27:T50e,

Nonmedical factors are often important considerations when choosing treatment options for illness. High levels of childhood hospitalization are of concern for psychological as well as medical and economic reasons. This study compared medical and psychosocial attributes of children managed at home or in hospital for childhood gastroenteritis to identify factors differentiating type of care. Parents of children under two years with gastroenteritis managed at home (n = 76) or in hospital (n = 76) were interviewed. Medical details and a range of intra-family factors (e.g., parenting skills, marriage) and extra-family factors (e.g., neighborhood, social contacts) were queried. Doctors (n = 6) rated the severity of symptomatology of each case based only on medical details. There was no difference in the medical severity of the gastroenteritis episodes for hospital and home care groups. Instead families were most clearly differentiated using discriminant analysis by social variables; specifically hospital care families had poorer scores than home care families on social contact indices. This highlights the necessity for focusing on the wider social context in efforts at decreasing the incidence of childhood hospitalization.

28:T45a,

Our hypothesis was that a one-day survey of all patients hospitalized on Adult General Care would demonstrate a need for expanded addiction services in a municipal teaching hospital in East Harlem. We interviewed 276 patients in Adult General Care on February 16, 1990 to assess whether they abused drugs or alcohol or were hospitalized for reasons related to substance use. Of the 276 patients interviewed, 18 percent used alcohol alone, 14 percent used drugs alone, 17 percent used both drugs and alcohol and 2 percent were hospitalized for reasons related to substance use. One hundred forty or 51 percent of all patients were admitted because of substance use and its sequelae or as a result of violence associated with the buying or selling of drugs. The percentage was highest on one medical floor where 89 percent of the patients were substance users and on medical floors in general where the average was 60 percent. Forty patients or 14 percent were known to be HIV seropositive. Given the high mortality in Harlem, the results of our one-day survey indicate a need for expanded addiction services.

29:T522,

Cases of mania associated with acquired immune deficiency syndrome (AIDS) are reviewed in an attempt to elucidate patterns that may be helpful in guiding treatment, determining prognosis, and understanding pathophysiology. Fourteen well-described cases in the English language literature were critically reviewed. Data was collected regarding chronological appearance of signs and symptoms, specific psychiatric symptoms, associated neurologic and cognitive function, objective testing of brain structure and function, and outcome. When mania or hypomania occur in the setting of a human immunodeficiency virus (HIV) infection, it frequently occurs once and does not recur. AIDS-associated manic states are adequately responsive to available anti-manic agents, however, AIDS patients may be more prone to deleterious side effects. Although mania or hypomania may be the presenting complaints that lead to the discovery of human immunodeficiency virus (HIV) seropositive status, mania tends to occur in people exhibiting signs of immunodeficiency as is exemplified, in the sample, by death occurring within six months of the psychiatric presentation in nearly a quarter of the patients. It is hypothesized that AIDS-related mania and agitated psychosis may be related to increased intracellular free calcium.

2a:T4da,The International Journal of Psychiatry in Medicine bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious,