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American Journal of Psychiatry

  • Volume 141
  • Number 11
  • November 1984

Publication date: 01 November 1984

Pages1343–1348

The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed "pride" by theologians and "...

https://doi.org/10.1176/ajp.141.11.1343

Publication date: 01 November 1984

Pages1349–1355

The standards for ECT recommended by an APA task force report and those embodied in federal court orders and state statutes and regulations are compared. The authors conclude that there is serious boundary and role confusion owing to progressive intrusion ...

https://doi.org/10.1176/ajp.141.11.1349

Publication date: 01 November 1984

Pages1356–1364

A new rating instrument, the Alzheimer's Disease Assessment Scale, was designed specifically to evaluate the severity of cognitive and noncognitive behavioral dysfunctions characteristic of persons with Alzheimer's disease. Item descriptions, ...

https://doi.org/10.1176/ajp.141.11.1356

Publication date: 01 November 1984

Pages1365–1370

Approximately 50% of depressed patients are resistant to the cortisol- suppressing effect of dexamethasone. To determine if glucocorticoid resistance could be a more generalized phenomenon in depressed patients, mitogen stimulation tests were performed on ...

https://doi.org/10.1176/ajp.141.11.1365

Publication date: 01 November 1984

Pages1371–1376

The authors compared two large samples of insomniac patients with a group of control subjects. Sleep difficulty usually began before the age of 40 and generally persisted for many years (average duration, 14 years). Several characteristic behaviors were ...

https://doi.org/10.1176/ajp.141.11.1371

Publication date: 01 November 1984

Pages1376–1380

Object relations theory is seen as a conceptual framework that adds to the classical Freudian structural theory. The synchrony between the two theories is manifest in psychodynamic group psychotherapy. This paper explores the convergence of these theories,...

https://doi.org/10.1176/ajp.141.11.1376

Publication date: 01 November 1984

Pages1381–1385

The author delineates the syndrome of identity diffusion as consisting of six clinical features: 1) contradictory character traits, 2) temporal discontinuity in the self, 3) lack of authenticity, 4) feelings of emptiness, 5) gender dysphoria, and 6) ...

https://doi.org/10.1176/ajp.141.11.1381

Publication date: 01 November 1984

Pages1386–1391

Previous research has addressed the marital problems of male but not female physicians. The author reviews the literature on women in medicine, reports findings on 16 female physicians with dysfunctional marriages whom he saw as patients, and describes ...

https://doi.org/10.1176/ajp.141.11.1386

Publication date: 01 November 1984

Pages1392–1396

While borderline personality disorder is a well-established psychiatric diagnosis, less is known about family functioning and interactional patterns in subjects with the disorder. The authors describe interactional patterns in families of borderline ...

https://doi.org/10.1176/ajp.141.11.1392

Publication date: 01 November 1984

Pages1397–1402

A sample of 100 preschool-age children referred to a child development unit were evaluated using DSM-III criteria for symptoms of depression. Only four children (4%) received a diagnosis of possible or definite depression; one of the four children ...

https://doi.org/10.1176/ajp.141.11.1397

Publication date: 01 November 1984

Pages1403–1408

Escalating costs of medical and psychiatric care have prompted a reevaluation of the health care delivery system and practice styles. There are several "procompetition" or market-based solutions that seek to make the consumer of care more price conscious ...

https://doi.org/10.1176/ajp.141.11.1403

Publication date: 01 November 1984

Pages1411–1413

The authors compared loxapine with chlorpromazine in inpatients with paranoid schizophrenia and found no difference in clinical efficacy. Thus a previous finding, based on retrospective analyses, that loxapine was superior to other neuroleptics in the ...

https://doi.org/10.1176/ajp.141.11.1411

Publication date: 01 November 1984

Pages1414–1418

Analysis of family history information from a prospectively studied group of 40 young female patients with anorexia nervosa and 23 normal control female subjects of similar age showed more depression and substance use disorders in first- and second-degree ...

https://doi.org/10.1176/ajp.141.11.1414

Publication date: 01 November 1984

Pages1419–1422

The most prevalent psychiatric disorders in the families of patients with anorexia nervosa are bipolar and unipolar major affective disorder. The presence of affective disorder, self-induced vomiting, or bulimia in the patient is not predictive of ...

https://doi.org/10.1176/ajp.141.11.1419

Publication date: 01 November 1984

Pages1423–1426

Psychiatrists treating patients with depression or nonspecific somatic complaints seldom think of lead intoxication as a possible cause. Because occupational exposure to lead is so common, these disturbances may often be associated with lead intoxication. ...

https://doi.org/10.1176/ajp.141.11.1423

Publication date: 01 November 1984

Pages1427–1429

The authors present the results of a controlled observation of withdrawal reactions accompanying cessation of desmethyldiazepam (clorazepate) therapy. The two subjects studied had had generalized anxiety disorder for several years; both were free from ...

https://doi.org/10.1176/ajp.141.11.1427

Publication date: 01 November 1984

Pages1430–1432

Spontaneous eye-blinking, a possible measure of central dopaminergic activity, was studied in 55 drug-free chronic schizophrenic patients subdivided by cerebral ventricular size. Blink rates were higher in schizophrenic patients than in normal control ...

https://doi.org/10.1176/ajp.141.11.1430

Publication date: 01 November 1984

Pages1432–1436

Muscarinic binding sites were assessed in the frontal cortex of 22 suicide victims and 22 control subjects. There were no significant differences between the two groups in either the number of binding sites (Bmax) or their relative affinity (Kd). The ...

https://doi.org/10.1176/ajp.141.11.1432

Publication date: 01 November 1984

Pages1437–1440

Data from a 4-year prospective study suggest that the objectives of the NIMH Psychiatry Education Branch for psychiatry residents in regard to consultation-liaison training can be achieved. Residents developed a more positive view about consultation-...

https://doi.org/10.1176/ajp.141.11.1437

Publication date: 01 November 1984

Pages1441–1444

CSF tyrosine, tryptophan, 5-hydroxyindoleacetic acid, 3-methoxy-4- hydroxyphenylglycol (MHPG), homovanillic acid (HVA), gamma-aminobutyric acid, choline, and calcium were compared in 33 anorexic and 14 normal women. The only significant difference between ...

https://doi.org/10.1176/ajp.141.11.1441

Publication date: 01 November 1984

Pages1445–1448

Results of the dexamethasone suppression test (DST) in 30 alcoholic patients tested on day 5 and again on day 25 after their last drink are presented. Nineteen patients (63%) failed to suppress cortisol on day 5; three (11%) failed to suppress cortisol on ...

https://doi.org/10.1176/ajp.141.11.1445

Publication date: 01 November 1984

Pages1449–1452

Using patient self-report and therapist questionnaires, the authors investigated the perceptions of patients at a community mental health service about several aspects of their clinical care: what they expected from treatment, what they found helpful ...

https://doi.org/10.1176/ajp.141.11.1449

Publication date: 01 November 1984

Pages1452–1454

The act of homicide specifically influences the clinical presentation of subsequent bereavement. Retrospective reports of 15 individuals who lost a relative through homicide revealed cognitive, behavioral, and affective reactions associated with the ...

https://doi.org/10.1176/ajp.141.11.1452

Publication date: 01 November 1984

Pages1455–1458

The improvement in the clinical methods of identifying borderline subjects makes it necessary to reevaluate the efficacy of the treatment offered them. A random sample of 52 borderline and schizotypal patients was treated with two major neuroleptics, ...

https://doi.org/10.1176/ajp.141.11.1455

Publication date: 01 November 1984

Pages1459–1460

A 63-year-old man had symptoms and a history suggestive of a manic episode. Meningeal cryptococcosis with normal pressure hydrocephalus was later found to be the underlying cause. Antifungal treatment resulted in sustained improvement of all mental ...

https://doi.org/10.1176/ajp.141.11.1459

Publication date: 01 November 1984

Pages1461–1463

Seven of nine patients with panic disorder given a standard glucose tolerance test developed symptomatic hypoglycemia but not panic attacks. These findings suggest that hypoglycemia is an unlikely cause of "spontaneous" panic attacks in this population.

https://doi.org/10.1176/ajp.141.11.1461

Publication date: 01 November 1984

Pages1463–1464

The author describes a 21-year-old woman with persistent disabling dysmorphophobia (atypical somatoform disorder) that failed to respond to neuroleptics and heterocyclic antidepressants but resolved completely with the monamine oxidase inhibitor ...

https://doi.org/10.1176/ajp.141.11.1463

Publication date: 01 November 1984

Pages1465–1467

Of six patients with a DSM-III diagnosis of organic affective syndrome, four exhibited cortisol nonsuppression on the dexamethasone suppression test (DST). Three nonsuppressors were retested after successful treatment and before discharge; two had normal ...

https://doi.org/10.1176/ajp.141.11.1465

Publication date: 01 November 1984

Pages1467–1468

The authors present three cases of depression requiring hospitalization in spouses of patients with progressive dementia. They discuss the stress of caring for demented people and the need for clinicians to inquire about depressive symptoms in care ...

https://doi.org/10.1176/ajp.141.11.1467

Publication date: 01 November 1984

Pages1469–1471

Among 2,215 male Navy alcoholic inpatients, a higher number of alcoholic first-degree relatives correlated significantly with poorer treatment outcome, measured by follow-up reports of job performance from their commands over 2 years.

https://doi.org/10.1176/ajp.141.11.1469

Publication date: 01 November 1984

Pages1472–1473

Forty minutes after receiving a single starting dose of trazodone, a patient developed complete heart block. The case illustrates that, despite the results of earlier studies, trazodone's effect on cardiac conduction may be severe in individuals at risk ...

https://doi.org/10.1176/ajp.141.11.1472

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