater parturition delay, impaired fetal growth, and increased perinatal mortality among the offspring. BSA dams had the highest blood ethanol levels of all groups fed ethanol diets, and exhibited the least difference in blood ethanol concentrations between the day (2 PM) and night (9 PM) periods of the diurnal cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of starvation on protein synthesis in neonatal rat liver.

Hepatic protein synthesis was measured in vivo and in vitro (liver slice) in 6- and 19-day-old rats. Fed and 15-hour starved rats were compared in each individual experiment. The study demonstrated that in the 6-day-old rat, hepatic protein synthesis is very sensitive to restrictions in dietary influx. In contrast, no significant differences in protein synthesis were detected when 19-day-old rats were fasted for 15 hours. In the fed state, the protein synthetic activity of the tissue unit was the same irrespective of age. Thus, it appears that it is not the maximal capacity for protein synthesis that changes with age, but rather the extent to which the system can adapt to the changing nutritional environment.