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This population-based, retrospective cohort study examined the association of tobacco use and diagnosis of a depressive disorder (DD) and suicide attempts (SA) before and after discharge from an inpatient addiction program (IAP). All 813 Olmsted County, Minnesota residents (537 males, 276 females) admitted for the first time to the IAP for treatment of alcoholism during the period 1972-1983 were studied. Tobacco use status at admission was classified as ever (current or former use) (85.5%), never (8.6%), or missing (5.9%). Subjects were followed through 1994. Current or former use of tobacco was markedly lower among those with a prior diagnosis of DD than those without this diagnosis (73.6% vs. 89.3%, p<0.001). Although females were more likely to have a diagnosis of DD and were less likely to have ever used tobacco than males, gender did not explain the relationship between tobacco use and DD. Tobacco use status was unrelated to a DD diagnosis after discharge from the IAP and was not associated with SA. [ABSTRACT FROM AUTHOR]

The article focuses on a study which discusses the age and sex differences in the responses of alcoholics to the Self-Administered Alcoholism Screening Test. Data on 583 patients were used for this study. Each patient was interviewed by a chemical dependency counselor, a psychiatric or medical resident and a supervising psychiatrist with experience in the field of alcoholism. There was a significant tendency for women alcoholics to report a greater incidence of problems with alcohol in other members of their families, especially spouses and siblings. The finding of significant sex differences on five of the six components of alcoholism patterns and consequences has a number of interesting ramifications.

Using criteria for the diagnosis of alcoholism established by the National Council of Alcoholism and by scores on the Self-Administered Alcoholism Screening Test, we compared the prevalence of alcoholism in a group of 99 patients hospitalized for the treatment of psoriasis with that in an age- and sex-matched control group hospitafaed for the treatment of other dermatologic disorders. Alcoholism was diagnosed in 11 psoriatic patients and 3 control patients (0.05 < p < 0.10); 10 of the 11 psoriatic patients were men, and 1 of the 3 control patients was a man ( p < 0.05). These differences, not noted in certain eariier studies, may reflect a basic association between the two diseases in males or indicate that alcohotem contributes to the morbidity of psoriasis. [ABSTRACT FROM AUTHOR]

Presents the perspectives of the publishers of `U.S. News & World Report' magazine's `America's Best Colleges' rankings and `Money Guide: Your Best College Buys Now' by `Money Magazine'. Weight of academic reputation in the ranking; Changes in methodology; Working with the higher education community; Data integrity; Analytical sophistication of the readers; Variables used; Quality issues.

Presents a study which examined gender differences in an undiagnosed sample of medical patients who were referred for evaluation of alcohol abuse. Methodology used in the study; Information on the Self-Administered Alcoholism Screening Test; Suggestion on essentials required to screen women for alcohol-related problems.

The Self-Administered Nicotine-Dependence Scale (SANDS) is a questionnaire to assist in the determination of the most appropriate intervention for the nicotine-dependent individual. Six content domains included are: (1) self-efficacy; (2) social skills deficit; (3) loss of control; (4) consequences of use; (5) social support for smoking; and (6) concern for healthy life-style. A preliminary set of 79 items was reduced to a 32-item scale, which, in turn, was divided into two non-overlapping subscales of 16 items each. Logistic regression analyses of an additional sample of subjects indicated that the SANDS added predictive power to knowledge of sex arid transdermal-patch status for predictions of smoking status 6 months later. [ABSTRACT FROM AUTHOR]

The Common Alcohol Logistic-Revised (CAL-R) scale was developed for use with MMPI or MMPI-2 with medical patients. It was derived from the Common Alcohol Logistic (CAL) scale and developed by (1) dropping the six CAL items deleted from the MMPI during construction of the MMPI-2 and recomputing item weights (using logistic regression); (2) calculating norms; and (3) repeating the validation procedure used in developing CAL. We used the same criterion group (1,221 alcoholics) and same contrast sample 0.621 nonalcoholic medical patients) used for CAL. Comparison of receiver operating characteristic curves, positive predictive value, and negative predictive-value for CAL. and CAL-R indicates that the latter has the same favorable ability to screen medical patients for alcoholism as the former. [ABSTRACT FROM AUTHOR]

We developed a MMPI alcoholism scale based on adult medical patient samples. Our criterion group consisted of 736 inpatients (525 males; 211 females) diagnosed as having alcoholism according to DSM-III criteria. Three contrast samples that totaled 13,120 individuals were used for control purposes. MMPI items were chosen by means of logistic regression. The 33 items yielded by this procedure formed a provisional scale (CAL, for common alcoholism logistic) that worked equally well for males and females. With new cross-validation samples, with sensitivity (propagation of alcoholics correctly identified) set at 90%, the specificity (proportion of nonalcoholics correctly identified) range from 90% to 96% for selected contrast samples. We conclude that this scale shows promise as a screening device in similar populations. [ABSTRACT FROM AUTHOR]

This article reports on the screening of medical patients for alcoholism with the Minnesota Multiphasic Personality Inventory (MMPI). Seven alcoholism scales for the MMPI were evaluated for effectiveness in screening medical. Although numerous alcoholism scales for the MMPI have been developed, none has been evaluated for effectiveness in screening medical patients. Therefore, seven scales that appeared to have merit were selected for such evaluation. Each scale was evaluated to determine its ability to identify correctly patients with alcoholism; and to ascertain the degree to which estimates of alcoholism in our samples, based on the results from each scale, agreed with previously reported estimates of prevalence.

This article presents a comparison between the Institutionalized Chronic Alcoholic Scale (ICAS) and MacAndrew scale (MAC) used in screening medical patients for alcoholism. To determine the efficacy of the ICAS in screening medical patients, the ICAS scores from five samples were evaluated. These included a criterion group of inpatients from an alcohol and drug-dependence unit (ADDU), two samples of medical patients, a sample of adult psychiatric inpatients, and a contemporary sample of normal adults. The criterion sample of MMPIs was obtained from 211 women and 525 men hospitalized on an ADDU with primary alcohol dependence. DSM-lII criteria were used for classification purposes.

The article discusses intellectual assessment of alcoholic patients. A study of 867 patients at a Midwestern alcoholism treatment center which used Shipley-Hartford Institute of Living Scale scores indicates that intellectual differences in this population are due to age and socioeconomic differences rather than due to alcoholism. However, these real differences can be used to plan dismissal and rehabilitation policies for individual patients. Intellectual assessment of alcoholic patients usually has examined the effects of alcoholism on cognitive abilities. The search for intellectual deficits associated with alcoholism has been the subject of extensive research and review.

This study assessed the effect of treating nicotine dependence in smokers undergoing inpatient treatment for other addictions. It was a prospective, nonrandomized, controlled trial with a 1-year outcome. The subjects were smoking patients (50 controls, 51 in intervention group) in an inpatient addictions treatment unit in a medical center. The enrollment of subjects was sequential: controls were enrolled first, after a 6-week washout period, intervention subjects were enrolled. Controls received usual care, and the intervention group received nicotine dependence treatment consisting of a consultation, 10 intervention sessions, and a structured relapse prevention program. Smoking cessation rate and abstinence from alcohol or other drug use were the main outcome measures. The confirmed smoking cessation rate at 1 year was 11.8% in the intervention group and 0.0% in the control group ( p= 0.027). Nicotine dependence intervention did not seem to interfere with abstinence from alcohol or other drugs (1-year relapse rate was 31.4% in the intervention group and 34.0% in controls). In this study, nicotine dependence treatment provided as part of addictive disorders treatment enhanced smoking cessation and did not have a substantial adverse effect on abstinence from the nonnicotine drug of dependence. [ABSTRACT FROM AUTHOR]

In order to evaluate the equivalence of interviewer-administered and computer-administered forms of the substance use disorder diagnostic schedule (SUDDS), both forms were presented to 100 substance-dependent inpatients. An additional 101 psychiatric outpatients were administered one form or the other. For patients who received both forms of the SUDDS, the percentage agreement ranged from 96% for the classification of a lifetime diagnosis of alcohol abuse/dependence to 88% for the classification of current diagnosis of alcohol abuse/dependence (kappa coefficients ranged from 0.709 to 0.865). Overall agreement with a clinician diagnosis (validity) and the two forms of administration varied from 100% for computer-generated diagnosis of current alcohol abuseldependence to 71% for computer-generated lifetime diagnosis of drug abuseldependence, when stratified by number of symptoms reported. No consistent differences were found in the performances of the two forms of the SUDDS, and we conclude that they may be used interchangeably. [ABSTRACT FROM AUTHOR]

In treatment of alcohol dependence, disulfiram is most useful in conjunction with a structured, supervised, aftercare program. However, it has been reported to cause psychiatric side effects and to interact with various psychiatric medications. Many patients with alcohol dependence suffer from other psychiatric disorders and are treated with such psychiatric medications. This paper reviews the pertinent clinical pharmacology of disulfiram and the literature on potential psychiatric complications and drug interactions of disulfiram. At the usual dosage, about 250 mg/day, disulfiram does not appear to increase significantly the risk of psychiatric complications or of psychiatric drug interactions. Therefore, it can be considered a treatment option for patients with alcohol dependence and other psychiatric disorders. [ABSTRACT FROM AUTHOR]

Results of stepwise discriminant analyses of the Self-Administered Alcoholism Screening Test (SAAST) administered to 181 alcoholics and 123 nonalcoholics in Mexico City were compared with results of a similar analysis of a sample in the United States (Rochester, MN). With sensitivities of 90% and 95%, specificities were 91.1% to 99.2% in the Mexican sample for total score and a nine-item version developed on the Rochester sample. A new nine-item version derived from the Mexican sample gave specificities between 95.1% and 99.2% at 90% and 95% sensitivities, as with the Rochester sample. The two items with greatest predictive power were the same in both cultures. [ABSTRACT FROM AUTHOR]

For a sample of 1156 patients (520 alcoholics and 636 nonalcoholics), discriminant function analyses were performed on the total score, a nine-item version, and a two-item version of the Self-Administered Alcoholism Screening Test (SAAST). With sensitivities set at 90 and 95%, specificities for the total score and nine-item versions ranged from 96.4 to 99.4%. Cross-validation of the nine-item version with the 'jackknife' procedure resulted in only one additional misclassi-fication of the 1156 subjects. Separate analyses of the male and female samples revealed that more items entered the discriminant function for women than for men and resulted in a higher, although clinically nonsignificant, percentage of correct classification for women. The results strongly support the use of either the total score or the nine-item version of the SAAST in large-scale screening for alcoholism in a medical patient population. [ABSTRACT FROM AUTHOR]

The hypothalamic-pituitary-adrenal axis of a group of patients suffering from alcoholism was studied by determining their plasma corticosteroid levels and urinary-free cortisol excretion before and after administration of 2 mg of dexamethasone. The patients were recently abstinent from alcohol and were found to be in a hypersecretory state. However, the axis appeared to be intact because they were able to suppress when steroid was given exogenously. [ABSTRACT FROM AUTHOR]

The equivalence of paper-and-pencil-administered and computer-administered versions of the Self-Administered Alcoholism Screening Test (SAAST) was investigated with alcoholic inpatients and nonalcoholic psychiatric outpatients. When the two formats were administered in counterbalanced order, total score mean differences were nonsignificant. In addition, mean differences on a short-form version were also nonsignificant. Equivalence was also determined by comparing the two formats in terms of classification agreement (i.e., classification of subjects into alcoholic and nonalcoholic categories). Agreement between the two formats was 95% in both the total score and short-form versions. Implications of these results as well as the advantages and disadvantages of using computer-administered alcoholism screening tests are discussed. [ABSTRACT FROM AUTHOR]

Fasting free amino acid concentrations in plasma of 20 control and 18 alcoholic subjects were compared in an attempt to validate previous reports that the molar ratio of α-amino- n-butyric acid/leucine (A/L ratio) is a marker for alcoholism. We were unable to confirm the observations of either altered α-amino- n-butyric acid or leucine concentrations or an increased A/L ratio in alcoholic subjects, and we conclude that the A/L ratio is not a biochemical marker for alcoholism. [ABSTRACT FROM AUTHOR]