SUMMARYBackground: The percentage of patients receiving long--term treatment with acid suppressive drugs, mainly proton pump inhibitors, is higher than the prevalence of diseases that are commonly accepted as the proper indication for long-term proton pump inhibitor use. Aim: To evaluate whether a patient-directed intervention (direct mail) reduced the prescription of antisecretory medication for dyspepsia in general practice. Methods: A cluster-randomized trial was performed. One hundred and thirteen chronic users of proton pump inhibitors were recruited by 20 general practitioners. An unsolicited information leaflet was sent to patients that suggested stopping or reducing the use of

An important reason to choose an intervention to treat psychological problems of clients is the expectation that the intervention will be effective in alleviating the problems. The authors investigated whether clinicians base their ratings of the effectiveness of interventions on models that they construct representing the factors causing and maintaining a client's problems. Forty clinical child psychologists drew causal models and rank ordered interventions according to their expected effectiveness for 2 cases. The authors found that different clinicians constructed different causal models for the same client. Also, the authors found low to moderate agreement about the effectiveness of different interventions. Nevertheless, the authors could predict clinicians' ratings of effectiveness from their individual causal models.

The screening efficiency of 2 methods to convert Child Behavior Checklist (CBCL) assessment data into Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses was compared. The Machine-Aided Diagnosis (MAD) method converts CBCL input data directly into DSM-IV symptom criteria. The Achenbach System of Empirically Based Assessment (ASEBA) proceeds more indirectly and uses DSM-oriented scales. The power of the 2 methods to predict DSM-IV diagnoses obtained via administration of the structured Diagnostic Interview Schedule for Children (DISC-IV) interview in a clinical sample was examined. DISC-IV interviews and CBCL reports from parents of 44 children, 25 boys, and 19 girls, ages 6 to 17 were used. The results showed comparable levels of predictive power for the 2 methods. Both methods were able to predict DSM-IV diagnoses and therefore can be used for screening DSM-IV diagnoses.

It was possible to capture parts of the theories of conduct disorder in the Causal Modelling framework but a multi-model approach may be necessary for the alternative theories of conduct disorder we evaluate. The application of the framework helps to see the relationships among the various theories of aspects of conduct disorder and demonstrates the need for more explicitness in the causal theories.

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