Naltrexone: a short-term treatment for opiate dependence

The narcotic antagonist, naltrexone, was studied in 242 patients during a 6-year period. Although a large number of subjects discontinued naltrexone abruptly, treatment was related to a significant decrease in opiate and nonopiate drug use. Methods for improving retention during induction and maintenance are discussed and posttreatment outcome results are presented. The authors conclude that naltrexone may be a useful short-term treatment option for opiate dependence.

Psychiatric diagnosis of morbidly obese gastric bypass patients

Eighty morbidly obese patients who had had gastric bypass operations were interviewed for psychiatric diagnoses using DSM-III criteria. The lifetime prevalence of Axis I clinical psychiatric diagnoses was 47.5%, with depressive disorders occurring in 28.7% of the total sample. No other diagnosis exceeded a 2.5% prevalence. The authors believe there is no evidence of an increased prevalence of major psychiatric disorder in obese persons when strictly defined diagnostic criteria are used.

The technique and early results of high gastric reduction for obesity

The high gastric reduction operation has been performed on one hundred and nine obese patients over a sixteen-month period. Patient selection, preoperative care, operative technique and postoperative care are described. Our early results show that a satisfactory initial and continuing weight loss can be sustained for a twelve-month period with a low morbidity and mortality. Further follow-up of these patients is required before the ultimate place of this procedure is established.

Effects of contingent payment on compliance with a naltrexone regimen

The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined. Patients were paid under contingencies based on either number of doses ingested or on a fixed time schedule. Reinforcement schedules based on number of doses ingested produced more consistent treatment-oriented behavior than a time-based schedule. Covariation between behavior and alternating contingencies (A-B-A) indicated that the schedules contributed to increased duration of treatment compared to previous noncontingent payment. The issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.

Blood pressure recording in children

Blood pressure levels for 148 children aged 0-14 years were recorded. Two different methods of measurement (the standard sphygmomanometer and the random-zero machine) and two cuffs of varying size were used on each child. Measurements of arm size and pulse rate were taken, and an assessment was made of the emotional state of each child: no association was found between these factors and the recorded measurement of blood pressure. The experiment does however show that: (1) the effect of cuff size can be minimized by using the largest cuff that will fit the child, and then applying a standard correction to the measurement taken; and (2) the random-zero machine is a preferable method of measurement as it reduces observer bias, though measurements taken with a standard and a random-zero machine are not directly comparable.