This paper describes changing smoking and drinking patterns before and during pregnancy in 313 expectant couples. Fathers were more likely to drink and smoke more heavily than mothers throughout. Before pregnancy in only 42% of couples were both partners safe drinkers and non-smokers. This increased to 50% during pregnancy. Most mothers reduced alcohol consumption during pregnancy and although about half of the fathers also changed their drinking patterns, only about a fifth decreased their consumption. Levels of paternal and maternal drinking in pregnancy were positively associated with pre-pregnancy levels. Rates and levels of both maternal and paternal smoking declined in pregnancy. There was a positive association between partners of both the prevalence and level of drinking and smoking between partners. There was some indication that mothers were more likely to reduce smoking and drinking if their partner joined them in doing so. Risk drinking in couples was more common in those who were older and of higher social status, but smoking was more common among the younger couples of lower social status.

In conclusion, on the basis of the assumptions used in the model, the use of fluvoxamine as maintenance therapy is clinically and economically justified in patients with depressive disorders.

Of 83 women who responded to surveys exploring postabortion coping, 30 women reported anniversary reactions associated with the abortion or due date. Women in the anniversary reaction group more often reported ambivalence about the decision to abort (p < 0.007). This group also acknowledged fewer suicidal thoughts and attempts, but expressed more concern about verbally abusing their children (p < 0.04). Strong trends toward dependency and somatoform disorders were present among anniversary group members (p < 0.06). The authors recommend that physicians be alert to the possibility of hidden anniversary reactions of both physical and emotional nature during patient evaluation.

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Rumination is a relatively rare, potentially fatal syndrome in infants. This article reviews the historical and current treatment of rumination. Two cases are presented: a six-month-old who narrowly escaped surgery when the disorder was not recognized, and a complicated case from the neonatology intensive care unit. Environmental changes and enhanced mothering are described as being critical to correction of rumination and appropriate weight gain.