Dr. Donlon Replies

The authors provide an overview of privatization, a major trend in mental health policy, focusing in particular on the reasons for and consequences of substantial growth and change in ownership of private psychiatric hospitals; the proportion of all nonfederal psychiatric inpatient beds in private facilities has increased from less than 10% in 1970 to 35% today. It is estimated that between 1970 and 1986, the proportion of total nonfederal psychiatric inpatient beds in the United States that were under corporate for-profit auspices increased from about 1% to 15%. The authors distinguish and examine several aspects of privatization and assess the implications of these changes for psychiatry and for public policy and research.

The authors investigated the pharmacological treatment of delusional depression by assigning patients on a random double-blind basis to amitriptyline alone, perphenazine alone, or a combination of the two. Fourteen (78%) of the 18 patients assigned to amitriptyline plus perphenazine were responders, compared with seven (41%) of 17 patients treated with amitriptyline alone and three (19%) of the 16 patients treated with perphenazine alone. The combination of amitriptyline and perphenazine was clearly superior (p less than .01).

Although attention deficit hyperactivity disorder is a common disorder of childhood, its status as a disorder in adults is not clear. The authors reasoned that if the adult diagnosis of the disorder is a valid clinical entity, it should be similar to the childhood disorder with regard to patterns of psychiatric and cognitive findings. Eighty-four adults with a clinical diagnosis of childhood-onset attention deficit hyperactivity disorder confirmed by structured interview who were referred for treatment were studied. Findings were compared with those from a preexisting study group of referred children with attention deficit hyperactivity disorder, nonreferred adult relatives of those children who also had attention deficit hyperactivity disorder, and adults without the disorder who were relatives of normal children. Subjects were evaluated with a comprehensive battery of psychiatric, cognitive, and psychosocial assessments. The referred and nonreferred adults with attention deficit hyperactivity disorder were similar to one another but more disturbed and impaired than the comparison subjects without the disorder. The pattern of psychopathology, cognition, and functioning among the adults with attention deficit hyperactivity disorder approximated the findings for children with the disorder. These results show that referred and nonreferred adults with attention deficit hyperactivity disorder have a pattern of demographic, psychosocial, psychiatric, and cognitive features that mirrors well-documented findings among children with the disorder. These findings further support the validity of the diagnosis for adults.

Back to table of contents Previous article Next article ArticleNo AccessDr. Weintraub and Associates ReplyWALTER WEINTRAUB, HENRY T. HARBIN, JONATHAN BOOK, GARY W. NYMAN, ALP KARAHASAN, THOMAS KRAJEWSKI, and BRUCE L. REGANWALTER WEINTRAUBSearch for more papers by this author, HENRY T. HARBINSearch for more papers by this author, JONATHAN BOOKSearch for more papers by this author, GARY W. NYMANSearch for more papers by this author, ALP KARAHASANSearch for more papers by this author, THOMAS KRAJEWSKISearch for more papers by this author, and BRUCE L. REGANSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.141.9.1128-aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Dr. Weintraub and Associates Reply." American Journal of Psychiatry, 141(9), pp. 1128-a–1129 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byResearch and Services Partnerships: The Practice Research Network: A Successful Collaboration in MarylandSandra J. Sundeen, M.S.N., Howard H. Goldman, M.D., Ph.D., Daniel J. Nieberding, M.S., L.C.P.C., Deborah A. Piez, M.S., L.P.C., and Robert W. Buchanan, M.D.1 May 2013 | Psychiatric Services, Vol. 64, No. 5Community Mental Health Journal, Vol. 41, No. 6A Three-Decade Perspective on Community and Public Psychiatry Training in OregonRupert Goetz, M.D., David L. Cutler, M.D., David Pollack, M.D., Neil Falk, M.D., Elizabeth Birecree, M.D., Bentson McFarland, M.D., Ph.D., George Keepers, M.D., and Dale Walker, M.D.1 September 1998 | Psychiatric Services, Vol. 49, No. 9Residency training in massachusetts: A new approach to state-university collaborationThe journal of mental health administration, Vol. 24, No. 1A Public-Academic Partnership to Train Psychiatric Residents in a Rural Mental Health ProgramDrew Bridges1 April 2006 | Psychiatric Services, Vol. 45, No. 1Academic Psychiatry, Vol. 16, No. 3The Program for Public Psychiatry: State-University Collaboration in ColoradoGordon Neligh, James H. Shore, James Scully, Haydee Kort, Brock Willett, Courtenay M. Harding, and George Kawamura1 April 2006 | Psychiatric Services, Vol. 42, No. 1The Maryland Plan: The Rest of the StoryWalter Weintraub, Gary Nyman, and Henry Harbin1 April 2006 | Psychiatric Services, Vol. 42, No. 1Community Mental Health Journal, Vol. 27, No. 6A basic residency curriculum concerning the chronically mentally ill1 April 2006 | American Journal of Psychiatry, Vol. 146, No. 10New Directions for Mental Health Services, Vol. 1989, No. 42New Directions for Mental Health Services, Vol. 1989, No. 44New Directions for Mental Health Services, Vol. 1989, No. 44Too Many Psychiatrists?WALTER WEINTRAUB1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 3Too Many Psychiatrists?ARTHUR S. MODE1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 3Accuracy of the diagnoses of affective disorders and schizophrenia in public hospitals1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 2New Directions for Mental Health Services, Vol. 1988, No. 37Psychiatric Quarterly, Vol. 59, No. 2Psychiatric Quarterly, Vol. 59, No. 2Psychiatric Quarterly, Vol. 59, No. 2Academic, community and state mental health program collaboration: The Oregon experienceCommunity Mental Health Journal, Vol. 23, No. 4CMHC's: Relationships with academia and the stateCommunity Mental Health Journal, Vol. 23, No. 4Recruitment of Public Psychiatrists: The Impact of University and State Collaboration on FMGs in MarylandWalter Weintraub, and Jonathan Book1 April 2006 | Psychiatric Services, Vol. 37, No. 10Graduates of Foreign Medical Schools in American PsychiatryRodrigo A. Munoz, and Michael Madigan1 April 2006 | Psychiatric Services, Vol. 37, No. 10TEAMS: Teamwork Training for Interns, Residents, and NursesJohn P. Bair, and Brad K. Greenspan1 April 2006 | Psychiatric Services, Vol. 37, No. 6Public-Sector PsychiatristsWalter Weintraub, and Henry T. Harbin1 April 2006 | Psychiatric Services, Vol. 37, No. 6In ReplyKevin Leehey, and John Misiaszek1 April 2006 | Psychiatric Services, Vol. 37, No. 6 Volume 141Issue 9 September 1984Pages 1128-a-1129 Metrics PDF download History Published online 1 April 2006 Published in print 1 September 1984

The authors report the latest findings from a 32-year longitudinal study of 269 back-ward patients from Vermont State Hospital. This intact cohort participated in a comprehensive rehabilitation program and was released to the community in a planned deinstitutionalization effort during the mid-1950s. At their 10-year follow-up mark, 70% of these patients remained out of the hospital but many were socially isolated and many were recidivists. Twenty to 25 years after their index release, 262 of these subjects were blindly assessed with structured and reliable protocols. One-half to two-thirds of them had achieved considerable improvement or recovery, which corroborates recent findings from Europe and elsewhere.

Back to table of contents Previous article Next article ArticleNo AccessTHE SCOPE AND PRACTICE OF AN EARLY-ACCESS BRIEF TREATMENT PSYCHIATRIC CENTERG. F. JACOBSON, D. M. WILNER, W. E. MORLEY, S. SCHNEIDER, M. STRICKLER, and G. J. SOMMERG. F. JACOBSONSearch for more papers by this author, D. M. WILNERSearch for more papers by this author, W. E. MORLEYSearch for more papers by this author, S. SCHNEIDERSearch for more papers by this author, M. STRICKLERSearch for more papers by this author, and G. J. SOMMERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.121.12.1176AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByLiteraturTraining for Crisis Counselling16 October 2007 | British Journal of Guidance & Counselling, Vol. 11, No. 2Customer Approach and Walk-in Clinic Drop-Out Phenomenon27 July 2016 | International Journal of Social Psychiatry, Vol. 29, No. 2Walk-in Clinic Drop-Outs27 July 2016 | International Journal of Social Psychiatry, Vol. 28, No. 3Crisis intervention with adultsNew Directions for Mental Health Services, Vol. 1980, No. 6Comprehensive Psychiatry, Vol. 20, No. 6Terapia breve em hospital fechadoArquivos de Neuro-Psiquiatria, Vol. 36, No. 3A HOSPITALIZATION CRITERIA CHECKLIST AS AN EVALUATION TOOL FOR AN EMERGENCY SERVICERobert Sherrill, Jr.1 April 2006 | Psychiatric Services, Vol. 28, No. 11Generic and Individual Approaches to Crisis InterventionConspiracy of silence: psychiatric counseling with students at high risk for academic failure1 April 2006 | American Journal of Psychiatry, Vol. 132, No. 11Evaluation Des Soins en Pedopsychiatrie26 April 2017 | Canadian Psychiatric Association Journal, Vol. 20, No. 3Crisis Intervention Counseling and Police Diversion from the Juvenile Justice System: A Review of the Literature14 July 2009 | Juvenile Justice, Vol. 25, No. 1Crisis intervention and social casework: Similarities and differences in problem-solvingClinical Social Work Journal, Vol. 2, No. 1Emergency services in community mental health: problems and promise.American Journal of Public Health, Vol. 64, No. 2Referral Failures: A One-Year Follow-UpWALTER A. CHAMEIDES, and JOE YAMAMOTO1 April 2006 | American Journal of Psychiatry, Vol. 130, No. 10Brief Hospitalization on a Crisis Service: A Study of Patient and Treatment VariablesW. RAY WALKER, LOWELL B. PARSONS, and W. DOUGLAS SKELTON1 April 2006 | American Journal of Psychiatry, Vol. 130, No. 8The relationship of interpersonal acting-out to the process of decompensationClinical Social Work Journal, Vol. 1, No. 1Crisis Intervention: Theoretical and Methodological Considerations26 June 2016 | Australian & New Zealand Journal of Psychiatry, Vol. 5, No. 3Emergency Services26 April 2017 | Canadian Psychiatric Association Journal, Vol. 16, No. 2Smith College Studies in Social Work, Vol. 41, No. 2Community Mental Health Journal, Vol. 6, No. 4An Outpatient Setting for Treating Chronically Ill Psychiatric PatientsRICHARD T. RADA, ROBERT S. DANIELS, and EDGAR DRAPER1 April 2006 | American Journal of Psychiatry, Vol. 126, No. 6Journal of the American Academy of Child Psychiatry, Vol. 8, No. 3Generic and individual approaches to crisis intervention.American Journal of Public Health and the Nations Health, Vol. 58, No. 2A Psychiatric Emergency Service and Some Treatment ConceptsWARREN B. MILLER1 April 2006 | American Journal of Psychiatry, Vol. 124, No. 7British Journal of Psychiatry, Vol. 114, No. 509A systematic approach to brief therapy for patients from a low socioeconomic communityCommunity Mental Health Journal, Vol. 3, No. 4Emergency Psychiatry: Referrals from a Personal Advisory Service26 June 2016 | Australian & New Zealand Journal of Psychiatry, Vol. 1, No. 2BRIEF PSYCHOTHERAPY: A PSYCHOANALYTIC VIEWROBERT D. GILLMAN1 April 2006 | American Journal of Psychiatry, Vol. 122, No. 6 Volume 121Issue 12 June 1965Pages 1176-1182 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1965

The authors' goal was to determine the levels of trauma and psychiatric symptoms in a randomly selected group of Cambodian refugees and to determine the relationship between the amount of trauma experienced and subsequent psychiatric symptoms. Data on traumatic experiences and symptoms of posttraumatic stress, dissociation, depression, and anxiety were collected on 50 randomly selected Cambodian refugees who had resettled in the United States. Subjects experienced multiple and severe traumas and showed high levels of all symptoms measured. Forty-three (86%) of the subjects met DSM-III-R criteria for posttraumatic stress disorder, 48 (96%) had high dissociation scores, and 40 (80%) could be classified as suffering from clinical depression. Correlations between trauma scores and symptom scores and among symptom scores were moderate to large. These results indicate that a high proportion of Cambodian refugees who are not psychiatric patients suffer from severe psychiatric symptoms and that there is a relationship between the amount of trauma they experienced and the severity of these symptoms.

The decision to change the primary locus of care for chronically ill psychiatric patients from the state mental hospital to the community has often set off a chain reaction of consequences. Notably, reducing the role of institutions has frequently resulted in destroying needed sanctuary for some patients. The author discusses the relationship between deinstitutionalization and the function of asylum and examines the relevance of three planning principles--functional equivalence, cultural relevance, and potential trade-offs--to the need of chronically ill psychiatric patients for asylum.

Back to table of contents Previous article Next article ArticleNo AccessInternational Perspectives in Schizophrenia: Biological, Social and Epidemiological FindingsALAN I. GREENALAN I. GREENSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.149.4.566AboutSections ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "International Perspectives in Schizophrenia: Biological, Social and Epidemiological Findings." American Journal of Psychiatry, 149(4), p. 566 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byPsychosis, Vol. 2, No. 1Neuropsychology Review, Vol. 19, No. 3Nordic Journal of Psychiatry, Vol. 63, No. 5American Journal of Psychiatric Rehabilitation, Vol. 12, No. 1A Longitudinal Study of Learning Potential and Rehabilitation Outcome in SchizophreniaStefan Watzke, Ph.D.Peter Brieger, M.D.Oliver Kuss, Ph.D.Henning Schoettke, Ph.D.Karl H. Wiedl, Ph.D.1 March 2008 | Psychiatric Services, Vol. 59, No. 3Journal of the International Neuropsychological Society, Vol. 14, No. 02International Journal of Psychiatry in Clinical Practice, Vol. 12, No. 2Improving the Accuracy of the Diagnosis of Schizophrenia by Means of Virtual RealityAnna Sorkin, B.Sc., Daphna Weinshall, Ph.D., Ilan Modai, M.D., M.H.A., and Avi Peled, M.D.1 March 2006 | American Journal of Psychiatry, Vol. 163, No. 3Theory of Mind Performance in Schizophrenia: Diagnostic, Symptom, and Neuropsychological CorrelatesJournal of Nervous & Mental Disease, Vol. 192, No. 1Scandinavian Journal of Psychology, Vol. 45, No. 1Journal of Clinical Psychology, Vol. 58, No. 7Neuropsychological Rehabilitation, Vol. 12, No. 3Dynamic Assessment of Cognitive Rehabilitation Potential in Schizophrenic Persons and in Elderly Persons With and Without DementiaEuropean Journal of Psychological Assessment, Vol. 17, No. 2Current Psychiatry Reports, Vol. 3, No. 5Preliminary Evidence of Improved Verbal Working Memory Performance and Normalization of Task-Related Frontal Lobe Activation in Schizophrenia Following Cognitive ExercisesBruce E. Wexler, M.D., Margot Anderson, B.A., Robert K. Fulbright, M.D., and John C. Gore, Ph.D.1 October 2000 | American Journal of Psychiatry, Vol. 157, No. 10Human Psychopharmacology: Clinical and Experimental, Vol. 15, No. 7Rehab Rounds: Cognitive Modifiability as a Measure of Readiness for RehabilitationKarl H. Wiedl, Ph.D.1 November 1999 | Psychiatric Services, Vol. 50, No. 11Best Practices: Managing Performance Indicators for Physicians in Community Mental Health CentersJames G. Baker, M.D., M.B.A.1 November 1999 | Psychiatric Services, Vol. 50, No. 11Psychiatric Rehabilitation Skills, Vol. 3, No. 1Cognitive Neuropsychiatry, Vol. 4, No. 1Acta Psychiatrica Scandinavica, Vol. 99, No. s395Acta Psychiatrica Scandinavica, Vol. 100, No. 2Occupational Performance and Metacognition22 April 2016 | Canadian Journal of Occupational Therapy, Vol. 64, No. 2Journal of Clinical and Experimental Neuropsychology, Vol. 19, No. 6Acta Psychiatrica Scandinavica, Vol. 94, No. s389Psychiatric Quarterly, Vol. 66, No. 3Maintenance of training effects on the Wisconsin Card Sorting Test by patients with schizophrenia or affective disorders1 April 2006 | American Journal of Psychiatry, Vol. 151, No. 1Acta Psychiatrica Scandinavica, Vol. 90, No. s384Cognitive remediation in schizophrenia: is it time yet?1 April 2006 | American Journal of Psychiatry, Vol. 150, No. 2 Volume 149Issue 4 April 1992Pages 566-566 Metrics History Published online 1 April 2006 Published in print 1 April 1992

Of 437 adolescent girls admitted to a psychiatric hospital for emotional problems, 61 reported an incestuous involvement. Their mean age at the time of their first experience was 11.9 years. The liaisons occurred as often with fathers as with stepfathers; other, less frequent perpetrators of incest included brothers, brothers-in-law, uncles, a grandfather, an adoptive father, and a half-brother. The authors note that the victim of incest is almost always a preadolescent and that the occurrence of incest is probably not accurately reported nationally.

Little attention outside the therapeutic setting has been given to specifying the aspects of social relationships that might be helpful for patients recovering from psychotic episodes. The authors studied 20 patients who had been hospitalized for a psychotic episode for 1 year following discharge to examine the role their social relationships played during this period. The data show that 12 functions of social relationships were important and that there were two phases of social needs--convalescence and rebuilding--over the recovery period. The authors discuss the theoretical and clinical implications of these findings.

The authors evaluated characteristics of patients whom clinicians accurately assessed as being at high or low risk for violence and patients for whom clinicians overestimated or underestimated the risk. At admission, physicians estimated the probability that each of 226 psychiatric inpatients would physically attack someone during the first week of hospitalization. Nurses rated assaultive behavior in the hospital with the Overt Aggression Scale. Acute symptoms were rated with the Brief Psychiatric Rating Scale. For the group as a whole, assessed levels of risk were substantially related to later physical aggression (sensitivity = 67%, specificity = 69%). Multinomial logit analysis showed that patients with psychotic disorders such as schizophrenia, organic psychotic conditions, and mania were more likely to be accurately assessed by clinicians as being at high risk (true positives) than to be true negatives or false positives. A recent history of violence was associated with higher estimated risk but did not distinguish true positives from false positives. An admission mental status characterized by low levels of hostility, uncooperativeness, and suspiciousness and high levels of depression, guilt, and anxiety differentiated true negative patients from others, but symptom profiles did not differ among true positives, false positives, and false negatives. Clinical judgments emphasizing gender and race/ethnicity were associated with predictive errors: nonwhite and male patients tended to be false positives. While clinicians can accurately classify the potential for violence in the majority of patients at admission, systematic errors characterize inaccurate assessments of the risk. Awareness of these patterns may help improve assessment of the risk of violence in clinical practice.

Back to table of contents Previous article Next article ArticleNo AccessDrs. McEvoy and Lohr ReplyJOSEPH P. MCEVOY, and JAMES B. LOHRJOSEPH P. MCEVOYSearch for more papers by this author, and JAMES B. LOHRSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.141.9.1136AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Drs. McEvoy and Lohr Reply." American Journal of Psychiatry, 141(9), p. 1136 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByMedicine, Vol. 96, No. 16Psychiatry and Clinical Neurosciences, Vol. 60, No. 6Psychiatry and Clinical Neurosciences, Vol. 59, No. 1, Vol. 20The Journal of ECT, Vol. 17, No. 3Refusal of ECT by a patient with recurrent depression, psychosis, and catatonia [clinical conference]1 April 2006 | American Journal of Psychiatry, Vol. 154, No. 9Acta Psychiatrica Scandinavica, Vol. 93, No. 2Anticonvulsants combined with nifedipine for epilepsy in adults1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 6Catatonia unexpectedly reversed by midazolam1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 6Effects of administering antidepressants to patients receiving ECT1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 6International Journal of Geriatric Psychiatry, Vol. 6, No. 10Lorazepam for treatment of catatonic symptoms and severe psychomotor retardation1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 9History of phencyclidine use and repeated assaults in newly admitted young schizophrenic men1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 9A case of psychogenic urinary retention1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 9Axis IV of DSM-IIIANDREW E. SKODOL, and PATRICK E. SHROUT1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 8Lorazepam: Therapeutic for Catatonic Schizophrenia?NIRAJ AHUJA1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 8Dr. Salam and Associates ReplySULTANA A. SALAM, AJIT K. PILLAI, and THOMAS BERESFORD1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 8Axis IV of DSM-III23 January 2015 | American Journal of Psychiatry, Vol. 145, No. 8Lorazepam: therapeutic for catatonic schizophrenia?23 January 2015 | American Journal of Psychiatry, Vol. 145, No. 8Psychogenic catatonia treated with lorazepam1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 6Depressive illness with delusions of AIDS1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 6An attempt to commit suicide by contracting AIDS1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 6Carbamazepine in the treatment of catatonia1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 3Treatment of catatonia with low-dose lorazepam1 April 2006 | American Journal of Psychiatry, Vol. 144, No. 9Lorazepam for psychogenic catatonia1 April 2006 | American Journal of Psychiatry, Vol. 144, No. 8Drug Development Research, Vol. 9, No. 1Brainstem and vermis atrophy in catatonia1 April 2006 | American Journal of Psychiatry, Vol. 142, No. 3Clonazepam in the treatment of recurrent symptoms of depression and anxiety in a patient with systemic lupus erythematosus1 April 2006 | American Journal of Psychiatry, Vol. 142, No. 3 Volume 141Issue 9 September 1984Pages 1136-1136 Metrics PDF download History Published online 1 April 2006 Published in print 1 September 1984

Victims of rape routinely are acknowledged to need counseling but not psychotherapy; if psychotherapy is provided, the major focus is on preexisting psychopathology. The author examines these assumptions and presents a different formulation based solely on an in-depth examination of the many levels of the trauma. Case material reveals the typical symptoms, conflicts, and defenses found in rape victims. The author makes recommendations for psychotherapeutic technique, especially in regard to difficulties in forming a therapeutic alliance.

Epidemiologic studies have reported an association between prenatal exposure to influenza and adult schizophrenia. The authors studied this association in individual patients with schizophrenia and also investigated the relationship of obstetric complications, another postulated risk factor, to adult schizophrenia. Using a structured interview instrument, the authors assessed infections during pregnancy, obstetric complications, gestational age, and birth weight by interviewing the mothers of 121 patients with DSM-III-R schizophrenia. Significantly more infections were reported in the second trimester of the patients' gestations than in the combined first and third trimesters. Influenza accounted for 70% of second-trimester infections. Patients with schizophrenia whose mothers reported having influenza during the second trimester were almost five times more likely to experience at least one definite obstetric complication than were patients who were not exposed to influenza during the second trimester; the exposed patients weighed a mean of 210 g less at birth than the unexposed patients. Maternal influenza during the second trimester may impair fetal growth and predispose to obstetric complications and lower birth weight in a proportion of individuals destined to develop schizophrenia.