Aggression and hostility in anabolic steroid users.
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Adult↗
Biomedical subjects
W R Yates
Publications and source records attributed to W R Yates.
Social support and depression in men during alcoholism treatment.
Psychiatric comorbidities have been shown to be important predictors of the outcome of alcoholism treatment. This study examines whether perceived lack of social support can be identified as an independent predictor of symptoms of depression experienced during alcoholism treatment over and above the effects of personality characteristics and the severity of alcohol and psychiatric history. We studied 189 alcoholic men in treatment at a rural midwestern Department of Veterans Affairs medical center. Multiple regression analyses found that reduced social support significantly predicted depression (measured by the Beck Depression Inventory) during treatment while controlling for personality characteristics and the alcoholism and psychiatric subscales of the Addiction Severity Index. Although self-esteem, neuroticism, and psychiatric severity also were significantly associated with depression in the hierarchical regression model, social support demonstrated the strongest unique contribution to depression of any of the predictors. These results suggest that social support has an independent association with depression and perhaps may play an important role in improving treatment compliance and the outcome of alcoholism treatment.
Adult↗
Anabolic steroid use among substance abusers in treatment.
BACKGROUND: Increasing illicit use of anabolic steroids in adolescent and young adult populations has been reported. To determine the scope of this problem and its relationship to psychoactive substance abuse, we evaluated the prevalence of anabolic steroid use among individuals seeking inpatient treatment for substance abuse. METHOD: A randomized mail survey of 175 inpatient substance abuse treatment directors elicited information regarding the prevalence of anabolic steroid use for inpatients treated in 1989 and the first half of 1990. Additionally, directors were surveyed for experience with DSM-III-R psychoactive substance dependence criteria for anabolic steroid use. RESULTS: Only 19% of centers responding had treated at least one individual using anabolic steroids. Facilities encountering anabolic steroid users reported a prevalence of less than 1% among all admissions. Anabolic steroid users were seen more commonly in privately funded facilities. Directors reported a majority of anabolic steroid users had at least three DSM-III-R psychoactive substance dependence criteria for anabolic steroid use. Treatment directors rarely found anabolic steroid use acknowledged as a problem by users and rarely found anabolic steroid use a primary reason for treatment. CONCLUSION: Users of illicit anabolic steroids may have significant clinical differences compared with users of other psychoactive substances of abuse and dependence.
Adolescent↗
Transient hypochondriasis: a new somatoform diagnosis?
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Adjustment Disorders↗
Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity.
The current study was undertaken primarily to identify whether psychiatric co-morbidity was associated with the rate and time of alcohol-related inpatient readmissions for a group of 255 patients discharged from alcoholism treatment at a midwestern rural medical center. A structured interview obtained information regarding psychiatric disorders, including depression, antisocial personality disorders and polysubstance abuse, as well as alcohol history and sociodemographics. Ninety-eight subjects (38.4% of sample) were readmitted for alcoholism-related diagnoses within 15 months of discharge. Patients with a long history of heavy drinking, high daily alcohol consumption and history of previous alcoholism treatment were most likely to be readmitted with an alcoholism-related primary diagnosis. Once these variables were controlled for, other major psychiatric disorders, polysubstances abuse and sociodemographic variables did not appear to predict time to readmission. However, other potentially more sensitive outcome measures such as return to drinking were not evaluated in the present study.
Alcohol Drinking↗
Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning. Effects of gender, age, and stage of illness.
We evaluated ventricular-brain ratio with computed tomographic scanning in a sample of 108 DSM-III-diagnosed schizophrenic patients and 75 healthy normal volunteers. Significant differences were noted between the patients and controls, but our large sample size also permitted us to determine that the statistically significant difference was contributed primarily through the male patients. Ventricular enlargement occurs only in some schizophrenic patients. In this particular sample, only 6% of schizophrenics had ventricular-brain ratios greater than 2 SDs from the control mean, and 28% were 1 SD greater than the control mean. However, the corresponding figures for male schizophrenics were 19% and 43%, indicating that there is much less overlap between normal individuals and ill subjects in the male population. First-admission schizophrenic patients also had significantly greater ventricular enlargement than did their age-equivalent normal controls, suggesting that ventricular enlargement in schizophrenia may antedate the onset of symptoms. Examination of ventricular size in schizophrenics and normal subjects from a broad age range suggests that ventricular enlargement does not progress over time at a greater rate in schizophrenic patients than in normal subjects.
Adult↗
Illicit anabolic steroid use: a controlled personality study.
The illicit use of anabolic steroids for strength and cosmetic reasons appears to be an increasing problem. Although alcohol and drug abuse have been associated with increased risk for personality psychopathology, the personality correlates of illicit anabolic steroid abuse are unknown. To determine whether personality psychopathology is common among anabolic steroid users, we evaluated a series of illicit anabolic steroid users and compared them with a group of age-matched alcoholics and 2 control groups. Anabolic steroid users were found to have increased risk for personality psychopathology compared with community controls. The risk appeared to be partially explained by a group membership effect. Additionally, similar to the alcoholic group, illicit anabolic steroid users also demonstrated significant antisocial traits.
Adolescent↗
The effect of gender and subtype on platelet MAO in alcoholism.
Decreased platelet MAO activity has been identified in male alcoholics with suggestions that this is primarily true of Type 2 alcoholics as defined by criteria from the Stockholm Adoption Study. Little information has been available regarding platelet MAO activity in female alcoholics. This study evaluated a group of 71 alcoholics receiving inpatient treatment, including 16 female alcoholics, for platelet MAO activity compared to controls. Female alcoholic's platelet MAO was significantly lower than controls and not different from activity levels in male alcoholics. Among male alcoholics, both Type 1 and Type 2 subgroups were lower than controls and Type 2 levels did not differ from Type 1 levels. Thus, we were unable to replicate a gender and subgroup low platelet MAO specificity among alcoholics, but did find significant differences between alcoholics and controls.
Adult↗
Longitudinal characteristics of hospital use before and after alcoholism treatment.
The frequency of inpatient hospital care for three years before and three years after alcoholism treatment was evaluated for a group of 255 patients of predominantly lower socioeconomic status treated for alcoholism at a rural midwestern medical center in 1983. Subjects were interviewed while in treatment to obtain information regarding alcoholism history and demographics. Hospital care was ascertained from an electronic data file of discharges from 172 acute care hospitals throughout the United States and Puerto Rico. One-third of the sample was never hospitalized for an alcohol-related condition in the years prior to or after alcoholism treatment, and 23% of the sample experienced no hospitalizations at all other than the treatment episode when interviewed. The majority of hospital stays before and after treatment were attributed to alcohol abuse. The frequency and total hospital length of stay for alcohol-related admissions increased yearly before treatment, peaked in the year after treatment, and then declined, but not to earliest pretreatment levels. Subjects experienced significantly more hospitalizations and length of stay after alcoholism treatment than before when comparing both the two three-year periods and the immediate 12 months before and after treatment. More frequent hospital care was also significantly associated with higher levels of daily alcohol consumption and drinking duration but not with sociodemographic indicators.
Adult↗
Panic disorder and cocaine abuse in alcoholics.
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Alcoholism↗
Adult children of alcoholics. A valid diagnostic group?
"Adult children of alcoholics" (COAs) has become a popular diagnostic categorization denoting a group of adults sharing a common environmental background. These individuals are felt to share common familial effects of early development in an "alcoholic" home. The COA concept has gained significant acceptance in the popular press with many substance abuse treatment centers developing programmed treatment approaches for Adult COAs. However, little research evidence is available to validate this diagnosis. To evaluate the validity of the Adult COA concept among patients in treatment for substance abuse, we compared a series of patients for a variety of demographic, personality, psychiatric illness, and substance abuse phenomenology measures. The results of this comparison showed few distinctions in phenomenology between the two groups. The COA group reported more specific problem-drinking behaviors and medical problems related to alcohol as well as a higher total alcoholism severity score. This study finds only limited support for the validity of the diagnosis of Adult COA in a distinct inpatient substance abuse population.
Adult↗
The initial presentation of depression in family practice and psychiatric outpatients.
Most reports characterizing the initial presentation of depression are based on patients seen in psychiatric settings. It is not clear whether the difficulty in identifying depression in medical clinic outpatients is due to physician unfamiliarity with the diagnostic criteria or because the psychiatric syndrome is not the same in early, mild cases that present with somatic symptoms. In this study, depressed patients choosing the medical clinic for care presented the same somatic symptoms as nondepressed medical patients. In comparison to depressed patients who presented to the psychiatric clinic, depressed medical patients' chief complaints were more somatic, obscure, and less psychologically focused. Depressed psychiatric patients had more symptoms on a medical review of systems checklist than did medical patients with an equivalent level of depression. When DSM-III criteria were applied, depressed patients from each clinic tended to fulfill the major and minor criteria in a similar pattern. However, the prevalence of depression in the medical setting was much lower and milder than was that presenting to the psychiatry clinic. Once present at a diagnosable stage, however, the syndrome appeared to be the same in both patient groups.
Adult↗
Personality risk factors for cocaine abuse.
To evaluate the role of personality in cocaine abuse, 59 adults meeting DSM-III criteria for cocaine abuse were compared to similar-aged non-cocaine alcohol abusers and community controls on a DSM-III measure of personality. Cocaine abusers were more likely than non-cocaine alcohol abusers to display narcissistic personality traits (Odds ratio 6.86, 95% CI = 4.52, 15.60). (Am J Public Health 1989; 79:891-892.
Adult↗
Comorbidity of bulimia nervosa and personality disorder.
Thirty patients meeting DSM-III-R criteria for bulimia nervosa with at least three bingeing episodes a week were compared with 30 age- and sex-matched controls on DSM-III personality measures. The bulimic patients were more likely to display cluster B (histrionic, narcissistic, antisocial, and borderline) personality abnormalities (odds ratio 15.0) and cluster C (avoidant, dependent, compulsive, and passive-aggressive) personality abnormalities (odds ratio 4.3) than were the community controls. This study supports the finding that personality disorder is a possible risk factor for bulimia.
Borderline Personality Disorder↗
CT abnormalities in tardive dyskinesia.
Many investigators have suspected neuropathology in tardive dyskinesia (TD) to center in the striatum. Previous computed tomographic (CT) studies of middle-aged and older subjects using linear measurements have reported primarily negative results. The present study attempts to identify neuropathological abnormalities in the periventricular region of young chronic schizophrenics using specific area measurements of in vivo brain imaging. A ratio of frontal horn area to maximal internal skull area (FHBR) was used in an effort to gain sensitivity and give a reliable measure of caudate atrophy. The ventricle-brain ratio (VBR) measurement and a cortical atrophy rating were also done. The TD and non-TD control groups did differ in the CT variables. Negative CT results do not rule out the possibility that more subtle neuropathological abnormalities may be present. Magnetic resonance imaging, with its superior gray/white matter differentiation and its ability to detect subtle differences in tissue, may discover abnormalities in TD.
Adult↗
Alcoholism in males with antisocial personality disorder.
Two hundred and sixty men entering an inpatient program for alcohol and drug treatment were interviewed and tested for cognitive disturbances and hepatic function. When the treatment group was separated by the presence or absence of antisocial personality disorder, the antisocial group was distinguished by several factors. Antisocial alcoholics were more likely to have an early onset of alcoholism and to be involved with other illicit drugs, and showed evidence of more problems with control of their drinking. They reported more alcohol-related problems as defined in DSM-III. Despite histories of a more severe form of alcoholism, the antisocials were no more likely to develop alcohol dependence or show signs of cognitive or hepatic toxicity.
Adult↗
Hyperactivity in children: changing diagnostic criteria.
Family physicians are frequently asked to discuss the probable course and outcome of hyperactivity in children. The literature is confusing with regard to the criteria used to define the hyperactivity syndrome. By using updated criteria, physicians can separate hyperactive children into two groups based on the presence or absence of coexisting conduct disorder. When these groups are considered separately, accurate predictions can be made about course and outcome.
Attention Deficit Disorder with Hyperactivity↗
Family abuse of methylphenidate.
Methylphenidate is often the drug of choice for pharmacologic treatment of attention deficit disorder. Cases of parental abuse of the drug have been reported. The likelihood of antisocial personality disorder appears to be greater in families of children with attention deficit disorder, which emphasizes the need for strategies to reduce the abuse of prescription methylphenidate.
Adolescent↗