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A 14-year-old boy was brought to us with complaints of recurrent fleeing episodes with confusion, short-term amnesia and behavioural problems, including restlessness, obstinacy and temper tantrums. He was diagnosed with dissociative fugue based on the DSM IV criteria. He had undergone counselling with his school counsellor, without much benefits. His illness was affecting his academic performance and relationships with parents and friends. The case was explored from the point of psychosocial stresses and the child’s disposition with characteristic expressions. The homoeopathic remedy Cuprum Metallicum was selected using Kent’s approach, as predominant mental characteristics were available. The selected remedy brought changes at the level of the disease expression (fleeing episodes) as well as the deeper aspect of his sensitivity and behaviour. Improvements occurred in his academic performance, social relationships, behaviour at school as well as his relationship with his parents. This experience emphasises the role of homoeopathy in mental disorders, especially dissociative fugue and also demonstrates the importance of characteristic mental state and expressions when selecting a similimum using Kent’s approach.

Yaira Chamorro,1 Lourdes Bolaños,1 Salvador Trejo,2 Omar Barrios,3 María de Lourdes Ramírez-Dueñas,1 Pablo Alvarez-Tostado,4 Alan Cervantes,5 Esmeralda Matute1,6 1Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, México; 2Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, México; 3Academia de Psicología,Centro Universitario UNE, A.C, Guadalajara, México; 4Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México; 5Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Guadalajara, México; 6Departamento de Estudios en Educación, Centro Universitario de Ciencias Sociales y Humanidades, Universidad de Guadalajara, Guadalajara, MéxicoCorrespondence: Esmeralda MatuteInstituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Francisco de Quevedo 180, C.P., Guadalajara, 44130, Jalisco, MéxicoTel +52 33 3818 0740, ext. 33373Email ematute@cencar.udg.mxBackground and Objective: Collecting information from different raters is important for diagnosing ADHD, but several factors can lead to gathering discrepant information. Our aim was to determine the agreement between parent and teacher’s when rating the list of ADHD symptoms (criterion A, DSM-IV) in a sample of Mexican school-age children. We explored whether inter-rater agreement varied by children’s age and sex, and each symptom of inattention, hyperactivity, and impulsivity.Methods: A total of 789 children (335 girls) from six elementary school grades grouped as G1 [grades 1– 2], G2 [grades 3– 4], and G3 [grades 5– 6]) were rated by their parents and teachers. We identified inter-rater reliability by using Cohen’s kappa coefficient by school level, sex, and ADHD symptoms. We explored the presence of symptoms considering parents’ and teachers’ ratings, individually and collapsed, using the AND/OR rules.Results: Low inter-rater agreement was observed. Moderate levels were observed in G1, but not in G2 or G3. Both groups of informants reported that more boys than girls met these criteria, but agreement by sex was still low, as were the results of the analyses by individual symptoms. Among the children that met the ADHD criteria, an inattention symptom was the one most frequently reported by both raters, whereas among non-ADHD children, a hyperactive symptom was the one most often reported.Discussion: The exclusive use of questionnaires fails to provide convergent information between raters. We highlight the importance of conducting comprehensive clinical histories when diagnosing ADHD in order to explore what these discrepancies show about the relationship symptoms/context.Keywords: multi-informant, agreement, ADHD, children

El objetivo del presente estudio fue identificar comorbilidad entre TEPT y TDM en personas víctimas del desplazamiento forzado y factores asociados. Se realizó una investigación de enfoque cuantitativo, diseño no experimental de corte transversal y alcance descriptivo-analítico. Fueron evaluadas 120 personas, de ambos géneros, entre 18 a 57 años, seleccionadas a través de un muestreo no probabilístico por conveniencia. Se utilizó una entrevista clínica estructurada para diagnósticos del Eje I (SCID-I) basada en los criterios del DSM IV para el TEPT y TDM, posterior a la aplicación de un cuestionario de datos sociodemográficos y antecedentes clínicos con el que se registraron los factores de riesgos y síntomas asociados. La prevalencia para TEPT fue del 48%, para TDM del 32% y 21% para comorbilidad, asociada con ideación e intento suicida y síntoma de rumiación. Los resultados fueron discutidos a la luz de otros estudios de prevalencia y la importancia de los factores de riesgo asociados en la comprensión de la comorbilidad entre TEPT y TDM.

Background Numerous studies on seasonality of birth for mood disorders and schizophrenia have been published but findings are inconsistent 1. We aim to test the hypothesis of lack of seasonal birth differences in hospitalized Bipolar Disorder and Schizophrenia patients. Methods 15969 inpatient records in UTHealth Harris County Psychiatric Center between 2012-2014 were enrolled (HSC-MS-14-0274). Patients birth months that were diagnosed as Schizophrenia (n=4178) and Bipolar Disorder (n=5303) according to the DSM IV Criteria were tabulated including admitting diagnosis. Texas Birth statistics between 1903-1997 were obtained as control group (n= 17096471). Results There was no significant difference for winter births between schizophrenia patients and control group (P=0.738) and there was no significant difference for winter births between bipolar patients and control group either (P= 0.862). Mann Kendall Trend Analysis showed no significant trends of birth months for schizophrenia, bipolar and control groups. Limitations The study limitations include being a retrospective study, inability to control for environmental factors, and recruiting from a single location. Conclusions Our large sample showed no association between birth season or months with schizophrenia or bipolar disorder. Severe schizophrenia that requires admission may not be related with birth seasonality.

Poor cognitive insight in schizophrenia has been linked to delusions, hallucinations, and negative symptoms as well as to depressive/anxiety symptoms. Its impact on quality of life has been less studied, especially in schizophrenia subjects with ongoing auditory hallucinations. The Beck Cognitive Insight Scale (BCIS) and the Quality of Life Scale (QLS) were administered to subjects who met DSM IV criteria for schizophrenia after due translation and validation. All subjects reported ongoing auditory hallucinations at recruitment. Mean composite cognitive insight scores from participants (N = 60) (2.97 ± 2.649) were in the lower range as compared to published literature. Cognitive insight scores as well as self-reflectiveness subscale scores, but not self-certainty scores, correlated significantly with the QLS scores p < 0.001. Results suggest that better cognitive insight, especially self-reflectiveness, may be linked to better quality of life. Self-reflectiveness could be a useful construct to address in psychotherapy to improve rehabilitation.

This study is intended to provide a comprehensive overview of the role of diet intervention on the behaviour of a random group of male and female School going Children of different socio-economic status and area of residence who meet the DSM IV criteria for ADHD. Though there is a wealth of research studies on the association of diet and supplements with the ADHD symptoms, there has been minimal empirical research in India charecterising dietary intervention with gender, socio-economic status and area of residence. The present study was carried out with a questionnaire consisting of 25 questions in the form of five scale rating which was administered to the subjects in six sessions to determine the prevalence of ADHD symptoms during the diet intervention. School going children of age group of 4-12 years were assessed for ADHD symptoms using DSM IV criteria. Forty one male and nine females with ADHD symptoms were selected for the diet intervention study. This current pre post study establishes that elimination of chocolates, Maida, bakery confectionaries, soft drinks, and junk food in the diet and replacing with highly nutritive value foods as per the RDA can reduce the ADHD symptoms. The study also revealed that gender, socio-economic status or the area of residence doesnt play any role in the diet intervention of ADHD children though the prevalance of ADHD is more seen in the males.

ABSTACT The purpose of this study is to determine the effects of ARPA on the life quality of the individuals with autism. The sample consisted of 59 individuals diagnosed with autism according to DSM IV criteria. The participant ages were between 4 and 18 years, and they were involved in the eight-week ARPA programme. PedsQL supplementary form for parents was used as a data collection tool, which consisted of 4 sub-dimensions, and 23 items were developed by Varni et al. A t-test was used for the correlated samples and ANOVA was used for repeated measures. According to the results, there was a significant decrease in the PedsQL subdimensions scores of all participants in terms of physiological functionality and emotional functionality. As a conclution, ARPA can positively contribute to the emotional and physical development of the individuals with autism and it can be effective in supporting the life quality of autistic individuals.

Self-compassion is posited to protect against posttraumatic stress disorder (PTSD) symptoms after exposure to traumatic events. Prior work has suggested self-compassion may only be related to avoidance symptoms using DSM IV criteria. Changes to the diagnosis in DSM 5 may have changed these relations. The current study examined the relation between self-compassion and PTSD symptoms using DSM IV and DSM 5 criteria. PTSD symptoms and self-compassion were evaluated in two trauma-exposed samples using measures that corresponded to DSM IV and DSM 5 criteria. Self-compassion was negatively correlated with aggregated PTSD symptoms for DSM IV and DSM 5. Self-compassion was correlated with avoidance symptoms for DSM IV but was correlated with all symptom clusters for the DSM 5. These results suggest that self-compassion may protect against PTSD symptoms using the most recent diagnostic criteria.

Background Diagnostic criteria for DSM-5 posttraumatic stress disorder (PTSD) are in many ways similar to DSM-IV criteria, raising the possibility that it might be possible to closely approximate DSM-5 diagnoses using DSM-IV symptoms. If so, the resulting transformation rules could be used to pool research data based on the two criteria sets.

Objective: The aim was to compare different scales capturing ADHD symptoms for older individuals’ self-reports about childhood and current ADHD symptomatology. An additional aim was relating these results to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD criteria. Method: The 25-item Wender Utah Rating Scale (WURS) administered in a population-based sample of 1,599 individuals aged 65 to 80. Two subsamples each with 30 individuals were randomly drawn based on their Wender Utah Rating Scale (WURS) scores, and studied using the Wender Riktad ADHD Symtom Skala (WRASS), interview assessed Barkley Scales, and DSM-IV ADHD criteria. Results: Higher WURS and WRASS scores were related to higher Barkley Childhood and Current Symptoms Scales Scores. Also, reporting more symptoms on these scales was related to meeting DSM-IV criteria for childhood and current ADHD. Conclusion: The results support significant persistence of ADHD symptoms when using different scales designed for the capture of childhood and current ADHD symptomatology. Further studies of ADHD in a lifespan perspective are encouraged.

This study investigated the relationship between disorders of the body self and personality defence mechanisms of women with bulimia nervosa. It was hypothesized that women with bulimia nervosa would not form a homogeneous group in terms of the body self disorder and that the extent of this disorder would be significantly related to personality functioning in terms of the defence styles adopted. The hypothesis was investigated with the aid of two questionnaires: the Body Self Questionnaire (Mirucka, 2005) and the Defence Style Questionnaire by Andrews, Singh and Bond (1993). 36 women aged between 15 and 25 years, who fulfilled the DSM IV criteria for bulimia nervosa participated in the study. Conclusions from the study were that: (1) the body self of bulimic women is differentially disordered at three levels: profound, moderate and minimal. (2) the degree to which the body self was found to be disordered is significant in psychological terms as it is related to the defence style adopted by the bulimic personality. The profound and moderate levels of body self disorder related to immature defence styles, while minimal levels of disruption to body self were associated with neurotic and mature styles.

The present study entitled "Prevalence of Eating Disorders in Adolescent girls in Srinagar city" was carried out in Srinagar. 100 adolescent girls from 5 schools, 20 from each, were selected randomly for the study. They were assessed through a structured questionnaire based on DSM IV criteria. It was found that the prevalence of eating disorders in our part of the world is very less as compared to the west as none of the adolescent girls in our study satisfied all the four criteria necessary for the diagnosis of anorexia nervosa or bulimia nervosa. However, about 30% of the adolescent girls satisfied two and 6% satisfied up to three criterias. As per the results obtained it was found that the mean weight of the sample was 47.90 kg with standard deviation of 6.36. Twenty three percent (23%) of the sample had weight less than 80% of expected for their age i.e. were malnourished. Although the prevalence of the eating disorders is very less in our city but the adolescent girls are becoming body conscious and many are at risk of developing eating disorder. As in the west no significant relation was found between family income and eating disorders although lower income groups showed higher prevalence of different criteria of eating disorders. Likewise there was no significant relation between eating disorder risk factors and features like age group, fathers and mothers qualification. Only one criterion, that is importance of being thinner than one's friends, showed statistically significant relation with age, qualification of parents etc. As many of the adolescent girls are at high risk of developing eating disorders, it seems to be right time to take preventive measures. Health education seems to be the best way to counter this problem. Both parents and children need to be educated. Mass media has to play a major role in bringing awareness regarding the problem.

Introduction- Diabetes mellitus (DM) is a major public health problem and it is a very common chronic metabolic disorder. There are so many studies which suggest co-morbidity of diabetes with depression and patients with depression have poor disease outcome. Aim- To study co-morbidity of diabetes and depression in outdoor patients. Material and Methods- Total 100 patients were studied. Diagnostic criteria of type 2 Diabetes Mellitus (type 2 DM) recommended by American Diabetes Association (ADA) was used. DSM IV criteria was adopted to diagnose depression. Hamilton score for depression was used to quantify the depressive symptoms. Plasma glucose values were compared in both the groups. Results and Conclusion- Prevalence of depression was higher in diabetic patients. Increasing severity of depression was associated with poor glycemic control.

A large number of criteria for evaluating of Internet addiction have been developed, recently. The research of Internet addiction among students of the Technical faculty in Bor, University of Belgrade has been conducted and its results are presented in this paper. The study included 270 students using criteria of Young’s Internet Addiction Test. In history of this University, that was the primarily research of this kind.

Delirium is common among old patients in hospital, especially those who undergo hip surgery. Various instruments have been developed for detecting delirium. One of these, the NEECHAM Confusion Sc ...

To assess diagnostic stability of initial autism spectrum disorder (ASD) diagnosed in children three years or less. Participants in the study included 77 (64 boys,13 girls) children in whom a diagnosis of Autistic Disorder (AD) and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) was made at age 3 years or less as per the DSM IV criteria. Children were recruited from the Outpatient services of the department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh. Multi-disciplinary evaluations including neurological, diagnostic, cognitive, and behavioral assessments were made. In addition, the Childhood Autism Rating Scale (CARS) was administered to assess symptom severity. Follow up was done around 4 years of age. At Time 1, 64 (83.11%) children were diagnosed as AD and 13 (16.88%) children with PDD-NOS. Follow up was possible in only 43 children (55.8%) at the mean age of 4 years 1 month (SD = 0.99) after a mean age interval of 1.65 years (SD = 0.95). At Time 2, 37 (86%) children were diagnosed as AD and 4 (9.3%) children were diagnosed with PDD-NOS, and 2 (4.65%) children were found to be off the ASD spectrum. The diagnosis of ASD (AD and PDD-NOS) was stable over time and 41 (95.3%) out of 43 children retained an ASD diagnosis. Looking at specific ASD diagnosis, AD diagnosis was stable for 33 out of 37 (89.18%) children and the PDD-NOS was stable for only 1 out of 6 (16.67%) children. An early and a stable diagnosis of ASD is possible provided there are expert clinicians available. Early detection and diagnosis of ASDs allows opportunities for children to profit more from early supports and interventions.

Background: The present study examines frequency of DSM-IV symptom and diagnostic criteria for separation anxiety disorder (SAD) by informant, age, and sex. Methods: Children aged 4–15 years with a primary DSM-IV diagnosis of SAD (N= 106) were assessed using structured diagnostic interviews (Kinder-DIPS; DSM-IV-TR Version). Frequency of DSM-IV symptom and diagnostic criteria were examined as a function of informant and child characteristics, along with impairment and distress ratings. Results: The most frequently reported symptoms were separation-related distress, avoidance of being alone/without an adult and sleeping away from caregivers or from home, with nightmares the least frequently endorsed criterion. Child report did not yield any significant sex or age differences. However, parent report revealed greater reluctance or avoidance of school attendance for girls than boys, and for younger children (

Inhalants are a serious public health concern and a dangerous form of substance use. An important unresolved issue in the inhalant literature concerns the validity of inhalant-use diagnoses and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, distinction between inhalant abuse and inhalant dependence. To address these limitations and provide the foundation for helping build stronger diagnostic and assessment tools related to inhalant problems, this study examined the dimensionality of the criteria set and the abuse-dependence distinction using item response theory (IRT) analysis.This study used data from a survey of the population of Missouri Division of Youth Services' residents of the residential treatment system. The current study focused on adolescents and young adults who reported a lifetime history of inhalant use (N = 279).The results from the IRT analysis showed no consistent hierarchical ordering of abuse and dependence criteria, providing strong evidence against the abuse-dependence distinction. The abuse criterion of legal problems associated with use represented the item with the highest level of inhalant severity. The dependence criterion that was related to giving up important social, occupational, or recreational activities provided the most accurate discrimination between individuals at different levels of severity.Inhalant-use disorders are best represented using a dimensional versus a categorical approach. IRT analysis provides guidance for selecting criteria that can be useful for brief assessments of inhalant-use problems.

A diagnosis with HIV is often considered traumatic. According to the DSM-IV-TR's criteria for PTSD, a traumatic event precipitates a set of reactions in an individual that includes avoidant behaviour, intrusive thoughts, and physiologic hyperarousal. However, persons diagnosed with HIV are typically concerned with events that will occur in the future such as physical decline and death, access to treatment, the welfare of dependants, and stigma and discrimination. Their concerns are thus future-oriented rather than anchored to a past traumatic event, which is the requirement of PTSD. This article argues that an HIV diagnosis may be inappropriately regarded as traumatic.

This study examines the extent to which parents and teachers agree on the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and its subtypes, as per the DSM IV criteria. It assesses whether the extent of agreement between informants improves by making the ADHD criteria more flexible.Parents and teachers of 119 clinic-referred sample of children (mean age=8.4 years, S.D= 2.48) with disruptive behavioral symptoms completed the Vanderbilt Attention Deficit Hyperactivity Disorder Diagnostic Parent and Teacher Rating Scales, respectively. Concordance of parent and teacher reports for the presence or absence of diagnosis of ADHD and type of ADHD was examined by percent agreement and the kappa statistics.Of the 119 children referred for disruptive behavior disorders, 96 (80.6%) met criteria for any type of ADHD according to the parents' report; and only 68 (57.1%) met criteria according to the teachers' report. Parent and teacher agreement for the diagnosis of any type of ADHD was only 52% (k= .11, n.s); and the agreement regarding diagnosis of sub-type was even poorer. Making the criteria more flexible vis-à-vis impairment or number of symptoms did not improve agreement between the informants.Clear guidelines are needed to reconcile the differences between informants in order to promote uniform diagnostic practices among clinicians working with children having ADHD.

The controversy concerning the validity and reliability of generalized anxiety disorder (GAD) appears to be particularly relevant in the elderly, since physical symptoms associated with GAD can readily be considered as the consequences of normal aging. This study aims to analyze the structure invariance of a questionnaire assessing the DSM-IV diagnostic criteria across samples of older adults and college students. Ninety-seven adults aged 65 or over and 130 college students completed the Worry and Anxiety Questionnaire (WAQ). The results revealed that factorial invariance could be assumed and, in addition, that scores for severity of GAD symptoms were higher in younger subjects than in older ones. The results support the applicability of DSM-IV criteria for GAD in elderly people, as the factorial structure of the WAQ was the same for this age group as for younger adults. A higher degree of GAD severity was found in the younger sample.

Background Current classifications of Mental Disorders are centered on Westernized concepts and constructs. “Cross-cultural sensitivity” emphasizes culturally-appropriate translations of symptoms and questions, assuming that concepts and constructs are applicable. Methods Groups and individual psychiatrists from various cultures from Asia, Latin America, North Africa and Eastern Europe prepared descriptions of main symptoms and complaints of treatment-seeking women in their cultures, which are interpreted by clinicians as a manifestation of a clinically-relevant dysphoric disorder. They also transliterated the expressions of DSM IV criteria of main dysphoric disorders in their cultures. Results In many non-western cultures the symptoms and constructs that are interpreted and treated as dysphoric disorders are mostly somatic and are different from the Western-centered DSM or ICD systems. In many cases the DSM and ICD criteria of depression and anxieties are not even acknowledged by patients. Limitations The descriptive approach reported here is a preliminary step which involved local but Westernized clinicians-investigators following a biomedical thinking. It should be followed by a more systematic–comprehensive surveys in each culture. Conclusions Westernized concepts and constructs of mental order and disorders are not necessarily universally applicable. Culturally-sensitive phenomena, treatments and treatment responses may be diversified. Attempts at their cross-cultural harmonization should take into consideration complex interactional multi-dimensional processes.

Background: A high smoking prevalence has been reported in treatment-seeking alcohol-dependent individuals. It has also been suggested that alcohol-dependent individuals who smoke may have a more severe course and greater severity of their alcoholism. Methods: This study evaluated the impact of tobacco use in 108 Swedish male type 1 alcohol-dependent individuals, recruited by advertisement in a local daily newspaper. They were sub-grouped into smokers (N = 50), snuffers (N = 12) and tobacco nonusers (N = 46). The number of criteria for the diagnosis of alcohol dependence was used to assess the severity of alcohol dependence. Results: The smokers were significantly younger compared to the tobacco non-using group, and also younger at their onset of excessive alcohol consumption. Both smokers and snuffers fulfilled significantly more DSM-IV criteria for alcohol dependence than tobacco nonusers. Furthermore, significantly higher proportions of smokers and snuffers fulfilled the criteria no 2 (experiencing withdrawal syndrome) and no 7 (continuing to use alcohol despite problems). Conclusions: These findings indicate that not only smoking, but also snuffing, is associated with greater severity of alcohol dependence, as reflected by the greater number of DSM-IV criteria.

We examined the DSM-IV criteria for pathological gambling as assessed with the DSM-IV-based Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002). We first analyzed the psychometric properties of the DIGS, and then assessed the extent to which performance on two judgment and decision-making tasks, the Georgia Gambling Task (Goodie, 2003) and the Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994), related to higher reports of gambling pathology. In a sample of frequent gamblers, we found strong psychometric support for the DSM-IV conception of pathological gambling as measured by the DIGS, predictive relationships between DIGS scores and all cognitive performance measures, and significant differences in performance measures between individuals with and without pathological gambling. Analyses using suggested revisions to the pathological gambling threshold (Stinchfield, 2003) revealed that individuals meeting four of the DSM-IV criteria aligned significantly more with pathological gamblers than with non-pathological gamblers, supporting the suggested change in the cutoff score from five to four symptoms. Discussion focuses on the validity of the DSM-IV criteria as assessed by the DIGS and the role of cognitive biases in pathological gambling.

Objective To evaluate (1) the Eating Disorder Not Otherwise Specified (EDNOS) prevalence in an eating disorder inpatient unit; (2) the impact of altering the diagnostic criteria for anorexia nervosa and bulimia nervosa on the prevalence of EDNOS. Method One hundred and eighty six eating disorder patients consecutively hospitalised were included in the study. The prevalence of anorexia nervosa, bulimia nervosa and EDNOS was evaluated with the Eating Disorder Examination (EDE). The EDNOS prevalence was recalculated after the alteration of three diagnostic criteria for anorexia nervosa and one for bulimia nervosa. Results Seventy eight patients (41.9%) met the diagnostic criteria for anorexia nervosa, 33 (17.8%) for bulimia nervosa and 75 (40.3%) for EDNOS. The alteration of the DSM-IV diagnostic criteria reduced the prevalence of EDNOS to 28 cases (15%). Conclusion EDNOS is a very frequent diagnostic category in an inpatient setting. Altering the diagnostic criteria for anorexia nervosa and bulimia nervosa reduced significantly the prevalence of EDNOS. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association.

This study used data gathered from the Diagnostic Interview Schedule, Version Three, Revised (DIS-III-R), which calculated diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), criteria and rescored the data to be compatible with the criteria of the Fourth Edition of the DSM (DSM-IV) for lifetime alcohol abuse and dependence.A psychologist reassigned questions from the DIS-III-R according to DSM-IV criteria. Another clinician evaluated the rescoring criteria and discrepancies were discussed and resolved. Using these criteria, SAS code was written to automate the rescoring of responses to DIS-III-R questions to DSM-IV diagnoses from a population of DWI offenders.There was a fair-to-good level of agreement between the DSM-III-R and rescored DSM-IV diagnoses (kappa = .65). Three hundred forty-eight subjects classified as alcohol dependent using DSMIII- R were reclassified as alcohol abuse in the DSM-IV rescore. Among subjects who were alcohol dependent based on DIS-III-R criteria, the distribution of DSM-IV diagnoses was similar across gender, age, and ethnic groups. There was no difference in agreement between DSMIII- R and the rescored DSM-IV diagnoses by age category. However, women and Hispanics had significantly higher weighted kappa statistics than men and non-Hispanic whites.Our rescoring results were consistent with earlier studies that compared DSM-III-R and DSM-IV diagnoses. Here, we offer an approach that may be useful to investigators who used the DIS-III-R in earlier studies. The DIS-III-R questions corresponding to DSM-IV criteria for alcohol abuse and alcohol dependence are on our Web site at www.bhrcs.org, along with the scoring algorithm.

Parents of 26 children With diagnoses of Asperger's disorder completed a symptom checklist to determine Whether the children met Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) criteria for Asperger's disorder, autism, or pervasive developmental disorder not otherWise specified. Results shoWed that almost all (20) met criteria for autism, and a DSM-IV-TR diagnosis of Asperger's disorder could not be confirmed in any child. Further, 95% of the parents Whose children did not have a DSM-IV-TR diagnosis of Asperger's disorder agreed With their child's diagnosis of Asperger's disorder. Our findings suggest that the hierarchical DSM-IV-TR criteria are not applied by clinicians to diagnose Asperger's disorder because most children With diagnoses of Asperger's disorder actually met DSM-IV-TR criteria for autism, Which precludes a diagnosis of Asperger's disorder. These findings are consistent With previous studies. Most experts noW agree that autism is a spectrum disorder and Asperger's disorder is actually high-functioning autism. Implications for the next revision of the DSM are discussed.

Objective: To determine the extent to which the developmental profile of children less than 4 years can help in distinguishing children with autism from children with developmental delay. Methods: Subjects were 32 children with autism as per the DSM IV criteria and 32 children with developmental delay matched on chronological and academic age. The Developmental Profile II was used to assess the developmental functioning in five domains including physical, social, self help, academic, and communication. Results: The two groups showed significantly different developmental profiles and these differences were accounted for mainly by significantly lower social skills and superior motor skills in the autistic group as compared to the developmentally delayed group. Conclusion: Developmental Profile II may help in distinguishing young children with autistic disorder from non-autistic children with comparable developmental delays.

The purpose of this study was to explore the utility of DSM‐IV criteria in diagnosing alcohol and marijuana abuse/dependence in adolescents. A modified version of the Structured Clinical Interview for DSM‐IV (SCID) was administered to assess substance abuse/dependence symptoms in 127 inpatient, treatment‐seeking adolescents with substance‐use disorders. The proportion of individuals with clinically relevant symptoms was examined separately for individuals classified with either abuse or dependence. Chi‐square tests of independence between the abusive/dependent classification and the presence/absence of a given symptom were also performed. Rates of DSM‐IV current substance use diagnoses were alcohol abuse 21 (16%), alcohol dependence 44 (35%), marijuana abuse 27 (21%) and marijuana dependence 72 (57%). A diagnosis of marijuana dependence was significantly more likely when tolerance symptoms were present but was not significantly dependent on the presence of withdrawal symptoms. By contrast, the presence of...

As human society is mainly cooperative, it is not clear how antisocial personality disorder (APD) persists. The current explanation is that sociopaths are cheaters who maximize their fitness by taking advantages from others. Although this argument is valid, we show here that society also benefits from APD. We propose that the old phylogeny of punishment, the fact of being a full member of society, the frequency of the disorder, genetics, linkage between two "contradictory" DSM IV criteria for the disorder, and the necessity for society to fight against antisocial behavior, play positive roles for society and/or human groups, especially in the ancestral environment.

Objective: To review the current knowledge on neurobiological aspects of autism and pervasive developmental disorders, as well as to provide pediatricians with up to date information on diagnosis and treatment of autism. Sources of data: Review of MEDLINE and Internet. Summary of the findings: Autism is the 3rd developmental disorder, with an incidence of 40 to 130/100,000 individuals. Diagnosis is based on clinical findings, following DSM IV criteria. Neuroimaging, investigation of fetal neurological status, and genetic investigation contribute towards a better understanding of the neurobiology of autism. Conclusion: Pediatricians are the first health professional to come in contact with patients with autism. Thus, they should be able to diagnose and to coordinate the multidisciplinary treatment of these patients.

Background: In Japan a new long-term care insurance (LTCI) system, the so-called ‘Kaigo-Hoken’, was started in April 2000. The present study analyzes the change in the type of destination after discharge from a senile dementia therapy ward before and after the implementation of LTCI at Fukuoka Prefectural Onga Hospital, Japan. Methods: The present study examines data from 199 inpatients discharged from the Fukuoka Prefectural Onga Hospital that had been diagnosed with dementia and met the DSM IV criteria for Alzheimer's type, vascular dementia or other type of dementia. For the purposes of comparison two periods were defined, ‘the first period’ was defined as the period from 1 April 1999 to 31 March 2000, before LTCI was implemented, while ‘the second period’ was defined as the period from 1 April 2000 to 31 March 2001, after LTCI had started. Subject data was analyzed on the basis of where the subject had resided pre-admission and their destination after discharge using the following classifications: nursing home or geriatric care facility, hospitalization, home and death. Results: While the certification rate of inpatients regarding long-term care increased slightly in the second period, no significant change was observed based on where the subject had resided pre-admission and their destination after discharge between the first and second periods. Conclusions: While LTCI is essential for Japan, it is necessary that people with dementia in senile dementia therapy wards are encouraged to return to their homes under the care and support of LTCI.

While diagnostic criteria for premenstrual syndromes (PMS) exist, studies rarely state how these criteria are operationally applied. We examined the consequences of application of different operational methods for DSM-IV criteria for premenstrual dysphoric disorder (PMDD) to individual cycles in women with PMS and controls. PMDD criteria require the presence of both certain types or numbers of symptoms (5/11 symptoms present premenstrually, at least one being one of four mood symptoms) and certain phenomenal characteristics (present premenstrually, absent postmenstrually, causing interference premenstrually). We identified individual cycles as symptomatic or asymptomatic by applying criteria that operationalized the required phenomenal elements of PMDD according to four severity thresholds: literal (i.e. present or absent), 30%, 50%, 70%. Data examined were Daily Rating Form symptom scores from two symptomatic menstrual cycles both in 25 women with PMS and 25 controls. Literal thresholds correctly identified 28% of symptomatic and 4% of asymptomatic cycles, compared with 86 and 70% identification with a 30% threshold, 60 and 86% with a 50% threshold, and 0 and 100% with a 70% threshold. An “optimal” combination of 30% thresholds for premenstrual symptomatology and premenstrual interference and a 50% threshold for postmenstrual symptomatology correctly identified 92% of symptomatic cycles in women with PMS and 72% of asymptomatic cycles in controls. Different criteria for cycle inclusion yield markedly different sample compositions. No single operational threshold of the phenomenal features maximizes selection of both symptomatic and asymptomatic cycles, largely consequent to the ubiquity of postmenstrual symptoms and premenstrual “interference” even in women without PMS. At the very least, the method for operationalizing DSM-IV criteria should be described in studies of PMDD.

Objective: To describe the characteristics of young people presenting with school refusal to a child and adolescent psychiatric unit and examine differences between those admitted for inpatient treatment and the rest. Method: One hundred and ninety-two adolescents who had been assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia were identified. An instrument was developed and used to gather data from files. Diagnoses were made by the consensus of two of the investigators using DSM IV criteria from all sources of information. Results: The commencement of school refusal generally occurred in the first 2 years of high school. School refusers had a high prevalence not only of anxiety, but also of mood and disruptive behaviour disorders. A family history of psychiatric illness was present in over half the sample. There were no differences between those subsequently admitted as inpatients and the rest in terms of symptom scores, family composition, family conflict, family separation or history of abuse. Those admitted for inpatient treatment were more likely to have a diagnosis of mood disorders and comorbid diagnoses and to have a maternal history of psychiatric illness. Conclusions: School refusal in adolescence can be a symptom of a variety of disorders, particularly anxiety and mood disorder. Treatment programs need to be geared to the range of diagnoses which occur in this patient group and to the various circumstances associated with the onset of the problem.

This paper presents a revised version of DSM-IV-J criteria for youth, the DSM-IV-MR-J, together with psychometric data stemming from its use in a major prevalence study of adolescent gambling and problem gambling. The case is made for further development and testing of current and emerging instruments to screen for problem gambling in youth, with the aim of establishing one internationally accepted gold standard measure.

The assumption that participants receiving an ICD10 diagnosis of posttraumatic stress disorder (PTSD) will also receive a DSM-IV diagnosis of PTSD was tested. Data were gathered for 1,364 participants using the Composite International Diagnostic Interview (CIDI). The 12-month prevalence of PTSD was 3% for DSM-IV and 7% for ICD10 Diagnostic Criteria for Research (ICD10-DCR). The agreement between the two systems was fair (kappa = .50). Forty eight percent of the discrepancies between the systems were accounted for by the additional criterion requiring clinically significant distress or impairment included in DSM-IV. The inclusion of symptoms of general numbing of responsiveness accounted for 18% of the discrepancies. It is concluded that ICD10-DCR PTSD cannot be assumed to be identical to DSM-IV PTSD.

We describe a brief self-report measure for assessing hypochondriacal fears in adults. Called the Survey of Health Concerns (SHC), the measure was developed using DSM IV criteria for diagnosing hypochondriacal disorder as a guide. The measure was standardized on a sample of 188 college students. It was shown to have good internal and temporal reliability over a 2-week period. Moreover, scores on the SHC correlated significantly with worry proneness as measured by the Penn State Worry Questionnaire, and with the Hs scale of the MMPI-2, which together support the convergent validity of the measure. While men and women scored the same, participants who were being treated for a medical condition scored higher than those who were not being treated. Men who were under a doctor's care scored especially high, although this was based on a small sample of men and the effect could be spurious. A principal component factor analysis revealed two primary factors: one that described participants who felt poorly, made frequent trips to the doctor, and were fearful of illness and dying, and another that described participants who were particularly fearful of infectious diseases and took active steps to avoid becoming sick. Relatively little is known about hypochondriacal disorder. One reason for the dearth of knowledge in this area is that there has been no practical and reliable way to assess hypochondriacal fears, or more generally speaking, people's tendency to worry about their health. The SHC may help to fill this void. Results are admittedly preliminary and further study in medical settings is needed.

This meta-analysis reports the effects of cognitive-behavioural treatment (CBT) on bulimia nervosa as defined by the DSM-III-R or DSM-IV criteria. In a previous meta-analysis, 26 studies were included using less strict diagnostic criteria for inclusion. The present meta-analysis only included randomized controlled studies fulfilling the DSM-III-R or DSM-IV criteria. Computer searches in MedLine, PsychLIT and references cited herein resulted in a large number articles, of which only seven fulfilled the criteria for inclusion. Effect sizes for binge eating and purging frequency were estimated using both between-group (treatment vs control) and within-group (pre- vs post-treatment) comparisons. The combined within-group effect size for binge eating was r = 0.55 ( d = 1.32) and for purging r = 0.61 ( d = 1.54). The corresponding combined effects for the between-group comparisons were r = 0.23 ( d = 0.47) and r = 0.28 ( d = 0.58), respectively. The combined probabilities for frequency of purging in between- an...

This study evaluated the factor structure of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria for attention-deficit/hyperactivity ...

Little is known about the boundaries between major depression and milder subsyndromal depressive states. With respect to depressive symptoms, does DSM-IV "carve nature at its joints"?In personally interviewed female twins from a population-based registry, the authors examined whether a range of values along three dimensions of the depressive syndrome assessed in the last year (number of symptoms listed in DSM-III-R under diagnostic criterion A for major depressive episode, level of severity or impairment required to score symptoms as present, and duration of episode) predicted future depressive episodes in the index twin and risk of major depression in the co-twin.An increasing number of criterion A symptoms predicted, in a monotonic fashion, a greater risk for future depressive episodes in the index twin as well as a greater risk for major depression in the co-twin. No such consistent relationship was seen with duration of episode. For severity, a single monotonic function predicted risk in the co-twin, while index twins with severe impairment had a substantially higher risk for future episodes than did those with less severe impairment. Four or fewer criterion A symptoms, syndromes composed of symptoms involving no or minimal impairment, and episodes of less than 14 days' duration all significantly predicted both future depressive episodes in the index twin and risk of major depression in the co-twin.The authors found little empirical support for the DSM-IV requirements for 2 weeks' duration, five symptoms, or clinically significant impairment. Most functions appeared continuous. These results suggest that major depression--as articulated by DSM-IV--may be a diagnostic convention imposed on a continuum of depressive symptoms of varying severity and duration.

The purpose of this study was to compare subsyndromal panic—infrequent panic (IP) and limited symptom attacks (LSA)—with panic disorder (PD) in psychiatric comorbidity, quality of life (QOL), and health care utilization and to assess validity of DSM-III-R criteria for panic disorder. Randomly selected adults were screened for the presence of PD, IP, and LSA by using the Structured Clinical Interview of the DSM-IIIR. Subjects with panic symptoms and matched controls completed a structured interview concerning comorbidity, QOL, and utilization. Although PD and IP subjects reported more psychiatric comorbidity than did LSA subjects, LSA subjects had more comorbid conditions than did controls. Differences in utilization were limited to PD subjects. Although subsyndromal panic was associated with poor QOL, panic-related work disability was primarily seen in PD subjects. Regression analyses demonstrated little difference between LSA and IP subjects, but interaction analysis supported the distinction between LSA and full-blown panic attacks. Compared with controls, LSA and IP subjects had more psychiatric comorbidity. PD subjects also had poorer QOL and more utilization. Interaction analysis supports DSM-IV criteria for panic disorder. Depression and Anxiety 8:33–38, 1998. © 1998 Wiley-Liss, Inc.

Background. Autism is a spectrum of neurodevelopmental disorders with manifestation within 3 years after birth. Manifestations of autism include behavior problems (hyperactivity, toys destruction, self-harm, and agression) and sleep and eating disorders. Etiology of autism is poorly understood. Oxidative stress and antioxidants can participate in pathobiochemical mechanisms of autism.Methods. Twenty-four children, aged 3–6 years, with autism according to the DSM IV criteria and using CARS were included in the study. Concentrations ofCoQ10-TOTAL,γ- andα-tocopherol,β-carotene, and lipid peroxidation were determined in plasma before and after three months of supportive therapy with ubiquinol at a daily dose2×50 mg. Data on behavior of the children were collected from parents at the same time.Results. Ubiquinol supportive therapy improved symptoms in children with autism, as communication with parents (in12%), verbal communication (in21%), playing games of children (in42%), sleeping (in34%), and food rejection (in17%), withCoQ10-TOTALplasma level above2.5 μmol/L.Conclusions. Beneficial effect of ubiquinol in children with autism has been demonstrated for the first time. We assume that plasma concentration ofCoQ10-TOTALand lipid peroxidation could be used as relevant biomarkers of ubiquinol supportive therapy.

This study investigated the utility of the PK scale of the MMPI-2 with college students. Results indicated that the PK scale, when combined with DSM IV criteria, does discriminate between college students who obtain a score of 65 or higher and those who score below 65.

Attention deficit hyperactivity disorder (ADHD) is the most common mental disorder in children. Despite an extensive amount of research, it remains a controversial diagnosis with changing diagnostic criteria. Descriptions of children with ADHD can be traced back as early as 1848 when a German physician, Heinrich Hoffmann, described a hyperactive child, "Fidgety Phil," and an inattentive child, "Harry Look in the Air," in a book he wrote for his children. In 1902, George Still presented a lecture series in England about 20 children who were aggressive, defiant, excessively emotional, and lacking inhibitory volition who were also noted to have impaired attention and overactivity. After World War I, similar behaviors were considered to be the result of brain damage associated with encephalitis. However, the disorder as it is now characterized first started to take shape in the 1960s and was known as minimal brain damage or dysfunction