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Biomedical subjects

F C Blow

Publications and source records attributed to F C Blow.

At least 73 records · Page 4Linked to original sources

Symptoms and correlates of anabolic-androgenic steroid dependence.

Forty-nine male weight lifters, all users of anabolic-androgenic steroids (AASs), completed an anonymous, self-administered questionnaire to investigate addictive patterns of use. At least one DSM-III-R symptom of dependence was reported by 94% of the sample. Three or more symptoms, consistent with a diagnosis of dependence, were reported by 57%. Dependent users (n = 28) could be distinguished from non-dependent users (n = 21) by their use of larger doses, more cycles of use, more dissatisfaction with body size, and more aggressive symptoms. Multiple regression analysis revealed that dosage and dissatisfaction with body size were the best predictors of dependent use. Patterns of other substances used, although not predictive of AAS dependence, revealed very low cigarette use and at the same time high alcohol consumption. These data support the notion that AASs are addicting, and suggest that dissatisfaction with body size may lead to dependent patterns of use. The implications for both prevention and treatment are discussed.

Adult↗

Clinical assessment and urine testing for anabolic-androgenic steroid abuse and dependence.

The emerging epidemic of anabolic-androgenic steroid use, no longer confined to elite athletes, is associated with adverse health consequences for which users may seek treatment. As with other forms of drug abuse, patients may deny or hide their use of steroids while seeking treatment for bothersome side effects or other problems. Thus, clinicians may increasingly, but unknowingly, see patients who are using steroids. Early detection and treatment of steroid abuse and dependence is critical in order to prevent serious and potentially fatal consequences. Therefore, it is incumbent upon clinicians to know the signs and symptoms of using steroids, and to be familiar with the clinical indications for urine testing. Using case examples, the authors review the assessment of steroid abuse and dependence in clinical practice and illustrate the role of urine testing in the assessment process.

Adult↗

Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism.

To identify the most effective method of screening for covert alcoholism Ewing's CAGE questionnaire was compared with several computer-assisted laboratory data profiles in a prospectively gathered, random sample of 915 adults admitted to a general hospital. Whether a subject was alcohol dependent (n = 244) or not (n = 671), as defined by DSM-III-R, was determined on the basis of a structured interview. The CAGE questionnaire was highly sensitive (76%) and specific (94%) for recognition of alcohol dependence (positive predictive power 87%). None of the discriminant laboratory functions gave recognition rates greater than chance alone. Until the sensitivities, specificities, and positive predictive powers of computer-assisted methods improve, brief interview alone remains the best screening method for general hospital populations.

Adult↗

Treatment implications of chemical dependency models an integrative approach.

Five basic models of chemical dependency and their treatment implications are described. The moral model, although disdained by most treatment professionals, actually finds expression in over half the steps of Alcoholics Anonymous. The learning model, albeit the center of the controlled drinking controversy, is also utilized by most abstinence-oriented programs. The disease model, which enjoys current popularity, sometimes ignores the presence of coexisting disorders. The self-medication model, which tends to regard chemical dependency as a symptom, can draw needed attention to coexisting disorders. The social model emphasizes the importance of environmental and interpersonal influences in treatment, although the substance abuser may endorse it as a justification to adopt a victim's role. A sixth model, the dual diagnosis model, is presented as an example of how two of the basic models can be integrated both to expand the treatment focus and to increase treatment leverage. Whereas the five basic models are characterized by a singular, organizing treatment focus, the dual diagnosis model is viewed as an example of a multifocused, integrative model. It is concluded that effective therapy requires (a) flexibility in combining elements of different models in order to individualize treatment plans for substance abusers, and (b) careful assessment of both the therapist's and the substance abuser's beliefs about treatment models in order to insure a treatment match based on a healthy alliance.

Alcoholics Anonymous↗

Anabolic-androgenic steroid dependence.

The authors believe that this is the first published case report of a patient whose dependence on a combination of anabolic and androgenic steroids meets the DSM-III-R criteria for psychoactive substance dependence. Tolerance, withdrawal symptoms, and the use of steroids to alleviate withdrawal symptoms occurred. An uncontrolled pattern of steroid use continued, despite adverse consequences, such as severe mood disturbance, marital conflict, and deterioration of the patient's usual values. Clinicians should be alerted to the possibility of dependence when asked to prescribe anabolic or androgenic steroids and should suspect steroid use among athlete patients who have mood or psychosocial disturbances.

Adult↗

Screening for alcoholism.

Alcoholism is one of the largest public health problems of the nation and is a significant cofactor in such ubiquitous diseases as hypertension, developmental abnormalities, heart failure, liver failure, and many other conditions. The cost to the nation's health is immense. One strategy for reducing morbidity and cost has been to establish methods for screening in order to increase recognition rates leading to increased rates of therapeutic intervention. In this article, the rationale for two methods of alcohol screening, brief interviews and biological markers of excessive drinking, the relevant statistical issues bearing on this problem, and the current research on screening exams are reviewed and summarized. Finally, some of the newer approaches toward alcoholism screening as well as the consequences to the medical care system should alcohol screening eventuate on a large scale are briefly described.

Alcoholism↗

A comparison of self-reported symptoms and DSM-III-R criteria for cocaine withdrawal.

The frequencies of 15 self-reported symptoms of cocaine withdrawal were compared in 75 subjects to the symptoms listed as criteria by DSM-III and DSM-III-R for either amphetamine or cocaine withdrawal. Three of the four most frequently reported symptoms, depression (75%), sleep disturbance (71%), and fatigue (69%), corresponded to DSM-III and DSM-III-R criteria. The only other DSM-III symptom, increased dreaming (33%), was infrequently reported, lending support to its deletion by DSM-III-R. Physical withdrawal symptoms, which are generally unappreciated in cocaine withdrawal, were reported by 64% of the sample. Neither the DSM-III criteria nor the new DSM-III-R criteria include other frequent symptoms which might contribute to relapse and impaired functioning, such as craving (69%), apathy/amotivation (67%), and restlessness (64%). Thus, these criteria may be too narrowly defined for treatment purposes.

Cocaine↗

AIDS encephalitis mimicking alcohol dementia and depression.

The authors report a case of encephalitis occurring in a setting consistent with acquired immune deficiency syndrome (AIDS). They point out that AIDS and its complications can mimic psychiatric syndromes, including depression and dementia, or delirium related to illnesses such as alcoholism. Acting out behavior, seen in the present case, may also be mistaken as a symptom of sociopathy.

Acquired Immunodeficiency Syndrome↗