The burden of conditions not attributable to mental disorders.

OBJECTIVE: The purpose of this study was to extend previous findings on the relationship of V code conditions to use of psychiatric services and treatment outcome. METHOD: The group under study involved 2,542 outpatients from three community mental health centers in Nova Scotia, Canada. From this group, three subgroups of patients were compared: 1) patients with V code conditions, 2) patients with DSM-III-R mental disorders, and 3) patients with both V code conditions and mental disorders. RESULTS: The majority of patients (61.8%) were diagnosed with V code conditions, and a substantial minority (19.6%) had V code conditions as the sole diagnoses. Patients with V code conditions without mental disorders were similar to patients with mental disorders in consumption of treatment resources and treatment outcome. CONCLUSIONS: Strategies for improving the efficiency of mental health services to patients with V code conditions need to be developed.

The PQRSTUV: the Personal Questionnaire Rapid Scaling Technique--'Ultimate Version'.

A variation of procedure is described which greatly reduces the time required to administer Mulhall's PQRST. It lessens the sensitivity of the scale but retains other features. It uses the same materials as PQRST with some minor clerical alterations and, like the PQRST, takes less time to construct than Shapiro's original PQ. It has been used routinely with general practice and psychiatry out-patient referrals and is likely to have clinical rather than research application.

Modified Personal Questionnaire Rapid Scaling Technique for measuring delusional beliefs.

The view of delusions as discrete and discontinuous phenomena is changing. Intensity of conviction in delusional belief has been used as a dependent variable in therapeutic attempts at belief modification. It has been measured using rating scales and developments of Shapiro's Personal Questionnaire (PQ) technique. The use of Mulhall's Personal Questionnaire Rapid Scaling Technique (PQRST) has not been reported in this context. The paper reports no new clinical data but describes a modified PQRST for measuring intensity of belief conviction, suitable for clients who cannot understand the PQ technique and easily administered by ward staff.

Systematic self-assessment by P.Q.R.S.T. (Personal Questionnaire Rapid Scaling Technique).

This paper presents a Personal Questionnaire which is sufficiently simple for use in most clinical settings. Following a brief description of Personal Questionnaires, their origin and background are discussed and some subsequent developments delineated. The method involves the use of a general set of adjectives which can be used to qualify the symptoms experienced by any given patient. Successive measurements of the symptoms can be made so that changes in their subjective intensity can be monitored. The internal consistency of ratings of each symptom on each occasion is used as a measure of reliability. As with all previous Personal Questionnaires the symptoms which are measured are unique to the individual, but unlike other methods the format of this Questionnaire is predetermined, which ensures its simplicity and ease of use.

Another calendar savant.

A 38-year-old patient, who can give the day of the week of any day this century, is described. He is believed to have been autistic in early childhood. The relationship of the autistic child and the adolescent idiot savant is discussed and brief reference made to the patient's method.

The clinical evaluation of obsessionality: a development of the Leyton Obsessional Inventory.

The Leyton Obessional Inventory gives both an indication of the range of obsessional symptoms present and the degree of resistance and interference associated with each symptom. A new method is described in which the covariation of resistance and interference is represented in the form of a matrix. The results, using this method, can give a unique picture of the quality of the patient's symptoms from the clinical standpoint and provide useful guidelines for treatment and follow up. Automatic data-provessing is offered for the convenience of clinicians and researchers wishing to utilize the test in this form.

Geometric chaoticity leads to ordered spectra for randomly interacting fermions.

A rotationally invariant random interaction ensemble was realized in a single- j fermion model. A statistical approach reveals the random coupling of individual angular momenta as a source for the empirically known dominance of ground states with zero and maximum spin. The interpretation is supported by the structure of the ground state wave functions.

Long-term effects of pinacidil in hypertensive dialysis patients.

In an open study, thirteen chronic dialysis patients with nonvolume dependent uncontrolled hypertension were treated with pinacidil for a mean period of 43 weeks. Seven patients were taking concomitant antihypertensive therapy. Twelve patients achieved long-term blood pressure control on a mean dose of 33 mg/day. The baseline supine blood pressure was 184/116 mmHg. After 1 week it had fallen to 161/95 mmHg and blood pressure control was maintained over the study period. Patient weight remained stable. The baseline reading was 61.6 kg and at the end of the study it was 59.7 kg. Pulse rate did not change significantly. For the eight patients not taking beta-blockers the mean change in pulse rate was 7.6 beats/min supine and 6.3 beats/min erect (NS). Pretrial urea and creatinine were 27.6 mmol/l and 1027 mumol/l and after 25 weeks they were 29.6 mmol/l and 1087 mumol/l, respectively (NS). Four patients had ECG evidence of left ventricular hypertrophy before the study and one on completion of the trial. Five patients showed correction of T-waves on their ECG's. Six patients experienced side effects, none of which warranted withdrawal of treatment. These findings suggest that pinacidil is a valuable alternative treatment for hypertensive dialysis patients.

Treatment of essential hypertension and hypertension associated with renal impairment with pinacidil: a new vasodilator.

Twenty patients with uncontrolled hypertension were treated with pinacidil for a mean period of 43 weeks (range 10-63 weeks). All patients achieved and maintained significant reductions in blood pressure. The supine blood pressure at baseline was 184/116 mmHg; after one week it was 161/95 mmHg and at 43 weeks it was 138/79 mmHg. The mean dose of pinacidil was 30 mg/day. There was no significant difference between the two groups with respect to the dose of pinacidil or the blood pressure response. Pulse rate and weight remained stable for the group as a whole. Five patients were not taking beta-blockers. The mean baseline pulse rate for this group was 78 beats/min and when maintained on pinacidil it was 82 beat/min (NS). Six patients were not taking diuretics. The mean baseline weight for this group was 78.5 kg and while maintained on pinacidil it was 79.2 kg (NS). There was no occurrence of oedema, hirsutism or first dose phenomenon. The mean glomerular filtration rate and renal plasma flow for the renal plasma flow for the renal group was 35.4 ml/min and 192.3 ml/min before pinacidil and after six months they were 32.7 ml/min and 183.2 ml/min (NS) respectively. Six patients experienced minor side-effects. We conclude that pinacidil is a potent, well tolerated antihypertensive agent which merits further study.

Comparative trial of volunteer and professional treatments of dysphasia after stroke.

A study of the treatment of dysphasia after stroke compared the progress of two groups of disabled patients. One received conventional treatment from qualified speech therapists and the other from non-professional volunteers. Methods of assessing communication difficulties were also compared and the impact of aphasic illness on families examined. No important differences in the results of treatment were seen between the two groups. The volunteers, however, often had to assume some of the responsibilities of social workers, and transport to hospital created practical and economic problems. It is concluded that the two forms of treatment provide essentially the same benefit, although doubt must still remain because relatively few patients were studied.