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PubMed2001

Personality and outcome in depression: an 18-month prospective follow-up study.

BACKGROUND: The relationship between personality and depressive illness is complex. The aim of this study was to assess whether the presence of a personality disorder or high neuroticism (N) scores predicted longer times to discharge or remission onset or higher risks of relapse for a cohort of depressed subjects admitted for the first time. METHODS: 100 consecutive subjects with ICD-10-defined depression were recruited on admission and followed up prospectively over an 18-month period. Personality function was rated using the informant-rated Standard Assessment of Personality in addition to the self-rated Maudsley Personality Inventory. Remission onset and relapse were defined operationally by scores on the Hamilton Rating Scale using recommended criteria. RESULTS: The presence of a personality disorder predicted longer times to remission onset. Personality trait accentuation did not. Higher end N-scores correlated with longer times to remission onset. Neither personality disorder nor high N-scores predicted relapse or discharge risk. Subjects with a personality disorder were treated as aggressively as those without but those with higher N-scores were not. LIMITATIONS: It is an in-patient sample. Fifteen subjects dropped out of follow-up and those who did so were more likely to have met criteria for two or more personality disorder categories or four or more traits from one personality disorder category. The analysis assumes that state and scar effects on N-scores were minimised. Treatment decisions were not controlled. CONCLUSIONS: These findings support the view that the presence of a personality disorder and high N-scores modify the short-term course to remission onset in depression.

Adult↗
PubMed1991

Personality stability and adolescent substance use behaviors.

Several personality needs have consistently been identified as placing adolescents at heightened risk for the relatively intensive use of alcohol and other drugs. At the same time, little is known about the natural history of personality change during adolescence as it relates to substance use behaviors. Yet, this question is of clear importance to our understanding of personality risk factors for substance use because personality needs appear less temporally stable during adolescence than later in the life span. In this study, we use prospective longitudinal data to investigate the relation of high-risk personality needs to substance use in two groups of adolescents: those who maintained a temporally stable personality need structure across 3 years and those who showed considerable changes in personality needs during the same time interval. Subjects were 12, 15, or 18 years old at the first test time and 15, 18, or 21 years old, respectively, at the second test time. For subjects of both sexes, only those who maintained a temporally stable, low-risk personality profile showed quite conservative substance use patterns across time compared with all others. Generalized personality changes were linked to more intensive substance use behaviors in males, especially among those who had high levels of risky personality needs at the first test time. In contrast, personality change, per se, did not appear as relevant to females' alcohol and other drug use behaviors until combined with information regarding their level of high-risk personality needs. The results are discussed in terms of their implications for prevention and future research.

Adaptation, Psychological↗
PubMed1993

Comorbidity of conduct disorder and personality disorders in an incarcerated juvenile population.

OBJECTIVE: Youths with conduct disorder extract an inordinate amount of time and money from the U.S. judicial system and taxpayers, yet studies pertaining to this population have been few. This study was undertaken to examine the co-occurrence of personality disorders and conduct disorder in a group of incarcerated children and adolescents and to raise the issue of the possibility of antisocial personality disorder in persons under the age of 18 years. METHOD: One hundred incarcerated juvenile offenders aged 11-17 years were randomly selected and then interviewed with the Diagnostic Interview for Children and Adolescents--Revised and the Structured Clinical Interview for DSM-III-R Personality Disorders to establish their psychiatric diagnoses. RESULTS: Eighty-seven percent of the group met the criteria for conduct disorder. Among those diagnosed as having conduct disorder, the only comorbid personality disorder that was present with significant frequency was antisocial personality disorder. The other comorbid personality disorder diagnoses that appeared most frequently were the borderline, narcissistic, paranoid, passive-aggressive, and dependent types. Borderline personality disorder was observed more frequently in the females than in the males with conduct disorder. CONCLUSIONS: The findings suggest that by using DSM-III-R criteria for adult personality disorders, one finds a considerable number of personality disorders in a young population with conduct disorder. The findings also show that youths manifest signs of antisocial personality disorder before they are 18 years of age, raising the question of how age should be incorporated into the diagnosis of personality disorder as DSM-IV is being prepared.

Adolescent↗
PubMedDate not supplied

[Dimensions of personality disorders and neurophysiological correlates].

INTRODUCTION: To objective is to identify the factorial structure underlying personality disorders, using clinical and personality measures, and to check whether the resulting structure is valid and theoretically comprehensible, using neurocognitive and psychophysiological measures for establishing possible differences between the factors. METHOD: From the data obtained with the scales MCMI-II and BFQ administered to a sample of 87 subjects diagnosed as a case of any clinical category of DSM-IV personality disorders, and 17 normal controls, we carried out first-order and second-order factor analyses. RESULTS: Five first-order factors (designated as aggressive personality, personality with social deficit, non-pathological personality, obsessive personality and non-assertive personality) and three second-order factors (non-pathological/obsessive personality) were found. CONCLUSIONS: On studying the second-order factors in relation to neurocognitive and psychophysiological measures, it was found that socially-inhibited and non-assertive personalities (factor 1) are characterized by specific neuropsychological deficits in sustained attention; that aggressive personalities (factor 2) are characterized by impulsiveness and deficit in concepts formation; and that in non-pathological personalities with obsessive traits (factor 3), as obsessiveness increases, subjects present less efficacy in sustained attention tasks and greater psychogalvanic response to stress.

Adult↗
PubMed2005

Association of personality disorders with Type A and Type B alcoholics.

Personality disorders frequently occur as comorbid disorder in alcohol-dependent subjects. Antisocial personality was described as an important characteristic in Cloninger's Type 2 and Babor's Type B subjects. The impact of other personality disorders on these alcoholism typologies, their pathogenesis and prognosis is, however, still unclear. The present study investigated the prevalence of personality disorders in 237 (194 males) detoxified alcohol-dependent patients after subtyping this sample according to Babor's Type A/B following the criteria suggested by Schuckit et al. (1995). Personality disorders were assessed with the SCID-II (DSM-IV). In all, 160 patients (68 %) could be classified as Type A, and 77 (32 %) as Type B. Type B subjects were younger, had an earlier onset,more alcohol intake and a more severe course of alcohol dependence. Type B patients had significantly more often any cluster A and B personality disorder, and significantly specifically more often a borderline, antisocial and avoidant personality disorder. There were no statistical differences concerning the other personality disorders. In summary, the Type A/B dichotomy using the criteria of Schuckit et al. (1995) was replicated successfully. Differences concerning cluster B personality disorder prevalence of Type B subjects demonstrated that these subjects are significantly more often affected from borderline and antisocial personality disorder. The impact of other personality disorders does not play a substantial role in subtyping alcoholics.

Adult↗
PubMed1994

Validity of self-defeating personality disorder.

OBJECTIVE: The purpose of this study was to assess the validity of DSM-III-R self-defeating personality disorder. METHOD: Applicants for inpatient treatment of personality disorders (N = 100) or psychoanalysis (N = 100) were independently evaluated face to face by experienced clinicians using the Structured Clinical Interview for DSM-III-R and the Personality Disorder Examination. Internal consistency; agreement between assessments; diagnostic efficiency of criteria; prevalence; sex ratio; comorbidity with axis I and II disorders; and relationship to education, current employment, and selection for psychoanalytically oriented treatment were examined. RESULTS: The internal consistency of the criteria set and the agreement between psychiatric assessments of self-defeating personality disorder were fair. The most discriminating criteria were those referring to a) choices leading to disappointment, failure, or mistreatment and b) rejection of opportunities for pleasure. A consensus diagnosis of self-defeating personality disorder was more common than all but three other axis II disorders. The sex ratio of the subjects with this diagnosis was not significantly different from the sex ratio of the entire subject group or of patients with other personality disorders. Significant comorbidity with borderline and dependent personality disorders and with current mood disorders was found. Patients with self-defeating personality disorder resembled patients with other personality disorders in educational attainment and treatment assignment. They were more likely to be employed. CONCLUSIONS: These data lend little support to the validity of self-defeating personality disorder as a separate personality disorder category.

Adolescent↗
PubMed2003

Personality diagnoses in adolescence: DSM-IV axis II diagnoses and an empirically derived alternative.

OBJECTIVE: The study of personality pathology in adolescence is in its infancy. This article examined the applicability and limits of DSM-IV axis II personality disorder diagnoses in adolescents, assessed the validity of a method for assessing adolescent personality pathology, and began to develop an empirically grounded classification. METHOD: A total of 296 randomly selected clinicians described a patient age 14-18 in treatment for maladaptive personality patterns using axis II ratings scales and the Shedler-Westen Assessment Procedure-200 for Adolescents (SWAP-200-A), a Q-sort instrument for assessing adolescent personality pathology. After examining the nature and frequency of axis II disorders in the sample, the authors used Q-factor analysis to identify naturally occurring groupings of patients on the basis of shared personality features. RESULTS: Axis II diagnoses in adolescents resembled those in adults, although application of DSM-IV criteria appeared to overdiagnose antisocial and avoidant personality disorder in adolescents. Q analysis with the SWAP-200-A isolated five personality disorders (antisocial-psychopathic, emotionally dysregulated, avoidant-constricted, narcissistic, and histrionic) and one personality style. Patients' dimensional scores on each diagnostic prototype showed predictable associations with ratings of current axis II disorders, measures of adaptive functioning, and symptoms assessed with the Child Behavior Checklist. CONCLUSIONS: With some exceptions, personality pathology in adolescence resembles that in adults and is diagnosable in adolescents ages 14-18. Categories and criteria developed for adults may not be the optimal way of diagnosing adolescents. Data from samples of adolescents may prove useful in developing an empirically and clinically grounded classification of personality pathology in adolescents.

Adolescent↗
PubMed2002

[Models for understanding personality pathology].

BACKGROUND: The prevalence of personality disorders is high and patients with personality disorders are known to be difficult to treat. The assessment of different types of personality disorders has been facilitated by the development of explicit diagnostic criteria. However, the diagnostic manuals have tended to be atheoretical, defining and classifying personality disorders mainly on a descriptive level of behaviour and symptoms. There is no consensus on a theoretical understanding of personality pathology. The concept of personality disorder is currently under debate and investigation, theoretically as well as empirically. MATERIAL AND METHODS: This paper presents some of the major theories of personality disorders that are currently discussed in the literature. RESULTS: The models represent different schools of thought, lean on different methodological assumptions, and focus on different aspects of personality. The theories are to varying degrees focused on aetiology, classification and treatment. A major trend is to supplement theories developed within the context of clinical psychiatry with models from normal psychology. INTERPRETATION: Personality disorder is a complex phenomenon. Different theories are probably useful for different aspects of personality pathology and for different groups of personality disorders. More empirical research is needed in order to clarify the validity of the different models.

Behavior↗
PubMedDate not supplied

[Characteristics of the forming personality in children suffering from anorexia nervosa].

AIM: The evaluation of forming personality in 30 children (27 girls and 3 boys) suffering from anorexia nervosa (average age--13.5). METHOD: Anamnesis from patients and their parents, clinical observation, psychiatric investigation, psychological investigation with use of following methods: The Thematic Apperception Test, Colorful Pyramids Test, The House-The Tree-The Man Test. RESULTS: After the conducted investigation and observation, the characteristics of the forming incorrect personality were observed in 80% of examined children. According to DSM IV classification, in 50%--from the cluster C, and in 30% cases--the cluster B. According to ICD-10 classification: 26.6% attributes of dependent personality, 16.6%--histrionic personality, 13.3% avoiding personality, 10%--anancastic personality, 6.7% borderline personality and 6.7% antisocial personality. CONCLUSIONS: There is predominating opinion in literature, connecting restrictive type of psychical anorexia, with disorders of personality of anxiety type--the cluster C, and the figure bulimic--with personality the cluster B. Those results were confirmed with statistical significance in the conducted examinations.

Adolescent↗
PubMed1992

Urinary excretion of diethylphosphorus metabolites in persons poisoned by quinalphos or chlorpyrifos.

The urinary excretion rates of diethyl phosphate and diethyl phosphorothioate and changes in blood cholinesterase activities were studied in fifteen persons self-poisoned either by the organophosphorus pesticide quinalphos (twelve persons) or by chlorpyrifos (three persons). The organophosphate poisoning was always indicated by a significant depression of serum and/or red blood cell cholinesterase activities. The return of serum cholinesterase activity in the range of referent values took more than 30 days and had a different course in different persons. The most rapid increase in red blood cell acetylcholinesterase activity was noted within 24 h after the first treatment with oximes Pralidoxime and/or HI-6. None of the spot urine samples, collected daily after admission of persons to hospital, contained measurable quantities of the parent pesticide. There was no correlation between the maximum concentration of total urinary diethylphosphorus metabolites normalized to creatinine and the initial inhibition of blood cholinesterase activities measured in samples collected on the day of admission to hospital. The excretion of metabolites followed the kinetics of a biphasic reaction. The half-time of urinary metabolites concentration decrease in the fast excretion phase in quinalphos poisoned persons was 5.5-14.2 h (eight persons) and 26.8-53.6 h (four persons) and in chlorpyrifos poisoned persons 3.5-5.5 h. The half-time for the slow excretion phase ranged from 66.5 to 127.9 h in all persons and for both compounds. For a given person, the rates of excretion of diethyl phosphate and diethyl phosphorothioate were about the same. However, in quinalphos poisoned persons the proportions of single metabolites in total diethylphosphorus metabolites varied with the initial maximum concentration of total metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

Are there differences between older persons who screen positive on the CAGE questionnaire and the Short Michigan Alcoholism Screening Test-Geriatric Version?

OBJECTIVES: To determine (1) the extent of agreement between the CAGE (acronym for cut down, annoyed by criticism, guilty about drinking, eye-opener drinks) and the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G) in identifying older persons who may have possible alcohol use disorders (AUDs) and (2) whether persons identified as having possible AUDs by each of these screening measures differ in their drinking, demographic, or health-related characteristics. DESIGN: Secondary analysis of a cross-sectional study using data from a self-administered mailed survey sample. SETTING: Three organizations were surveyed: (1) members of the American Association of Retired Persons and, in southern California, (2) managed care enrollees in a large medical group and (3) attendees of a community-based senior health center. PARTICIPANTS: One thousand eight hundred eighty-nine persons aged 55 and older completing a health risk appraisal for older persons (Health Risk Appraisal for the Elderly (HRA-E)). MEASUREMENTS: The HRA-E included items on drinking behaviors (including amount of alcohol use, the CAGE, and the SMAST-G) and health and demographic characteristics. RESULTS: Twenty-six percent of all persons screened positive on the CAGE or the SMAST-G. Fewer than half of all persons screening positive on either the CAGE or the SMAST-G, screened positive on both measures. Among current drinkers, persons screening positive on the SMAST-G alone drank less than persons screening positive on the CAGE alone, and these persons drank less than those screening positive on both the SMAST-G and the CAGE. More men screened positive on the CAGE alone than on the SMAST-G alone. CONCLUSION: Fewer than half of persons screening positive on either the CAGE or the SMAST-G screened positive on both measures, suggesting that these instruments may be capturing different aspects of unsafe drinking. A screening strategy employing both brief measures may identify more AUDs among older persons having differing demographic and health characteristics.

Age Factors↗
PubMed2006

Formaldehyde exposure in a gross anatomy laboratory--personal exposure level is higher than indoor concentration.

GOAL, SCOPE AND BACKGROUND: Cadavers for gross anatomy laboratories are usually prepared by using embalming fluid which contains formaldehyde (FA) as a principal component. During the process of dissection, FA vapors are emitted from the cadavers, resulting in the exposure of medical students and their instructors to elevated levels of FA in the laboratory. The American Conference of Governmental Industrial Hygienists (ACGIH) has set a ceiling limit for FA at 0.3 ppm. In Japan, the Ministry of Health, Labour and Welfare has set an air quality guideline defining two limit values for environmental exposure to FA: 0.08 ppm as an average for general workplaces and 0.25 ppm for specific workplaces such as an FA factory. Although there are many reports on indoor FA concentrations in gross anatomy laboratories, only a few reports have described personal FA exposure levels. The purpose of the present study was to clarify personal exposure levels as well as indoor FA concentrations in our laboratory in order to investigate the relationship between them. METHODS: The gross anatomy laboratory was evaluated in the 4th, 10th and 18th sessions of 20 laboratory sessions in total over a period of 10 weeks. Air samples were collected using a diffusive sampling device for organic carbonyl compounds. Area samples were taken in the center and four corners of the laboratory during the entire time of each session (4-6 hours). Personal samples were collected from instructors and students using a sampling device pinned on each person's lapel, and they were 1.1 to 6 hours in duration. Analysis was carried out using high performance liquid chromatography. RESULTS AND DISCUSSION: Room averages of FA concentrations were 0.45, 0.38 and 0.68 ppm for the 4th, 10th and 18th sessions, respectively, ranging from 0.23 to 1.03 ppm. These levels were comparable to or relatively lower than the levels reported previously, but were still higher than the guideline limit for specific workplaces in Japan and the ACGIH ceiling limit. The indoor FA concentrations varied depending on the contents of laboratory sessions and seemed to increase when body cavity or deep structures were being dissected. In all sessions but the 4th, FA levels at the center of the room were higher than those in the corners. This might be related to the arrangement of air supply diffusers and return grills. However, it cannot be ruled out that FA levels in the corners were lowered by leakage of FA through the doors and windows. Average personal exposure levels were 0.80, 0.45 and 0.51 ppm for instructors and 1.02, 1.08 and 0.89 ppm for students for the 4th, 10th and 18th session, respectively. The exposure levels of students were significantly higher than the mean indoor FA concentrations in the 4th and 10th sessions, and the same tendency was also observed in the 18th session. The personal exposure level of instructors was also significantly higher than the indoor FA level in the 4th session, while they were almost the same in the 10th and 18th sessions. Differences in behavior during the sessions might reflect the differential personal exposure levels between students and instructors. CONCLUSION: The present study revealed that, if a person is close to the cadavers during the gross anatomy laboratory, his/her personal exposure level is possibly 2 to 3-fold higher than the mean indoor FA concentration. This should be considered in the risk assessment of FA in gross anatomy laboratories. RECOMMENDATION AND OUTLOOK: If the risk of FA in gross anatomy laboratories is assessed based on the indoor FA levels, the possibility that personal exposure levels are 2 to 3-fold higher than the mean indoor FA level should be taken into account. Otherwise, the risk should be assessed based on the personal exposure levels. However, it is hard to measure everyone's exposure level. Therefore, further studies are necessary to develop a method of personal exposure assessment from the indoor FA concentration.

Air Pollution, Indoor↗
PubMed1995

Listeria monocytogenes infection and serotype distribution among HIV-infected persons in Los Angeles County, 1985-1992.

Persons infected with human immunodeficiency virus (HIV) are at greater risk of infection with Listeria monocytogenes (LM) than the general population. We quantify the risk of listeriosis in persons with acquired immune deficiency syndrome (AIDS) and HIV infection in Los Angeles County (LAC) and report the LM serotype distribution among HIV-infected patients with listeriosis. Active surveillance for listeriosis was performed in LAC during most of the period from 1985 through 1992. Thirty-four (10%) of 351 nonperinatal cases of listeriosis reported in LAC from 1985 through 1992 were in HIV-infected persons, 25 of whom met the 1987 AIDS case definition. The incidence of listeriosis was 95.8 and 8.8 cases per 100,000 person-years among persons with AIDS and all HIV-infected persons, respectively, but only 1.0 case per 100,000 person-years in the total population. Excluding cases from a 1985 listeriosis epidemic associated with consumption of contaminated Mexican-style cheese, 11 (65%) of 17 HIV-infected persons with available isolates were infected with LM serotype 1/2b, whereas only 64 (31%) of 208 other persons with listeriosis and available isolates were infected with LM serotype 1/2b (odds ratio = 4.1; 95% confidence interval = 1.3-14.1). LM serogroup 1/2b may have been more common among HIV-infected persons in LAC than among other persons with listeriosis because of differences in diet or sexual practices, or to chance alone. Persons with HIV-infection, especially those with AIDS, should be educated in avoiding foods at high risk of listerial contamination, such as soft cheeses, foods sold from delicatessen counters, and undercooked chicken.

Adolescent↗
PubMed2006

Personal digital assistants change management more often than paper texts and foster patient confidence.

INTRODUCTION: Rapid retrieval of information, including drug treatment options, is critical to emergency department practice. OBJECTIVES: To assess feasibility and patient acceptance of personal digital assistants and to determine the scope of management changes. METHODS: Emergency medicine residents (EMRs, n = 18) and emergency medicine attending (EMAs, n = 12) used personal digital assistants with drug database and clinical references. Text versions were also available in the emergency department. We did a prospective, random, cross-over time-motion study, recording retrieval time, source, and changes to patient care for 16 and 8 h for EMRs and EMAs, respectively. We surveyed patients for confidence in EMRs and EMAs with personal digital assistants, and perceived efficiency. RESULTS: EMRs accessed paper (n = 131) or personal digital assistant (n = 181) information on 92.3% of patients (n = 17, both). They accessed personal digital assistant on 61.4% of patients vs. 44.5% with texts (odds ratio 1.99, 95% confidence interval 1.4-2.80). Mean access times were 9.3 and 9.4 s, respectively, +1.4 for both. Personal digital assistant access was 75%/25% between pharmacopeia and clinical resource. Personal digital assistants changed drug choice in 39/181 patients (21.5%), and other management (diagnosis, treatment or disposition) in 15/181 patients (8.3%). Odds ratio for change in management for personal digital assistant vs. paper was 2.00 (95% confidence interval 1.11-3.60). We surveyed patient perception for 198 of 295 patients (67.1%). Fifty percent reported more confidence in their EMRs and EMAs with a personal digital assistant, while 5% reported less confidence. Sixty percent agreed strongly that there is too much medical information to remember. CONCLUSIONS: Personal digital assistants are feasible in an academic emergency department and change management more often than texts. EMRs accessed personal digital assistants more often than paper texts. Patient perceptions of physicians who use personal digital assistants are neutral or favorable.

Attitude of Health Personnel↗
PubMed1999

Drug treatment of hypertension in older persons in an academic hospital-based geriatrics practice.

OBJECTIVE: To investigate the prevalence of hypertension in older persons, the prevalence of the different antihypertensive drugs used to treat hypertension, the prevalence of the different antihypertensive drugs used to treat hypertension in persons with prior myocardial infarction (MI) or congestive heart failure (CHF), and the prevalence of lowering the blood pressure to <140/90 mm Hg with therapy. DESIGN: A retrospective analysis of charts from all older patients seen from December 1, 1997, through August 31, 1998, at an academic, hospital-based geriatrics practice was performed to investigate the prevalence of hypertension in older persons, the prevalence of different antihypertensive drugs used to treat hypertension, the prevalence of different antihypertensive drugs used to treat hypertension in persons with prior MI or CHF, and the prevalence of lowering the blood pressure to <140/90 mm Hg with therapy. SETTING: An academic hospital-based geriatrics practice staffed by fellows in a geriatrics training program and fulltime faculty geriatricians. PATIENTS: A total of 459 men and 1360 women, mean age 80 +/- 8 years (range 59 to 101 years), were included in the study. MEASUREMENTS AND MAIN RESULTS: Hypertension was present in 1051 of the 1819 persons in the study (58%). Target organ damage, clinical cardiovascular disease, or diabetes mellitus was present in 738 (70%) of these 1051 persons. Of the 1051 persons with hypertension, 520 (49%) were treated with diuretics, 297 (28%) with beta-blockers, 445 (42%) with angiotensin-converting enzyme (ACE) inhibitors, 171 (16%) with calcium channel blockers, and 13 (1%) with other antihypertensive drugs; 41 (4%) received no antihypertensive therapy. The last blood pressure recorded on the chart was <140/90 mm Hg for 735 of the 1051 persons (70%) with hypertension. Of 306 persons with hypertension and prior MI, 182 (59%) were treated with beta-blockers, 146 (48%) with ACE inhibitors, 96 (31%) with diuretics, and 29 (9%) with calcium channel blockers. Of 103 persons with hypertension and CHF, 103 (100%) were treated with diuretics, 94 (91%) with ACE inhibitors, 22 (21%) with beta-blockers, and 3 (3%) with calcium channel blockers. CONCLUSIONS: The prevalence of hypertension in the 1819 older persons seen in an academic, hospital-based geriatrics practice was 58%. Educational efforts led to increased use of diuretics and beta-blockers and decreased use of calcium channel blockers in treating hypertension. The last blood pressure recorded on the chart was <140/90 mm Hg in 70% of older persons with hypertension in the study.

Aged↗
PubMed2006

[Effects of the personal stereo system on hearing in adolescents].

OBJECTIVES: This study was conducted to evaluate the effects of the personal stereo system on the hearing in adolescents. METHODS: A total of 68 adolescents (age: 13-18 years) who visited the ENT Department at a University Hospital in Daegu were personally interviewed. The questionnaires were about general characteristics of the subjects, the time of personal stereo system use (year, hour) and place. Cumulative exposure to the personal stereo system was calculated by the product of the total years and the daily hours of their use. Pure tone audiometry was performed and the hearing threshold was measured at 500, 1000, 2000, 4000 and 8000 Hz. RESULTS: The average time of using a personal stereo system a day was about 3 hours and 75% of the subjects used a personal stereo system for 2-5 years. The elevation of threshold was more prominent in the subjects who used personal stereo systems for 4 years and more compared with those subjects who used them for 3 years and under. The elevation of hearing threshold was also more prominent in the subjects who used personal stereo systems for 4 hours and more a day compared with those subjects who used personal stereo systems for 3 hours and under a day. The elevation of hearing threshold was more prominent in the subjects who used personal stereo systems for 13 hour x years and more compared to the subjects who used them 12 hour x years and under. CONCLUSIONS: These results suggest that the elevation of hearing threshold can happen to adolescents who used personal stereo systems for a long time. In order to prevent hearing loss, we need to teach adolescents appropriate usage of the personal stereo system and hearing tests should be included in the periodic school-based physical examination for the adolescents.

Adolescent↗
PubMed1997

Anergy skin testing and tuberculosis [corrected] preventive therapy for HIV-infected persons: revised recommendations. Centers for Disease Control and Prevention.

This report updates and supersedes previous recommendations (MMWR 1991;40[No. RR-5]:27-33) for the use of anergy skin testing in conjunction with purified protein derivative (PPD)-tuberculin skin testing of persons infected with human immunodeficiency virus (HIV). In February 1997, CDC convened a meeting of consultants to discuss current information regarding anergy skin testing, PPD skin testing, and tuberculosis (TB) preventive therapy for HIV-infected persons. In formulating these recommendations, CDC considered the results of this meeting, as well as a review of published studies pertaining to PPD and anergy skin testing of persons who are infected with HIV. Isoniazid preventive therapy is effective in reducing the incidence of active TB among persons who have HIV infection and latent TB. Because of the complications associated with TB disease in HIV-infected persons, these persons must be screened for tuberculin infection. HIV-infected persons who have positive reactions to skin testing with PPD tuberculin should be evaluated to exclude active TB and offered preventive therapy with isoniazid if indicated. However, HIV-infected persons may have compromised ability to react to PPD-tuberculin skin testing, because HIV infection is associated with an elevated risk for cutaneous anergy. Anergy testing is a diagnostic procedure used to obtain information regarding the competence of the cellular immune system. When a clinician elects to use anergy testing as part of a multifactorial assessment of a person's risk for TB, the two Food and Drug Administration-approved Mantoux-method tests (mumps and Candida), used together, with cut-off diameters of 5 mm of induration, are recommended. Efforts to apply the results of anergy testing to preventive therapy decisions must be supplemented with information concerning the person's risk for infection with Mycobacterium tuberculosis. Factors limiting the usefulness of anergy skin testing include problems with standardization and reproducibility, the low risk for TB associated with a diagnosis of anergy, and the lack of apparent benefit of preventive therapy for groups of anergic HIV-infected persons. Therefore, the use of anergy testing in conjunction with PPD testing is no longer recommended routinely for screening programs for M. tuberculosis infection conducted among HIV-infected persons in the United States.

AIDS-Related Opportunistic Infections↗
PubMed1994

Five-year outcome from eating disorders: relevance of personality disorders.

In order to assess the relationship of personality disorder and eating disorder outcome 30 eating disordered patients were followed up 4-5 years after taking part in a study examining the prevalence of personality disorders in eating disordered individuals. Subjects with personality disorders did not differ from those without personality disorders in the amount of symptomatic change over time, although their psychopathology generally remained more severe. The relationship of personality disorder and clinical outcome ratings varied depending on the personality measure. SCID-II personality disorder diagnoses were not significantly associated with outcome ratings, but were related to a greater likelihood to be hospitalized and treated with psychotropic medications. Results with a new personality measure, the Wisconsin Personality Inventory, did display an association between personality disturbance and eating disorder outcome ratings and also suggested that borderline personality was a significant predictor of outcome.

Adolescent↗