Diagnostic And Statistical Manual Of Mental Disorders , Third Edition Research Articles

SCREENING FOR DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS: VALIDATING THE CENTER FOR EPIDEMIOLOGIC STUDEES DEPRESSION SCALE FOR CHILDREN

The utility of the Center for Epidemiologic Studies Depression Scale for Children (CES-DC), a modified version of the Center for Epidemiologic Studies Depression Scale, was explored in a sample of children, adolescents, and young adults at high or low risk for depression according to their parents' diagnosis. Proband parents were participants in the Yale Family Study of Major Depression who had children between the ages of 6 and 23 years. Diagnostic and self-report information on offspring was collected over two waves, spaced 2 years apart, from 1982 to 1986. Support was obtained for the reliability and validity of the CES-DC as a measure of depressive symptoms, especially for girls and for children and adolescents aged 12-18 years. Children with major depressive disorder or dysthymia, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), had elevated scores in comparison with all other respondents. The CES-DC lacked diagnostic specificity; children with a range of current DSM-III diagnoses had elevated scores on the measure. A cutoff point of 15 and above for screening children and adolescents for current major depressive disorder or dysthymia may be optimal. Depressed respondents scoring below this cutoff point (false negatives) showed better social adjustment than true positives; nondepressed respondents scoring above this cutoff point (false positives) showed worse adjustment than true negatives. Factor analysis was used to construct an abbreviated, four-item version of the scale. The abbreviated scale was shown to be useful as a screen.

ソフトウエア技術者の精神健康 Ｉ． 心身愁訴，精神障害の頻度

This study examined the physical complaints, mental complaints and psychiatric disorders in software engineers. Subjects were 101 male software engineers. They were evaluated by a semistructured interview. Psychiatric diagnosis was based on DSM-III (Diagnostic and Statistical Manual of Mental Disorders, third edition). The results are summarized as follows: 1) Physical complaints were observed in 68% of the subjects with 25% of the subjects complaining of physical ill-health. This study showed that 12% of the subjects had hypertension, 12%, gastritis or gastro-duodenal ulcer, 14%, allergic disease, and 19% miscellaneous diseases. 2) Of the subjects 62% had mental complaints and 31% mental ill-health. Depressive symptom was the most frequent mental complaint with 32% of the subjects diagnosed as DSM-III. The common diagnoses were adjustment disorders (19%), major affective disorders (6%), psychological factors affecting physical condition (5%) and dysthymic disorder (3%). Only one subject sought professional help from a psychiatrist for relief of mental complaints. The data suggest the severity of mental ill health in software engineers, but methodological limitations preclude a firm conclusion at this time. Further studies should be made on the mental health state in software engineers.

ソフトウエア技術者の精神健康 ＩＩ． 仕事上のストレッサーの分類および仕事上のストレッサーと精神障害の関連性

Occupational stressors and psychiatric disorders were studied in a sample of 101 male software engineers. Psychiatric diagnosis was based on DSM-III (Diagnostic and Statistical Manual of Mental Disorders, Third Edition). The results can be summarized as follows: 1) More than 30% of the subjects were not satisfied with their work. 2) Occupational stressors ascertained in the interview could be classified into "quantity of job," "quality of job," "role in organization," "relations with others," "work conditions," "career development," "reward," "organizational structure and climate," "low social support," and "lack of decision making." "quality of job" (35%), "quantity of job" (30%), and "role in organization" (33%) were the most common stressors for the subjects. 3) Among the occupational stressors, only "quantity of job" was significantly related to psychiatric disorders (p less than 0.05). The results suggest that many software engineers are not satisfied with their work and that "quantity of job" has the greatest influence on their mental health. Some measures should be taken to avoid potential health hazards, for the research findings indicate a relationship between occupational stressors and mental health in software engineers.

Prevalence and recognition of alcohol abuse in a primary care population

The purpose of this study was to assess the prevalence, physician recognition, and treatment of alcohol abuse among patients of 19 senior medical residents practicing in a hospital-based, primary care setting. Interviews of 242 outpatients were conducted, and alcohol abuse and dependence, as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), were determined using the Diagnostic Interview Schedule. Twenty percent of the patients studied had abused or were dependent on alcohol at some time in their lives and 5 percent reported abuse or dependence within the last year. Of the techniques studied, a short screening questionnaire (Short Michigan Alcohol Screening Test [SMAST]) was the most accurate way of identifying patients who abused alcohol, and physician assessments were more accurate than laboratory tests. Although the physicians were aware of serious alcohol problems among 77 percent of their patients who met DSM-III criteria for alcohol abuse or dependence in the previous year, they identified only 36 percent of their patients with less serious problems or past alcohol abuse. They had only discussed alcohol abuse with 67 percent of the patients they identified as alcohol abusers. We conclude that a short screening questionnaire (SMAST) is an accurate means of identifying alcohol abuse. Despite the recognition of serious alcohol problems by the physicians, the problem is not addressed routinely even among patients that are recognized as alcoholic.

European Perspectives on the Classification of Depression

The publication by the American Psychiatric Association in 1980 of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) - a text whose influence has been felt throughout the entire world and whose system of classification, particularly within the context of depressive disorders, has now been adopted by the majority of research work, no matter in what country it is implemented or published - has given the impression that an ‘American perspective’ has been substituted for the ‘European perspective’ that was predominant up to that point. However, this is a simplistic view of a complex history. Certainly, the basic methods of DSM-III originated from within those traditions which are particularly rooted in the USA, such as the quantitative approach to diagnostic criteria; these derive in the final analysis from the ‘statistical psychology’ devised by James McKeen Cattell at the University of Pennsylvania in 1887, and subsequently taught by him at Columbia University. But even among those factors which appear to be characteristically American, European origins can be detected: when he was in London, Cattell was the pupil of Galton, the founder of biometry. Furthermore, there has never existed in Europe any unanimity of opinion with regard to the problems of nosology: concepts supported in the German-speaking countries, in France, in the UK, or in the Scandinavian countries have only been partially adopted elsewhere and occasionally have remained specific to their national tradition. This paper will examine two of the fundamental points in the classification of depression which are linked to European perspectives - the notion of affective disorder and the endogenous/non-endogenous dichotomy - and will discuss the present situation created by the discordance which exists between the European and American approaches.

A new screening test for dementia.

The purpose of this study is to develop a new screening test for detecting the demented elderly in the early stage in communities. The test is easy to apply for consultation, guidance and care and is capable of administering differential diagnoses. Based on the 9 dementia rating scales used in Japan, Europe and the U.S., a new test was completed after investigating and modifying the design 5 times. The test consists of 20 items. This test was given to 203 subjects (59 males and 144 females) including normal elderly as well as those suspected of suffering from dementia. The internal consistency, reliability and validity were studied using clinical diagnoses (diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) and Karasawa's Criteria for Judging Senility), Hasegawa's Dementia Rating Scale and Mental Status Questionnaire (MSQ) as external criteria. The present test was confirmed to have sufficient effectiveness as the screening test for dementia.

Identification and Treatment of Borderline Personality Disorder

THE INCLUSION of the borderline personality disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is evidence that there is increasing recognition of this syndrome.1 Because social workers often serve as intake workers, they are in the unique position of being able to identify these clients early on. Such early identification and diagno sis facilitates the planning of appropri ate and effective treatment. More and