Significance of tattooes in narcotic abusers.

Social aspects of tattooed compared to non-tattooed narcotic addicts attending a methadone maintenance programme were investigated. It was found that those who were tattooed reported greater current social instability and a more deprived background compared to those without tattooes. None of the tattooes specifically identified the subjects as belonging to the drug scene nor could the age at which the subject was first tattooed be used to predict subsequent drug abuse. The presence of tattooes was unrelated to the current dose of methadone and to the duration of attendance on the methadone programme.

Impact of a psychiatric outreach service for homeless persons with schizophrenia.

Since 1988 a 24-hour psychiatric out reach service has been in operation in the inner city of Sydney to provide services to residents of refuges for the homeless. A total of 506 homeless persons with schizophrenia were referred to the outreach service between April 1988 and mid-1992, of whom 91 failed to attend. Hospitalization data were collected for the four years before and the four years after each individual's referral to the service. After the introduction of the service, the rate and duration of psychiatric hospital admissions for residents with schizophrenia who were treated by the outreach service decreased significantly, whereas those who failed to attend showed no such decrease.

Prevalence of cognitive impairment among homeless people in inner Sydney.

The prevalence of cognitive impairment was assessed among a cohort of homeless men and women selected randomly from the dining rooms of the seven largest hostels offering emergency shelter in inner Sydney. They were interviewed using sections of the Composite International Diagnostic Interview 2.0. A total of 204 subjects (155 men and 49 women) were interviewed, of whom 20 (10 percent) showed evidence of cognitive impairment as assessed by the Mini Mental State Examination. Subjects with cognitive impairment were significantly older than those without impairment (mean ages of 57 and 41, respectively). Reasons for cognitive impairment among homeless individuals are complex and remain to be elucidated.

Misuse of anticholinergic drugs by people with serious mental illness.

This study assessed misuse of anticholinergic drugs in a population of 50 patients with serious mental illness who were assertively managed by a community-based outreach team in Sydney, Australia. One-third of the subjects reported having misused anticholinergics over the previous month. All anticholinergics were misused, and trihexyphenidyl (benzhexol) was misused most frequently. Most subjects misused at least one other drug as well. On direct questioning, the reason given most frequently was "to get high"; on indirect questioning, reasons were related more to peer participation and feelings of futility. Marginalized patients living in the community are vulnerable to the misuse of anticholinergic drugs.

Brief communication. Transvestism in history.

Cross-dressing recorded in Western history, from mythological to modern times, is briefly reported. These accounts are presented to broaden the context of current reports of transsexualism as well as homosexuality.

Motivation for cross-dressing in heterosexual transvestism.

The literature concerning the motivation for cross-dressing in heterosexual transvestism is briefly reviewed. Thirty-three members of a club established for heterosexual transvestites were interviewed. The sensations they derived from cross-dressing and the importance of compulsive and narcissistic aspects in their transvestite behaviour were assessed and compared with those reported by 24 transsexual subjects. While cross-dressed, transvestite and transsexual subjects frequently reported feeling relaxed, comfortable and relieved of masculine demands. Transvestite subjects showed significantly more compulsive and narcissistic aspects in their transvestite behaviour than transsexual subjects. Fetishistic pleasure was infrequently given as a motivation for cross-dressing.

A case of familial heterosexual transvestism.

A brief review of the literature concerning familial transvestism is given. The case history of father-son heterosexual transvestism is presented. The son appears to have been ignorant of his father's transvestism. Early childhood experiences as an aetiological factor seem inadequate to explain the similarities of the two subjects' transvestite behaviour. It is suggested that constitutional factors play a part in the aetiology of heterosexual transvestism.

A heterosexual transvestite club: psychiatric aspects.

An Australian club for heterosexual transvestites, the Seahorse Club, is described. Emphasis is given to the history and activities of the club and the behaviour of members at club meetings. Indications for referring transvestites requesting medical help to the club are discussed.

Profile of narcotic abuse in peninsula Malaysia.

Demographic and drug abuse characteristics of 3,484 new drug abuse contacts presenting to the General Hospital, Kuala Lumpur, Malaysia are reported. The large majority were heroin inhalers. They were different from the traditional Eastern opium inhalers and similar to Western heroin injectors in that they were young, male, single, and frequently unemployed. These features and the relative underrepresentation of Chinese suggest that the Chinese of this study did not learn narcotic abuse from opium-smoking relatives.

Significance of tattoos in male psychiatric patients.

The study investigated the social background and current social stability of 45 tattooed males. Tattooed subjects compared to non-tattooed controls were more likely to report leaving home and school early, to report spending a period in a boys' institution and in prison, and showed greater current instability with regard to accommodation and employment. Tattoos were significantly associated with a current diagnosis of personality disorder and alcoholism and past treatment for drug abuse and parasuicide.

Self-inflicted enucleation of both eyes.

Categories of self-injurious behaviour are briefly reviewed. Serious and bizarre self injurious behaviour is usually psychotic in origin. The literature concerning self-inflicted enucleation of the eyes is reviewed and two additional patients, both with a diagnosis of schizophrenia, are reported. The lack of pain and the lack of concern shown by the patients and their management are discussed.

Tests of gender feelings and behavior in homosexuality, transvestism and transsexualism.

Categorized 64 male transsexual and transvestite Ss into two groups on the basis of the strength of their feminine gender identity. The two groups were compared to a homosexual group and a control group on four tests designed to measure gender feelings and behavior, namely: the California Personality Inventory Femininity Scale, the Draw-A-Person test, the Franck Drawing Completion test, and the Information and Vocabulary subtests of the WAIS. It was found that the CPI-Fe scale and DAP test significantly correlate with the degree of feminine gender identity reported by the Ss. However, the two tests appear to measure different aspects of gender feelings and behavior in some Ss.

Preadult feminine behaviors of male transvestites.

Feminine behaviors during the childhood and adolescence of volunteer male transvestites who had shown a period of fetishism were investigated. The transvestites were categorized into two groups. Twenty who were satisfied with cross-dressing were termed nuclear transvestites, and 14 who desired at least a partial feminization were termed marginal transvestites. It was found that during their preadult years marginal transvestites showed significantly more feminine behaviors than nuclear transvestites, and both transvestite groups reported significantly more feminine behaviors than "normal" controls.

Two clinically discrete syndromes of transsexualism.

Transsexuals are defined as subjects who have a sustained feminine gender identity combined with a wish to alter their bodily appearance towards the feminine. The results of this study indicate that they can be differentiated into two clinically discrete groups. In an investigation of 29 transsexuals who sought a change of sex operation it was found that those who had experienced fetishistic arousal were significantly more likely to be older, to have experienced heterosexual intercourse, to be married and to show penile responses to pictures of men and women indicative of a more heterosexual orientation. They had less experience of homosexual contact to orgasm as compared transsexuals who had not experiennced fetishistic arousal , but this difference was not statistically significant. Frequency of cross-dressing, strenght of feminine gender identity and intensity of desire for a sex change operation did not discriminate the two groups. The fact that desire for a sex change operation may be associated with experience of fetishistic arousal could be one reason for the higher incidence transsexualism in men than in women.

The discrete syndromes of transvestism and transsexualism.

The literature concerning the relationship between transvestism and transsexualism is briefly reviewed. Some workers consider the two conditions to be on a continuum, whereas others feel that they are independent clinical entities. To clarify the relationship between the two syndromes, biographical data were collected and penile volume changes recorded in 29 subjects who identified themselves as transsexuals and 35 who identified themselves as transvestites. In comparison to the transvestite subjects, significantly more transsexuals were younger, were single, cross-dressed fully, and reported homosexual interest, a feminine gender identity, and a desire for a sex-change surgery. In comparison to the transsexual subjects, significantly more transvestites reported heterosexual interest, cross-dressed partially, and had shown fetishistic arousal. It is concluded that transvestism and transsexualism are separate clinical entities.