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• Oxazepam and diazepam were compared in healthy elderly volunteers. Absorption of diazepam was faster than oxazepam and onset of clinical effects were more profound. Diazepam accumulation was extensive, washout was slow and active compounds were present two weeks after the last dose. Oxazepam accumulation was significantly less and elimination significantly faster than diazepam. There was no difference between oxazepam and diazepam in sedation or fatigue during the drug treatment, but sedative effects persisted for two weeks after diazepam therapy was discontinued. Sedation rapidly returned to baseline in the oxazepam group. Thus, the differing pharmacokinetic profiles of diazepam and oxazepam have clinical consequences during multiple dosage in the elderly.

Forty male volunteers over the age of 60 took either a daily dose of diazepam (12 mg) or placebo for a two‐week period. Differential responses to these compounds partially depended upon age and the initial symptom level. Diazepam produced sedative side effects, a modest antidepressant effect, and a reduction in memory. Placebo had an antianxiety effect in the relatively older subjects, and was associated with decreased fatigue, improved memory and improved motor function. Considerable variability was observed in both drug and placebo responses among the elderly. A self‐rating depression scale (D30R) was useful for assessing changes in affective states and in discriminating between the effects of active drug and placebo.

The importance of diagnostic differentiation between early senile deterioration and depressive disorders in the aged led to the development of Sandoz Clinical Assessment—Geriatric (SCAG) as a new rating instrument especially applicable to the elderly. It is composed of 18 symptom areas rated on a 7‐point format. Study 1 was carried out on 51 geriatric subjects (25 volunteers and 26 hospital inpatients at a health center), tested by SCAG and also by the widely used MSER (Mental Status Examination Record). In Study 2, data were obtained on 8 subjects tested by 4 psychiatrists, to determine interrater reliability. The statistical findings indicated that SCAG is a valid and reliable instrument for assessing psychopathology in the elderly.

A survey was made of drug prescriptions written for all medical/surgical patients in a general hospital on a single weekday in 1978. Of these 348 patients, 195 were over the age of 60. In this elderly group, 62 (32 percent) were receiving psychoactive drugs. Flurazepam was the drug most commonly prescribed (in 63 percent of the patients). Diazepam was the most frequently prescribed nonhypnotic psychoactive drug (in 29 percent). Neuroleptic drugs and phenothiazine anti‐emetics (in 52 percent) were not prescribed for psychosis but for augmenting analgesia and sedation and for reducing nausea. The average daily doses were about 20 percent of those used to treat psychotic young adults. All antidepressants (in 9.7 percent) had been prescribed before admission. No monoamine oxidase inhibitors were used, and doses of tricyclic antidepressants were half to one‐third lower than those used to treat younger depressed adults. Antidepressants, which pose a risk to the elderly patient, were overprescribed and underdosed.

Drugs for the treatment of various medical or psychiatric disorders may sometimes cause or exacerbate depression in the elderly. Drug interactions due to polypharmacy (a common method of prescribing for aged patients) may also play a role in the genesis of depression. The roles of specific drugs and of drug interactions are reviewed. Criteria for the diagnosis of depression in the elderly, as well as differential diagnostic guidelines, are presented and constructive suggestions offered.

Diagnosis of depression in the elderly is sometimes difficult owing to the presence of ego defensive mechanisms or somatic symptoms that can disguise the affect. Depression also may precede, or be associated with a variety of medical illnesses which are common among older persons. Specific ego defenses and representative medical illnesses are discussed. The concepts of a depressive equivalent and pseudodementia, which particularly act to disguise the depression, are reviewed in detail.

THE MORE widespread use of marihuana and marihuana-like drugs in the general population and the controversy about their possible harmful, as well as beneficial, effects have led to an increased interest in studying these compounds during the last few years. At the same time, the identification of l-Δ1-3,4 trans-tetrahydrocannabinol (THC) as a constituent of marihuana and its synthesis by Gaoni and Mechoulam1,2 have made possible the systematic study of this substance, which is presumed to be the most active element in marihuana (l-Δ1 is also referred to as l-Δ9; l-Δ1 follows terpene nomenclature, which was used by Mechoulam and Gaoni, whereas l-Δ9 follows standard chemical abstracts nomenclature).The major aim of the present study is the delineation of some of the psychological effects of THC. This paper will deal primarily with the systematic measurement of

Secobarbital was administered to offspring of family threesomes to test the resiliency of family problem-solving processes to psychological changes in one of its members. Twenty-four families were used, half receiving 175 mg of secobarbital and the other half receiving a placebo on a double-blind basis. Family problem solving and speech patterns were measured by a card-sorting experimental procedure and computer analysis of automatically-transcribed voice records.The drug produced no objective change in the problem solving of the offspring or his family but produced marked changes in the family's speech patterns. The findings suggest that speech changes may have been compensatory, preventing a sustained change in family problem-solving process in response to the drug.

Among young adult subject applicants to a research program, those who indicated they had used marihuana scored differently than did nonusers on a battery of personality tests. More users than nonusers were found among those who showed psychiatric impairment. The use of drugs in addition to marihuana seemed to exaggerate some of the differences observed. Moreover, changing patterns of drug use/abuse were evidenced by differing personality-drug use relationships in the periods 1968 through 1969 and 1970.

A review of scales for rating mood in geriatric patients reveals the criteria that must be met: 1) the subject must be responsive and cooperative; 2) the scale should be brief, with clear response choices; and 3) the questions should be clear and relevant to the current situation of the patient. Individual mood scales do not offer much advantage over a brief, well constructed, multidimensional rating scale.

Rating scales for the assessment of behavior in geriatric patients are reviewed in two categories: 1) specific, and 2) nonspecific for geriatric populations. The advantages of each are discussed. The choice must be left to the rater's judgment in view of his investigative requirements.

The article presents questions and answers pertaining to mental illness, including what role noninvasive brain stimulation plays in the treatment of psychiatric disorders, what drugs are available for treating Alzheimer's disease, and how taking psychoactive medications for a prolonged period of time affects the brain.

• We compare the effects of chlordiazepoxide, oxazepam, and placebo on hostility, as both an inner motivational or potential state and verbal interpersonal behavior. This article reports the findings relevant to the latter dimension of hostility and integrates them with those findings, presented in an initial report, relevant to hostility as an inner motivational state. The verbal data again support the hypothesis that chlordiazepoxideinduced increases in verbal interpersonal hostility, following frustration, are greater than those associated with placebo. With regard to oxazepam, the verbal hostility data were consonant with the motivational data that suggested that oxazepam does not substantially disinhibit hostility but did not as consistently differentiate oxazepam and chlordiazepoxide at the level of overt hostile behavior.