Boundary disturbance in borderline and psychotic states

This study examines evidence for boundary disturbances in depressive, borderline, and schizophrenic hospitalized inpatients. Certain thought disorder signs on the Rorschach are reconceptualized as indices of boundary formation, which is defined as the capacity to create particular distinctions along wome bipolar coordinate of experience where previously no distinction was possible, and which defines each cluster of experience through a maintenance of differential functioning. The borderline group scored significantly high on the indices of laxness and moderately severe inner-outer boundary formation. The schizophrenic group scored significantly higher on indices of self-other and somewhat higher on severe inner-outer boundary disturbance. Schizophrenics may be organized at a level of self-other boundary formation which subsumes inner-outer boundary formation, while the borderline group is organized at a level of inner-outer boundary formation.     

Antidepressant treatment of children: clinical relapse is unrelated to tricyclic plasma concentrations

Plasma concentrations of imipramine and amitriptyline and their desmethylated metabolites were measured in 20 children being treated for major depressive illness 2 wk. and 5 to 10 wk. after achieving drug dosages of 2.25 mg/kg body weight. At 2 wk. all children had exhibited clinical improvement, but by 10 wk. 4 of the 10 children treated with imipramine and 5 of the 10 children treated with amitriptyline had experienced clinical relapse of depressive symptoms. Tricyclic antidepressant plasma concentrations and ratios were comparable in the subgroups of children who maintained their clinical improvement and those who relapsed. There was no evidence of a systematic decline in plasma tricyclic antidepressant concentrations in those children who relapsed.     

Target Groups for Preventing AIDS Among Intravenous Drug Users

The acquired immune deficiency syndrome (AIDS) has rapidly become the most serious medical consequence of injecting illicit drugs. Its potential impact on intravenous (IV) drug use is enormous. Human immunodeficiency virus (HIV, also known as HTLV-III and LAV), the virus that causes AIDS, appears, usually, to lead to lifelong infection. At present there is no effective treatment, and the treatments under development may require lifelong antiviral therapy. Since most of the antibody produced in response to HIV infection does not neutralize the virus, and since there is substantial genetic variation in the virus, it will be difficult to develop a vaccine. Even after vaccines are developed, testing their safety and efficacy will be formidable problems. Until either effective treatment or vaccines are developed, control of the epidemic among IV drug users must be attempted through behavior change/prevention efforts. In this paper we will review the epidemiology of AIDS among IV drug users and characteristics of the IV drug-use subculture relevant to prevention efforts. We will then identify different target groups for these prevention efforts, present available evidence about behavior change in these groups, and then briefly discuss how to prevent transmission of HIV to heterosexual partners who are not themselves IV drug users and to the children of IV drug users.     

Baiting bioethics

Various criticisms of bioethics are reported and evaluated in an effort to determine what it is reasonable to expect of this rapidly developing field and what should be its future directions. Specific charges by Renée Fox, Judith Swazey, and William Bennett are explored. Fox and Swazey contend that bioethics champions individualism and pays little attention to social relationships, that bioethicists distance themselves from the human settings where ethical issues are experienced, and that bioethics pretends to a false validity. Bennett indicts bioethics on the grounds that it promotes ethical relativism and moral indifference. Gorovitz argues the case against these contentions but urges ethicists systematically to assess their critics' statements.