Electrocardiographic and echocardiographic abnormalities are common in long-term cocaine abusers. Despite the frequent occurrence of left ventricular hypertrophy, Doppler-derived diastolic filling pattern was not altered. Concomitant alcohol use did not affect the prevalence of these abnormalities.

This study evaluated the hypothesis that homeless individuals would display higher levels of neurological deficits than non-homeless individuals, particularly in frontal lobe or executive functions. Eighteen acutely homeless, 15 chronically homeless, and 20 non-homeless individuals admitted to an inpatient psychiatric service received a battery of neurological and psychosocial measures. In comparison to non-homeless subjects with comparable levels of psychopathology, homeless individuals showed higher levels of hostility, prior criminal activity, and family history of psychiatric illness, but lower levels of depression. A positive relationship between hostility and neurological soft signs was observed among chronically homeless subjects. These results suggest that a substantial subset of nonpsychotic homeless veterans suffers from "occult" neurological deficits.

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The vicissitudes of medical treatment are affected in large part by patient compliance. Noncompliance can be caused by a variety of psychological, somatic, and socioeconomic factors. Overcompliance would seem on the surface to be less of a problem, but it too can have serious consequences in terms of treatment success. Several psychological factors account for overcompliance. The physician's best defenses against both noncompliance and overcompliance are to listen carefully to the patient for clues to one of these impending behaviors and to establish good rapport with the patient. An individualized approach is important, and in some cases participation in organized self-help groups is of benefit.