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Hypnotizability and psychopathology.

The authors compared the hypnotic responsivity of 115 chronically ill psychiatric patients with that of 83 nonpatient volunteers. The Hypnotic Induction Profile was administered to all subjects, and diagnoses were established for the patients according to Research Diagnostic Criteria. All of the diagnosed patients (those with thought disorder, affective disorder, generalized anxiety, and miscellaneous disorders) were significantly less hypnotizable than the nonpatient comparison group. This effect was unrelated to age or medication differences. The authors discuss the implication of these findings in relation to a new model of hypnotic responsivity that takes into account the moderating effects of severe psychopathology.

Adult↗

The dilemma of denial in the assessment of competency to refuse treatment.

To illustrate the dilemma in evaluating and treating patients who deny their illness, the authors present the case of a woman with paranoia who denied she was ill and refused medication. They focus specifically on the issue of whether a patient who denies his or her illness is truly legally competent to refuse or consent to treatment. They conclude that the assessment of such competency requires a consideration of the accuracy of the patient's "appreciation of the nature of his or her situation" and that safeguards have to be built into a system for evaluating competency along these lines to prevent abuse.

Adult↗

Impact of DSM-III on clinical practice.

The authors compared criterion-based diagnoses (DSM-III) with clinical diagnoses (DSM-II) for 102 psychiatric inpatients. The introduction of specified diagnostic criteria represented a refinement of existing diagnostic practices rather than a qualitatively different approach to diagnoses; however, in the schizophrenia and affective disorder categories, nonwhites and women were more often assigned to worse prognostic category by the DSM-II system than were white men with similar symptoms. The authors suggest that the introduction of DSM-III criteria may ensure more appropriate diagnosis and treatment for nonwhites and women.

Alcoholism↗

Three cases of AIDS-related psychiatric disorders.

Psychiatric disorders related to acquired immune deficiency syndrome (AIDS) can take various and complex forms. The authors present cases of AIDS patients in whom paranoia, organic brain syndrome, depression, or suicidal ideation was present.

Acquired Immunodeficiency Syndrome↗

Social networks and psychopathology among substance abusers.

The authors studied the social networks and psychopathology of 168 patients with diagnoses of substance abuse. Small network size was correlated with higher scores on the Modified Michigan Alcohol-Drug Screening Test, higher symptom reports on the SCL-90 and the Beck Depression Inventory, and more observed psychopathology according to the Brief Psychiatric Rating Scale. Larger network size was correlated with better functioning according to the Global Assessment Scale and DSM-III axis V. The authors conclude that such symptom complexes as paranoia and phobia may undermine the social networks of substance abusers more than such symptom complexes as anxiety and depression.

Adaptation, Psychological↗

Diagnosis and clinical course of erotomanic and other delusional patients.

Twenty-eight patients with erotomanic delusions were compared with 80 patients with other delusions to clarify questions about diagnosis and course of illness in erotomania. The erotomanic patients were a heterogeneous group with respect to both diagnosis and course. They had significantly more manic symptoms than the comparison group and more affective diagnoses than would be expected from the literature; 25% (N = 7) had schizoaffective disorder and 7% (N = 2) had bipolar disorder. A subgroup of monodelusional erotomanic patients was identified who met the DSM-III-R criteria for delusional disorder, thus supporting the decision to include erotomanic delusions in this diagnostic category in the revision of DSM-III.

Adolescent↗

Chronological association between increases in drug abuse and psychosis in Connecticut state hospitals.

Disagreement remains as to whether drug use can result in an autonomous psychotic disorder. If drug use can create new psychosis cases, an increase in the number of psychosis patients ought to be observable following periods of increased drug use by the general population. First admissions data for the categories of drug abuse and schizophrenia/paranoid disorders from all Connecticut state hospitals from 1965 to 1983 were examined to determine the prevalence of psychotic disorders before, during, and after a period of increased drug use by the general population. Affective disorders first admissions were examined for comparison. A rapid increase in new schizophrenia admissions coincided with a peak period for drug-related admissions. The data suggest that increased drug use of the late 1960s may have contributed to the increase noted 3 to 5 years later in first admissions of patients diagnosed with psychotic disorders.

Adolescent↗