Software Vault: The Gold Collection/Software Vault - The Gold Collection (American Databankers) (1993).ISO/cdr11/subsanx.zip/SUBSTANX.TXT

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*****AMERICAN FAMILY PHYSICIAN/GP*****

Laux G  Puryear DA
Benzodiazepines--misuse, abuse and dependency.
AM FAM PHYSICIAN 1984 Nov; 30(5):139-47
Recent European articles report many adverse effects of
  benzodiazepines, including aberrant symptoms, toxic states,
  dependency and withdrawal syndromes. The dependency may be primary
  high-dose, primary low-dose (therapeutic) or secondary dependency
  (multiple drug abuse). Withdrawal syndromes include rebound effects
  and benzodiazepine-specific reactions. Anxiolytic use of
  benzodiazepine should be limited to the treatment of short-term
  anxiety-producing situations.


Lowenstein DH  Massa SM  Rowbotham MC  Collins SD  McKinney HE
  Simon RP
Acute neurologic and psychiatric complications associated with
  cocaine abuse.
AM J MED 1987 Nov; 83(5):841-6
This report reviewed 996 emergency room visits and 279 hospital
  admissions of patients with complications of cocaine abuse seen at
  the San Francisco General Hospital between 1979 and 1986. In 143
  cases, acute neurologic or psychiatric symptoms were the primary
  complaint, and case-notes provided sufficient detail for analysis.
  The major neurologic complications included one or more seizures (n =
  29), focal neurologic symptoms or signs (12), headache (10), and
  transient loss of consciousness (six). Psychiatric disturbances
  included agitation, anxiety, or depression (33), psychosis and
  paranoia (24), and suicidal ideation (18). The most serious
  consequences were found in patients with prolonged seizures or
  strokes, those who jumped out of buildings, and those who attempted
  suicide by overdosing with other drugs. There was no correlation
  between the appearance of complications and the reported route of
  administration, the amount of cocaine used, or prior experience with
  cocaine. The number of patients who are seeking hospital attention
  for these or related complaints appears to be rising substantially.
  Cocaine abuse, regardless of the use pattern, is associated with a
  variety of potentially severe neurologic and psychiatric
  complications.

     Department of Neurology
     University of California
     School of Medicine
     San Francisco 94143.

*****AMERICAN JOURNAL OF PSYCHIATRY*****
Westermeyer J  Neider J
Social networks and psychopathology among substance abusers.
AM J PSYCHIATRY 1988 Oct; 145(10):1265-9
The authors studied the social networks and psychopathology of 168
  patients with diagnoses of substance abuse. Small network size was
  correlated with higher scores on the Modified Michigan Alcohol-Drug
  Screening Test, higher symptom reports on the SCL-90 and the Beck
  Depression Inventory, and more observed psychopathology according to
  the Brief Psychiatric Rating Scale. Larger network size was
  correlated with better functioning according to the Global Assessment
  Scale and DSM-III axis V. The authors conclude that such symptom
  complexes as paranoia and phobia may undermine the social networks of
  substance abusers more than such symptom complexes as anxiety and
  depression.
     Department of Psychiatry
     University of Minnesota
     Minneapolis 55455.

Christie KA  Burke JD Jr  Regier DA  Rae DS  Boyd JH  Locke BZ
Epidemiologic evidence for early onset of mental disorders and higher
  risk of drug abuse in young adults.
AM J PSYCHIATRY 1988 Aug; 145(8):971-5
Data from the National Institute of Mental Health (NIMH)
  Epidemiologic Catchment Area Program, an epidemiologic survey of five
  communities, showed that four major disorders commonly begin in late
  adolescence or young adulthood. The median age at onset for anxiety
  disorders is 15 years; for major depressive episode, 24 years; for
  drug abuse or dependence, 19 years; and for alcohol abuse or
  dependence, 21 years. Findings also suggest that for respondents 18-
  30 years old, having a major depressive episode or anxiety disorder
  doubles the risk for later drug abuse or dependence.
     Division of Clinical Research
     National Institute of Mental Health
     Rockville
     MD 20857.

Post RM
Cocaine psychoses: a continuum model.
AM J PSYCHIATRY 1975 Mar; 132(3):225-31
The author describes an orderly progression of clinical syndromes
  (euphoria, dysphoria, paranoid psychosis) with cocaine use that is
  related to dosage, chronicity, and genetic and experiential
  predispositions. That affective alternations are caused by a drug
  which also produces a schizophreniform psychosis suggests a continuum
  with implications for understanding the endogenous psychoses. The
  author emphasizes that alternations in the same neurotransmitter
  substances may be involved in these multiple psychiatric syndromes,
  which contrasts with previous "one illness, one transmitter" models.

Winokur G  Black DW  Nasrallah A
Depressions secondary to other psychiatric disorders and medical
  illnesses.
AM J PSYCHIATRY 1988 Feb; 145(2):233-7
The authors studied 401 patients with depressions secondary to
  psychiatric illnesses (substance abuse disorders or somatoform,
  anxiety, or personality disorders) or depressions secondary to
  medical illnesses. They found that the patients with depressions
  secondary to psychiatric illnesses had an earlier age at onset, were
  more likely to have suicidal thoughts or to have made suicide
  attempts, were less likely to have memory problems, were less
  improved with treatment and more likely to relapse on follow-up, and
  had more alcoholism in their families than patients with depressions
  secondary to medical illnesses. Depressions secondary to medical
  illnesses seem to fit the category of reactive depression, and
  depressions secondary to psychiatric illnesses fit the definition of
  neurotic depression.
     Department of Psychiatry
     University of Iowa College of Medicine
     Iowa City 52242.

Mellman TA  Uhde TW
Obsessive-compulsive symptoms in panic disorder.
AM J PSYCHIATRY 1987 Dec; 144(12):1573-6
Previous reports have noted an increased prevalence of obsessive-
  compulsive symptoms in patients with panic disorder. The authors
  found a prevalence of obsessive-compulsive symptoms in 19 (27%) of 70
  patients with panic disorder. Compared to a subgroup of 25 patients
  with classic features of panic disorder and no obsessive-compulsive
  symptoms, the subgroup with obsessive-compulsive symptoms had an
  earlier onset of illness, were more likely to have personal and
  family histories of major depression and substance abuse, and showed
  a poorer outcome after treatment.
     Unit on Anxiety and Affective Disorders
     NIMH
     Bethesda
     MD 20892.

Garvey MJ  Tollefson GD
Prevalence of misuse of prescribed benzodiazepines in patients with
  primary anxiety disorder or major depression.
AM J PSYCHIATRY 1986 Dec; 143(12):1601-3
Seventy-one patients with major depression or an anxiety disorder
  were treated with benzodiazepines. They were followed prospectively
  for evidence of misuse or abuse. There was no evidence of
  benzodiazepine abuse. Five patients (all with major depression)
  misused their benzodiazepines.

Benedikt RA  Kolb LC
Preliminary findings on chronic pain and posttraumatic stress
  disorder.
AM J PSYCHIATRY 1986 Jul; 143(7):908-10
Of 225 patients referred to a Veterans Administration pain clinic for
  treatment of chronic pain, 22 (10%) were later diagnosed as having
  posttraumatic stress disorder. Many of the 22 also had current or
  past histories of depression, anxiety, or substance abuse.

Aronson TA  Craig TJ
Cocaine precipitation of panic disorder.
AM J PSYCHIATRY 1986 May; 143(5):643-5
The authors describe three patients whose panic disorder began during
  recreational use of cocaine and continued autonomously even after the
  drug was stopped. Theoretical and practical implications are
  discussed.


*****ARCHIVES OF GENERAL PSYCHIATRY*****

Andreasen NC  Grove WM  Shapiro RW  Keller MB  Hirschfeld RM
  McDonald-Scott P
Reliability of lifetime diagnosis. A multicenter collaborative
  perspective.
ARCH GEN PSYCHIATRY 1981 Apr; 38(4):400-5
It is important to determine the reliability of lifetime diagnosis in
  a nonpatient population, for this type of diagnostic data and this
  type of sample are used in many genetic, epidemiological, and
  nosological studies. We examined the reliability of lifetime
  diagnosis when the Schedule for Affective Disorders and Schizophrenia-
  Lifetime Version and Research Diagnostic Criteria were used to
  interview ill and well relatives of probands in the National
  Institute of Mental Health Collaborative Study of the Psychobiology
  of Depression. Subjects were interviewed three times, so data are
  available concerning both short- and long-interval test-retest
  reliability. Short-interval test-retest reliability was excellent for
  both diagnoses and symptoms. Reliability was also quite high in the
  long-interval test-retest study. We conclude that it is possible to
  make lifetime diagnoses reliably in a nonpatient population.

Winstead DK  Parker M  Willi FJ
Propoxyphene on demand. Analgesic-seeking behavior in psychiatric
  inpatients.
ARCH GEN PSYCHIATRY 1977 Dec; 34(12):1463-8
Although anxiety is known to enhance a patient's response to pain,
  the exact relationship is unclear. This problem is particularly acute
  among psychiatric patients where analgesics are frequently both used
  and abused. This study attempts to evaluate factors associated with
  analgesic use among these patients with the hypothesis that anxiety,
  other measures of psychopathology, and ward tension would be
  associated with frequent analgesic use. An unselected series of
  psychiatric admissions during a three month period were administered
  the State-Trait Anxiety Inventory, MMPI, and a questionnaire dealing
  with prior drug use. Propoxyphene napsylate (Darvon-N) was made
  freely available on request from nurses who recorded details of the
  interaction on a prepared card. The nursing staff also recorded
  unusual incidents on the unit and evaluated daily the level of ward
  tension. The results indicate that, when made freely available to
  psychiatric inpatients, propoxyphene was used very conservatively and
  for appropriate complaints. Factors associated with drug seeking
  behavior are discussed in relation to other research regarding the
  use and abuse of analgesics.

Wood DR  Reimherr FW  Wender PH  Johnson GE
Diagnosis and treatment of minimal brain dysfunction in adults: a
  preliminary report.
ARCH GEN PSYCHIATRY 1976 Dec; 33(12):1453-60
Minimal brain dysfunction (MBD) has long been considedrnen
adoption studies
  suggest that MBD may persist into adult life where its existence is
  concealed by the application of a variety of diagnostic labels. In
  order to test the hypothesis that MBD does persist into adulthood, 15
  putative MBD adults were identified on the basis of current MBD-like
  complaints, self-description of MBD characteristics in childhood, and
  a parental rating (on a standardized form) of "hyperactivity" in
  childhood. Eleven of the 15 subjects were given a double-blind trial
  of methylphenidate hydrochloride, and all 15 were given an open trial
  of pemoline, imipramine hydrochloride, or amitryptiline
  hydrochloride. Eight of the 11 showed a significant response to the
  double-blind trial of methylphenidate. Of the 15, eight showed a good
  response to stimulants or tricyclic antidepressants, two showed a
  moderately favorable response, and five were unresponsive to drug
  therapy.
Atkinson JH Jr  Grant I  Kennedy CJ  Richman DD  Spector SA
  McCutchan JA
Prevalence of psychiatric disorders among men infected with human
  immunodeficiency virus. A controlled study.
ARCH GEN PSYCHIATRY 1988 Sep; 45(9):859-64
We used structured diagnostic interviews and rating scales to assess
  lifetime prevalence of psychiatric disorders, by DSM-III criteria,
  among an unselected sample of 56 ambulatory homosexual men in four
  groups: men with acquired immunodeficiency syndrome (AIDS), men with
  AIDS-related complex (ARC), men asymptomatic or mildly symptomatic
  but seropositive for antibody to human immunodeficiency virus (HIV),
  and HIV-seronegative men. An age- and demographically matched
  comparison group of 22 healthy, heterosexual controls was also
  studied. The homosexual men had lifetime rates of alcohol or
  nonopiate drug abuse (22/56 [39.3%]), generalized anxiety disorder
  (22/56 [39.3%]), and major depression (17/56 [30.3%]) that often
  preceded diagnosed medical illness or knowledge of HIV status. The
  six-month point prevalence of these disorders in homosexual men was
  also high, especially alcohol abuse in patients with AIDS-related
  complex, and the occurrence of a DSM-III disorder within the previous
  six months significantly exceeded that in heterosexual controls. The
  data suggest that there may be a higher prevalence of anxiety
  disorder and major depressive illness in homosexual men when compared
  with sociodemographically matched heterosexual men and that the
  psychiatric morbidity may have preceded the onset of the AIDS
  epidemic. These findings indicate that awareness of psychiatric
  history is necessary to comprehensive medical care of men at high
  risk for AIDS, even among relatively healthy outpatients.
     Department of Psychiatry
     UCSD School of Medicine
     La Jolla 92093.

Hesselbrock MN  Meyer RE  Keener JJ
Psychopathology in hospitalized alcoholics.
ARCH GEN PSYCHIATRY 1985 Nov; 42(11):1050-5
This study utilized the DSM-III criteria and the National Institute
  of Mental Health Diagnostic Interview Schedule to assess the
  prevalence of lifetime psychopathology among hospitalized alcoholics.
  Antisocial personality (ASP) and substance-use disorder were common
  psychopathologies among male alcoholics and major depression and
  phobia were common among female alcoholics. The onset of most
  psychopathologies preceded the abuse of alcohol among women. In men,
  however, with the exception of ASP and panic disorder, the onset of
  psychopathology was subsequent to that of alcohol abuse and/or
  dependence. Diagnoses of ASP and substance abuse were characterized
  by early onset of regular intoxication and alcohol abuse. Gender and
  the presence of specific psychopathology appeared to modify the
  course and symptom picture of alcoholism. In general, alcoholic women
  showed a later onset of regular intoxication and a more rapid
  progression to alcohol abuse and dependence than alcoholic men.


*****ARCHIVES OF INTERNAL MEDICINE*****

Tennant FS Jr
Outpatient treatment and outcome of prescription drug abuse.
ARCH INTERN MED 1979 Feb; 139(2):154-6
Forty-six consecutive patients who voluntarily sought outpatient
  treatment for abuse of one or more prescription drugs were studied.
  Barbiturates, amphetamines, and diazepam were the most common drugs
  abused. Desired treatments by patients included counseling, medical
  withdrawal, or medical maintenance with the drug of abuse or a
  chemically related drug. Twenty-two (47.8%) patients left treatment
  and relapsed within one month; another eight (17.4%) patients
  relapsed between one and three months after entering treatment. Only
  13 (28.3%) reported abstinence 90 days after entering treatment. This
  experience suggests that a wide range of medical, social, and
  psychologic resources are required to treat prescription drug abuse,
  and that long-term drug abstinence is difficult to achieve with all
  patients.


*****BRITISH JOURNAL OF CLINICAL PHARMACOLOGY*****

Akiskal HS  Chen SE  Davis GC  Puzantian VR  Kashgarian M  Bolinger JM
Borderline: an adjective in search of a noun.
J CLIN PSYCHIATRY 1985 Feb; 46(2):41-8
Outpatients diagnosed as borderline (N = 100) were prospectively
  followed for 6-36 months and examined from phenomenologic
  developmental, and family history perspectives. At index evaluation,
  66 met criteria for recurrent depressive, dysthymic, cyclothymic, or
  bipolar II disorders, and 16 for those of schizotypal personality.
  Other subgroups included sociopathic, somatization, panic-
  agoraphobic, attention deficit, epileptic, and identify disorders.
  Compared with nonborderline personality controls, borderlines had a
  significantly elevated risk for major affective but not for
  schizophrenic breakdowns during follow-up. Prominent substance abuse
  history, tempestuous biographies, and unstable early home environment
  were common to all diagnostic subgroups. In family history,
  borderlines were most like bipolar controls, and differed
  significantly from schizophrenic, unipolar, and personality controls.
  It is concluded that, despite considerable overlap with subaffective
  disorders, the current adjectival use of this rubric does not
  identify a specific psychopathologic syndrome.


*****JOURNAL OF NERVOUS AND MENTAL DISEASE*****

Strassman RJ
Adverse reactions to psychedelic drugs. A review of the literature.
J NERV MENT DIS 1984 Oct; 172(10):577-95
The use of naturally occurring and synthetically derived compounds
  for their "psychedelic" effects has been a part of human culture for
  thousands of years. The basic pharmacology of the major synthetic
  psychedelic compounds (primarily lysergic acid diethylamide [LSD]-25)
  is described and reference is made to their potentially beneficial
  psychological effects. Adverse reactions, defined as dysphoric and/or
  maladaptive/dysfunctional responses to the use of these drugs,
  sometimes require careful clinical judgment in order to diagnose.
  These reactions can be effectively classified along a temporal
  continuum. Acute, short-lived reactions are often fairly benign,
  whereas chronic, unremitting courses carry a poor prognosis. Delayed,
  intermittent phenomena ("flashbacks") and LSD-precipitated functional
  disorders that usually respond to treatment appropriate for the non-
  psychedelic-precipitated illnesses they resemble, round out this
  temporal means of classification. The question of organic brain
  damage as well as permanent changes in personality, attitudes, and
  creativity in patients and normals who have repeatedly ingested
  psychedelic drugs is controversial, but tends to point to subtle or
  nonsignificant changes. Future areas for study of the psychedelics'
  pharmacological, psychological, and therapeutic effects are
  suggested.

Weller RA  Halikas JA
Objective criteria for the diagnosis of marijuana abuse.
J NERV MENT DIS 1980 Feb; 168(2):98-103
Among 97 chronic marijuana users, 9% were found to have had multiple
  life problems as a consequence of their marijuana use when evaluated
  during a 5-year follow-up study. Operationally defined criteria for
  marijuana abuse are presented which are analogous to criteria
  commonly used in diagnosing alcoholism. These criteria identified
  marijuana abusers who manifested many problems from marijuana use,
  including fighting, panic attacks, and traffic tickets. This was in
  contrast to the majority of the chronic users who did not have
  multiple complications from their marijuana use. The marijuana
  abusers had used marijuana more frequently, had used greater amounts
  of marijuana, and had begun using it at an earlier age than
  nonabusers. A high rate of alcoholism was found in the abusers but
  was not statistically greater than in nonabusers. The objective
  criteria presented here offer a method for simple, prompt evaluation
  of potential problems from marijuana use.

Kroll P  Chamberlain KR  Halpern J
The diagnosis of Briquet's syndrome in a male population: the
  Veterans Administration revisited.
J NERV MENT DIS 1979 Mar; 167(3):171-4
Fifty psychiatric inpatients at a VA Hospital felt to be at high risk
  for the development of somatic complaints were surveyed for Briquet's
  syndrome. When criteria for the syndrome were strictly applied, no
  men were found with the disorder. If the criteria were minimally
  relaxed, two patients did have a sufficient number of symptoms in
  multiple areas to qualify for the diagnosis. However, they had
  alternative clinical and research diagnoses and none of the
  personality characteristics noted in previous populations of women
  surveyed for Briquet's syndrome.

Spaulding W
The relationships of some information-processing factors to severely
  disturbed behavior.
J NERV MENT DIS 1978 Jun; 166(6):417-28
Thirty-five psychiatric inpatients with heterogeneous diagnoses were
  given four tasks: Mueller-Lyer Illusion, Wisconsin Card Sorting Text,
  Object Sorting, and Rokeach dogmatism questionnaire. Tasks were
  chosen to represent a broad sampling of paradigms, spanning levels of
  information processing, involving perceptual, conceptual and
  attitudinal processes. Subjects' behavior was assessed by the
  Inpatient Multidimensional Psychiatric Scale (IMPS). Each IMPS scale
  was analyzed in turn as a function of perceptual/cognitive variables,
  in multiple regression analysis. To provide basis for comparison,
  traditional clinical measures were included as independent variables
  (MMPI scales) and dependent variables (intelligence, chronicity, and
  premorbid adjustment). Results showed that different patterns of
  disordered behavior were predicted by different perceptual/cognitive
  variables. MMPI scores were predicted primarily by traditional
  measures. Interrelationships of all variables suggested three subject
  groups: chronic, process-type schizophrenics with perceptual
  abnormalities, paranoid patients with conceptual abnormalities, and
  affectively disordered patients with predominantly attitudinal
  abnormalities.
Schuckit MA  Petrich J  Chiles J
Hyperactivity: diagnostic confusion.
J NERV MENT DIS 1978 Feb; 166(2):79-87
Histories of hyperactive symptoms were evaluated for two samples of
  young men and women under treatment for drug or psychiatric
  disorders. More than one in five had shown hyperactivity but almost
  all of these developed pictures of other psychiatric problems,
  frequently the antisocial personality, by late adolescence. This
  picture is felt to reflect inaccurate use of hyperactive labels in
  difficult-to-handle children. The potential consequences of these
  practices are discussed.

Naditch MP  Alker PC  Joffe P
Individual differences and setting as determinants of acute adverse
  reactions to psychoactive drugs.
J NERV MENT DIS 1975 Nov; 161(5):326-35
The relationship between setting and individual differences in
  determining acute adverse reactions to psychoactive drugs was
  examined using retrospective data from 483 drug users. Five
  dimensions of setting were identified. Although there were some small
  setting main effects, these effects failed to reach significance when
  shared variance with individual difference variables was considered.
  For acute adverse reactions to LSD, however, there were seven
  independent interaction effects between setting and individual
  difference variables. There were two interaction effects of smaller
  magnitude related to acute adverse reactions to marijuana. The
  significance of these results for the current controversy over the
  relative importance of situational vs. personality determinants of
  behavior was discussed.

Green BL  Lindy JD  Grace MC
Posttraumatic stress disorder. Toward DSM-IV.
J NERV MENT DIS 1985 Jul; 173(7):406-11
  posttraumatic stress disorder diagnosis as described in DSM-III. The
  helpfulness of DSM-III is acknowledged, but gaps in that
  classification are noted. These are organized into three areas: the
  etiology of the disorder, its natural history, and diagnostic
  specificity. Suggestions are made for conceptualizing these issues
  and for research that needs to be undertaken to help resolve them.
  The authors urge more theoretical and empirical attention to these
  important issues in the upcoming years, so that later diagnostic
  descriptions and understandings will be more precise.
*****MAYO CLINIC PROCEEDINGS*****

Finlayson RE  Hurt RD  Davis LJ Jr  Morse RM
Alcoholism in elderly persons: a study of the psychiatric and
  psychosocial features of 216 inpatients.
MAYO CLIN PROC 1988 Aug; 63(8):761-8
The medical records of 216 elderly persons, admitted to the hospital
  for treatment of alcoholism, were reviewed. Concern of family and
  friends was the most common factor motivating patients for admission.
  Patients with late-onset alcoholism reported an association between a
  life event and problem drinking more frequently than did the early-
  onset alcoholics. The most common associated psychiatric disorders
  were tobacco dependence (67%), organic brain syndrome (25%), atypical
  or mixed organic brain syndrome (19%), and affective disorder (12%).
  Fourteen percent of patients also had a drug abuse or dependence
  problem, all using legally prescribed drugs. Psychiatric diagnoses
  and results of psychologic testing did not differ between early-onset
  and late-onset alcoholism groups. In a 60-patient cohort studied for
  correlation of outcome of treatment for alcoholism with major
  psychiatric diagnoses, no associations were found.

     Department of Psychiatry and Psychology
     Mayo Clinic
     Rochester
     MN 55905.

*****MEDICAL CLINICS OF NORTH AMERICA*****

Kranzler HR  Liebowitz NR
Anxiety and depression in substance abuse: clinical implications.
MED CLIN NORTH AM 1988 Jul; 72(4):867-85
Accurate diagnosis in patients presenting with anxiety and/or
  depressive symptoms requires that the contribution of substance abuse
  be carefully considered. When chemical dependence is identified,
  detoxification may be all that is necessary. However, if indicated,
  specific treatment of the mood or anxiety disorder may reduce
  substance use as well.
     University of Connecticut School of Medicine
     Farmington.

*****POSTGRADUATE MEDICINE*****

Schuckit MA
Anxiety treatment. A commonsense approach.
POSTGRAD MED 1984 Feb 1; 75(2):52-63
Common sense should guide the nonpsychiatrist physician in diagnosing
  and treating the symptom of anxiety. Possible causes of anxiety
  include various medical disorders in which anxiety is inherent,
  chronic illness, CNS stimulant intoxication, CNS depressant
  withdrawal, and primary psychiatric disorders, including the primary
  anxiety disorders. If none of these conditions is found, situational
  anxiety may be the diagnosis by exclusion. Generally, treatment
  should involve education and supportive psychotherapy, behavioral
  therapies designed to promote relaxation and adjustment to stress,
  and short-term pharmacotherapy. Although some clinical data from
  uncontrolled studies point to the possible importance of others drugs
  (eg, beta-blocking agents) in treating anxiety, the major
  pharmacotherapy rests with antianxiety drugs, particularly the
  benzodiazepine. Because each benzodiazepine appears to be relatively
  effective, a specific agent is selected for a particular clinical
  situation on the basis of its kinetic (especially its half-life) and
  side-effect profiles. A nonbenzodiazepine soon to be released in the
  United States, buspirone (Buspar), appears to be effective and
  nonaddictive and is not potentiated by alcohol. However, the final
  verdict as to its usefulness and safety in treating anxiety awaits
  results of further testing.
*****ACTA PSYCHIATRICA SCANDINAVICA*****

Allgulander C
History and current status of sedative-hypnotic drug use and abuse.
ACTA PSYCHIATR SCAND 1986 May; 73(5):465-78
Sedative-hypnotic drug use and abuse increased in Europe after World
  War II and peaked about 1972. Clinical and follow-up descriptions of
  abusers support the concept of a psychiatric addiction syndrome,
  different from a low-dose withdrawal syndrome. Although these drugs
  may be prescribed unnecessarily, large portions of the general
  population with pathological psychic distress and insomnia do not
  receive psychotropic treatment, in spite of findings pointing to
  genetic and biochemical factors in the genesis of these. Research on
  underlying mechanisms and the rationale for maintenance therapy is
  needed.
*****ADDICTIVE BEHAVIORS*****

Klajner F  Hartman LM  Sobell MB
Treatment of substance abuse by relaxation training: a review of its
  rationale, efficacy and mechanisms.
ADDICT BEHAV 1984; 9(1):41-55
The efficacy of relaxation training as a treatment for alcohol and
  drug abuse is reviewed, and directions for future research derived.
  Such use of relaxation procedures, notably progressive muscular
  relaxation and meditation, has been widespread and is premised on the
  assumptions that substance abuse is causally linked to anxiety and
  that anxiety can be reduced by relaxation training. However, the
  evidence suggests that such precipitating anxiety is limited to
  interpersonal-stress situations involving diminished perceived
  personal control over the stressor, and that alcohol and other drugs
  are often consumed for their euphoric rather than tranquilizing
  effects. Consequently, the empirical support for the effectiveness of
  relaxation training as a treatment for substance abuse in general is
  equivocal. As well, the existing outcome studies suffer from numerous
  methodological and conceptual inadequacies. In cases of demonstrated
  effectiveness, increased perceived control is a more plausible
  explanation than is decreased anxiety.


*****ADOLESCENCE*****

Chasanoff E  Schrader C
A behaviorally-oriented activities therapy for program for
  adolescents.
ADOLESCENCE 1979 Fall; 14(55):569-77
A behaviorally-oriented activities therapy program was designed and
  implemented with adolescents who manifested problems in school, at
  home, and with peers. Baseline measures for target behaviors were
  taken within the activities therapy program and, after a behavioral
  analysis, specific techniques were chosen to remediate problems.
  Techniques employed included: contingency contracting, assertiveness
  training, relaxation training, and cognitive restructuring.
  Evaluation of the effectiveness of each program was performed through
  daily measurement of the frequency of the occurrence of the target
  behaviors. Three case studies are presented which are illustrative of
  the range of programs which can be successfully implemented with this
  population.


*****ADVANCES IN ALCOHOL AND SUBSTANCE ABUSE*****

Gilliland K  Bullock W
Caffeine: a potential drug of abuse.
ADV ALCOHOL SUBST ABUSE 1983-84 Fall-Winter; 3(1-2):53-73
Recent investigations of caffeine abuse have questioned the
  indiscriminant use of this commonly accepted drug. In some
  individuals, chronic excessive caffeine consumption leads to the
  development of caffeinism, a syndrome which includes increased
  anxiety, depression, frequency of psychophysiological disorders, and
  possibly degraded performance. This paper reviews research
  demonstrating the abuse potential of caffeine. Special attention has
  been given those factors which mediate the wide individual
  differences in consumption patterns, susceptibility to abuse, and the
  varied psychological and physiological responses to this drug. While
  the development of caffeine abuse is probably best viewed as an
  idiosyncratic process, general guidelines for the recognition of
  potential abuse, and caffeinism proper, are offered.


*****AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE*****

Kosten TR  Gawin FH  Rounsaville BJ  Kleber HD
Cocaine abuse among opioid addicts: demographic and diagnostic
  factors in treatment.
AM J DRUG ALCOHOL ABUSE 1986; 12(1-2):1-16
Cocaine is becoming a major drug of abuse among the general
  population and among opiate addicts. Reports from the early 1970s
  found that most abusers were older Black males with some antisocial
  characteristics. Cocaine abuse at that time was reported by about 17%
  of opiate addicts seeking treatment and by 7 to 11% of ex-addicts on
  methadone maintenance. However, that rate increased dramatically
  during the 1970s, and in our 1980 study of 533 addicts we found that
  74% of opiate addicts applying for treatment used cocaine. It was the
  second most abused nonopioid drug after marijuana, surpassing alcohol
  intoxication. Although the mean number of days of abuse over the
  previous 30 days was substantially lower among the addicts on our
  methadone maintenance program (mean = 1.4 days, n = 120) than among
  the addicts applying for treatment (mean = 9 days, n = 204), the
  following associations with cocaine abuse were consistent in both
  subsamples. Cocaine abuse was more frequent among Blacks. It was
  associated with a variety of antisocial indices including Research
  Diagnostic Criteria antisocial personality disorder, number of
  arrests, and legal, family, employment, and drug abuse problems as
  assessed by the Addiction Severity Index and the Social Adjustment
  Scale. Several differences emerged between Black and White cocaine-
  abusing addicts, the most interesting being an increased rate of
  anxiety disorders among White cocaine abusers. Based on these
  associations, we offer several guidelines for treating cocaine abuse
  in opiate addicts.


*****AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY*****

Vittone BJ  Uhde TW
Differential diagnosis and treatment of panic disorder: a medical
  model perspective.
AUST NZ J PSYCHIATRY 1985 Dec; 19(4):330-41
The authors present a review of existing literature along with new
  data regarding the phenomenology, differential diagnosis, course and
  treatment of panic disorder and agoraphobia. Panic attacks are viewed
  as central to the development of these disorders, and individual
  cognitive frameworks contribute to the manner in which a patient's
  symptoms evolve. An apparent though unclear relation to depressive
  states is described. Substance abuse may also be a consequence of
  recurrent panic attacks. A scheme towards differential diagnosis of
  panic disorder from other psychiatric and medical disorders is
  proposed. Personality characteristics of these patients vary
  considerably, but certain factors, such as dependency, are common.
  Family relations are often strained and assume importance in
  treatment. Data on the longitudinal course of illness is presented
  implying a relationship of panic disorder to both depression and
  stressful life events in many patients. Treatments that thus far seem
  most effective are pharmacological and behavioural approaches.
  Imipramine, MAO inhibitors, and alprazolam currently appear to be the
  most useful medications employed, although other agents may at times
  be useful alternatives. Dietary interventions, family therapy, and
  group and individual psychotherapy are also reviewed and discussed as
  adjunctive therapies in the treatment of panic disorder.


*****DISEASES OF THE NERVOUS SYSTEM*****

Kochansky GE  Hemenway TS 3d  Salzman C  Shader RI
Methaqualone abusers: a preliminary survey of college students.
DIS NERV SYST 1975 Jul; 36(7):348-51
A questionnaire was used to survey the methaqualone experiences of
  college student users, and psychological test data from these users
  and a control group of non-users were compared. On differential
  pattern found was that methaqualone users have experimented with a
  wider variety of psychoactive drugs than have non-users. However, the
  two groups were essentially indistinguishable on the psychological
  test variables assessed. A preliminary modal profile of the college
  student methaqualone abuser and abuse experience was generated.

*****DRUGS*****

Pinder RM  Brogden RN  Speight TM  Avery GS
Doxepin up-to-date: a review of its pharmacological properties and
  therapeutic efficacy with particular reference to depression.
DRUGS 1977 Mar; 13(3):161-218
Doxepin is closely related in structure and general pharmacological
  properties to other tricyclic antidepressant drugs such as
  amitriptyline and imipramine. It combines antidepressant activity
  with a sedative effect and in this respect resembles amitriptyline,
  with which it shares a similar profile of clinical action. The mood
  elevating effect of doxepin appears to be similar to that of
  amitriptyline but is probably less marked than that of imipramine and
  in some studies has been slower to take effect than imipramine. At
  dosages which have achieved a similar overall response rate, doxepin
  tends to cause fewer or less troublesome side-effects than
  imipramine, amitriptyline or amitriptyline-prephenazine. The more
  marked sedative properties of doxepin make it more useful than
  imipramine in depressed patients with sleep distrubances and in
  depression associated with anxiety. The benzodiazepines remain the
  drugs of choice in anxiety states. but when anxiety is accompained by
  significant depression, doxepin is more effective than
  chlordiazepoxide or diazepam. Doxepin is usually well tolerated, and
  in particular by the elderly and those with cardiovascular disease.
  Side-effects are similar in nature to those of other tricyclic
  antidepressants, with dry mouth, drowsiness and constipation being
  the most common. Postural hypotension is uncommon. Although doxepin
  appears to cause fewer cardiovascular side-effects in usual
  therapeutic doses, it has an intrinsic cardiotoxicity on overdosage
  similar to other tricyclics.
*****ENCEPHALE*****

Lamontagne Y  Hand I  Annable L  Gagnon MA
[Physiological and psychological effects of biological feed-back
  training (alpha and EMG) among drug using college students]
ENCEPHALE 1977; 3(3):203-6  (Published in FRENCH)
Twenty-four volunteer college students, who were regular drug users,
  were randomly allocated to three training groups of equal size: alpha
  feedback, EMG feedback and a joked control group. Subjects, who were
  unaware of which feedback condition they received, were asked to
  practice at home during a six month follow-up period to achieve a
  relaxed state similar to that experienced during training. No group
  was successful in retaining gains made in their alpha levels during
  each session. The EMG group, however, significantly reduced their
  muscular activity during training and retained the improvement during
  follow-up. The alpha and joked groups did not significantly improve
  their EMG during training but at follow-up achieved the same levels
  as the EMG group. There was evidence to suggest a reduction in drug
  use among light and medium users that was maintained during follow-
  up. Significant and lasting improvements were made by each group in
  the duration and quality of their sleep. Anxiety levels were also
  reduced.
*****INTERNATIONAL JOURNAL OF THE ADDICTIONS*****
Hall SM
The abstinence phobias: links between substance abuse and anxiety.
INT J ADDICT 1984 Sep; 19(6):613-31
This paper presents a new model to explain the observed relationship
  between anxiety and substance abuse. Specifically, the concept of
  "abstinence phobias," common across psychoactive substances, is
  developed. The evidence needed to support this concept is outlined,
  and relevant data from studies of opiate, alcohol, and tobacco
  dependences are reviewed. Parallel data obtained from the treatment
  of obesity are discussed. It is concluded that the abstinence phobia
  merits further study; clinical implications are also considered.

True WR  Pevnick JS
Abuse of pentazocine combined with tripelennamine: an interaction of
  pharmacological and demographic characteristics.
INT J ADDICT 1983 Dec; 18(8):1063-71
Abuse of pentazocine (Talwin) and tripelennamine (Pyrabenzamine) (P
  and T) was studied in a group (N = 16) of inpatients. They were
  queried about subjective effects and their drug preferences. P and T
  use was associated with more anxiety than was the opiate or drug-free
  state. P and T use did not produce euphoria, and users preferred this
  drug next to last among other abused drugs. P and T use was further
  studied in outpatients (N = 628) using Client Oriented Data
  Acquisition Process information. These patients were younger and more
  often male, Black, and single or separated when compared with opiate
  users. They began using the drug later and had many fewer years
  invested in its use.

Hobfoll SE  Segal B
A factor analytic study of the relationship of experience seeking and
  trait anxiety to drug use and reasons for drug use.
INT J ADDICT 1983 May; 18(4):539-49
The relationship of measures of sensation seeking and trait anxiety
  to drug use and reasons for drug use was studied among a sample of 92
  detained or adjudicated adolescent males in a residential detention
  facility. Experience seeking was found to be related to drug use in
  general, and especially use of "hard" drugs. Anxiety tended to be
  related to drug avoidance, except in the case of marijuana and
  alcohol use. Reasons for drug use which related with experience
  seeking were excitement and thrill oriented, whereas reasons
  associated with anxiety were related to feelings of discomfort for
  this sample. In general, experience seeking was a stronger factor
  than trait anxiety in these findings. Implications for more action-
  oriented and less insight-oriented treatment are discussed in light
  of these results.

Orive R  Gerard HB
Personality, attitudinal, and social correlates of drug use.
INT J ADDICT 1980 Aug; 15(6):869-81
Retrospective data on 106 young people collected 10 years prior to
  this study as well as contemporaneous data were analyzed to determine
  predictors of drug use. Results indicate that personality factors
  fared poorly in distinguishing users from nonusers with the exception
  of anxiety and IQ for hallucinogen use only. Users tended to have
  high IQs and low anxiety. Social factors seem to play a major role in
  the spread of drug use. The initiator of the adolescent into drug use
  is not a group leader but rather an equal status peer group member.
  Factors in the spread of drug use follow similar patterns for licit
  as well as illicit drugs.

*****JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS*****

Peet M  Yates RA
Beta-blockers in the treatment of neurological and psychiatric
  disorders.
J CLIN HOSP PHARM 1981 Sep; 6(3):155-71
Beta-blockers, originally introduced into clinical practice for the
  treatment of cardiovascular disorders, are being increasingly
  advocated in the treatment of diverse neurological and psychiatric
  conditions. Thus, propranolol and certain other beta-blockers have
  been shown to be effective, and may be the drugs of choice, in the
  treatment of benign essential tremor and the prevention of recurrent
  migraine attacks. These drugs also have a useful role to play in the
  treatment of anxiety and alcohol withdrawal states, although beta-
  blockers have not come into general use in these conditions. The
  action of propranolol and related drugs in these neurological and
  psychiatric conditions is generally considered to be mediated by
  blockade of peripheral beta-adrenergic receptors, although other
  effects, either central or peripheral, may also be involved. The use
  of beta-blockers in the treatment of psychosis remains controversial.
  Current evidence does not support the use of propranolol in
  schizophrenia, but further studies in mania are warranted.


*****JOURNAL OF CLINICAL PSYCHOLOGY*****

Charlesworth EA  Dempsey G
Trait anxiety reductions in a substance abuse population trained in
  stress management.
J CLIN PSYCHOL 1982 Oct; 38(4):764-8
Investigated a 2-week (eight-session) stress management training
  program into an ongoing psychotherapy group for 11 hospitalized
  polydrug-abusing patients. These patients were compared to a control
  group of 14 similar patients on the same ward, who were participating
  in different psychotherapy groups. Results indicated that the stress
  management treatment group produced significant decreases in trait
  anxiety on the STAI (p less than .005) and TMAS (p less than .01).
  The control group's reduction was not significant, and the difference
  between the two groups was significant (p less than .05). Subjective
  reports suggested that treatment Ss used the stress management
  techniques to overcome insomnia associated with withdrawal, to manage
  anger, and to reduce situational anxiety.

Berger A  Wrobel TA  Lycaki H
Levels of basic personality factors in a psychiatric population.
J CLIN PSYCHOL 1980 Apr; 36(2):378-82
Diverse sets of factors have been claimed by various investigators to
  be basic personality variables of the highest factor order. A sample
  of 400 psychiatric patient records were rated for pressence or
  absence of 14 criteria. The data were factor analyzed, and four
  factors were extracted. Three of the four factors resemble Eysenck's
  three-factor model of personality at the universal or general level.
  The fourth factor is interpreted to be a behavioral dimension at a
  lower level. The results are discussed in terms of the population and
  the type of data utilized.

*****JOURNAL OF PERSONALITY ASSESSMENT*****

Gordon LB
Preferential drug abuse: defenses and behavioral correlates.
J PERS ASSESS 1980 Aug; 44(4):345-50
Response styles and defensive patterns of 30 polydrug abusers, 30
  sedative-hypnotic abusers, and 30 hospitalized medical control
  subjects were assessed. These subjects were drug-free and matched for
  sex, WAIS IQ, and socioeconomic status. The Rorschach was
  administered to all subjects. A frustration-producing task
  (insolvable anagrams) was administered to half of the subjects in
  each group. Solvable anagrams were administered to the remaining
  subjects. All subjects were then asked to select one of two stories
  for each of eight TAT cards and complete a Profile of Mood States
  Questionnaire. The Rorschach data indicate that polydrug abusers are
  less well organized, less able to delay gratification, and more
  restless and distractible when compared to the sedative-hypnotic and
  control groups. The behavioral data lend support to the
  pharmacodynamic theory of drug abuse in that each drug abuser group
  responded to the frustration produced by the inability to solve
  anagrams in a way consistent with the effects of the abused drugs.
  Implications of these data for treatment planning are discussed.
*****JOURNAL OF PSYCHIATRIC RESEARCH*****

Hasin DS  Grant BF
Psychiatric diagnosis of patients with substance abuse problems: a
  comparison of two procedures, the DIS and the SADS-L. Alcoholism,
  drug abuse/dependence, anxiety disorders and antisocial personality
  disorder.
J PSYCHIATR RES 1987; 21(1):7-22
We compared DSM-III and RDC diagnoses from the DIS to RDC diagnoses
  from the SADS-L for alcohol and drug use disorders, anxiety disorders
  and Antisocial Personality Disorder in a group of patients with
  substance abuse problems. Kappa values for substance use disorders
  were fairly good. The instruments did not agree well on anxiety
  disorders, or on Antisocial Personality Disorder. Criterion
  differences gave rise to some of the disagreement between the
  instruments on Antisocial Personality Disorder, but the causes of
  disagreement for the anxiety disorders were not so clear. The
  implications of these findings are discussed.

Schuckit MA  Sweeney S
Substance use and mental health problems among sons of alcoholics and
  controls.
J STUD ALCOHOL 1987 Nov; 48(6):528-34
Data from a questionnaire sent to 864 university male students and
  nonacademic staff were used to compare self-reports of substance
  intake patterns and problems as well as family histories of
  depression and substance abuse across four groups: Group 1, 682 men
  (79%) who had no alcoholic first or second-degree relative; Group 2,
  101 men (12%) who reported an alcoholic second-degree relative only;
  Group 3, 59 men (7%) who reported an alcoholic first-degree relative
  only and Group 4, 22 men (3%) with alcoholism in both first- and
  second-degree relatives. Although few men were already alcoholics or
  drug abusers and the groups did not differ significantly on the
  quantity and frequency of alcohol intake, there was an increase in
  the personal history of alcohol-related problems from Group 1 to
  Group 4. There were no significant differences across the groups on
  the proportion of nonalcoholic relatives demonstrating drug abuse or
  depressive disorders.
     Veterans Administration Medical Center
     San Diego
     California 92161.


*****NEUROTOXICOLOGY AND TERATOLOGY*****

Jarzembski WB
Electrical stimulation and substance abuse treatment.
NEUROBEHAV TOXICOL TERATOL 1985 Mar-Apr; 7(2):119-23
The use of electrical currents for the treatment of disease has been
  considered since antiquity but it has only been in recent years that
  suitable devices have been available to scientific investigators to
  provide stimulation currents for clinical use. These devices have
  been used extensively for the relief of intractable pain and are an
  accepted treatment modality today. Other investigators have turned to
  the investigation of the effects of tiny currents, less than one
  milliampere, applied to the head. Recent investigations have been
  successful in the alleviation of such symptoms as insomnia,
  depression, and tremor. Other investigations have shown similar
  currents to be effective in relieving stress that accompanies
  withdrawal from substance abuse. In spite of these successes,
  resulting from scientific investigation of the effects of cranial
  electrical stimulation, there is still a general reluctance to use
  this new modality. It is the purpose of this paper to review
  pertinent aspects of this treatment so the health care practitioner
  may make judgements with respect to the safety and efficacy of
  cranial electrical stimulation.


*****PHARMACOTHERAPY*****

Goldberg HL
Buspirone hydrochloride: a unique new anxiolytic agent.
  Pharmacokinetics, clinical pharmacology, abuse potential and clinical
  efficacy.
PHARMACOTHERAPY 1984 Nov-Dec; 4(6):315-24
Buspirone is the first of a new class of anxioselective agents, the
  azaspirodecanediones. It achieves peak serum concentrations within
  one hour and has a serum half-life of 2 to 5 hours. Animal studies
  have suggested antianxiety activity and the absence of abuse
  potential. Buspirone is both a dopamine agonist and antagonist, and
  appears to interact with numerous neurochemical systems in the brain,
  but not with gamma-aminobutyric acid or at benzodiazepine receptors.
  Buspirone increases prolactin and growth hormone levels under
  experimental conditions. In healthy subjects, it has much less effect
  on psychomotor performance and electroencephalographic results than
  diazepam. Buspirone offsets some of the impairment due to alcohol
  when the agents are combined. The drug has anxiolytic properties
  comparable to those of diazepam, with less sedating effects. It had
  no abuse potential in tests with casual drug users.


*****PHARMAKOPSYCHIATRIE NEURO-PSYCHOPHARMAKOLOGIE*****

Carranza J
Long term use and abuse of benzodiazepines.
PHARMAKOPSYCHIATR NEUROPSYCHOPHARMAKOL 1980 Sep; 13(5):254-8
1. We have stressed the detrimental effect that lay publications, T.
  V. and mass media has had on the pharmacotherapy of anxiety and
  depressive reactions with benzodiazepines. 2. We have reviewed the
  scientific literature and found few well documented cases of
  benzodiazepine dependence if one considers that benzodiazepines are
  the most prescribed medications. 3. We discussed the possibility that
  the seizures reported on withdrawal of benzodiazepines used for very
  long periods, is not a "proof" of a physical dependence, but rather
  clinical evidence of the well known anticonvulsant effect of
  benzodiazepines. 4. We have hypothesized that the withdrawal
  syndromes associated to high dosages of benzodiazepines might have a
  different neurochemical mechanism to that observed in alcohol and
  barbiturates withdrawals.


*****PRIMARY CARE; CLINICS IN OFFICE PRACTICE*****

*****PSYCHOLOGIE MEDICALE*****

Foggitt RH  Gossop MR  Nicol AR
Psychoneurotic disturbance and drug-taking in Borstal boys.
PSYCHOL MED 1976 Feb; 6(1):133-7
Their own accounts of their use of drugs, together with a detailed
  description of psychiatric history and present mental state, were
  obtained from a sample of institutionalized delinquents, Subjects
  reporting extensive involvement in drug abuse were found to be
  disturbed on a number of psychiatric variables; however, those
  reporting some limited abuse were less disturbed than subjects