No abstract

Sjögren's syndrome is an autoimmune disorder primarily affecting women, with decreased saliva and tear production as the principal characteristic. Cognitive, neurological, and psychiatric disorders also are associated with Sjögren's. The present study addressed the hypothesis that patients with Sjögren's syndrome differ significantly from matched controls in the prevalence and impact of a number of neuropsychiatric abnormalities. Sjögren's patients and controls (n = 37 per group) underwent medical and psychiatric evaluation, demographic assessments, quality of life and symptom evaluation, and extensive testing of cognitive function and memory. Patients and controls were closely matched for age, gender distribution, verbal IQ, marital status, educational level, employment status, and current/past medical or psychiatric history. On most subjective self-ratings, Sjögren's patients reported greater fatigue, impaired physical functioning, feeling depressed, and autonomic symptomatology compared to controls. Impaired memory was described mainly as loss of thought continuity in the midst of a task or activity. However, the majority of objective measures of cognition, psychomotor function, and memory showed minimal differences between groups. Sjögren's patients rate themselves as impaired on multiple ratings of emotional, cognitive, and physical function, but objective measures of cognition reveal fewer substantive differences between patients and matched controls. Sjögren's patients perceive deteriorated physical function over time, but they achieve a level of functioning comparable to controls despite the burden of their illness.

Sixty-six subjects, 64 of whom were female hospital or medical school employees, were asked if they were willing to take two tablets of "acetylhydroxybenzoate" or a placebo when they next had a headache, after receiving varyingly detailed descriptions of the actions and hazards of the drug. Comprehension and consent to volunteer were inversely related to length of form. In the groups receiving the longer form two subjects volunteered to take the drug despite the presence of contraindications; five subjects missed the point that fatal reactions might occur. When told that the drug described was in fact aspirin, 20 of 21 who had refused to take "acetylhydroxybenzoate" said that they would continue to take aspirin. The data suggest that the information provided to subjects should be brief and to the point, to maximize comprehension and intelligent decision-making. These results have important implications for consent procedures, drug advertising, and drug warnings.