(Wender PH Kalm M Prevalence of attention deficit disorder, residual type, and other psychiatric disorders in patients with irritable colon syndrome. AM J PSYCHIATRY 1983 Dec; 140(12):1579-82 On the basis of the observations that chronic nonspecific diarrhea is a precursor of irritable colon syndrome and that chronic nonspecific diarrhea is associated with attention deficit disorder in childhood, the authors conducted a psychiatric diagnostic evaluation of 22 adults with irritable colon syndrome. Six (27%) of the patients received a diagnosis of attention deficit disorder, residual type, six (27%) were diagnosed as having dysthymic disorder, and five (23%) had had episodes of unipolar depression. The relationship between the presence of these disorders and greater severity of irritable colon syndrome was statistically significant. (Heiman EM Use of stimulants for alcoholic patients with attention deficit disorder [letter] AM J PSYCHIATRY 1983 Sep; 140(9):1272 Wood D Wender PH Reimherr FW The prevalence of attention deficit disorder, residual type, or minimal brain dysfunction, in a population of male alcoholic patients. AM J PSYCHIATRY 1983 Jan; 140(1):95-8 The authors assessed the prevalence of attention deficit disorder, residual type, in a population of young adult male alcoholic patients in two residential alcohol treatment programs. They found the prevalence of the disorder in this sample to be 33% and hypothesize that attention deficit disorder in childhood (and adulthood) may be associated with an increased risk for the development of alcoholism. If substantiated, this finding could be of theoretical and therapeutic importance. Reimherr FW Wood DR Wender PH An open clinical trial of L-dopa and carbidopa in adults with minimal brain dysfunction. AM J PSYCHIATRY 1980 Jan; 137(1):73-5 MBD has long been considered a childhood disorders. Recent research suggests that in some it persists into adult life and that at least one form is a consequence of reduced activity of dopaminergic systems in the brain. To test this hypothesis, three adults with "presumptive" MBD were given L-dopa plus carbidopa. Although overall this combination was less effective than stimulant medication, all the patients showed an initial response, and in one patient L-dopa seemed to potentiate the effect of methylphenidate. The authors point out that various dopamine agonists have different effects and that the possible potentiation effect is consistent with a dopaminergic hypothesis. Richmond JS Young JR Groves JE Violent dyscontrol responsive to d-amphetamine. AM J PSYCHIATRY 1978 Mar; 135(3):365-6 Huey LY Zetin M Janowsky DS Judd LL Adult minimal brain dysfunction and schizophrenia: a case report. AM J PSYCHIATRY 1978 Dec; 135(12):1563-5 Rybak WS More adult brain dysfunction [letter]. AM J PSYCHIATRY 1977 Jan; 134(1):96-7 Mann HB Greenspan SI The identification and treatment of adult brain dysfunction. AM J PSYCHIATRY 1976 Sep; 133(9):1013-7 The authors hypothesize that adults who have had minimal brain dysfunction as children constitute a distinct diagnostic entity, adult brain dysfunction (ABD), which may exist alone or with a variety of other psychiatric syndromes. Patients with ABD share a basic impairment in ability to focus attention effectively; they may have different personality structures, symptom complexes, and behavioral patterns. However, with medication that corrects this impairment, remarkable improvement in the presenting symptoms and in the ability to work in therapy may occur, leading to changes in personality structure and behavior. Handford HA Brain hypoxia, minimal brain dysfunction, and schizophrenia. AM J PSYCHIATRY 1975 Feb; 132(2):192-4 The author hypothesizes that individuals who suffer brain hypoxia prenatally, perinatally, or immediately postnatally constitute a population at risk for minimal brain dysfunction and for schizophrenia in adulthood. This hypothesis has implications for early intervention with children who have MBD and their families and for multidisciplinary management of these cases throughout childhood. Mattes JA Dysthymia and attention deficit disorder in adults [letter] AM J PSYCHIATRY 1986 Jan; 143(1):114-5 Wender PH Reimherr FW Wood D Ward M A controlled study of methylphenidate in the treatment of attention deficit disorder, residual type, in adults. AM J PSYCHIATRY 1985 May; 142(5):547-52 Thirty-seven adult patients meeting the Utah criteria for attention deficit disorder, residual type, were entered into a double-blind crossover trial of methylphenidate and placebo. A moderate-to-marked therapeutic response occurred in 21 (57%) of the patients while receiving methylphenidate and in four (11%) while receiving placebo, a highly significant difference statistically and clinically. The responding patients showed significant improvement in the following areas: attentional difficulty, motor overactivity, affective lability, and impulsivity. The diagnosis of attention deficit disorder, residual type, should be considered in patients with prominent complaints of impulsivity, restlessness, emotional lability, and hot temper who do not suffer from schizophrenia or major mood disorder and do not have symptoms of schizotypal or borderline personality disorders. *****ARCHIVES OF GENERAL PSYCHIATRY***** Mattes JA Boswell L Oliver H Methylphenidate effects on symptoms of attention deficit disorder in adults. ARCH GEN PSYCHIATRY 1984 Nov; 41(11):1059-63 The objectives of this study were (1) to determine whether attention deficit disorder (ADD) is a specific diagnostic entity in adulthood; (2) to evaluate, using a double-blind crossover design, the efficacy of methylphenidate hydrochloride in adults with evidence of residual ADD with hyperactivity (ADD-H) (N = 26); and (3) to evaluate the specificity of drug response by also administering methylphenidate to patients with similar adult symptoms but no childhood history of ADD- H (N = 35). Results indicated success in differentiating relatively distinct groups. However, no overall benefit from methylphenidate was evident, regardless of childhood history of ADD-H. Approximately 25% of the sample appeared clinically to benefit from methylphenidate, but no clear-cut predictors of drug response were identified; history of drug abuse (polydrug) appeared to be the best predictor. Even among the responders, benefit was generally not as marked nor as clinically valuable as in childhood ADD-H. Horton AM Jr Fiscella RA Diagnosis of attention-deficit disorder-residual type [letter] ARCH GEN PSYCHIATRY 1986 Feb; 43(2):192 Gittelman R Mannuzza S Shenker R Bonagura N Hyperactive boys almost grown up. I. Psychiatric status. ARCH GEN PSYCHIATRY 1985 Oct; 42(10):937-47 We report a prospective longitudinal study of 101 male adolescents (ages 16 to 23 years) who had been diagnosed hyperactive in childhood (ages 6 to 12 years), compared with 100 normal controls. The DSM-III diagnoses were made blind to group membership. Information was obtained for 98% of the original cohort. The full attention deficit disorder with hyperactivity (ADDH) syndrome persisted in 31% of the probands vs in 3% of the controls. The only other two conditions that distinguished the groups significantly were conduct and substance use disorders. These disorders aggregated significantly among the probands with continued ADDH. The results indicate that the greatest risk factor for the development of antisocial behavior and drug abuse is the maintenance of ADDH symptoms. Substance use disorders followed the onset of conduct disorder in the overwhelming majority of the cases. Cantwell DP Hyperactive children have grown up. What have we learned about what happens to them? ARCH GEN PSYCHIATRY 1985 Oct; 42(10):1026-8 Wender PH Reimherr FW Wood DR Stimulant therapy of 'adult hyperactivity' [letter] ARCH GEN PSYCHIATRY 1985 Aug; 42(8):840 Knuckey NW Gubbay SS Clumsy children: a prognostic study. AUST PAEDIATR J 1983 Mar; 19(1):9-13 Twenty-four clumsy children of whom 13 had matched controls were reappraised eight years after their original assessment. The findings indicate that developmental clumsiness generally has a favourable prognosis. Mild and moderate degrees of clumsiness improved to normality, but severe degrees of clumsiness had a less favourable outcome only in regard to motor proficiencies. Clumsiness seemed not to have bearing, either on social class or on the subsequent pursuit of sporting activities. Although there was a lower level of academic achievement in the clumsy children, who also chose careers which were less manually exacting, these observations did not reach statistical significance. Maturational lag might be the aetiology in mild developmental clumsiness, whereas structural lesions involving the cerebral cortex may be present in more severely afflicted children. These findings should be considered when counseling clumsy children, both academically and vocationally. Weiss G Hechtman L Milroy T Perlman T Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. J AM ACAD CHILD PSYCHIATRY 1985 Mar; 24(2):211-20 *****JOURNAL OF CLINICAL PSYCHIATRY***** Hooberman D Stern TA Treatment of attention deficit and borderline personality disorders with psychostimulants: case report. J CLIN PSYCHIATRY 1984 Oct; 45(10):441-2 A case is reported of a young woman with attention deficit disorder and concomitant borderline personality disorder who was successfully treated with methylphenidate. The overlapping criteria for these disorders are discussed and recommendations for treatment with psychostimulants are suggested. Manshadi M Lippmann S ODaniel RG Blackman A Alcohol abuse and attention deficit disorder. J CLIN PSYCHIATRY 1983 Oct; 44(10):379-80 The prevalence of alcohol abuse among the fathers, and ADD in family members, of 22 adult psychiatric patients with persistent attention deficit disorder was found to be significantly higher than in 20 matched controls. Further research is necessary to determine the reasons for, and clinical implications of, these associations. Plotkin D Halaris A DeMet EM Biological studies in adult attention deficit disorder: case report. J CLIN PSYCHIATRY 1982 Dec; 43(12):501-2 The authors describe the case of a patient diagnosed as suffering from attention deficit disorder, adult type. The case is noteworthy because of its presentation as manic disorder and the accompanying neurologic deficits. Biochemical and behavioral observations suggested an abnormality in noradrenergic transmission. Gomez RL Janowsky D Zetin M Huey L Clopton PL Adult psychiatric diagnosis and symptoms compatible with the hyperactive child syndrome: a retrospective study. J CLIN PSYCHIATRY 1981 Oct; 42(10):389-94 Characteristics of the hyperactive child syndrome have been described extensively. More recently, reports have indicated that manifestation of the hyperactive child syndrome may persist into adulthood, both as a continuation of childhood symptoms and as psychopathologic entities. This study evaluated 100 adult psychiatric inpatient Veterans for self-report of symptoms of childhood and adulthood hyperactivity, attentional deficit, and impulsivity. Psychotic and non-psychotic psychiatric patients reported a significantly higher incidence of childhood hyperactive syndrome symptoms than did age and sex matched controls. In both childhood and adulthood, character disorder patients reported the highest incidence of target symptoms. Milman DH Minimal brain dysfunction in childhood: outcome in late adolescence and early adult years. J CLIN PSYCHIATRY 1979 Sep; 40(9):371-80 Seventy-three patients, diagnosed in childhood as having minimal brain dysfunction syndrome and further classified as either developmental lag (38%) or organic brain syndrome (62%), were followed into late adolescence and early adult life. At follow-up 7% were free of psychiatric disorder, 80% had various types of personality disorder, and 14% were borderline psychotic. Global outcome was rated as satisfactory in 20%, unsatisfactory in 80%. Associated with an unsatisfactory outcome were these initial findings: low normal or borderline intelligence, multiplicity of behavioral and neuropsychological findings, learning disabilities, special class placement, and initial classification of organic brain syndrome. Initial differentiation between developmental lag and organic brain syndrome foreshadowed different psychopathological features having significant polarities and little overlap, as well as different global outcome. Elliott FA Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome. J NERV MENT DIS 1982 Nov; 170(11):680-7 This paper reports the neurological findings in 286 patients with a history of recurrent attacks of uncontrollable rage occurring with little or no provocation and dating from early childhood or from a physical brain insult at a later date. Objective evidence of developmental or acquired brain defects was found in 94 per cent. The most common abnormality was minimal brain dysfunction, which was present in 41 per cent. The diagnosis was not made on behavioral symptoms alone; there had to be positive neurological and/or laboratory evidence (electroencephalogram, computerized axial tomography scan, x-rays, psychological tests). The most common symptom apart form episodic dyscontrol was complex partial seizures which had occurred at some time in the life of 30 per cent of the patients. In many the seizures had not been recognized as epileptic because of their subtle form and rare occurrence. Convulsions and dramatic attacks with unconsciousness were rare. One third of the patients presented a variety of psychiatric disorders persisting for days, weeks, or months in addition to episodic rage. Another type of periodicity was exhibited by women whose episodes occurred solely or mainly in the premenstrual week. Detection of both adult minimal brain dysfunction and complex partial seizures requires detailed and well informed interrogation because many of the symptoms are far from obvious and are unlikely to be uncovered by a superficial medical history or neurological examination. Andrulonis PA Glueck BC Stroebel CF Vogel NG Borderline personality subcategories. J NERV MENT DIS 1982 Nov; 170(11):670-9 A careful study of 106 patients, diagnosed as borderline using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, is in progress at a private psychiatric facility. Three distinct subcategories of the borderline personality disorder have been identified: history of no organicity, history of trauma, encephalitis, or epilepsy, and history of attentional deficit disorder/learning disabilities. A discriminant function analysis approach clearly distinguishes the three borderline subcategories from one another and from a schizophrenic control group. Borderline patients also show significant sex differences. The borderline personality disorder is viewed as either on a continuum with affective disorders and atypical psychoses, or with organic brain dysfunction including the episodic dyscontrol syndrome and/or adult minimal brain dysfunction. Future research should be directed toward further classifying homogeneous subgroups of borderline patients in order to provide more specific and effective treatment. Eyre SL Rounsaville BJ Kleber HD History of childhood hyperactivity in a clinic population of opiate addicts. J NERV MENT DIS 1982 Sep; 170(9):522-9 Although childhood hyperactivity has been shown to be related to a variety of adult psychiatric disorders, no previous study has specifically explored its relation to adult opiate addiction. In this study, 22 per cent of a population of 157 opiate addicts seeking treatment reported childhood histories of hyperactivity. Demographic and developmental features such as high male to female sex ratio, normal intelligence quotient but lower level of educational and occupational achievement, and earlier arrest record supported the retrospective diagnosis. In addition, the subgroup with a history of childhood hyperactivity differed in symptom and personality measures from those without such a history in a way suggesting that those with a history of hyperactivity in childhood were manifesting adult sequelae of the disorder. Alterman AI McLellan AT A factor-analytic study of Tarter's "hyperactivity-MBD" questionnaire. ADDICT BEHAV 1986; 11(3):287-94 A number of studies have suggested a relationship between childhood hyperactivity and subsequent alcohol abuse. Research with alcoholics has utilized retrospective, self-report questionnaires to examine the relationship between childhood hyperactivity and alcoholism. Since it is now recognized that "hyperactivity" has been rather loosely and broadly defined, it would seem reasonable to determine the independent behavioral dimensions subsumed within it. The present study factor analyzed the data of 145 alcoholic inpatients on Tarter's 'hyperactivity/MBD' questionnaire. Four factors which included 26 of Tarter's original 50 items were derived--hyperactivity- impulsivity, attentional-socialization problems, antisocial behavior, and learning disability. These factors and the items contained therein were compared with four scales developed on a rational basis by the Hesselbrocks. Additionally, the factor scores of the subjects were cluster analyzed yielding six interpretable clusters. A number of these, such as hyperactivity-impulsivity alone, hyperactivity- impulsivity combined with attentional-socialization problems, and hyperactivity-impulsivity combined with antisocial behavior, are of considerable theoretical interest. Accordingly, further requirements for establishing the validity of the factor analyzed scales and the cluster analysis-based responder groupings were delineated. *****ADOLESCENCE***** Crabtree LH Jr Cram BH Gever B Horowitz H Minimal brain dysfunction in adolescent and young adult psychiatric inpatients. ADOLESCENCE 1983 Spring; 18(69):211-23 This paper presents data on a study of 100 consecutive young adult psychiatric admissions to Horsham Hospital, to determine the incidence of minimal brain dysfunction in this population, to define the subcategories of common psychiatric presentation, and to compare these data with those from the companion study conducted by our research group of fifty consecutive adolescent psychiatric admissions, reported by Horowitz, 1981. *****AMERICAN JOURNAL OF ORTHOPSYCHIATRY***** Hechtman L Weiss G Perlman T Hyperactives as young adults: past and current substance abuse and antisocial behavior. AM J ORTHOPSYCHIATRY 1984 Jul; 54(3):415-25 In a ten-year prospective follow-up study, young adults who had been diagnosed as hyperactive in childhood were found to have had greater involvement with alcohol and drug use and with courts and police than did matched controls during the five years preceding evaluation. However, differences between groups were generally not significant in the year prior to evaluation, and tests indicate that they had attained similar levels of moral development. Results suggest a more encouraging adult outcome than has previously been expected for hyperactive children. Hechtman L Weiss G Long-term outcome of hyperactive children. AM J ORTHOPSYCHIATRY 1983 Jul; 53(3):532-41 A review of outcome studies of hyperactive children suggests that they experience significant academic, social, and conduct difficulties during adolescence, and that social, emotional, and impulse problems persist into young adulthood for the majority. While some hyperactive children were found to be functioning normally as adults, a troublesome minority were experiencing severe psychiatric or antisocial problems. Kupfer DJ Detre TP Koral J Relationship of certain childhood 'traits' to adult psychiatric disorders. AM J ORTHOPSYCHIATRY 1975 Jan; 45(1):74-80 An investigation of 174 adult psychiatric outpatients reporting on nine different difficulties they may have experienced as children suggests certain links between childhood difficulties and lifelong personality traits, as well as adult psychiatric symptomatology. Findings suggest that the childhood traits related to schizophrenia might be manifestations of minimal organic brain dysfunctioning. *****AMERICAN JOURNAL OF PSYCHOTHERAPY***** Bellak L A possible subgroup of the schizophrenic syndrome and implications for treatment. AM J PSYCHOTHER 1976 Apr; 30(2):194-205 Supported by extensive clinical data of three generations, the hypothesis is advanced that Minimal Brain Dysfunction is the major etiologic and pathogenic factor for one subgroup of adult schizophrenics. Genetic factors apparently play the main but not exclusive role. Pathogenic as well as diagnostic, therapeutic, prognostic, and preventive aspects are discussed. *****ANALES DE LA REAL ACADEMIA NACIONAL DE MEDICINA***** Tellenbach H [Failing fathers: a condition for hebephrenia] AN R ACAD NAC MED (MADR) 1981; 98(3):472-84 (Published in SPANISH) *****ANNALES MEDICO-PSYCHOLOGIQUES***** Crepin J Guerard A Menguy JM [On the treatment of a case of hebephrenia. Initial argument for an experimental institutional psychiatry] ANN MED PSYCHOL (PARIS) 1967 Mar; 125(3):451-3 (Published in FRENCH) *****AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY***** Cawte J Psychiatric sequelae of manganese exposure in the adult, foetal and neonatal nervous systems. AUST NZ J PSYCHIATRY 1985 Sep; 19(3):211-7 It is important for psychiatrists to recognise that vulnerability to the trace element manganese is different in the adult, foetal and neonatal nervous systems, and that different syndromes may result from exposure. *****BIOCHEMICAL JOURNAL***** Stern J Cowie V Iherited abnormalities affecting the nervous system: genetic and psychiatric aspects. BIOCHEM J 1969 Feb; 111(3):9P-10P *****BIOLOGICAL PSYCHIATRY***** Rudin DO The choroid plexus and system disease in mental illness. I. A new brain attack mechanism via the second blood--brain barrier. BIOL PSYCHIATRY 1980 Aug; 15(4):517-39 Schizophrenia and certain idiopathic neuroses and retardations may be caused by polygenic sensitization to exogeneous peptide antigens or viruses causing a covert immune complex basal lamina disease of the choroid plexus. This organ has the general structure and disease susceptibility of many other transport organs but acts as a second blood--brain barrier putting at risk to contamination and dysfunction the periventricular primary personality (limbic) brain now thought to be centrally involved in schizophrenia. Genetic variability selects different antigens and different target organs so that a complex statistical structure of disease expression can result over the transport organ group as well as between this group and the endocrines and exocrines. This leads to the concept of intra- and intercombined system diseases all of which may have a covert biphasic (hyper-hypo) time course. To this extrinsic combinatorial complexity may be added an intrinsic or neural combinatorial complexity resulting from the fact that the choroid plexus is threaded throughout the limbic system and subject to spotty disease characteristic of many immunopathies. In this way a wide range of behavioral disorders may arise as well as mental retardations if the process occurs during development. In this paper we discuss basic mechanisms. In the next paper of the series we examine systemic lupus erythematosus, the prototypical "combined transport dysfunction," as a model for schizophrenia. In the last paper we search for specific exogeneous peptide triggers for schizophrenia viewed as one expression of combined transport organ dysfunction. We conclude that immunofluorescent and virological surveys should be conducted in all mental illnesses as well as clinical trials of interferon therapy and elemental diets. *****CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE***** Gauthier M Stimulant medications in adults with attention deficit disorder. CAN J PSYCHIATRY 1984 Aug; 29(5):435-40 The long-term prospective studies done in the last two decades on children suffering from attention deficit disorder with hyperactivity (ADD-H) give evidence of persistent disability in a majority of them when they reach adulthood. The literature on the use of stimulant medication in adults suffering from attention deficit disorder, residual type (ADD-R), is critically reviewed. After optimistic case reports two controlled double-blind studies have recently showed contradictory results. Some adults appear clearly to be helped by stimulant medication, but more investigations, especially with children diagnosed in childhood and followed-up, are needed before any firm conclusion can be made about the usefulness or non- usefulness of stimulants in ADD-R. There, as it is the case in childhood, medication might be insufficient by itself and might have to be associated with other forms of treatment. Hechtman L Weiss G Perlman T Hyperactives as young adults: self-esteem and social skills. CAN J PSYCHIATRY 1980 Oct; 25(6):478-83 Eighteen pairs of young adult hyperactives and controls, matched for age, sex, IQ and socioeconomic class and education completed, were assessed on tests of social skills and self-esteem. Hyperactive subjects had significantly more difficulty than matched controls in social skills tests which involved direct oral responses than those involving written responses. This would suggest that the hyperactive young adults cognitively know what the most appropriate response would be from a number of possibilities, but have problems spontaneously producing such a response. Situations dealing with heterosocial and assertion situations were more difficult for hyperactives than job interview situations. Hyperactive young adults also scored significantly worse than matched controls on a number of self-esteem tests, thus supporting the findings of previous psychiatric assessments and the California Psychological Inventory. Finally, no significant correlations were found between the self- esteem and social skills tests. Possible explanations for the findings are discussed. *****CANADIAN PSYCHIATRIC ASSOCIATION JOURNAL***** Packer S Treatment of minimal brain dysfunction in a young adult. CAN PSYCHIATR ASSOC J 1978 Nov; 23(7):501-2 A discussion of the clinical picture and treatment of minimal brain dysfunction in post adolescence is presented. Small amounts of methylphenidate appear to have a salutary effect on symptoms such as irritability, moodiness, restlessness and poor concentration . *****CLINICAL NEUROPHARMACOLOGY***** Saul RC Nortriptyline in attention deficit disorder [letter] CLIN NEUROPHARMACOL 1985; 8(4):382-3 Gualtieri CT Ondrusek MG Finley C Attention deficit disorders in adults. CLIN NEUROPHARMACOL 1985; 8(4):343-56 Twenty-two adults who met DSM-III criteria for "Attention Deficit Disorder, Residual Type" (ADD-RT) were evaluated in a series of clinical experiments. Although certain personality and psychological factors typified the ADD-RT group, methylphenidate blood levels, the growth hormone response to methylphenidate, and the brainstem evoked response did not distinguish subjects from matched controls. Male subjects seemed to be a more homogeneous group than female subjects. Socioeconomic status and IQ, but not severity of ADD symptoms, were found to predict outcome. ADD adults seem to be numerous and easy to identify, at least on the basis of symptoms. However, the validity of ADD-RT as a "distinct clinical entity" is open to question. *****COMPREHENSIVE PSYCHIATRY***** Amado H Lustman PJ Attention deficit disorders persisting in adulthood: a review. COMPR PSYCHIATRY 1982 Jul-Aug; 23(4):300-14 De Obaldia R Parsons OA Yohman R Minimal brain dysfunction symptoms claimed by primary and secondary alcoholics: relation to cognitive functioning. INT J NEUROSCI 1983 Sep; 20(3-4):173-81 A group of chronic alcoholics were classified as Primary or Secondary alcoholics according to a self-administering questionnaire. Primary, compared to Secondary, alcoholics claimed a significantly higher number of childhood symptoms associated with the Hyperkinetic and/or the Minimal Brain Dysfunction (Hk/MBD) Syndromes. Primary alcoholics also performed significantly poorer on the Shipley and Raven tests than Secondary alcoholics and had more severe alcoholic dependence scores. High Hk/MBD patients performed more poorly than Low Hk/MBD patients on the Shipley and Raven tests. The results support the hypothesis that a childhood history of Hk/MBD might be a predisposing factor to a more severe type of alcoholism. The results also suggest that certain alcoholics may have premorbid deficits in cognitive functions. Yellin AM Hopwood JH Greenberg LM Adults and adolescents with attention deficit disorder: clinical and behavioral responses to psychostimulants. J CLIN PSYCHOPHARMACOL 1982 Apr; 2(2):133-6 Mattes JA Propranolol for adults with temper outbursts and residual attention deficit disorder. J CLIN PSYCHOPHARMACOL 1986 Oct; 6(5):299-302 Thirteen adults with temper outbursts and residual attention deficit disorder (ADD) were given propranolol to 640 mg/day in an open study. Eleven of the patients improved, with improvement in temper and other symptoms of ADD, indicating a need for controlled studies. This suggests a novel pharmacological approach to residual ADD. Elliott FA The episodic dyscontrol syndrome and aggression. NEUROL CLIN 1984 Feb; 2(1):113-25 This article concerns the syndrome of episodic dyscontrol, not psychopathic behavior. It is discussed as a symptom of many disorders, both psychologic and physical; organic causes and correlates, pathophysiology, and pharmacologic treatment are given. Horton AM Jr Decker EB Neuropsychological assessment of an adult's minimal brain dysfunction: a case study. PERCEPT MOT SKILLS 1981 Apr; 52(2):676-8 A 38-yr.-old married man complained of difficulties in remembering and concentration. Related were difficulties in orienting himself in space, planning and completing visual-spatial tasks, and participating in complex perceptual-motor activities. Neurological and traditional psychological examinations indicated no organic deficits. Neuropsychological evaluation produced evidence suggestive of subtle cerebral dysfunction. Limitations of traditional assessment strategies to identify the clinical manifestations of adults' minimal brain dysfunction are briefly discussed. *****PSYCHIATRIC CLINICS OF NORTH AMERICA***** Andrulonis PA Glueck BC Stroebel CF Vogel NG Shapiro AL Aldridge DM Organic brain dysfunction and the borderline syndrome. PSYCHIATR CLIN NORTH AM 1981 Apr; 4(1):47-66 *****PSYCHIATRY RESEARCH***** Reimherr FW Wender PH Ebert MH Wood DR Cerebrospinal fluid homovanillic acid and 5-hydroxy-indoleacetic acid in adults with attention deficit disorder, residual type. PSYCHIATRY RES 1984 Jan; 11(1):71-8 Following the hypothesis that attention deficit disorder in adults (attention deficit disorder, residual type; ADD, RT), as well as in children, is associated with decreased central dopaminergic activity, the authors measured lumbar cerebrospinal fluid monoamine metabolites in a group of adults with ADD, RT and matched control subjects. Patients were then entered into a double-blind, placebo-controlled trial of methylphenidate. It was predicted that the patients would have lower levels of homovanillic acid (HVA), the major dopamine metabolite in humans. Patients who had a significant response to methylphenidate showed a trend in this direction. Nonresponding patients had significantly higher levels of HVA than controls. Wender PH Wood D Reimherr F Studies in attention deficit disorder, residual type (minimal brain dysfunction in adults). PSYCHOPHARMACOL BULL 1984 Winter; 20(1):18-20 Hechtman L Weiss G Perlman T Hyperactives as young adults: past and current antisocial behavior (stealing, drug abuse) and moral development [proceedings] PSYCHOPHARMACOL BULL 1981 Jan; 17(1):107-10 Gittelman R Mannuzza S Diagnosing ADD-H in adolescents. PSYCHOPHARMACOL BULL 1985; 21(2):237-42 Wender PH Wood DR Reimherr FW Pharmacological treatment of attention deficit disorder, residual type (ADD,RT, "minimal brain dysfunction," "hyperactivity") in adults. PSYCHOPHARMACOL BULL 1985; 21(2):222-31 Varley CK A review of studies of drug treatment efficacy for attention deficit disorder with hyperactivity in adolescents. PSYCHOPHARMACOL BULL 1985; 21(2):216-21 * Weiss G Followup studies on outcome of hyperactive children. PSYCHOPHARMACOL BULL 1985; 21(2):169-77 Wood DR Reimherr FW Wender PH Amino acid precursors for the treatment of attention deficit disorder, residual type. PSYCHOPHARMACOL BULL 1985; 21(1):146-9 Bellak L Charles E Schizophrenic syndrome related to minimal brain dysfunction: a possible neurologic subgroup. SCHIZOPHR BULL 1979; 5(3):480-9 *****SUBSTANCE AND ALCOHOL ACTIONS/MISUSE***** Goodwin DW Familial alcoholism: a separate entity? SUBST ALCOHOL ACTIONS MISUSE 1983; 4(2-3):129-36 Numerous studies indicate that alcoholism runs strongly in families. Recent evidence from twin and adoption studies suggest the illness may have a genetic component. These studies have stimulated two lines of research which are actively being conducted in several centers. One type of research involves comparing alcoholics with a positive family history of alcoholism with alcoholics who lack such a history. The second line of research involves comparing college-age sons of alcoholics with sons of nonalcoholics before members of either group have had an extensive drinking history. Studies consistently show that "familial" alcoholics differ from "nonfamilial" alcoholics in having (a) an earlier age of onset and (b) symptoms of greater severity. Familial alcoholism has also been associated with a childhood history of hyperactivity and conduct disorder and an adult history of antisocial behavior. In one study, familial alcoholics more often showed signs of structural and functional brain abnormalities than did nonfamilial alcoholics. Sons of alcoholics versus controls have been reported to have higher blood acetaldehyde levels after drinking alcohol and also demonstrate more subjective and motor tolerance for alcohol. Sons of alcoholics also generate more alpha activity on the EEG after alcohol and make lower scores on the categories test of the Halstead Battery. About half of hospitalized alcoholics have a family history of alcoholism. Studies indicate that the family-history-positive and family-history-negative alcoholics differ on a number of variables. Twin, adoption and high- risk studies add further evidence that "familial alcoholism" is a separate diagnostic entity.