Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications

BACKGROUND: Increasing attention has been directed in recent years to the detection and treatment of psychiatric co-morbidity among depressed individuals. The overlap of social phobia (SP) and avoidant personality disorder (APD) has been well recognized and a relationship between these disorders and depression has been suggested. METHODS: The pattern and clinical implications of co-morbidity of SP and APD with major depressive disorder (MDD), diagnosed by DSM-III-R criteria, were studied among 243 out-patients presenting with depression. RESULTS: Overall, 26.7% of adults in our sample with MDD met criteria for SP and 28.4% for APD. Almost two-thirds of depressed adults meeting criteria for social phobia or avoidant personality disorder met criteria for both (SP+APD). Depressed adults who met criteria for both SP+APD exhibited a significantly higher proportion of atypical depression (54.8%) compared with those with neither SP nor APD (31.1%). Among depressed patients, the co-occurrence of SP with APD was also associated with an earlier age of onset of MDD, a greater number of comorbid Axis I diagnoses, and greater impairment of social adjustment and assertiveness. CONCLUSIONS: Results confirm the overlap of SP and APD in a depressed population and the high prevalence of these disorders in MDD. They suggest that depressed individuals with both SP and APD but not SP alone are at particularly high risk for atypical depression and for social dysfunction in excess of that caused by a current major depression.     

Development of the multidimensional index of life quality. A quality of life measure for cardiovascular disease

OBJECTIVES: The purpose of this study was to design a multidimensional measure of health-related quality of life appropriate for patients with cardiovascular disease that was psychometrically sound, brief, and easy to administer. METHODS: Qualitative interviews conducted with healthy subjects and patients with cardiovascular diseases identified nine major quality of life domains. Based on the responses of 129 cardiovascular disease patients recruited from hospitals and clinics, a criterion-based approach was used to select 35 questionnaire items that best tapped these domains. Psychometric properties of the Multidimensional Index of Life Quality (MILQ) were tested with a sample of 348 patients with various cardiovascular diseases. RESULTS: Cronbach's alpha was 0.76 or higher for eight of the nine MILQ domains. Test-retest reliability coefficients were 0.73 or greater in all but two domains. Individual domain scores as well as a weighted overall quality of life index were correlated highly with self-assessed health and the number of heart-related symptoms. CONCLUSIONS: The Multidimensional Index of Life Quality is a psychometrically reliable and valid instrument for measuring quality of life in patients with cardiovascular diseases. The MILQ also may be a suitable measure for other types of chronic diseases.     

Effect of hydroxylamine hydrochloride on the bacterium Shigella dysenteriae 1 and antigens isolated from them

A study was made into the functional status of hypophysis, adrenal cortex, ovaries, and thyroid gland in patients with kraurosis and leukoplakia vulvae. The above patients demonstrated profound disturbances in the system hypophysis-ovaries, that attest to the need for applying corrective therapies to treat the disturbed hormonal homeostasis.     

Antagonism by locally applied dopamine into the nucleus accumbens or the corpus striatum of alpha-methyltyrosine-induced disruption of conditioned avoidance behaviour

Male Sprague-Dawley rats were trained to avoid an electric shock in a two-way shuttle-box. The local application of dopamine into the nucleus accumbens or the corpus striatum was found to antagonize the suppression of conditioned avoidance behaviour induced by systemically administered alpha-methyltyrosine, emphasizing the importance of these dopamine-rich brain structures in mediating conditioned avoidance behaviour.     

Vascular injuries associated with dislocation of the knee

Two hundred and forty-five knee dislocations were analyzed including forty-one new cases. The high incidence of injuries to the popliteal artery that accompanies this lesion (32 per cent) was confirmed, and it was re-emphasized that vascular repair must be completed within six or at the most eight hours from the time of injury to avoid amputation. Of the patients not treated within that time period, 86 per cent had an amputation and two-thirds of the remaining 14 per cent had ischemic changes.     

The contamination of nickel surfaces during oxidation in fused silica reaction vessels

In many experiments involving the high temperature oxidation of nickel in fused silica reaction vessels the final oxidation products have been found to include silica as -cristobalite. Prior to oxidation the nickel was decarburized by exposure to oxygen followed by hydrogen reduction of the remaining oxide film. The silicon of the silica was transferred from the vessel walls to the specimen as silicon monoxide formed by the reduction of the silica by the carbon monoxide produced during the decarburization step. The silicon monoxide was reduced at the metal specimen by residual carbon to form silicon which then dissolved in the nickel. Detectable contamination of the surface took place during subsequent oxidation when the silicon was preferentially oxidized at the surface. The reaction of carbon monoxide with the silica tube was enhanced by devitrification caused by previous high temperature (> 700° C) treatment. Contamination could be avoided if the tube was never heated above 700° C and was minimized at 900° C by more complete decarburization of the specimen.