Psychiatric diagnosis before serological testing for the human immunodeficiency virus

Article Abstract:

Adults in three risk groups for acquired immunodeficiency syndrome (AIDS) were rated by mental health professionals to see whether such people have an abnormally high incidence of psychopathology before receiving results of a blood test for infection with human immunodeficiency virus (HIV). Asymptomatic homosexual/bisexual men, intravenous drug users, and heterosexual partners of people known to be or suspected of being infected with HIV, made up the subject group. Their scores on the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised, were compared with those of people who had already been informed they were HIV-positive, and with scores of a random community sample of people on another psychological test, the Diagnostic Interview Schedule. The lifetime rate of mental disorders of people in the three risk groups was about twice those of subjects in the community sample; however, those who tested positive for HIV were no more likely to have a disorder than those who tested negative. The study group also had an abnormally high incidence of alcohol or drug dependence, even when the intravenous drug users were removed from the statistical comparisons. Looking at homosexual/bisexual men alone, those in the study group had considerably more psychopathology than the other homosexual subjects, and the men whose tests were positive had more pathology than those whose tests were negative. It should be noted that most subjects had no demonstrable psychopathology, in spite of being members of risk groups for AIDS. The findings suggest that those at risk for AIDS may experience an abnormally high rate of mental disturbance, a fact that should be considered in treating such people. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mental illness, Mental disorders, AIDS virus carriers, HIV carriers

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Psychiatric aspects of organ transplantation

Article Abstract:

The increase in the number of organ transplants performed since experimentation was begun in the 1960s has been dramatic. Along with improved surgical methods, the use of cyclosporine and muromonab-CD3 as immunosuppressive agents has greatly reduced the mortality rates of the recipients, because donated organs are now less likely to be rejected by the recipient's immune system. The psychiatric impact upon both the recipient and the donor are discussed in this article. Experiences and complications of the organ recipients are discussed in depth. It was found that stress and anxiety experienced during the pre-transplant and postoperative periods may contribute to complications and organ rejection. Therefore, consultation and close monitoring by a psychiatrist is critical for these patients. Although psychiatric disorders may exist, long-term prognosis may still be good. As a member of the transplant team, the psychiatrist is consulted in the process of selecting appropriate recipients and donors of transplants, a process that must consider both physical and ethical factors. The assessment of depression, anxiety, and organic brain dysfunction are focal points of the evaluations. In the future, the psychiatrist will no doubt play a role not only in the selection of transplant patients, but in the assessment of rehabilitation after surgery, and the prediction of which patients are likely not to comply with therapy. The shortage of organ donors and increased health care costs make this psychiatric function critical. The author suggests that preoperative interventions by psychiatrists would assist potential transplant patients and may decrease mortality. Also, methods to increase the rate of donation of organs for transplantation should be examined.

Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Donation of organs, tissues, etc., Tissue donation, Organ donors, Tissue donors

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Psychiatric status of adolescents who had extreme temperaments at age 7

Article Abstract:

The temperaments of seven-year-old children were evaluated to detect predictive factors for psychopathology (mental illness) in adolescence. This longitudinal study examined a random sample of 980 seven-year-old Canadian children, and from this group selected 24 children with extremely difficult temperaments and 15 children with extremely easy temperaments at age seven. These children with extreme temperaments were reassessed at age 12 and at age 16 for clinical diagnoses; 97 percent of the original group was available for follow-up. Along with standardized questionnaires, the children's IQ, socioeconomic status, and family functioning were also evaluated. At age 16, 27 percent of those with an extremely easy temperament and 43 percent of those with an extremely difficult temperament received a clinical diagnosis for a mental disorder. In those with extremely difficult temperaments, characteristics that were associated with pathology in adolescence were withdrawal from novelty, low adaptability, high intensity, and negative mood. A mixture of internalized and externalized symptoms was found in children with extremely difficult temperaments. The two groups had similar IQ scores and performed equally well academically. However, temperament alone was not predictive of poor mental health outcome. The family environment was very influential. Children with difficult temperaments and dysfunctional families all received a clinical diagnosis at age 12 or 16. (Consumer Summary produced by Reliance Medical Information, Inc.)

Environmental aspects, Identification and classification, Adolescent psychopathology, Temperament in children, Childhood temperament

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