[The Dizziness Handicap Inventory for quality control in the treatment of vestibular dysfunction]. / Dizziness Handicap Inventory in der Qualitätssicherung der Therapie vestibulärer Funktionsstörung.

Treatment of vestibular dysfunction remains a challenge for many otolaryngologists. This is true not only for establishing the differential neurotologic diagnosis, but also for treatment and treatment monitoring in vestibular dysfunction patients. Particularly quality control of therapeutic measures is generally poorly documented. The validated German version of the Dizziness Handicap Inventory (DHI) represents a viable option for evaluation and monitoring of treatment outcomes. In this study, patients who were treated at the Otorhinolaryngology Department of the University Hospital Aachen because of unilateral peripheral vestibular disorders were asked to complete the DHI before and after treatment. Posttherapeutic DHI scores were collected by telephone. Evaluation of the DHI scores underlined the significant benefit of treatment in 92%. Furthermore, the DHI prove to be useful for documentation of patients' disorders and treatment and thus for quality assurance.

Assessment of the effects of drugs on memory.

This survey is based on 70 controlled investigations of the effects of drugs on memory in healthy volunteers. Although detracting effects were predominant, enhancements were reported as well. The effects of 29 well-known drugs on 15 familiar tests are summarized in a way that permits comparisons of the effects of different drugs and of test sensitivities. There is a discussion of factors that could bias or obscure investigations of the effects of drugs on learning and remembering.

Marijuana effects on the speed of memory retrieval in the letter-matching task.

Marijuana's effect on the speed of retrieving simple information from memory was studied using a task in which subjects saw two letters and decided whether or not they had the same name. Subjects smoked a single marijuana or placebo cigarette under double-blind conditions. Marijuana slowed reaction time relative to placebo, but this effect was not influenced by the demands on memory retrieval or by providing advance information relevant to the required decisions, suggesting that memory retrieval was unimpaired.

Marijuana effects on associative processes.

Acute marijuana effects on associative processes involved in long-term memory retrieval were studied. Results were partially consistent with expectations based on previous subjective reports that marijuana promotes more uncommon associations. Marijuana altered responses when people gave as many examples of a specified category (e.g., CLOTHING) as they could for 2 min, and when they gave an example of a specified category beginning with a specified letter (e.g., WEAPON - G). Reaction time in the latter task and in prior studies was not altered in the expected manner, a finding problematic for some theoretic interpretations of marijuana's effects on associative processes.

Marijuana effects on visual imagery in a paired-associate task.

Marijuana effects on visual imagery, examined using a paired-associate learning task, differed from expectations based on previous subjective reports that marijuana enhances visual imagery. Subjects (48 men, mean age 22.4 yr.) were assigned to four groups (12 subjects per group) differing in (a) whether or not they received specific instructions to use imagery to facilitate learning and (b) whether they received marijuana or placebo. Imagery instructions improved recall, but marijuana did not influence the amount of this improvement. After the memory tests, subjects instructed to use imagery described their images. Marijuana decreased the rated vividness of these imagery descriptions.

Pharmacotherapy for age-related behavioral deficiencies.

This review observes a distinction between drugs for treating age-related behavioral losses or impairments among the old and the psychopharmacotherapeutic drugs used in treating disturbed or disordered behavior in adults of various ages. The placebo-controlled studies confirm numerous responses to drugs designed specifically for treating impaired behavior in old people, and the responses of normal or mildly impaired subjects to some of these drugs suggest the possibility of prophylactic applications.

Behavioral toxicity of psychotropic drugs.

The present review of psychomotor response to psychotropic substances is restricted to normal subjects and describes responses to the initial standard dose of psychotropic substances in common use. Only placebo-controlled studies which permitted statistical analysis of treatment group differences were considered for the summary. It was revealed that virtually all psychotropic substances have immediate detracting effects. The nature of the effects varied somewhat according to the class of drug. It is suggested that this kind of information has safety implications which could influence the choice of medication.

Somatic discomforts among depressed women.

An inventory of 69 somatic discomforts was used to identify those discomforts most likely to be concurrent with a clinically severe depression in a sample of 223 recently hospitalized women. The inventory provided scores for each of 15 classes of discomfort. The classes of discomfort with the highest average score for the depressed sample at admission also yielded significantly lower scores for a nonpatient control sample (P less than .05). The four classes of discomfort most pertinent to depression were designated autonomic, wakefulness, dry mouth, and fatigue. The items of discomfort contributing to these classes showed a statistically significant diminution in severity during treatment (P less than .05).

Effects of benzodiazepines on psychomotor performance.

1 The literature relating to the effects of benzodiazepines on psychomotor performance is critically reviewed. 2 The multiple and diverse psychomotor tests used are assessed according to their ability to demonstrate differences between drugs. 3 Three general conclusions are: (1) The speed with which simple acts of a repetitive nature are performed may be impaired by benzodiazepines. (2) learning and immediate memory will also be impaired. (3) there is relatively little indication that well established higher mental faculties are adversely involved.

Psychomotor changes during initial day of benzodiazepine medication.

1 The detracting psychomotor effects of diazepam (5 mg three times daily) and clobazam (an investigational 1,5-benzodiazepine) were compared with placebo effects over the course of the initial day of medication. Tests were administered at hourly intervals and the data were analyzed from the standpoint of contrasts at each session and from the standpoint of trends that accrued during the course of the day. 2 It is concluded that among normal volunteers diazepam 5 mg three times daily may be near the threshold for detracting psychomotor consequences during the initial day and that clobazam seems to be without detracting consequences and may have some enhancing effects.

Persisting symptoms in schizophrenia predicted by background factors.

A social worker's Home Inquiry was conducted for 75 schizophrenic males as soon as possible after hospitalization. A standard set of items based on this inquiry was scored in terms of nine factors. These Home Inquiry factor scores were found to have modest but statistically significant correlations with specific symptom ratings conducted two years after admission. In the present sample, an interpersonally uncomfortable childhood home and low premorbid self-esteem have untoward implications for the remission of symptoms.

Persisting personalities among depressed women.

Descriptions of patients' premorbid personalities were provided by family informants at the time of the depressive episode, and one year later at follow-up the informants were asked to describe the current personalities. A comparison of the initial and follow-up descriptions for a sample of 190 depressive women showed that personality characteristics traditionally ascribed to depressive patients tended to provide a persisting characterization for most of the sample. There was a diminution in the incidence of certain personality characteristics for a small but significant portion of the sample.