This study of DSM-III-R personality disorder (PD) classification provides an empirical approach to determine (1) the discriminative power of each criterion and (2) the optimal number of criteria needed to diagnose the presence of each PD. A semistructured assessment of 110 outpatients was performed for the 11 PDs and their 104 diagnostic criteria. Sensitivity, specificity, and predictive powers were calculated for each criterion item. Logistic regression was performed to determine (1) univariate weightings of the individual criteria as applied to a given diagnosis, and (2) multivariate measures of the criteria that significantly improved the chi-square value in a stepwise fashion. The significant items were then equally weighted to calculate the optimal number needed to diagnose category membership. Of 104 PD criteria, 41 discriminated at a significance level of .05 or less, and each PD could be optimally diagnosed with fewer criteria than currently required. We can empirically reduce the number of criteria combinations comprising individual categories, decrease heterogeneity, and narrow diagnostic boundaries. This increases the likelihood of identifying etiological factors, predictors of clinical course, specific treatments, familial aggregation, and neurobiological correlates for the PD taxa.

Adolescent↗

PubMedDate not supplied

Erythropoietin and visual hallucinations in patients on dialysis.

The authors encountered five patients who first had visual hallucinations while taking erythropoietin. Since this association had not previously been reported, the authors studied a convenience sample of dialysis patients at two institutions to determine the incidence of visual hallucinations in patients on erythropoietin and possible associated risk factors. Eleven percent of the patients had visual hallucinations at one institution with no other factor than erythropoietin as a probable cause and 2% at the other. Significant risk factors for hallucinations included diabetic retinopathy or cataracts (chi 2 = 4.59, df = 1, P = 0.032) and older age (t = 2.24, df = 123, P = 0.27). A multivariate analysis comparing visual hallucinations, eye pathology, and age showed that eye pathology was close to the trend level of significance but that age maintained significance as a risk factor. The visual hallucinations occurred in response to the administration of erythropoietin and appeared to vary in relation to dose. Similarities between the syndrome of visual hallucinations in dialysis patients taking erythropoietin and the syndrome of visual hallucinations in dialysis patients taking erythropoietin and the Charles Bonnet syndrome are discussed.

Age Factors↗

PubMedDate not supplied

Religious and other predictors of psychosocial adjustment in cancer patients.

The authors tested the hypothesis that religious variables, such as a person's belief that his/her illness was God's will, would predict psychosocial adjustment in 50 patients who were predominantly Catholic Hispanic women attending a medical oncology clinic (42 women, 8 men). The patients were free of an Axis I mental disorder, cognitive impairment, and severe pain and were not undergoing intensive chemotherapy. By using the Psychosocial Adjustment to Illness Scale as the outcome measure, the authors found few associations with religious variables, but many to clinical variables.

Adaptation, Psychological↗