Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants.

OBJECTIVE: To understand how postpartum posttraumatic stress disorder (PTSD) symptoms in mothers of high-risk infants progress and identify what factors predict postpartum PTSD. STUDY DESIGN: We prospectively obtained self-reported psychological data from neonatal intensive care unit discharged infants' mothers (NICU mothers) at the infants' corrected ages of 1 (T0), 3 (T1) and 12 months (T2) and mothers of healthy infants (controls). Maternal sociodemographic and infant-related factors were also investigated. RESULT: PTSD was present in 25 and 9% of NICU mothers and controls, respectively. We identified four PTSD patterns: none, persistent, delayed and recovered. The postpartum PTSD course was associated with trait anxiety. Whether the infant was the first child who predicted PTSD at year 1 (adjusted odds ratio=7.62, 95% confidence interval=1.07 to 54.52). CONCLUSION: Mothers of high-risk infants can develop early or late PTSD, and its course can be influenced by factors besides medical status. We therefore recommend regular screenings of postpartum PTSD.

Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications.

BACKGROUND: Medication compliance is a critical issue in pharmacotherapy. This study evaluated the clinical utility of the Medication Event Monitoring System (MEMS), a newer method for monitoring medication compliance, compared with pill count, a traditional measure, in a sample of patients treated for alcohol dependence with naltrexone. METHOD: Ninety-three outpatients meeting DSM-III-R criteria for alcohol dependence participated in a 10-week open-label study of naltrexone. They were provided with naltrexone, 50 mg daily, and concurrent counseling. Measures of medication compliance and drinking during treatment were collected every 2 weeks. RESULTS: Pill count yielded a significantly (p < .001) higher estimate of compliance (87.6%+/-18.1%) than the MEMS (80.4%+/-20.6%). However, the estimate of compliance obtained with the MEMS was more consistently correlated with treatment outcome (percentage of days abstinent, percentage of heavy drinking days, and mean alcohol amount consumed per drinking occasion) than the pill count compliance rate. In addition, classification of the sample into compliant and less compliant groups using the MEMS data yielded groups that differed more clearly on drinking outcomes than did stratification on the basis of pill count. CONCLUSION: In pharmacotherapy research, the MEMS may provide more reliable and valid information about subjects' medication compliance than pill count. Clinically, information obtained with the MEMS could be used to provide feedback to patients about their pill-taking behavior to enhance compliance and overall outcome of therapy.

Tourette disorder and HLA typing.

HLA A, B, C and DR were typed in 73 Korean patients with Tourette disorder meeting the diagnostic criteria of DSM III-R and compared with 291 normal subjects. Relatively higher frequencies were found in HLA A11 and A26(10) with lower incidences in HLA A24(9) and B13. A family history of tic disorders was associated with a lower frequency of HLA A24(9).

Cross-cultural study of alcoholism: comparison between Kangwha, Korea and Yanbian, China.

A cross-cultural comparison study of alcohol use disorder between Kangwha and Yanbian was conducted using the Korean version of the Diagnostic Interview Schedule (DIS). The subjects of the two areas studied were all native Koreans but lived in different sociocultural environments. A significant difference in lifetime prevalence rate of alcohol abuse (Kangwha 16.48%, Yanbian 6.95%; p less than 0.05) and similarity of alcohol dependence (Kangwha 10.23%, Yanbian 11.50%; p less than 0.05) were found. Among a total of 21 items of alcoholic symptoms, 14 items showed significant differences in frequencies between the two areas. The authors have suggested that alcohol abuse and alcohol dependence are two different diagnostic categories in origin, alcohol abuse is more related to socio-cultural environment and alcohol dependence to biogenetic background. The authors have discussed the possible reasons for a higher prevalence rate of alcohol abuse in Kangwha compared to Yanbian.