Counselling problem drinkers in medical wards: a controlled study

Seven hundred and thirty one men admitted to medical wards were interviewed to identify problem drinkers who had not received previous treatment for alcoholism and who had some social support. One hundred and sixty one met the diagnostic criteria; 156 agreed to a follow up interview and were allocated to one of two groups. One group received a session of counselling about their drinking habits from a nurse while the other received only routine medical care. Both groups reported a reduction in alcohol consumption when interviewed 12 months later, but the counselled group had a significantly better outcome than the control group. It is concluded that systematic screening for alcohol consumption and related problems should become a routine part of medical assessment and that advice on drinking habits is effective if given before irreversible physical or psychosocial problems have developed.

A consensual validation of schizoid personality in childhood and adult life

Life histories and interview descriptions of 23 young men diagnosed as offizoid in middle childhood and adult life and of 20 control subjects not given this diagnosis were presented for diagnostic rating to two independent general psychiatrists. Agreement about the presence or absence of schizoid personality was good. It is concluded that, in the case of boys, the syndrome of schizoid personality in childhood (Asperger's syndrome) corresponds to or is subsumed by the more general clinical picture psychiatrists have of schizoid personality in adult life, and that our original use of this diagnostic label for the youngsters we described was not idiosyncratic.

Screening for problem drinkers among medical inpatients

Among 275 patients aged between 18 and 65 admitted to general medical wards, 19.3 per cent were found to have a current alcohol-related problem and/or previous treatment for alcoholism. 13.2 per cent were newly identified cases, with men significantly outnumbering women. The house physician's history referred to alcohol consumption in 32 of 34 new cases but often underestimated consumption, adverse social problems and dependence symptoms. Laboratory markers were not sufficiently sensitive to be used as screening tests on their own.

Mean cell volume and gamma-glutamyl-transpeptidase as markers of drinking in working men

The usefulness of serum-gamma-glutamyl-transpeptidase (gamma-GT) and mean cell volume (MCV) as markers of alcohol consumption was assessed in men in employment (266 company directors and 222 manual workers in alcohol-production firms) and in 34 male alcoholic patients. The correlations of admitted consumption with gamma-GT were 0.307 (directors) and 0.418 (manual workers) and with MCV 0.439 (directors) and 0.360 (manual workers). A man with an MCV of over 98 fl and a gamma-GT level above 50 i.u./l had a 62% chance of admitting to drinking over 450 g alcohol per week. Although the probability of being a heavy drinker increases progressively with elevation in both these tests, as screening tests they lack power, though false positives may be explained in party by inaccurate self-reports by both survey subjects and patients. For clinical purposes, however, the tests have a use in supplementing self-report and in following problem drinkers in outpatient treatment.

Saving face ? Survey respondents who claim their last week's drinking was atypical

Thirty-one per cent of survey respondents asked about their last week's drinking claimed it was atypical. They are shown, by examining their levels on two blood tests (mean cell volume and gamma-glutamyl transpeptidase) and by a comparison of their consumption on a recent social occasion with that of their companions, to be reporting a trivial difference between their last week and their typical week and appear to be attempting to deny heavy habitual consumption.

Schizoid personality in childhood: a controlled follow-up study

Twenty-two boys with schizoid personality were followed-up some 10 years later and compared with a matched control group with other diagnoses who had been referred to the same child psychiatry department. The diagnostic category is shown to have predictive validity. A start has been made towards an operational definition of the syndrome.

Psychological construing in schizoid children grown up

Twenty former male patients who in childhood had been diagnosed as having schizoid personality were followed up in adulthood. In comparison with controls, they used psychological ways of construing infrequently. Interpretations of this finding are discussed, in particular its relationship to impaired empathy.

Sheltered accommodation in the community mental health service in the 13th Arrondissement of Paris

The well-developed community psychiatric services in the 13th Arrondissement use a large number of places in sheltered accommodation. Reasons for this are explored. It may be that there are areas in the U.K. where the need for such accommodation is greater than the Department of Health and Social Security has estimated.

Application to the alcohol dependence syndrome of a method of determining the sequential development of symptoms

Temporal ordering of core items in the alcohol dependence syndrome was investigated in 38 men admitted to an alcoholism treatment unit. An analysis of rank sums yielded a modal sequence which resembled classical descriptions of alcoholism, though 'loss of control' appeared very early.

Home treatment of basal cell carcinoma

The sap of the plant Euphorbia peplus is not uncommonly used as a home treatment for warts and basal cell carcinomas. This report documents its successful use on a biopsy-proven basal cell carcinoma.