Could FLUVOXAMINE, a serotonergic medicine used in certain impulsive conditions, help PATHOLGICAL GAMBLERS? (AMJPsychiatry 155:12, pp.1781-1783). Researchers studied a small sample with a DSM-IV diagnosis of pathological gambling and a South Oaks Gambling Screen score greater than 5. 10 patients completed the 8-week trial of fluvoxamine. Seven of the 10 patients with pathological gambling demonstrated a reduction in the urge to gamble. This study should be assessed with caution because of the non-double-blind design and the small number of subjects. Also, the results do not fully separate the antidepressant benefit as distinct from an anti-gambling effect of the drug. Still, those who did respond showed a complete cessation of all gambling behaviors. . . .
TRUST IS A characteristic belief that the sincerity, good will or truthfulness of others can generally be relied upon. And trust is important to health as well. (Journal of Behavioral Medicine 21,6; pp.517-526, 1998). Researchers at Duke and Oregon examined a sample consisting of 50 men and 50 women. Participants ranged in age from 55 to 80 years, and averaged 12.7 years of education. Life satisfaction was rated on a 10 point Cantril ladder. Psychological well-being was rated via the Bradburn. Affect Scale. High levels of trust, as measured by the Interpersonal Trust Scale, were associated with a variety of indicators of good health over an 8-year period and longer survival over a 14-year follow-up. Think positive. . . .
One scenario where trust is irretrievably violated is in the traumatized.
SURIVOR OF STATE SPONSORED TERRORISM. In TESTIMONY PSYCHOTHERAPY the survivor and interviewer establish a working alliance that makes it possible for the survivors trauma story to be told and documented. Testimony works through narration of individuals' personal experiencing of collective traumatization in a new social context. Their remembrances can be used to develop new collective understandings of history and communal identity that can better support peace and social trust. Researchers utilized testimony in 20 adult survivors of ethnic cleansing-Bosnian refugees who had resettled in Chicago in the previous two years. (AMJ Psychiatry 155.12, pp 1720-1726, December 1998) They all met symptom criteria for the diagnosis of posttraumatic stress disorder (PSTD). The rate of PSTD diagnosis decreased from 100% at pretestimony to 75% posttestimony, and 53% at 6-month follow-up. The study subjects demonstrated decrease in depressive symptoms, and improvement in overall function as well. . . .
HOW WELL DOES MEDICINE RESPOND TO THE WARNINGS SIGNS OF SUICIDALITY? A systematic sample of patients who were 15 years old or older was taken from consecutive cases of attempted suicide referred to a general hospital in Helsinki between January 1 and July 31, 1990. 43% who received a diagnosis of current unipolar DSM III-R major depression were studied. (AMJ Psychiatry 155:12 pp. 1778-1780, December 1998) In 39 cases (91%) the method of the index attempt was overdose. After the index attempt, 72% of the suicide attempts were referred for psychiatric consultation. While almost all were compliant with recommendations, only one in seven was receiving antidepressant in adequate doses, and 22% were receiving psychotherapy. The clear majority failed to receive adequate treatment for depression both before and after the attempt. . . .
Does UNEMPLOYMENT lead to SUICIDE? Recent mortality investigations have confirmed the increased incidence of suicide among unemployed people. A University of Oslo study monitored suicidal ideas in a 5-year follow-up of a representative sample of long term unemployed Norwegians. (Acta Pschiatr Scand 1998:98 p. 480-486) A random sample of all subjects aged 16 to 63 years and registered as unemployed for more than 12 weeks in the four municipalities of Greenland, southern Norway, was offered a routine health examination in 1988. Of the 374 subjects invited, 310 individuals attended. Researchers, using a variety of questionnaires, found 17% with suicidal ideation. This rate was higher than the general population. In 1993, 228 people answered a postal questionnaire. Only 6% of those re-employed demonstrated suicidal ideation, while 22% of those still unemployed had suicidal thoughts. . . .
How frequent are PSYCHOTIC SYMPTOMS in combat related POSTTRAUMATIC STRESS DISORDER? (J Clin Psychiatry 60:1, pp. 29-32, January 1999) 53 male combat veterans admitted to a rehabilitation unit were evaluated for psychotic symptoms. 72 % were white, 17% were Hispanic, and 11% were black. 21 patients (40%) were found to have a history of psychotic symptoms that were reported to have been active in the 6 months prior to admission. Auditory hallucinations were the most common, followed by visual hallucinations and delusions. Psychotic symptoms were associated with the presence of current major depression in 17/21 cases, or 81%, and were more common in the minority veterans; 11/21 or 52% were affected....
