No abstract

This study examines the relationship between posttraumatic stress disorder (PTSD) and dissociative experiences in a sample of 158 recent female assault victims (74 rape, 84 nonsexual assault) and 46 comparison subjects who had not been assaulted within the last year. Results indicated that victims had elevated scores on Dissociative Experiences Scale (DES) as compared to the comparison subjects, but that this elevation was not as high as for other traumatized samples. The level of dissociation reported by assault victims declined significantly over the three month course of the study. DES scores were related to PTSD diagnosis and symptom severity, but only among nonsexual assault victims. In rape victims, there was no correlation between dissociation and PTSD. Recent victims with a history of childhood sexual abuse were significantly more dissociative than those who did not report such a history. These results are discussed with regard to vulnerability factors for developing PTSD subsequent to a criminal assault.

This study examines the relationship between posttraumatic stress disorder (PTSD) and dissociative experiences in a sample of 158 recent female assault victims (74 rape, 84 nonsexual assault) and 46 comparison subjects who had not been assaulted within the last yeax Results indicated that victims had elevated scores on the Dissociative Experiences Scale (DES) as compared to the comparison subjects, but that this elevation was not as high as for other traumatized samples. The level of dissociation reported by assault victims declined significantly over the three month course of the study. DES scores were related to PTSD diagnosis and symptom severiy, but only among nonsexual assault victims. In rape victims, there was no correlation between dissociation and PTSD. Recent victims with a history of childhood sexual abuse were significantly more dissociative than those who did not report such a history. These results are discussed with regard to vulnerability factors for developing PTSD subsequent to a criminal assault.

There are few studies of assaults against psychiatric residents. The only two domestic studies specifically investigating assaults against residents each surveyed a single residency program. In the present study, 333 psychiatric residents in 11 training programs in Pennsylvania were surveyed about assaults and threats on them during residency. One hundred fifty-five questionnaires (46%) were completed and returned. Of the respondents, 41 % experienced a physical assault and 48% were threatened at some time during their training. Ten percent of the respondents were assaulted more than once, and 30% of the respondents were threatened more than once. There was no significant correlation between rates of threats or assaults and age, sex, or training sites. The majority of threats and assaults occurred in either an inpatient setting (56%) or a psychiatric emergency service (31%). The authors found that residents were provided with minimal training in aggression management during their residency.

lectroconvulsive therapy (ECT) is commonly prescribed for older patients. After acute treatment E with ECT, some patients are continued in maintenance ECT (M-ECT) treatment because of drug refractoriness or inability to tolerate drug side effects. Some M-ECT patients are in partial or full remission from their depressive illness and receive ECT once or twice a month to prevent relapse or recurrence. Most M-ECT'-9 studies have not specifically addressed the issue of efficacy and safety in patients over 75 years of age.We havP previously reported on the efficacy and safety of M-ECT in an older (average age 68 years) population.' Here we present data on the eight patients over the age of 75 from this earlier study who were successfully and safely treated with M-ECT. Four cases are reported in detail. METHODSWe retrospectively reviewed the charts of all patients treated in our outpatient ECT clinic over a 4-year period and identified eight patients who were 75 years or older.Patients were referred by their treating psychiatrists, based on their judgment that pharmacotherapeutic management would fail to prevent relapse or recurrence. All eight patients had responded only to a limited extent to standard treatments (pharmacotherapy and psychotherapy). No antidepressant or antipsychotic medications were administered during the time that the patient was in the maintenance ECT program.Patients were required to present with a responsible relative or caretaker for the purposes of transportation and supervision after the treatment. Informed consent was obtained prior to the initiation of an outpatient treatment. Patients were NPO after midnight on the day of treatment. Our technique for administering ECT is described in detail elsewhere.' All patients were continously monitored by EKG 5 minutes prior to the induction of anesthesia until they were awake after the treatment.The continuation protocol was guided by a schedule of decreasing treatments. The first maintenance treatment was given 1 week after the last acute treatment, the second treatment 2 weeks later, the third treatment 3 weeks later, and then monthly. Treatment frequency was adjusted from this protocol, as necessary, based on the patient's clinical condition. Patients were evaluated at each outpatient visit with the Hamilton Rating Treatment Protocol