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Due to the high solar radiation, constant over the whole year, solar energy is one of the most promising energy sources of the Caribbean for the next decades. But up to now this potential is not used, mainly due to the high costs of solar cells. Solar energy conversion is mainly dominated by expensive cells based on silicon. A promising alternative is the dye sensitized solar cell (DSSC) based on Titanium dioxide (TiO2), which has generated considerable interest in the last years. Thus, the objective of this study was to analyse and optimize the DSSCs’ performance depending on their preparation and lighting condition. Therefore, five different natural dyes were extracted from local Colombian fruits and vegetables, such as Achiote, Agraz, Corozo, Mora and Remolacha. They were characterized using an UV-Spectrophotometer and used as sensitizers to fabricate the DSSCs. To optimize the DSSCs, different conditions and parameters were changed. It was thereby found that beside the fruit that was used, also the thickness of the TiO2 layer and the preparation procedure of the dye solution have a direct impact on the cell efficiency. The cells fabricated with achiote dye solution were found to have the best efficiency, reaching up to 0,21% under sun and 0,075% under a halogen lamp. The study was executed in the context of internships at the Universidad del Norte in Barranquilla, Colombia, which was enabled by the DAAD through RISE program scholarships. Resumen La energía solar es una de las más promisorias fuentes de energía en el Caribe en las próximas décadas debido a la alta radiación solar y a que se mantiene muy constante durante la mayor parte del año. Sin embargo, hasta ahora este potencial no se usa debido a los altos costos de las celdas solares, cuya comercialización está principalmente dominada por costosas celdas basadas en silicio. Una alternativa prometedora son las celdas solares sensibilizadas con colorantes (DSSC, por sus siglas en inglés) basadas en dióxido de titanio (TiO2), las cuales han generado bastante interés en los últimos años. Así, el objetivo del presente estudio fue analizar y optimizar el desempeño de las DSSC dependiendo de su preparación y condiciones de iluminación. Por ello se usaron cinco colorantes naturales diferentes extraídos de frutas y vegetales, tales como: Achiote, Agraz, Corozo, Mora y Remolacha. Estos colorantes fueron caracterizados usando un espectrofotómetro en ultravioleta y visible, y usados como sensibilizadores en la fabricación de las DSSC. En el proceso de optimización se cambiaron varias condiciones y parámetros. En ello se encontró que además de los colorantes usados, los grosores de las capas del TiO2 y los procedimientos de preparación de la solución colorante tienen un impacto directo en la eficiencia de las celdas. Finalmente, se encontró que las celdas con las mejores eficiencias fueron las de Achiote, cuya eficiencia alcanzó el 0,21% bajo iluminación directa del sol y de 0,075% de eficiencia cuando fue iluminada con una lámpara halógena. Este estudió se desarrolló en el contexto de intercambios académicos en la Universidad del Norte con el apoyo del DAAD a través del programa RISE. Résumé L’énergie solaire est l’une des sources d’énergie les plus prometteuses dans les Caraïbes, pour les décennies à venir, dû au rayonnement solaire élévé qui reste constante pendant la majeure partie de l’année civile. Cependant, jusqu’à présent ce potentiel n’a pas été pleinement exploité, en raison de coût élevé des cellules solaires, dont la commercialisation a été dominée par des cellules de silicium à prix élevé. Une solution prometteuse sont les cellules solaires sensibilisés par un colorant (DSSC, en anglais), à base de dioxyde de titane (TiO2.), qui a suscité des réactions considérables pour ces dernières années. Donc, l’objectif principal de cette étude était d’analyser et d’optimiser la performance de DSSC, en fonction de de ses conditions de préparation et d’illumination. Ainsi, cinq colorants naturels ont été utilisés, de fruits et végétaux extraits, à partir d’Achiote, Agraz, Corozo, Mûr et de Betteraves. Ces colorants ont été caractérisés en utilisant un spectrophotomètre, dans l’ultraviolet et le spectre visible, et utilisés des comme sensibilisants, pour la fabrication des DSSC. Dans le processus d’optimisation des diverses conditions et paramètre ont été changés. En cela il a été établi qu’en plus des colorants utilisés, les épaisseurs de couche du TiO2. et les processus de préparation de solution colorante ont un impact direct sur la efficacité des cellules. On se retrouva finalement que les cellules avec les meilleures efficacités ont été celles de l’Achiote, dont une efficacité du 0,21% a été atteint, avec un éclairage de la lumière directe du soleil, et une efficacité du 0,075%, lorsqu’elle est éclairée par une lampe halogène. Cette étude a été élaboré dans le contexte d’échanges universitaires dans l’Universidad del Norte appuyée par le service allemand d’échanges universitaires (DAAD), à l’aide du programme RISE. Resumo A energia solar é uma das fontes de energia mais promissores no Caribe, nas próximas décadas, devido à alta radiação solar que se mantém constante durante a maior parte do ano. No entanto, até agora este potencial não é usado por causa do alto custo das células solares, cuja comercialização é dominada principalmente por células de silício de preço elevado. Uma alternativa promissora são as células solares sensibilizadas por corante (DSSC, por sua sigla em Inglês) à base de dióxido de titânio (TiO2), que geraram um interesse considerável nos últimos anos. Assim, o objetivo deste estudo foi analisar e aperfeiçoar o desempenho de DSSC dependendo de suas condições de preparação e de iluminação. Assim, foram usados cinco diferentes corantes naturais extraídos de frutos e vegetais, tais como: Anato, Agraz, Corozo, Mora e Beterrabas. Estes corantes foram caracterizados usando um espectrofotómetro de ultravioleta e visível, e utilizados como sensibilizadores na fabricação do DSSC. No processo de optimização várias condições e parâmetros foram alterados. Verificou-se que a adição dos corantes utilizados, as espessuras das camadas de TiO2. e métodos de preparação da solução de corante tem um impacto direto sobre a eficiência das células. Finalmente descobriu-se que as células com as melhores eficiências foram anato, cuja eficiência de 0,21% com iluminação solar direta e eficiência de 0,075% quando foi iluminado com uma lâmpada de halogéneo. Este estudo foi desenvolvido no contexto do intercâmbio acadêmico com a Universidad del Norte e apoiado através do programa RISE.

Cu(In,Ga)Se 2 absorbers were investigated by surface photovoltage (SPV) in the Kelvin probe and fixed capacitor arrangements before and after deposition of CdS or In 2 S 3 buffer layers as well as before and after deposition of ZnO window layers. Effects such as passivation of surface states, partial electron transfer from ZnO into In 2 S 3 , decrease of the ideality factor after deposition of ZnO and slow electron transfer through In 2 S 3 were demonstrated. The results show that SPV measurements open opportunities for dedicated studies of charge separation at hetero-junctions between ordered and disordered semiconductors.

Single layers and combined layer systems with Cu(In,Ga)(S,Se)2, ZnS-nanodot (nd) and In2S3 layers were investigated by surface photovoltage spectroscopy in the Kelvin-probe arrangement and compared with the open-circuit voltage (VOC) of solar cells. The In2S3 and ZnS-nd layers were prepared by the spray ion layer gas reaction (ILGAR) technique from Indium chloride (InCl3), Indium acetylacetonate (In(acac)3) and Zinc acetylacetonate, respectively. The surface photovoltage signals of Cu(In,Ga)(S,Se)2 were larger for the Cu(In,Ga)(S,Se)2/ZnS-nd/In2S3 than for the Cu(In,Ga)(S,Se)2/In2S3 layer system showing that a ZnS-nd layer additionally passivated the Cu(In,Ga)(S,Se)2 surface. ILGAR In2S3 deposition from InCl3 precursor solution led to a modification of surface defects of ZnS-nd and to generation of defect states below the band gap of Cu(In,Ga)(S,Se)2, which has not been observed for deposition from Indium acetylacetonate precursor. Defect generation during ILGAR In2S3 deposition with InCl3 precursor resulted in a lower VOC of Cu(In,Ga)(S,Se)2/ZnS-nd/In2S3/ZnO : Al solar cells. Copyright © 2012 John Wiley & Sons, Ltd.

The adsorption of large organic molecules, including tetracene and perylene, on clean Si(100) is followed by scanning tunnelling microscopy (STM) in an ultra high vacuum environment. Different adsorption sites have been observed for these organic molecules. Two types of tetracene adsorption are indicated by filled state images but three types can be distinguished in empty state images. Molecules aligned both along and perpendicular to the silicon dimer rows can be observed. Measurements of the length of this molecule in all configurations indicate that the molecule stays intact during the adsorption process. High resolution of STM images reveal that the perylene molecules bond to the substrate in a vertical orientation and forming packs of perylene aligned perpendicular to the silicon dimmer rows. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

The room temperature deposition of PTCDA on hydrogen passivated Si(1 1 1), as a function of evaporation temperature and dosing time, has been studied by STM. At low evaporation temperature, 200 °C, clusters with an average size of 3.5 nm are formed on the surface. The mobility of the small clusters is so high, even at room temperature, that most of the clusters are trapped at surface defects. By increasing the evaporation temperature to 230 °C, larger clusters are formed which have lower mobility. The growth process is identified as a Volmer-Weber mechanism. On increasing the evaporation temperature further to 250 °C, crystals with dendritic shape are formed with an average size of 150 nm. The terraces of the crystal are formed with the (1 0 2) basal plane of the α-phase. Molecular resolution on the terrace also allows us to identify the molecular mechanism involved in the growth of the dendritic crystals.

Scanning tunnelling microscopy (STM) has been used to follow the adsorption of tetracene molecules on the Si(100)-2 × 1 surface. Two distinct types of adsorption are indicated by filled state images but three types may be distinguished in empty state images. Molecules aligned both along and perpendicular to the silicon dimer rows can be observed. The calculated charge densities associated with occupied and unoccupied orbitals near the Fermi level are compared with the STM images. Possible bonding arrangements and their correlation with the STM images are postulated.

The surface recombination velocity at clean and modified Si(1 0 0)2×1, Si(1 1 1)-1×1 and Si(1 1 1)-7×7 surfaces was studied with the pulsed photoluminescence technique. High resolution electron energy loss spectroscopy and low energy electron diffraction were employed to correlate the surface recombination velocity to the chemical bonds at the surface and the surface morphology. Passivation of surface dangling bonds by the chemisorption of water and maleic anhydride shows that the surface dangling bonds are not recombination active. In contrast, we observe that the introduction of oxygen or carbon atoms into Si backbonds causes the generation of non-radiative recombination centres.

We show that, counterintuitively, maleic anhydride on Si(1 0 0) surfaces adsorbs on inter-row sites. Our first principles simulations establish that this site is preferred for coverages of less than 1/8 ML. In simulations of scanning tunnelling images we establish also, that the corrugation is enhanced by more than 0.5 A, if a single molecular state contributes to the tunnelling current. The combined evidence of images and simulations allows the conclusion that experiments in fact reveal the geometry of single molecular wavefunctions.

A new, centered orthorhombic crystal, a = 20.7 A, b = 19.3 A, c = 3.4 A, and β = 90 A, of perylene, C20H12, has been grown epitaxially on a Cu(110) surface under UHV conditions. The crystal structure has been studied with HREELS, LEED, and STM. Vibrational spectra reveal that the molecular planes are parallel to the substrate. Electron diffraction indicates an almost square unit cell in the ab plane in which the a axis is commensurate along the 〈110〉 azimuth of the Cu substrate, while the b axis is incommensurate along the 〈001〉 azimuth. STM images show a large scale smooth morphology of the organic crystal indicative of layer-by-layer growth, while high-resolution images show the details of the centered orthorhombic structure of perylene and the nature of the 3D grain boundaries.

The defect transformation under growth of submonolayer oxides on silicon surfaces is studied in situ on reconstructed Si(100)-2×1 and Si(111)-7×7 surfaces and on hydrogenated Si surfaces of Si nanocrystallites. The methods of the quenching of the photoluminescence of bulk c-Si due to surface recombination and of the infrared free carriers absorption in mesoporous Si are used. It is shown that dangling bonds at Si–Si dimers are not recombination active. Non-radiative surface defects are generated during the earliest stages of oxidation. The generation of hole traps is tightly related to an increase of physisorbed H 2 O at hydrogenated Si surfaces during the native oxidation.

The formation of electronic states in the fundamental gap at the maleic anhydride/Si(1 0 0)-2×1 interface has been studied with photoluminescence (PL) measurements and high resolution electron energy loss spectroscopy (HREELS). We observe that the room temperature adsorption of maleic anhydride on Si(1 0 0)-2×1, where the organic molecules are mainly in a di-σ coordination, results in a gap state density D it =1.8(2)×10 12 eV −1 cm −2 which is slightly lower than determined for the clean Si(1 0 0)-2×1 surface. After heating maleic anhydride/Si(1 0 0)-2×1 to 1115 K, the gap state density has increased to 6.4(6)×10 12 eV −1 cm −2 which we relate to the formation of silicon carbide structures on the silicon surface.

The chemisorption of maleic anhydride on Si(100)-2×1 at room temperature has been studied with scanning tunneling microscopy (STM). We observe that, at low coverages below 0.12 monolayer, the unsat...

Levels of autoantibodies against beta-adrenergic receptors and mitochondrial antigens were estimated by the ELISA method in a group of 41 cardiomyopathic children. These results were compared with results obtained from 26 sera of a control group. In the group of cardiomyopathic patients 11 sera with significantly increased levels of autoantibodies against beta-adrenergic receptors and seven sera with increased levels of autoantibodies against mitochondrial antigens were found. In no sample of the control group did we observe sera with increased levels of autoantibodies. Statistical significance of this data was evaluated by chi 2-test (p less than 0.005 or p less than 0.05, resp.).

The adsorption of perylene on the Si(001) surface is studied by means of first-principles density-functional theory calculations. Our results indicate that perylene adsorbs in an upright way in accordance with experimental observations. A number of conceivable geometries are considered and compared with respect to their adsorption energies, to their behavior in scanning tunnelling microscopy experiments and to their spectral response in an electron energy loss setup. Only the combination of these three aspects allows for the unique identification of the realized adsorption structure. In order to obtain complete energy loss spectra that can be related directly to experiments a recently developed method is used which allows for the easy calculation of both vibrational frequencies and intensities.

The subcellular localization of peptide antibodies against G-protein alpha subunits was studied by the indirect immunogold technique with Lowicryl K4M embedded rat cardiac tissue. Two antibodies were used. The alpha common peptide antibody recognizes the alpha subunits of Gs, Gi and Go. The alpha i common peptide antibodies recognize the alpha subunits of all Gi alpha subtypes (G1-3). Immunoreactivity against alpha common and alpha i common antibodies was found along the cell surface of cardiomyocytes and endothelial cells. No immunoreactivity was seen on sarcoplasmic reticulum membranes. T-tubule membranes showed a little reactivity. Distribution patterns obtained with alpha common and alpha i common antibodies were identical. Immunogold was seen in cardiocytes from both atria and ventricles. In light-microscopical studies with peroxidase-conjugated secondary antibodies, heavy immunostaining was seen in SA and AV nodes.

Under physiological conditions different parts of the heart reveal superspecialization of the myocardium reflected by biochemical, functional, structural and histochemical differences, which are even more pronounced under pathological conditions. Postischemic reperfusion, Ca paradox and injury caused by reactive oxygen species were found to result in transmurally unhomogenous damage of the ventricular wall. In the present experiments isolated perfused rat hearts were subjected to damage by the above mechanism and a different vulnerability of defined parts of the heart was observed. Activities of glycogen phosphorylase, SDH, beta-HBDH, and LDH were studied histochemically in both ventricles, the atria and the specialized conductive system of the heart. Marked decreases of activities were observed in the ventricular muscle. The enzyme activities were less decreased in the atrial muscle. Conductive fibres were the least affected tissue in this respect. The differential changes were most sensitively reflected by glycogen phosphorylase. The differences in transmural distribution of damage were shown to be dependent on a complex of specific factors such as intramural pressure gradient, transmural pressure, end-diastolic intraventricular pressure, differences in transmural vessel distribution, transmural hematocrit differences, blood flow, perfusate volume, and endothelial injuries of different origin. It can be concluded that differences in ultrastructure as well as in enzyme activities in different parts of the heart reflect functional, structural and metabolic heterogeneity of the different functional parts of the heart muscle.

Polyclonal specific antisera to beta-receptors were prepared by immunization of rabbits with beta-receptors isolated from a dog myocardium according to Becker et al. (1988). Cryostat sections of the dog heart were fixed in paraformaldehyde in PBS, and incubated with polyclonal antisera to beta-receptors. Sections were then washed and incubated in peroxidase-labelled anti-rabbit antibody. After visualization of the tissue-bound peroxidase with diaminobenzidine, sections were dehydrated in graded alcohols and mounted in Canada balsam. The results demonstrate specific reaction of antibodies on the myocyte sarcolemma.

Plasma total testosterone, free testosterone, LH, and sex hormone-binding globulin (testosterone-estradiol-binding globulin) were measured in adult men hospitalized for treatment of burns. Total testosterone was below the normal range in 37 of 41 patients. Free and total testosterone levels declined very rapidly after the burn, remained low for weeks, and rose toward the end of hospitalization, but usually had not reached normal levels at discharge. The more severe the burns, the lower were the testosterone levels. LH levels were below normal during the first 4 days after the burn and remained in the low or mid normal range thereafter. Sex hormone-binding globulin levels were normal or slightly low. The data suggest the presence of a central defect in the release of LH. Large doses of opiate analgesics or an increase in endogenous opiate peptides related to severe persistent pain might be contributing factors to the pituitary-testicular hypofunction found in burned men.

Management of the violent patient begins with rapid, systematic global assessment of the behavior followed by attention to its most likely cause. The evaluation should focus on the issue of provocation in the pre-assault phase; the goal-directedness of the assaultive behavior in the assault phase; and the response of the patient after the attack. Organic and psychodynam ic causes as well as drug-related violence are discussed. The author gives recommendations for assessment and management of assault on the general hospital ward and in the emergency room, and discusses violence directed toward physicians.

Seclusion incidents were studied irr an undercrowded maximum security hospital where seclusion is used in response to episodes of violent or disruptive behavior. Population-based seclusion rates for days with an above-mean census were compared with those for days with a below-mean census. Contrary to expectations derived from studies of overcrowded prisons, the total seclusion rate was higher under low census conditions. Although the seclusion rate for parasuicide incidents was higher under high census conditions, seclusion rates for battery, assault, and disorderly conduct incidents were each higher under low census conditions. These findings are interpreted as indicating that correctional officers observe a smaller proportion of battery, assault, and disorderly conduct incidents under high census conditions. Such underdetection must be taken into account, along with underreporting, in studies of intrainstitutional incidents.

Two large aftercare clinics were established to provide treatment and rehabilitative care for a chronic mentally ill population requiring neuroleptic drugs. The clinics have evolved rapidly and expanded their service over the past 3 years but have required constant monitoring and modification in order to provide quality as well as quantity care in the community setting. These modifications are described and the importance of further community-based investigation in the rehabilitation and treatment of the chronic mentally ill is stressed.

The relative neglect of the chronically ill psychiatric patient in community mental health planning emphasizes the need for new treatment methods and resources. This paper presents an eight-year experimental application of psychoanalytic principles in an outpatient clinic with a form of therapy (termed "adaptive psychotherapy") specifically designed for the treatment of the chronically ill psychiatric patient. The advantages of this clinic for the training of mental health professionals are also discussed.

The control of undesirable behaviors by aversive techniques under the label “aversion therapy” has become an increasingly prominent behavior therapy. The attention given to these techniques is a measure of resistance of disorders such as sexual deviations to more traditional therapies. Although effective in the animal laboratory, aversive control applied clinically may not be entirely appropriate. Some theoretical and practical draw-backs to aversion therapy are discussed, and an alternative is suggested in the use of positive behavioral control. In illustration, two cases of transvestism are presented.

Summary Problems encountered in the psychotherapeutic management of severely disturbed patients are examined. Although “human interest” has its role to play in the care of chronic psychotic patients, this paper attempts to delineate and reaffirm the necessity for specific diagnosis and treatment techniques which rely on the concepts of patient and therapist adaptations. “Adaptive psychotherapy” is defined, its theoretical basis outlined, its goals and principles described and clinical vignettes of its techniques are presented.

Summary This communication summarizes a seven year experiment in teaching adaptive psychotherapy. The patient population involved is chronically and severely ill and requires ongoing indefinite contacts on an intermittent or continuing basis. A clinic is described which provides opportunities for a brief socialization experience and individual, marital, and family psychotherapy. The structure of the clinic is such that the supervisor-administrator has maximum opportunities for teaching interventions. Most trainees have many preconceptions and prejudices about the difficulties and the efficacy of adaptive psychotherapy. Although some of these misgivings are rational and concerned with usual learning tasks, part of the problems arise from anxiety associated with the need for different behavior than that previously utilized by the therapist in “psychotherapy.” In particular, rapid dynamic assessment of the disabling problem, the capacity to reach therapeutic decisions with limited information, the management of very sick individuals, and an active approach are important training elements in the T.A.C. Such experiences early and late in residency training with appropriate supervision have usually enabled the trainee to acquire his own style of interventions appropriate to this type of patient and this kind of therapy.

The authors describe three adopted girls, aged 9 and 10, who falsely alleged that their adoptive mothers dressed them in rags, made them do all the chores, and favored their stepsiblings. Underlying these false accusations of abuse was a history that included 1) actual abuse of the child in a previous placement, 2) early loss of a mothering figure, and 3) emotional abuse in the adoptive home. Professional involved in child protection eed to recognize this syndrome because intensive family therpay and temporary placement of the child outside the home are required in all cases. The child's false accusation of abuse is a cry for help and should not be dismissed as a manipulative fabrication. Language: en

Indications for high dosage neuroleptics have become increasingly more debatable with recent emphasis on outpatient community management of the severely ill schizophrenic patient. Early studies suggest that high dose neuroleptics have greater effectiveness with some schizophrenic patients while remaining low in toxicity. As part of a rater blind study, 16 patients with the diagnosis of either chronic undifferentiated or chronic paranoid schizophrenia were placed on standard dose piperacetazine following a washout period. The dosage was then gradually increased until the patient achieved maximal effect with a minimum of side effects. Eight patients required standard dose (25-160 mg/day) while the remaining eight required high dose (160-400 mg/day). The two clinical groups are compared for therapeutic efficacy and toxicity. High dose piperacetazine was found to be effective in seven patients refractory to low dosage. Although the incidence of side effects was higher with the high dose patients, toxicity (liver, blood, renal) was not increased in patients requiring high dose medication. Indications for high dose neuroleptics are briefly discussed.

Data collected from detailed autobiographies of 77 convicted rapists revealed that 50 percent of them were drinking at the time of the rape and that 35 percent were alcoholics. This strong association between alcoholism and forcible rape highlights the importance of follow-up treatment programs for the alcoholic sex offender; such programs should focus on adequate control of his drinking behavior as well as on his sexual adjustment. Language: en

This study shows a high association among drinking, alcoholism, and child molestation. Forty-nine percent of the child molesters were drinking at the time of commission of the offense, and 34% were drinking heavily, defined as 10 or more beers or the equivalent. The alcoholism rate for the group was 52% based on the MAST or 33% based on the more stringent Pokorny shortened version of it. An interesting and unexpected finding was a statistically significantly lower incidence of drinking at the time of commission of the offense in male-child molesters compared with female-child molesters. In addition, the male-child molesters had a definitely lower alcoholism rate compared with female-child molesters. The importance of these findings for treatment programs is emphasized.

Although epidemiological data suggest that the development of cirrhosis in alcohol abusers is related to the duration and amount of ethanol intake, the fact that only a small percentage of alcohol abusers develop cirrhosis remains unexplained and suggests a possible predisposing genetic factor. Several previous studies have reported an association between various human leucocyte antigens (HLA) and alcoholic cirrhosis. In this study HLA antigen frequencies were determined in Anglo- and Spanish-American cirrhotic and noncirrhotic alcoholics and in a control group of nonalcoholic patients without liver disease. No statistically significant differences in HLA frequencies among the groups were found. Our comparisons of HLA frequencies between cirrhotic and noncirrhotic alcoholic patients do not support the hypothesis that individual susceptibility to the development of alcoholic cirrhosis is genetically determined.

The main purposes of this study were to examine the effects of one-day treatment of anxiety and to test whether significant relief of anxiety can be achieved in a short time period by frequency individual adjustment of doses. A double-blind crossover study of halazepam and placebo was carried out with 22 patients, 20 completing the study. Each treatment lasted for one day. Oral medication was administered starting with a dose of 40 mg and the dose adjusted every 2 hours. The total daily dose did not exceed 600 mg. Several rating and self-rating scales were used. All observer rating scales and several self-rating scales discriminated at a significant level. The design appeart to be suitable for the rapid screening for anti-anxiety properties of new drugs.

Recent reports indicate that visual conversion reactions are not as rare as previously believed. The ophthalmological diagnosis is made by unique positive findings (tubular fields and fluctuating visual acuity) in the presence of a normal electrooculogram, electroretinogram, and visual evoked responses. The psychiatric findings in children and adults differ; in general, adults have more psychopathology, tend also to have other psychosomatic symptoms or conversion symptoms, and have greater personal and social disability from the symptoms. In young children, inadequately understood feelings of being threatened, usually because of strife within the family, tend to predominate. In adults, long-standing stress or insoluble conflicts of various kinds tend to be prominent. In addition there is sometimes a history of trauma to the eye, a fear of eye disease, a history of eye disease in the family, or other preoccupations with vision such as can occur in the families of professionals treating eye disorders. Visual conversion reactions must be differentiated from organic eye disease and from malingering. Visual conversion reactions can complicate organic disease of the eye or optic pathways and can precede or mask early symptoms of organic eye disease. Several features are described in this paper which may be useful in differentiating visual conversion reactions from organic disease and from malingering. The treatment of visual conversion reactions of recent onset in children can usually be carried out successfully by a concerned and understanding ophthalmologist with occasional psychiatric consultation, whereas in adults referral to a psychiatrist is usually indicated. In adults, recovery is usually less rapid and the ultimate prognosis tends to be worse.

The main purpose of this study was to compare sensitivity of several self-rating scales to drug effects in anxious and depressed patients. Twenty-two distressed nonpsychotic outpatients completed a double-blind crossover trial of chlordiazepoxide and placebo. All self-rating scales of depression, anxiety, somatic symptoms, and feelings of inadequacy discriminated significantly between chlordiazepoxide and placebo. The decrease in self-rated depression was about equal to the decrease in self-rated anxiety. Subscales describing well-being were more sensitive to drug effects than subscales describing symptoms. A questionnaire (The Symptom Questionnaire) and one of the self-rating scales (Symptom Rating Test) were more sensitive than global self-rating scales, global observer-rating scales, and the Hamilton Anxiety Rating Scale. Some of the self-rating scales discriminated significantly between drug and placebo even when the sample size was reduced to two subsamples of eight patients each. High and significant positive correlations between two scales did not indicate equal sensitivity in discriminating between drug and placebo.