Diaphragm/spermicide use increases the risk of urinary tract infection (UTI). To determine whether spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.

Study highlights importance of including both adults with psychiatric disability and their parents in family research. Comparing experiences of adults and parents can help to describe disruptions due to mental illness and perceived availability of social resources in the context of family life.

Psychometric properties of a brief self-report measure of personal loss for adults coping with psychiatric disability are examined. The Personal Loss from Mental Illness Scale (PLMI) is a 20-item measure that assesses overall perceptions and four interrelated aspects of personal loss from mental illness. Using a sample of 158 adults with serious mental illness, the PLMI was found to have a meaningful factor structure, good internal consistency and high test-retest reliability. Construct validity is evidenced by positive correlations between personal loss scores, number of psychiatric hospitalizations, self-reports of loneliness, psychological symptoms, and problems with alcohol. PLMI scores were unrelated to scores on a personal growth measure and negatively correlated with scores on a positive well-being scale. Implications of the PLMI for research on coping, adaptation and recovery from serious mental illness are discussed.

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