House officer stress syndrome

The author describes a stress response syndrome prevalent among physicians in training, the house officer stress syndrome. Episodic cognitive impairment, chronic anger, pervasive cynicism, and family discord occur in nearly all cases, usually in a benign form. Severely affected house officers, however, may also suffer from major depression, suicidal ideation, and substance abuse. Possible contributing stresses include sleep deprivation, excessive work load, patient care responsibility, perpetually changing work conditions, and competition. Approaches to prevention and management of the malignant form of the syn drome include improved work conditions, increased group responsibility, and psychiatric referral.     

Individual differences in alpha rhythm responsivity: Inter-task consistency and relationships to cardiovascular and dispositional variables

Individual differences in EEG alpha rhythm responsivity were examined with respect to: (1) consistency of response across cognitive tasks; (2) relationships to cardiovascular responsivity; and (3) relationships to dispositional variables. Inter-task correlations revealed a significant degree of stability in subjects' alpha responses to four ‘sensory rejection’ tasks: mental arithmetic, time estimation and imagining oneself as cold or warm. Individuals evidencing greater suppression of alpha activity during mental arithmetic also displayed greater heart rate increase and greater digital vasoconstriction, as well as obtaining higher scores on the Activity subscale of the EASI-III Temperament Survey and on the ‘Hard Striving’ subscale of the Jenkins Activity Survey for Health Prediction, a measure of the Coronary-Prone Behavior Pattern. Alpha responsivity in the time estimation and warm imagery tasks was also associated with greater heart rate increase. The results suggest that alpha responsivity is related to individual differences affecting one's attentiveness or involvement in experimental tasks.     

Psychological reactions to sterilization procedures

The authors address the complex psychiatric problems relating to the termination of fertility—either voluntary or involuntary. Although adverse reactions are relatively rare, it is important for the medical team to be aware of the normal and abnormal reactions to sterilization procedures and to provide prompt and adequate intervention. To illustrate the diversity of problems encountered by the liaison psychiatrist working in this area, six cases are presented and discussed.     

Increased exercise level and plasma lipoprotein concentrations: A one-year,randomized, controlled study in sedentary,middle-aged men

Eighty-one sedentary but healthy men aged 30–55 participated in a 1 yr randomized study of the effects of exercise on plasma lipoprotein concentrations. Forty-eight were assigned to a running program, while 33 remained as sedentary controls (an approximately 3:2 ratio). After 1 yr the running group had become significantly fitter and leaner than the control group. Lipoprotein concentration changes in the runners (vs. controls) uniformly favored reduced risk of coronary heart disease, but were not significant when all 46 participants with complete data were included. However, the 25 men who averaged at least eight miles (12.9 kilometers) per wk of running increased their plasma high-density-lipoprotein (HDL) cholesterol level by 4.4 mg/dl (p = 0.045) and their HDL₂ mass level by 33 mg/dl (p = 0.059), vs. controls. Significant correlations were found for distance run per wk vs. change in plasma HDL-cholesterol (r = 0.48), HDL₂ (r = 0.41), and low-density-lipoprotein cholesterol (r = ?0.31). Changes in percent body fat and in HDL-cholesterol were correlated (r = ?0.47) in runners. There appears to be a threshold at about 8 miles per wk above which a 1-yr running program leads to beneficial lipoprotein changes.