Current treatment approaches to obsessive-compulsive disorder.

The two most useful treatments in obsessive-compulsive disorder are pharmacotherapy with potent serotonin reuptake-blocking agents and behavioral techniques, such as exposure and response prevention. Based on the authors' cumulative clinical experience, it is suggested that patient education, cognitive therapy, and psychodynamic psychotherapy are helpful adjuncts during various treatment stages of obsessive-compulsive disorder. The patient's strengths and knowledge of the illness can be used by the nurse-therapist to determine the implementation and timing of these therapeutic measures. Specific behavioral and cognitive techniques that may be useful in treating specific symptoms of obsessive-compulsive disorder are highlighted. Suggestions for future nursing research are outlined.     

Emory University Project on Children of Disturbed Parents

Young children (from birth to 5 years of age) of schizophrenic, depressed, and well mothers were studied to assess their intellectual, social, and neuropsychiatric functioning. The sample derived from predominantly black, low-income, single-parent families. An extensive battery of laboratory and home-based tests was administered three times, each 1 year apart, to test the stability of findings. Schizophrenic offspring, as a group, had more problems than others. They showed more deficits on social competence, had lower IQ's (the youngest children only), and were overrepresented in the group of children with multiple negative indices. However, both schizophrenic offspring and depressive offspring sometimes performed more poorly than children with well mothers (presence of symptoms of psychiatric disorder and certain categories of social behavior). In certain instances, the children of depressed mothers were worse off than either other group (small for age and showing less social competence at home). Deficits were found in the child-rearing environment provided by the disturbed mothers. Both schizophrenic and depressed mothers were rated as less affectively involved and less responsive than well mothers. Schizophrenic mothers were rated as providing the poorest overall environment: less play stimulation, fewer learning experiences, and less emotional and verbal involvement. The following possible protective factors were identified in the mothers: lesser severity of illness, older age, higher education, higher IQ, work experience, and presence of spouse, boyfriend, or other relative to help in child care.     

Genes in idiopathic calcium oxalate stone disease

An examination of the urinary excretions of 101 normal subjects indicated that the major genetic influence on calcium excretion is a codominant pair of alleles giving rise to three phenotypes, low, intermediate and high (hypercalciuric) excretors. This inference was based on variance, Hardy-Weinberg and segregation analyses. Similar independent gene pairs also appear to influence oxalate and citrate excretion, A 3-locus Hardy-einberg table using estimates of gene frequencies derived from the study of normals suggests that only 3 or 4 leading genes are involved in oxalate stone disease. Strong candidate genes identified from molecular and physiological studies cannot be proposed at present, but it is assumed that they influence the transport of these ions in either the intestine, kidney or both organs. The identification of the genes involved should be facilitated by the reduction of dietary influences on urinary excretions through the use of formula diets.