Eating disorders are often associated with regurgitation of gastric contents into the mouth and dental erosion. In this study the dental status was evaluated in bulimic patients. Thirty-five bulimics, diagnosed in the Outpatient Departments of Psychiatry and Adolescent Psychiatry of the University Central Hospital in Helsinki, and 105 controls matched for age, sex, and educational level were examined clinically, and the factors associated with dental erosion and caries were evaluated in an interview. Severe dental erosion and dental caries were significantly commoner among bulimics than controls. Bulimics commonly had a low salivary flow rate, but other apparent risk factors of dental erosion did not differ from those of controls. A feeling of dry mouth was commoner among bulimics than controls, and bulimics had an increased tooth sensitivity to cold and touch. More should be done to protect teeth from dental erosion among bulimics, because loss of tooth tissue remains even if the eating disorder disappears.

No abstract

Evidence on the relation between the threat of nuclear war and mental health among adolescents is conflicting. We studied 1493 adolescents in the 10th to 12th grades in school, who completed self-administered questionnaires 1-43 days before the Persian Gulf war broke out. Regression analyses controlled for several potential confounders. After this, the frequency of thinking about nuclear war and the frequency of fearing nuclear war were positively related to perceived present state anxiety among both boys and girls. Among boys, both thinking and fearing were positively related to the psychosomatic symptom score. Among girls, estimates on deaths due to nuclear war associated significantly with psychosomatic symptoms. Long-term effects of the threat of nuclear war on mental health of adolescents merit further study.

KARI POIKOLAINEN, RIITTA KANERVA, JOUKO LO 8 NNQVIST Poikolainen K, Kanerva K, Lö nnqvist J. Increasing fear of nuclear war among adolescents before the outbreak of the Persian Gulf War. Nord J Psychiatry 1998;52:197 -202. Oslo. ISSN 0803-9488. After the occupation of Kuwait by Iraq, tension grew in the Persian Gulf area, and war became increasingly likely until it broke out on 16 January 1991. Uncertainty about the magnitude of warfare and the possible use of nuclear, chemical, and biological weapons may have caused fear all over the world. We studied the perceived threat of nuclear war among adolescents between 4-21 December 1990 (n = 1137) and 15 -16 January 1991 (n = 336) in Finland. Increases were found in both the frequency of thinking about and the frequency of fearing nuclear war between December and January among both girls and boys. Both the frequency of fear and its increase were higher among girls than boys. After adjusting for potential confounders in regression analyses, the adolescents studied in January, just before the onset of the Gulf War, feared nuclear war clearly more often and thought about it more often than the group studied in the previous December. Fear of nuclear war was also positively related to time spent reading newspapers, the number of positive life events, and the tendency to adopt neurotic defense styles among both sexes. Among girls, fear was also positively related to trait anxiety. Among boys, higher fear levels were related to lower self-esteem. We conclude that the threat of modern warfare may spread fear among a major part of the adolescents living far from the area of actual conflict.

Immature defence style cluster has earlier been found to be a risk factor for eating disorders but the role of individual defence styles in the aetiology of these disorders has remained unknown. In a case±control design, 57 incident, consecutive female eating disorder patients aged 14±22 years were compared with 337 female control subjects, drawn from the general population and matched for age and hospital catchment area. Eating disorder patients had higher scores of sublimation, undoing, and passive aggression, and lower scores of displacement and splitting than controls. Patients with eating disorder differ signi®cantly from controls in the use of speci®c defence styles.