Inpatient alcoholics (N = 145) were followed at 6-month intervals for 18 months postdischarge. The drinking outcomes were compared based on overall degree of AA attendance. Results did indicate higher percentages of abstinence for AA attenders, but only at 18 months. AA attenders also indicated fewer days drinking during the first 6 months, with fewer days drunk for AA attenders at 18 months. Those subjects attending AA for the entire 18 months reported a total abstinence rate of 50%.

Using a modified version of the Hackett-Cassem denial scale we measured preoperative denial in 121 patients scheduled for CABG surgery. A significant inverse relationship was found between the denial scale and Hamilton Anxiety measures four days postoperatively (p less than .02). Longitudinal assessments were carried out using the Spielberger State Anxiety Inventory (SSAI), the Zung Self-Rating Depression Scale (Zung SDS) and the Psychosocial Adjustment to Illness Scale (PAIS). Six months following the surgery, significant negative relationships between denial and these self-report outcome measures were observed as follows: denial and SSAI (p less than .001), denial and Zung SDS (p less than .01), and denial and PAIS (p less than .01). However, the same analysis at twelve months showed no statistically significant correlations between denial and these psychologic outcome measures. Our findings suggest that denial serves as an adaptive mechanism, especially in the immediate postoperative period. Furthermore, higher levels of denial may be predictive of improved psychologic outcome for up to six months following surgery. Subsequently, however, other events, unrelated to the surgery, may be of greater importance than preoperative denial in determining psychological outcome from CABG surgery.

A “customized” clinical typology of six types (for 10% to 30% of the sample each) was derived on 150 inpatient alcoholic veterans as part of a more comprehensive clinical research project. The types were derived on 18 variates, which included the 13 clinical and validity scales of the MMPI, 2 intellectual estimates, 2 perceptual estimates, and an employment rating, using Ward's procedure. The MMPI clinical profiles for the types matched closely known MMPI actuarial patterns, as well as those from prior alcoholism typing research. The non‐MMPI variates seemed to add importantly to the clinical meaningfulness of the derived types. Type contrasts on a number of demographic and index variables were also significant and provided additional descriptive and validation data. The desirability and utility of combining several common measures as a basis for types that would be a central part of ongoing clinical programming and research are discussed.

Moyamoya disease (MMD) is a rare cerebral vasculopathy with limited information on the associated cognitive and emotional sequelae, particularly presenting in a psychiatric setting. We present the case of a 25-year-old female with a history of MMD and depressive disorder. She underwent revascularization surgery following an ischemic stroke at age 15 years. Magnetic resonance imaging at the time of the current assessment revealed markedly abnormal appearance in the anterior cerebral circulation with extensive periventricular collateral vasculature involvement. Neuropsychological assessment data revealed deficits in inhibition and problem-solving, consistent with frontal lobe dysfunction. We discuss the importance of further research on the neuropsychological sequelae of MMD.

The prospect of and the evaluative period for transplantation can be stressful for individuals with heart failure (HF). Little is known about the impact of psychosocial factors on service utilization and health outcomes. The current study examined the impact of depression, dysthymia, and anxiety on two-yr hospitalization and mortality among 96 individuals with HF who were evaluated for transplantation. Results revealed that only a small percentage of individuals endorsed sufficient symptomatology to meet criteria for a psychiatric, Axis I disorder (3.1% = anxiety; 2.1% = depression; 1.0% = dysthymia) although a significant proportion of the sample was prescribed an antidepressant or an anxiolytic (37%). Multivariable regression analysis was conducted to examine the association between significant independent demographic, medical, and psychiatric predictors and total duration of hospitalizations; logistic regression analysis was used to examine the relation between predictors and mortality. An increase in anxious symptoms was associated with a decrease in total number of days hospitalized during the two-yr period following the initial evaluation. Similarly, as depressive symptoms increased, risk of two-yr mortality decreased. Future research should assess communication between the patient and providers to further elucidate the potential relationship between psychiatric symptoms, service utilization/hospitalization, and mortality in this patient population.