Sexual abuse, disordered personality and eating disorders

Standardised personality assessments were administered to 50 consecutive referrals to an Eating Disorders Clinic. A history of childhood sexual abuse was identified in 30% of patients using a modified version of the SLEI. This rate is comparable with those from other studies. Overall, 52% of the patients were rated as having a personality disorder but a significantly higher proportion of women with a personality disorder had a history of childhood sexual abuse compared with those without a personality disorder (13/26 v. 2/24, Fisher P less than 0.001). Although in patients with eating disorders no clear causal link between CSA and personality disorder was demonstrated, our findings emphasise the need to inquire sensitively into the sexual history of such patients.

Sexual Relationships between Doctors and Patients

‘In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional illdoing and seduction, and especially from the pleasures of love with women or with men be they free or with slaves.’

Hippocratic Oath

A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients

The excellent immediate response of many depressive states to ECT is well established, but unfortunately relapse is common. Pare (1968) noted that it was becoming increasingly common for anti-depressant drugs to be given concomitantly with and after ECT in order to prevent relapse, but there appear to be only two reports bearing on the value of this procedure. Seager and Bird (1962), in a blind trial, followed up 28 ECT treated depressives and found that the six month relapse rate was markedly lower in those who received imipramine after discharge (17 per cent) compared with those on placebo (69 per cent). Imlah et al. (1965), in a study of 124 patients, found that a relapse rate of about 50 per cent within six months of ECT when used alone was reduced by over one half when ECT was combined with and followed by either imipramine or phenelzine, but their trial was not conducted blind. The after-care of depressed patients is so important, particularly in view of the risk of suicide, that further evidence seemed desirable.