RESUMO
The multiaxial system of DSM-III includes nondiagnostic data that are valuable in understanding possible etiological factors and in treatment planning and prognosis. The authors describe the reliability of axis IV--severity of psychosocial stressors--and axis V--highest level of adaptive functioning in the past year--for 281 adult patients interviewed in phase one of the DSM-III field trials. The kappa coefficient of agreement for axis IV was .62 for joint interviews and .58 for separate interviews, which the authors consider at least fair. Reliability for axis V was quite good, .80 for joint interviews and .69 for separate interviews. Eighty-one percent of the participating clinicians judged the multiaxial system to be a useful addition to traditional diagnostic evaluation, although many indicated that they had difficulty quantifying severity of psychosocial stressors.
Assuntos
Manuais como Assunto , Transtornos Mentais/diagnóstico , Adolescente , Adulto , Estudos de Avaliação como Assunto , Humanos , Transtornos Mentais/classificação , Estados UnidosRESUMO
The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.
Assuntos
Manuais como Assunto , Transtornos Mentais/diagnóstico , Adolescente , Adulto , Estudos de Avaliação como Assunto , Humanos , Transtornos Mentais/classificação , Estados UnidosRESUMO
Replacing a traditional pension with a cash balance plan raises a number of complicated and unsettled legal issues, including the protection of accrued benefits, the rate of benefit accrual, age discrimination and notice requirements. This article discusses those issues and concludes that routine conversions to cash balance plans appear to be legal both currently and into the foreseeable future.
Assuntos
Administração Financeira/legislação & jurisprudência , Pensões , Salários e Benefícios/legislação & jurisprudência , Fatores Etários , Employee Retirement Income Security Act , Humanos , Aposentadoria/economia , Aposentadoria/legislação & jurisprudência , Estados UnidosRESUMO
The effects of opioids on testicular function were assessed in the rat through measurements of serum testosterone levels, testicular interstitial fluid (TIF) formation and TIF testosterone levels after morphine and opioid antagonist (naloxone, naltrexone) treatment. Serum and TIF levels of testosterone were significantly decreased 1 to 6 h after morphine (10 mg/kg) injection, and TIF volumes were decreased 2-3 h after injection morphine. Each of these decreases was dose-related. In contrast to the effects of morphine, the opioid antagonist naloxone increased TIF testosterone but did not alter TIF volumes. Moreover, the opioid antagonist naltrexone totally blocked morphine's effects on both testosterone secretion and TIF volume, suggesting that morphine's testicular effects were mediated by naltrexone-sensitive opioid receptors in the testes. The possible role of morphine-induced reductions in gonadotropin secretion in morphine's testicular effects was also examined. Morphine suppressed testosterone secretion and TIF volumes after pretreatment with human chorionic gonadotropin, which reverses morphine's suppression of luteinizing hormone (LH). Our results, therefore, indicate that morphine exerts effects on testicular function that are independent of its effects on LH. They furthermore support the hypothesis that both endogenous and exogenous opioids disrupt two major aspects of testicular function: Testosterone secretion and TIF formation. Because of the role of TIF in maintaining testicular function, our results suggest that opioid-induced changes in testosterone secretion into TIF and TIF formation may, at least in part, explain the well-established effects of opioids on reproductive endocrinology and function in the male.
Assuntos
Endorfinas/fisiologia , Morfina/farmacologia , Testículo/efeitos dos fármacos , Testículo/fisiologia , Animais , Relação Dose-Resposta a Droga , Interações Medicamentosas , Espaço Extracelular/metabolismo , Gonadotropinas/fisiologia , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Sistema Hipotálamo-Hipofisário/fisiologia , Hormônio Luteinizante/sangue , Hormônio Luteinizante/metabolismo , Masculino , Morfina/antagonistas & inibidores , Naloxona/farmacologia , Naltrexona/farmacologia , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/fisiologia , Ratos , Ratos Sprague-Dawley , Receptores Opioides/efeitos dos fármacos , Receptores Opioides/fisiologia , Testículo/metabolismo , Testosterona/biossíntese , Testosterona/sangue , Testosterona/metabolismo , Fatores de TempoRESUMO
To examine whether nitric oxide (NO) mediates the suppression of testosterone secretion by alcohol (ethanol), adult male rats were pretreated with a NO synthase inhibitor, NG-nitro-L-arginine methyl ester (NAME), then treated with alcohol. Serum and testicular interstitial fluid (TIF) testosterone concentrations, serum luteinizing hormone (LH) concentrations, blood alcohol concentrations (BAC), and TIF volumes were measured 2 hr after alcohol treatment at a time of peak effects of alcohol and NAME on testosterone secretion. Pretreatment with NAME (30 or 100 mg/kg, subcutaneous) 30 min before alcohol treatment (0.5-3 g/kg, intraperitoneal) completely blocked the alcohol-induced suppression of testosterone secretion into the general circulation and into TIF without significantly altering blood alcohol concentrations (BAC) or TIF volumes. These results support the hypotheses that NO synthase inhibitors can antagonize alcohol-induced suppression of testicular steroidogenesis, that alcohol interacts with arginine-NO synthase systems that regulate testicular steroidogenesis, and that NO is involved in mediating alcohol's testicular and reproductive effects.
Assuntos
Aminoácido Oxirredutases/antagonistas & inibidores , Etanol/farmacologia , Testosterona/sangue , Aminoácido Oxirredutases/fisiologia , Animais , Arginina/análogos & derivados , Arginina/farmacologia , Injeções Intraperitoneais , Hormônio Luteinizante/sangue , Masculino , NG-Nitroarginina Metil Éster , Óxido Nítrico Sintase , Radioimunoensaio , Ratos , Ratos Sprague-DawleyRESUMO
Rats with bilateral lesions of the medial frontal cortex were tested in a T-maze for the ability to learn a position habit and to make four reversals of it. Rats with medial frontal cortical lesions showed deficits in reversal learning. In addition, they were found to be hyperactive in an open field. Treatment with the dihydropyridine calcium channel antagonist, nimodipine, did not reduce these behavioral deficits.