The research was designed to assess whether bipolar manic patients are unique in showing excessive interactive behavior and whether interactive behavior is linked to positive thought disorder in mania and other psychotic disorders. We compared the interactive behavior of manic patients versus schizophrenics and nonpsychotic patients. Degree of interactive behavior and severity of thought disorder were assessed in an inpatient sample of 140 patients, including 38 bipolar manic patients, and control samples of 40 acute schizophrenic patients, 32 nonpsychotic patients, and 30 chronically hospitalized schizophrenic patients. The assessment battery used standardized tests to assess interactive behavior and thought disorder. Manic patients displayed significantly more interactive behavior on all three tests than the other three patient groups. Interactive behavior made a greater contribution to the thought disorder of manic patients than to the thought disorder of the other three diagnostic groups. The other two acute patient groups also showed relationships between interactive behavior and thought disorder. The chronic schizophrenics did not show this pattern. The data indicated that many types of acute patients show some interactive behavior, but bipolar manic patients demonstrate more excessive interactive behavior than do other patients. There is a closer link between excessive interactive behavior and thought disorder in manic patients.

Acute Disease↗

PubMedDate not supplied

Psychosocial versus biomedical risk factors in Kevorkian's first forty-seven physician-assisted deaths.

This article examines biomedical and psychosocial data on the first forty-seven cases of physician-assisted suicide (PAS) of Kevorkian as collected by means of both a physical autopsy and a preliminary psychological autopsy. The following patterns emerge: 1) The physical condition of these PAS patients was not typical of the conditions that lead to death in the United States. 2) Consistent with the above findings, our pilot data indicate that only 31.1 percent of these patients were terminal. While 73.9 percent were described as reporting pain, only 42.6 percent were revealed at autopsy to have a specific anatomical basis for their pain. However 36 percent were described as depressed, 66 percent as having some disability, and perhaps of key importance, 90 percent expressed a fear of dependency. Most important, our pilot data suggest the possibility of large gender differences, since 3) 68.1 percent of these forty-seven PAS's are women and only 31.9 percent are men. This represents the reverse of the gender pattern for completed suicides in the United States in 1995, resembling instead the approximate pattern for unsuccessful suicide attempts. 4) Approximately 75 percent of both men and women in the above sample were described as reporting pain. Men were almost twice as likely to have had an anatomical basis for the pain and three times as likely to be terminal. Our pilot data indicate PAS women are more likely to be described as depressed and twice as likely to have had a history of previous unsuccessful suicide attempts. 5) Kevorkian's patients were older than the typical unaided suicides in America. Reported pain decreases with age as does depression; however anatomical basis for pain increases slightly with age, and no age effect emerges for terminality. 6) Approximately two-thirds of those physician-assisted suicides were at middle SES levels. History of disability was the biggest risk factor for the low SES patients and fear of dependency for the high SES patients.

Age Factors↗