The purpose of this study was to identify differences in family functioning between subjects with pseudoseizures and their families, and control subjects with epilepsy. Thirty-one adult subjects with pseudoseizures and 31 controls with intractable epilepsy, whose diagnoses were confirmed using video-EEG, were recruited from the epilepsy unit of a tertiary care hospital over a 4-year period. Each study participant and their first-degree adult family members completed two standardized questionnaires designed to measure family functioning: the McMaster Family Assessment Device (FAD) and the Beavers Self-Report Family Inventory (SFI). Individuals with pseudoseizures, when compared with epileptic subjects, exhibited significantly elevated scores in three scales of the FAD and in one scale of the SFI, indicating greater psychopathology within the family, as perceived by the individual. Statistically significant differences with the FAD were on measures of affective involvement (p = .044), communication (p = .004), and general functioning (p = .013). The SFI revealed significantly greater difficulty with conflict (p = .050). No differences were noted between subjects with both pseudoseizures and epilepsy and subjects with pseudoseizures alone. In comparison with the families of the epileptic group, the families of subjects with pseudoseizures displayed statistically significant elevations in their responses on the roles scale (p = .003) of the FAD. The responses of the family members did not differ in regard to the role they assumed within the family unit (i.e., spouse, parent). In summary, individuals with pseudoseizures view their families as being more dysfunctional, particularly in the area of communication, whereas their family members perceived difficulties in defining roles. This suggests that family education and interventions focusing on these areas, may be an important aspect of the treatment of patients with pseudoseizures.

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Suicide is the second leading cause of death in adolescents. The suicide rate in the 15 to 24 year old age group has increased at a faster rate than in any other age group. This study is a descriptive and retrospective investigation of 204 files from the Chief Medical Examiner's office of all youths aged 24 years and less in the province of Manitoba who committed suicide between 1984 and 1988. The study found a high male to female ratio, a large number of younger adolescents and a suicide rate in the Native population which was ten times that of non-Natives. The method of suicide varied by gender and race. Males more often used hanging and guns; females were more likely to overdose. Natives tended to hang themselves more than non-Natives, while non-Natives more often used guns. The highest percentage of Native suicides occurred in urban areas. Depression and substance abuse were identified as risk factors. A number of recommendations regarding information gathering post-suicide, as well as prevention and intervention programs are proposed.

N onattendance at outpatient appointments has been recognized worldwide as a significant clinical and systemic problem (1). Missed appointments are economically costly to mental health systems and personally costly to patients, who experience a greater risk of relapse and readmission to hospital (2).

Patient noncompliance is a major problem in clinical practice. In order to better understand this issue, 236 appointments at an outpatient psychiatry clinic of a large urban general hospital were examined. Five variables significantly discriminated patients who kept their appointments from patients who did not. Patients who were younger, had a history of missed appointments, were scheduled to see a resident physician, had a routine appointment and lived a distance from the hospital, were at greater risk of missing their appointment. This information helps to identify patients at high risk of nonattendance and allows clinicians to plan schedules and appointments more efficiently.

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