Consistency of posttreatment alcoholics' drinking patterns.
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Biomedical subjects
Publications and source records attributed to C G Watson.
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Previous research has indicated that schizophrenics are particularly likely to have been born during the winter months. In the present investigation, we studied the relationships of this birth-seasonality effect to year-to-year variations in the incidences of eight seasonal diseases and climatological temperature extremes in 3,246 schizophrenics. The winter birth-seasonality effect was greater in the years directly following those marked by high levels of infectious disorders than in years directly following those with low incidences of these diseases. Winter diseases (particularly diphtheria, pneumonia, and influenza) appeared to be more involved than others. These effects appeared among unmarried (presumably severe) schizophrenics but not among married patients, suggesting that the relationship is specific to process schizophrenia. The fact that most of the significant and near-significant relationships paired strength of birth seasonality to previous-year disease incidences suggested a prenatal rather than postnatal effect. Birth seasonality did not vary with winter or summer temperature extremes.
Compared a suicide-completion group to a psychiatric control sample on the 13 traditional MMPI scales, three experimental item pools, and eight profile patterns earlier described as indicative of suicidal tendencies (N = 84). Also compared the frequencies with which the groups endorsed each of the 566 MMPI items. The number of resulting significant differences was less than chance. The results argue against the use of the MMPI to predict suicide at this time.
Reviewed the research on the MMPI Schizophrenia-Organicity (Sc-O) and Psychiatric-Organic (P-O) Scales, measures developed to separate brain-damaged patients from schizophrenics and from functional psychiatric patients as a whole. Over 10 cross-validations, the average Sc-O scale hit rate has been 69%, which suggests that it is a better differentiator of brain-damaged from schizophrenic males than most popular ability-based organicity tests. Hit rates for five studies that contrasted organic and psychiatric patients on the P-O scale also averaged 69%. The scales appear to be useful in both medical and psychiatric hospitals, but their validities in female samples are not well established. A system for making diagnostic decisions from ability and personality measures in combination is described, and evidence is cited that it improves on the hit rates achieved by either type of test alone.
Several studies have suggested that patients with affective, neurotic, and personality disorders are particularly likely to have been born during the early months of the year. They suggest that seasonal factors may play a role in the etiologies of these disorders. However, Lewis and Griffin (1981) have suggested that the reported seasonal exaggerations in psychiatric patients' birthrates simply may reflect artifacts. We searched for seasonal trends in the birth patterns of neurotics (N = 989), alcoholics (N = 2,870), affective disorders (N = 320) and personality disorders (N = 713), both before and after controlling for these artifacts. No significant effect appeared.
Adenomas of the parathyroid gland, the majority of which are of the solitary chief cell type, are the most frequent cause of primary hyperparathyroidism. Parathyroid adenomas composed predominantly or exclusively of oxyphil cells are rare and were previously considered nonfunctioning. Among 160 consecutive patients with primary hyperparathyroidism who were explored surgically, ten (6.25 per cent) had adenomas of the oxyphil cell variety. The eight women and two men in this series ranged in age from 28 to 82 years (average, 58 years). The tumors weighed from 0.2 to 4.0 g (average, 1.2 g). Nine of the adenomas were located in the left neck, while the remaining tumor was in the right neck. Histologically, the tumors were composed almost exclusively of transitional and typical oxyphil cells. A residual "capsular" parathyroid composed of chief cells was identified in each case. Electron microscopy, phosphotungstic acid-hematoxylin staining, and the immunoperoxidase technique for cytochrome c oxidase showed the presence of numerous mitochondria in oxyphil cells. All patients had normal serum calcium levels four months to four years (average, 23 months) after removal of the neoplasms.
A total of 100 men were studied to determine the relationship between belief in the abstinence theory and outcome after treatment of alcoholism. Twenty-seven subjects reported believing that at least some alcoholics can tolerate a single drink without losing control or can learn to drink in moderation and the remaining 73 rejected both contentions. The mean alcohol-consumption ratings of the two groups over 10 evaluations covering the first 18 months after treatment did not differ. The Groups X Time interaction effect, which would have indicated a difference in the rates at which recidivism developed in the two groups, was also nonsignificant. Finally, the percentages of the two groups who were rated as abstinent, in complete control of their drinking or in control most of the time were compared at each of 10 follow-up points. Only a chance number of these differences were significant. The results suggest that there is little relationship between belief in or rejection of the abstinence theory and recidivism.
Self-reports on drinking among alcoholics (100 men inpatients) were compared with descriptions of their consumption given by collaterals (one friend or relative each) at 10 points during an 18-month follow-up study. The correlations between the two were only moderate; barely one-half of the variance in the alcoholics' self-reports corresponded to the collaterals' assessments. Patients underestimated collaterals' descriptions about three times as often as they overestimated them, but their over- and underestimations appeared to be of roughly equal size. The relationships between alcoholics' and collaterals' reports tended to be curvilinear. Among subjects whom the collaterals had described as abstinent or controlled drinkers, patients' and collaterals' assessments were similar but patients' descriptions grossly underestimated collaterals' reports when uncontrolled consumption was reported by the latter. The results support a moratorium on the use of patients' self-reports in follow-up studies on alcohol consumption.
A history of myocardial infarction should not be a deterrent to the performance of an elective inguinal herniorrhaphy. This operation has been proved to be safe for this patient population and is attended by a low and quite acceptable complication rate. Thorough preoperative evaluation ensures optimal management in both the perioperative and postoperative period. In stark contrast with elective inguinal herniorrhaphies, emergency procedures are associated with an alarming morbidity and mortality, often the result of cardiovascular complications. In the postinfarction patient with an inguinal hernia, the dual goals of complete cardiac rehabilitation and improved quality of life can be facilitated in a safe and sure manner by elective inguinal herniorrhaphy under local anesthesia.
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Previous research has suggested that left-handedness relates to delinquency and violence. In an effort to pinpoint the nature of this apparent relationship, we compared the MMPIs of 72 left- and 687 right-handed men 60 yr. old or less on an alcohol treatment ward. No significant differences appeared. The results are compared to earlier research and hypotheses for further research are suggested.
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Previous research indicates that many brain-damage screening tests lack the ability to separate organic from functional patients at a satisfactory level. However, the Smith Symbol-Digit Modalities Test, the Benton Visual Retention Test, the Background Interference Procedure variation of the Minnesota Percepto-Diagnostic Test, and the MMPI Psychiatric-Organic Scale have shown some promise in earlier studies. Their abilities to separate brain-damaged patients from five functional samples in a psychiatric setting were compared here. The Smith proved capable of discriminating organics from all functional samples both before and after demographic matching. The Benton and the Minnesota Percepto-Diagnostic Test separated our organics from our functional groups before matching, but results with them after matching were unencouraging. The P-O scale separated the organics from four of the five functional samples before matching and two afterward. The combined use of the P-O and Smith provided a higher level of discrimination than that attained with either alone, correctly identifying 90% of the organics and 79% of the functional Ss.
Von Domarus and Arieti have theorized that failure to reason by conventional logical rules is at the root of schizophrenic thought disorder, but the available research on this view is inconclusive. We compared the performance of schizophrenics (N = 100), brain-damaged patients (N = 50) and psychiatric controls (N = 50) on closely matched measures of Overexpansive and "Von Domarus" (similarity implies identity) syllogistic reasoning errors. Before the samples were matched for education and intelligence, the brain-damaged and schizophrenic patients made more Overexpansive errors than the controls, but the Von Domarus error difference was not significant. After matching, both differences were nonsignificant. The results indicate that inability to use syllogistic reasoning properly is probably not the root cause of schizophrenic thought disorder.