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Biomedical subjects

B J Powell

Publications and source records attributed to B J Powell.

At least 55 records · Page 3Linked to original sources
PubMed1987

Primary and secondary depression in alcoholic men: an important distinction?

The primary-secondary depression distinction was investigated in male alcoholic patients from five Veterans Administration Medical Centers. The Psychiatric Diagnostic Interview, a DSM-III-compatible, criterion-referenced, structured interview, was administered to 565 patients admitted to the Alcoholism and Drug Treatment Units. Seventy-eight patients (13.8%) who exhibited only alcoholism and depression were divided into three subgroups based on the temporal onset of depression relative to the onset of alcoholism. Although few statistical differences were found, observed trends suggested more impairment in alcoholic patients with primary depression than in those with concurrent or secondary depression. The findings indicate that the primary-secondary depression distinction may have important clinical relevance and should be made whenever possible.

Adult↗
PubMed1986

Lithium compliance in alcoholic males: a six month followup study.

One hundred alcoholic patients were followed at monthly outpatient clinics for 6 months. Half were assigned low to moderate doses of lithium carbonate and half to chlordiazepoxide (10 mg tid) (active placebo). Drinking behavior and medication compliance were monitored at monthly clinics. After 6 months 52% of the lithium and 44% of the chlordiazepoxide patients were medication compliant. Of the 48% remaining in the lithium group, 14% did not return for a single visit while 14% came only once. Twenty percent came to clinic regularly; however they had never taken the medication as assigned. Of the 56% non-compliant chlordiazepoxide patients, 16% did not attend a single clinic; 24% came only once or twice and the remaining 16% attended clinics regularly although they were never medication-compliant. Drinking days and the percentage of patients reporting abstinence for one or more months were determined for medication compliant patients and for patients who attended clinic regularly but who did not take medication. Data were analyzed by Kruskal-Wallis one way analysis of variance tests. While lithium and chlordiazepoxide compliant patients tended to report fewer mean drinking days per month (4.6 and 4.8 respectively) than the non-medication group (6.9) these differences were not significant; however, compared to 44% in the non-medication group, 60% of the lithium patients and 58% of the chlordiazepoxide patients reported having significantly more months of abstinence (p less than .05). These results do not show that lithium is differentially efficacious in reducing alcohol consumption.

Adult↗
PubMed1986

Survey of alcohol and drug misuse in spinal cord injured veterans.

Although the spinal cord injured population is considered by many to be especially vulnerable to alcohol and drug misuse, there is little factual information regarding the prevalence of alcohol and drug misuse among this group. To survey alcohol and drug misuse in a large population of spinal cord injured veterans, a 61-item questionnaire was mailed to 2000 randomly selected members of the Paralyzed Veterans of America organization. Of 1083 questionnaires returned, 992 were usable. The results were analyzed with regard to sociodemographic data, level of injury, type of accident, current medication use and the use of alcohol and recreational drugs. Statistical analyses were performed using chi-square tests. The majority of respondents indicated the regular use of alcohol prior to age 21 and before the spinal injury (70.1%). Conversely, the majority who acknowledged the use of recreational drugs reported the use began after the injury (75%). In contrast to the notion that the spinal cord injured individual is at high risk for alcohol and drug misuse, this study indicates alcohol and drug use is far less than in the general population.

Adult↗
PubMed1986

When alcoholics drink aftershave: a study of nonbeverage alcohol consumers.

A one-year prospective study was conducted to describe nonbeverage alcohol (NBA) consumption (the use of substitutes for traditional forms of ethanol) among alcoholics. It was found that 11% of inpatient alcoholics at a veterans' hospital and 8.6% of alcoholics at a community hospital had consumed NBA. Substances consumed ranged from toiletries to organic solvents, often in quantities exceeding the theoretical lethal dose. 'Ready availability' was cited as the primary reason for consumption. Social, demographic and psychiatric parameters were then compared between 48 VA alcoholics who used NBA and 48 nonusing alcoholics. No social or demographic differences were found, but NBA drinkers drank more alcohol (P less than 0.0001), had higher global alcoholic severity scores (P less than 0.0001), more severe withdrawal symptoms (P less than 0.0001), and a higher frequency of antisocial personality disorder (P = 0.009) and drug abuse (P = 0.005). When NBA drinkers were subdivided by quantity of NBA consumption and recency of latest ingestion, no social or psychological differences were found between groups, except for more frequent and heavier illicit drug use among 'heavy' NBA consumers (P less than 0.0001).

Alcohol Drinking↗
PubMed1985

Comparison of three outpatient treatment interventions: a twelve-month follow-up of men alcoholics.

Men inpatient alcoholics (N = 174) from a Veterans Administration medical center who were preselected by employment status were randomly assigned to one of three outpatient treatment interventions: (1) medication only, (2) active support or (3) untreated medical monitoring. Subjects were followed monthly for 1 year, with an 85% 12-month follow-up rate. Although the sample as a whole showed reduced alcohol misuse and improved social functioning after 12 months, the specific form of treatment was unrelated to outcome. These findings suggest that the intensity of the outpatient treatment experience is not related to outcome and that time-consuming interventions are not differentially cost-effective.

Adult↗
PubMed1985

Alcoholics who drink mouthwash: the spectrum of nonbeverage alcohol use.

Nonbeverage alcohol (NBA), or substitutes for traditional forms of beverage alcohol, includes such substances as mouthwash, aftershave lotion and alcohol-based fuels. Literature pertaining to the prevalence, clinical significance and toxicity of this practice is reviewed, using illustrative cases from a series of 48 NBA consumers. It was found that 10-15% of alcoholics hospitalized in detoxication units have consumed NBA; half of these patients are regular consumers. Addiction to NBA itself may occur. Its use is primarily related to easy accessibility, rather than social or monetary factors. Polydrug misuse and antisocial personality disorder are more frequent in NBA users, but use is not pathognomic of end-stage alcoholism. The 48 NBA users reported surprisingly few toxic symptoms from acute ingestion, perhaps because tolerance to some substances in NBA may occur. Isopropyl alcohol was the exception, reproducibly causing symptoms suggestive of severe gastritis.

1-Propanol↗
PubMed1985

The discriminate validity of the Psychiatric Diagnostic Interview.

The discriminate validity of the Psychiatric Diagnostic Interview (PDI), a criterion-referenced, structured diagnostic instrument, is discussed. Data presented indicate that the PDI has an acceptable level of discriminate ability, making it a useful screening tool for detecting a variety of well-defined psychiatric disorders.

Ambulatory Care↗
PubMed1984

Sex-role affiliation among male alcoholics.

Male alcoholic veterans were sex-typed more frequently as feminine than masculine on the PRF ANDRO when compared to college males or older, nonalcoholic veterans (N = 123). Endorsement of passive-feminine characteristics among alcoholics (1) is interpreted to be a consequence, not a cause of the disorder; (2) is considered reversible with the achievement of sustained sobriety; and (3) is a feature that possibly needs to be addressed directly in order to facilitate successful therapeutic interventions.

Adult↗
PubMed1983

Employment factors in outpatient recovery of alcoholics: a multivariate study.

This study examined the effects of patient and treatment variables on alcoholic outpatient recovery over a one year period. One-hundred-seventy-four subjects, dichotomized by age (less than or equal to 42 or greater than 42) and employment status (employed or unemployed), were randomly assigned to one of three treatment groups (medical check-up, medication, or multi-therapy). Seventy-eight percent of these subjects were available for follow-up. Dependent measures included neuropsychological functioning and subject ratings of mood and alcohol consumption. Statistical analysis was by a 2 X 3 X 2 MANOVA. Employment status was a significant variable relative to positive outcome changes on mood and neuropsychological functioning. Moreover, older employed alcoholics showed a significant reduction of confusion. No group differences were noted at outcome with respect to age or treatment. The implications of the results for conventional alcoholism outpatient treatment are discussed.

Adult↗
PubMed1982

Prevalence of additional psychiatric syndromes among male alcoholics.

The prevalence of psychiatric syndromes among 565 male alcoholic VA inpatients was examined using the structured Psychiatric Diagnostic Interview (PDI). Almost two-thirds fulfilled criteria for one or more additional psychiatric syndromes. Subjects positive only for alcoholism reported a significantly later onset of problem drinking and fewer first-degree relatives who abused alcohol than those positive for one or more additional syndromes. The most frequent additional syndromes were affective disorders and antisocial personality. The possible significance of subtyping alcoholics by the presence or absence of coexisting psychiatric syndromes is discussed.

Alcoholism↗
PubMed1980

Psychological adjustment and sex-role affiliation in an alcoholic population.

Examined the relationship among sex-role categories and indices of social/personal adjustment and psychiatric symptoms in a male alcoholic (N = 123) population. No significant relationships were found between PRF sex-role categories and measures of distress, mood disturbance and psychiatric symptomatology; nor was sex-role type found to be associated with behaviors common to alcoholism. These findings differ from those of others, which report that less sex-typed males have more adjustment problems. The inability to demonstrate a relationship between maladjustment and the PRF ANDRO typology raises the question whether sex-role affiliation is largely independent of factors suggestive of poor mental health.

Adaptation, Psychological↗
PubMed1978

Clinical management of father-daughter incest. A critical reexamination.

The professional literature relevant to child incest cases is reviewed. Four questions related to clinical management are examined. Although physical separation of the offending parent and child is typically recommended, there is insufficient evidence to support the belief that an incestuous relationship per se is inevitably harmful to the mental health of the child. It is suggested that exclusive focus on the sexual relationship can sometimes prevent the clinician from providing maximum assistance to the child and family. A representative case history is discussed.

Adolescent↗