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The sport of competitive bodybuilding requires an intense regimen of weightlifting and dieting, often aided with muscle-building or fat-burning drugs, and culminating in an on-stage posing competition. Despite these rigorous demands, competitive bodybuilding is popular, with thousands of competitions performed annually around the world. Although many studies have addressed the psychological features of various sports and the athletes who compete in them, few have examined the psychological aspects of bodybuilding. Even fewer studies have specifically examined competitive bodybuilders, as opposed to the much larger group of "recreational" bodybuilders who do not compete. The limited available literature suggests that competitive bodybuilders may show an increased risk for four categories of psychopathology: muscle dysmorphia, eating disorders, abuse of appearance- and performance-enhancing drugs, and exercise dependence. However, in each of these categories, one must carefully distinguish between the planned and dedicated behaviors required for success in the sport, as opposed to frankly pathological behaviors that impair social or occupational function, cause subjective distress, or lead to adverse health consequences. Future work should attempt to better assess the nature and prevalence of these conditions among competitive bodybuilders, with perhaps greatest attention to the issue of drug use. [ABSTRACT FROM AUTHOR]

Anabolic-androgenic steroids (AAS) have been linked to a range of problematic behaviors, but AAS use is still sometimes portrayed as more benign than other forms of classical drug abuse. To address this issue, we compared the prevalence of anti-social behaviors among adolescent AAS users, non-AAS illicit drug users, and drug non-users. We examined 3 waves (2004, 2008, and 2012) of self-reported cross-sectional data from a secondary school survey conducted in Stockholm, Sweden (total n = 19,773; response percentage, 79.6%). Across all survey years, the risk ratios for virtually all measured anti-social behaviors were significantly higher among AAS users compared to non-AAS illicit drug users and to drug non-users. [ABSTRACT FROM AUTHOR]

The article offers information on body dysmorphic disorder (BDD), a psychiatric condition characterized by engrossment with a perceived deficiency in one's appearance. It states that BDD has similar features with the obsessive-compulsive spectrum. It also responds to its treatments such as serotonergic antidepressants and cognitive-behavioral therapy. It adds that muscle dysmorphia is a form of BDD in which males become preoccupied with their insufficient masculine appearance.

Background: A substantial literature suggests that users of illicit 3,4-methylenedioxymethamphetamine (MDMA or “ecstasy”) display residual cognitive deficits. Most MDMA users, however, use other illicit drugs as well, so it is difficult to be certain that these deficits are due to MDMA, as opposed to other drug use or additional confounding factors. Methods: We administered a battery of neuropsychological tests to 23 young MDMA users who reported minimal exposure to any other drugs, including alcohol, and to 16 comparison individuals equally involved with the rave subculture, but reporting no MDMA use. We compared the groups by regression analyses adjusting for numerous potentially confounding variables. To test for a possible dose–response effect, we also performed a median split of 12 moderate MDMA users (22–50 lifetime uses) and 11 heavy users (60–450 uses), and compared these subgroups with non-users. Results: MDMA users as a whole performed worse than non-users on most test measures, but these comparisons rarely reached statistical significance. This picture changed markedly in the subgroup analysis: although moderate users displayed virtually no differences from non-users on any measures, the heavy users displayed significant deficits on many measures, particularly those associated with mental processing speed and impulsivity. These differences did not appear explainable by differences in family-of-origin variables, verbal IQ, levels of depression, or time since last MDMA use. Conclusions: The presence of residual cognitive deficits, even among unusually “pure” frequent users of illicit MDMA, analyzed with adjustment for confounding variables, augments the evidence that MDMA itself, rather than some associated factor, is responsible for the deficits observed. [Copyright &y& Elsevier]

Anabolic-androgenic steroid (AAS) use represents a major public health problem in the United States, but the risk factors for this form of drug use are little studied. We evaluated 48 men who had used AAS for at least 2 months and 45 men who had never used AAS, using a verbal interview and a battery of questionnaires covering hypothesized demographic, familial, and psychosocial risk factors for AAS use. All subjects in both groups were experienced weightlifters; thus, differences between groups were likely to be associated specifically with AAS use, rather than with weightlifting in general. The AAS users and non-users generally described similar childhood and family experiences, but users reported significantly poorer relationships with their fathers and greater childhood conduct disorder than non-users. At the time that they first started lifting weights, AAS users and non-users were similar in their perceived physical, social, and sexual status, but users were significantly less confident about their body appearance. AAS users displayed much higher rates of other illicit substance use, abuse, or dependence than non-users, with use of other illicit substances almost always preceding first use of AAS. These findings suggest that AAS use may be most likely to occur in men with high levels of antisocial traits and low levels of body esteem. [Copyright &y& Elsevier]

Background: Individuals who initiate cannabis use at an early age, when the brain is still developing, might be more vulnerable to lasting neuropsychological deficits than individuals who begin use later in life. Methods: We analyzed neuropsychological test results from 122 long-term heavy cannabis users and 87 comparison subjects with minimal cannabis exposure, all of whom had undergone a 28-day period of abstinence from cannabis, monitored by daily or every-other-day observed urine samples. We compared early-onset cannabis users with late-onset users and with controls, using linear regression controlling for age, sex, ethnicity, and attributes of family of origin. Results: The 69 early-onset users (who began smoking before age 17) differed significantly from both the 53 late-onset users (who began smoking at age 17 or later) and from the 87 controls on several measures, most notably verbal IQ (VIQ). Few differences were found between late-onset users and controls on the test battery. However, when we adjusted for VIQ, virtually all differences between early-onset users and controls on test measures ceased to be significant. Conclusions: Early-onset cannabis users exhibit poorer cognitive performance than late-onset users or control subjects, especially in VIQ, but the cause of this difference cannot be determined from our data. The difference may reflect (1) innate differences between groups in cognitive ability, antedating first cannabis use; (2) an actual neurotoxic effect of cannabis on the developing brain; or (3) poorer learning of conventional cognitive skills by young cannabis users who have eschewed academics and diverged from the mainstream culture. [Copyright &y& Elsevier]

‘Flashbacks’ following use of hallucinogenic drugs have been reported for decades; they are recognized in DSM-IV as ‘Hallucinogen Persisting Perception Disorder (Flashbacks)’, or HPPD. We located and analyzed 20 quantitative studies between 1955 and 2001 examining this phenomenon. However, many of these studies were performed before operational criteria for HPPD were published in DSM-III-R, so they are difficult to interpret in the light of current diagnostic criteria. Overall, current knowledge of HPPD remains very limited. In particular (1) the term ‘flashbacks’ is defined in so many ways that it is essentially valueless; (2) most studies provide too little information to judge how many cases could meet DSM-IV criteria for HPPD; and consequently (3) information about risk factors for HPPD, possible etiologic mechanisms, and potential treatment modalities must be interpreted with great caution. At present, HPPD appears to be a genuine but uncommon disorder, sometimes persisting for months or years after hallucinogen use and causing substantial morbidity. It is reported most commonly after illicit LSD use, but less commonly with LSD administered in research or treatment settings, or with use of other types of hallucinogens. There are case reports, but no randomized controlled trials, of successful treatment with neuroleptics, anticonvulsants, benzodiazepines, and clonidine. Although it may be difficult to collect large samples of HPPD cases, further studies are critically needed to augment the meager data presently available regarding the prevalence, etiology, and treatment of HPPD. [Copyright &y& Elsevier]

Objective: Testosterone supplementation may produce antidepressant effects in men, but until recently it has required cumbersome parenteral administration. In an 8-week randomized, placebo-controlled trial, the authors administered a testosterone transdermal gel to men aged 30-65 who had refractory depression and low or borderline testosterone levels. Method: Of 56 men screened, 24 (42.9%) displayed morning serum total testosterone levels of 350 ng/dl or less (normal range=270-1070). Of these men, 23 entered the study. One responded to an initial 1-week single-blind placebo period, and 22 were subsequently randomly assigned: 12 to 1% testosterone gel, 10 g/ day, and 10 to identical-appearing placebo. Each subject continued his existing antidepressant regimen. Ten subjects receiving testosterone and nine receiving placebo completed the 8-week trial. Results: The groups were closely matched on baseline demographic and psychiatric measures. Subjects receiving testosterone gel had significantly greater improvement in scores on the Hamilton Depression Rating Scale than subjects receiving placebo. These changes were noted on both the vegetative and affective subscales of the Hamilton Depression Rating Scale. A significant difference was also found on the Clinical Global Impression severity scale but not the Beck Depression Inventory. One subject assigned to testosterone reported increased difficulty with urination, suggesting an exacerbation of benign prostatic hyperplasia; no other subject reported adverse events apparently attributable to testosterone. Conclusions: These preliminary findings suggest that testosterone gel may produce antidepressant effects in the large and probably underrecognized population of depressed men with low testosterone levels. [ABSTRACT FROM AUTHOR]

Reviews literature which focused on the issue of body image in boys. Association of distress with body image dissatisfaction; Correlation between body image satisfaction and various measures of self-esteem; Problem posed by using a single row of images of increasing size to assess boys' responses to body image questions.

Presents a study which assessed whether cultural ideals of the male body, as illustrated by `Playgirl' magazine, have changed from 1973 to 1997. Overview of studies on the evolution of society's ideals for the male body; Methodology used; Results and discussion.

Tests the hypothesis that men in modern Western societies would desire to have leaner and more muscular body than the body they have. Comparison of actual fat and muscularity with that of perceived images chosen by subjects; Possible consequences of discrepancy between men's actual and ideal muscularity.

Studies the phenomenon of muscle dysmorphia among male weightlifters using a battery of demographic, psychiatric and physical measures. Characteristics of muscle dysmorphia; Psychopathology observed among men with muscle dysmorphia indicated by body dissatisfaction, eating habits, prevalence of anabolic steroid use and lifetime prevalence of mood, anxiety and eating disorders.

Abstract Rationale: Even though marijuana is the most commonly abused illicit drug in the United States, it is still undetermined whether withdrawal after chronic use results in changes in aggressive behavior in humans. Objective: The present study investigated the pattern and duration of changes in aggressive behavior in long-term marijuana users during a 28-day abstinence period verified by daily urines. Methods: Chronic marijuana users who had smoked marijuana on at least 5000 occasions (the equivalent of smoking daily for approximately 14 years) and who were smoking regularly when recruited were studied on days 0 (when they were still smoking), 1 (during acute withdrawal), 3, 7 and 28 of a 28-day detoxification period. Aggressive behavior was measured using the Point Subtraction Aggression Paradigm. Results: Compared to controls and to the pre-withdrawal data, chronic marijuana users displayed more aggressive behavior on days 3 and 7 of marijuana abstinence. These increases in aggressive responding returned to pre-withdrawal levels after 28 days and were paralleled by small, non-significant changes in depression and anxiety scores. Conclusions: Our findings confirm previous reports of an abstinence syndrome associated with chronic marijuana use and suggest that aggressive behavior should be an additional component of this syndrome. [ABSTRACT FROM AUTHOR]

Offers results of a study that tested the hypothesis that frequent marijuana use might produce residual neuropsychological effects in college students. Participants; Intervention; Main outcome measures; Results; Conclusions.

Assesses the characteristics of men with eating disorders. Characteristics of the eating disorders; Comorbid psychiatric disorders; Sexual orientation and behavior; Family environment and childhood experiences.

Investigates the prevalence of childhood sexual abuse among women with bulimia nervosa in the United States, Austria and Brazil. Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria for bulimia nervosa; Survey questions used in interview; Psychopathology of bulimic subjects who report sexual abuse.

Objective: We sought to compare the features of bulimic subjects in two countries (Austria and the United States). Method: To assess how bulimia nervosa presents in different cultural settings, we interviewed 33 women recruited from the University of Innsbruck, Austria, who met DSM-III-R criteria for bulimia nervosa and 33 bulimic women recruited from two universities in Massachusetts. Preliminary results on these bulimic groups have previously been reported. The present stud adds a control group of 33 Austrian women and 33 Boston women who were recruited and interviewed by identical methods. Results: Bulimic women in both countries proved significantly distinguishable from controls on eating behavior, attitudes toward body shape and weight, lifetime prevalence of major mood discarder, and a few variables regarding childhood experiences. In addition, we found several marked differences between Austria and the United States which appeared independent of the diagnosis of bulimia nervosa. The most prominent of these were satisfaction with body image and levels of substance abuse. Conclusions: Bulimia nervosa appears to exhibit stereotypic ‘core’ features which are independent of culture, but it has other features which may influenced by underlying cultural differences. [ABSTRACT FROM AUTHOR]

"Recovered memory therapy" for eating disorders and other psychiatric conditions seeks to help the patient recover repressed memories of childhood sexual abuse and other traumatic experiences. Through this technique, it is hoped that the patient can work through these experiences to achieve feller from shame, body dissatisfaction, and symptoms of depression and eating disorders. However, this method was questioned in the recent Ramona case, where a father successfully sued two therapists and a hospital for allegedly implanting false memories of childhood sexual abuse in his bulimic daughter. The testimony and verdict in this case recall the principle of primum non nocere: Although it is clearly reasonable to consider an unproven therapeutic technique in an attempt to relieve human suffering, the potential risk of the technique—in this case the possible induction of false incest memories—must be weighed carefully against the technique's expected benefits. [ABSTRACT FROM AUTHOR]

We compared 33 college women meeting DSM-III-R criteria for bulimia nervosa, recruited at Leopold Franzens Universität in Innsbruck, Austria, with 33 bulimic women recruited by identical methods at Northeastern University and Boston University in Boston, Massachusetts. Bulimia nervosa showed striking stereotypy across the two cultures. Austrian and American subjects reported similar demographic features, bulimic symptoms, severity and chronicity of illness, associated personal and familial psychiatric disorders, upbringing and family environment, and frequency of childhood sexual abuse. Only two variables, substance abuse and satisfaction with body image, differed markedly between the two groups. These differences appear to represent ambient differences between American and Austrian culture as a whole, rather than specific features of the bulimic syndrome. [ABSTRACT FROM AUTHOR]

The authors present a case of anorexia nervosa and subsequent mania both preceded by remote right-sided head injury in a young man. In spite of the apparent lack of neurologic sequelae in this case, metabolic brain imaging revealed persistent cerebral physiologic dysfunction in the right hemisphere. Furthermore, both anorexic and affective syndromes resolved with anticonvulsant treatment. The authors suggest that anorexia and bipolar affective disorder in this patient may he linked to right-sided cerebral dysfunction. [ABSTRACT FROM AUTHOR]

Three lines of evidence have suggested that electrophysiologic abnormalities may play a role in bulimia: (1) findings of abnormal EEGs in bulimic patients, (2) evidence that bulimia may respond to anticonvulsant medications, and (3) a possibly elevated frequency of seizures in bulimic patients treated with antidepressant medications. A review of these findings, together with new data from our center and others suggests that electrophysiologic abnormalities do not play a major role in bulimia (although such abnormalities may perhaps be more common in individuals with "atypical" eating disorders). However, the apparently increased frequency of seizures in bulimic patients treated with bupropion remains unexplained. Further research is needed to clarify this finding. [ABSTRACT FROM AUTHOR]

Seven studies using structured diagnostic interviews have assessed the prevalence of borderline personality disorder among patients with eating disorders, yielding rates from 0% to 42% in different samples. However, many patients with eating disorders suffer from depression, and there is substantial overlap between the symptoms of depression and those of borderline personality disorder. Thus, structured interviews for borderline personality disorder—most of which are of untested or uncertain specificity—may perhaps frequently produce false-positive diagnoses of borderline personality disorder in patients with eating disorders and hence yield exaggerated. Considering the grave implications of the borderline diagnosis, one must remain critical of studies in this area until further data, using instruments of documented specificity, blind ratings, and suitable control groups, become available. [ABSTRACT FROM AUTHOR]

The present study investigated the relationship between crime and substance abuse in a sample of 133 consecutively evaluated male prisoners. Using the Structured Clinical Interview for DSM-III-R, we assessed the prevalence of various forms of substance abuse in this population and attempted to judge whether substance abuse played a role in the index crime which has led to the present incarceration. In addition, we assessed whether there was a relationship between the nature of substance dependence and the type of crime committed, whether sexual, violent, or non-violent. Among the 133 prisoners, 95% obtained a diagnosis of dependence on one or more substances. Fifty-eight percent of the inmates reported that they were acutely intoxicated with one or more substances at the time they committed the index crime and an additional 6% were withdrawing from a substance at the time of the crime. There was no significant correlation between the type of substance abuse diagnosis and the type of crime committed. Similarly, there was no significant correlation between the number of individuals who reported they were intoxicated at the time of the offense and the type of crime committed. [ABSTRACT FROM AUTHOR]

Abstract We administered 14 mg nicotine patches to 16 patients, all non-smokers, who displayed akathisia from antipsychotic drugs. On single-blind ratings, akathisia appeared significantly reduced on days when patients were wearing the patches as compared to the baseline day. These findings, if confirmed, may help to explain the high rates of tobacco use among psychotic patients, and may suggest avenues for the treatment of akathisia. [ABSTRACT FROM AUTHOR]

Objetivo: Este estudio evaluó la estabilidad del trastorno por atracón en una muestra poblacional. Método: Los autores entrevistaron a 888 familiares de primer grado de 300 probandos con sobrepeso u obesos (150 con un trastorno por atracón y 150 sin trastornos de la conducta alimentaria a lo largo de la vida) que fueron incluidos en un estudio de familias. Compararon la duración total de la enfermedad entre los familiares con diagnósticos a lo largo de la vida de trastorno por atracón (n = 131), bulimia nerviosa (n = 17) y anorexia nerviosa (n = 18). Resultados: La duración media a lo largo de la vida del trastorno por atracón fue de 14,4 años (DE = 13,9), significativamente más prolongada que la de la bulimia nerviosa (media = 5,8 años, DE = 9,1) y la de la anorexia nerviosa (media = 5,9 años, DE = 7,4). Estas diferencias cambiaron poco cuando el análisis se limitó a las familiares femeninas o a los familiares de los probandos sin un trastorno de la conducta alimentaria a lo largo de la vida. Conclusiones: Estos resultados sugieren que el trastorno por atracón es al menos tan crónico como los trastornos bien validados de anorexia nerviosa y bulimia nerviosa y probablemente constituye un síndrome estable. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the stability of binge eating disorder in a community sample. Method: The authors interviewed 888 first-degree relatives of 300 overweight or obese probands (150 with binge eating disorder and 150 with no lifetime eating disorder) who were recruited during a family study. They compared the total duration of illness among relatives with lifetime diagnoses of binge eating disorder (N=131), bulimia nervosa (N=17), and anorexia nervosa (N=18). Results: The mean lifetime duration of binge eating disorder was 14.4 years (SD=1 3.9), significantly longer than for either bulimia nervosa (mean=5.8 years, SD=9.1) or anorexia nervosa (mean=5.9 years, SD=7.4). These differences changed little when analysis was restricted to female relatives or to relatives of the probands with no lifetime eating disorder. Conclusions: These findings suggest that binge eating disorder is at least as chronic as the well-validated disorders anorexia nervosa and bulimia nervosa and likely represents a stable syndrome. [ABSTRACT FROM AUTHOR]

Editorial. Comments on a study by Solowij et al in this issue about the effect of long-term cannabis use. Conclusion of the study that cannabis use produces neuropsychological deficits; How other studies have not indicated long-term damage; Proposed reasons for the differences, including use individuals seeking treatment for cannabis dependence in the Solowij study.

Examines the prevalence of substance use and its relationship to attributes of life style among college students. Percentage rate of homosexual activity by drug users; Proportion of students reporting visits to a psychiatrist.

Explores a novel source of underground drug information. Hallucinogens on the Internet; Illicit use of hallucinogens in the United States; Hallucinogen-related Internet sites; Internet sites that provides information on how to obtain, synthesize, extract, identify and ingest hallucinogens.

Explores the association between abuse of 3,4-methylenedioxymethamphetamine (MDMA) or `ecstasy' and high-risk sexual behaviors among gay and bisexual men in New York City. Association of MDMA use with a history of unprotected anal intercourse; Ability of MDMA to increase energy and sexual receptivity.

Presents the results of a study which assessed the opinions of American psychiatrists regarding the diagnostic status and scientific validity of the Diagnostic and Statistical Manual-IV (DSM-IV) categories of dissociative amnesia and dissociative identity disorder.

The authors reflect on the increased prevalence of body image disorders in men and how this can lead to abuse of anabolic-androgenic steroids (AAS). Information is provided on research of muscle dysmorphia, a former of body image disorder defined by an obsessive preoccupation with muscular appearance. The authors go on to argue the lack of studies on the long-term health consequences of AAS abuse.

Among these are: (1) major mood disorders, which may be associated with aggression, violence, and sometimes criminal behavior; (2) muscle dysmorphia, which may be both a cause and an effect of AAS use; and (3) AAS dependence syndromes. Although AAS are not addictive in the classical sense, a surprisingly high percentage of AAS users develop an AAS dependence syndrome. AAS dependence shares many features with dependence on classical drugs of abuse (e.g., tolerance, withdrawal, large amounts of time devoted to obtaining and using the drug, continued use despite adverse effects), but differ somewhat in that AAS do not deliver an immediate "reward" of intoxication in the manner of most classical drugs. Couple's treatment might be particularly promising with AAS users, since partners of AAS users are often eager for the AAS user to discontinue the drugs. [Extracted from the article]

Presents a letter to the editor about the manifestations of chronic fatigue syndrome.

Editorial. Comments on the recommendations of the Royal College of Psychiatrists regarding the handling patients with memories of childhood sexual abuse. Overview of cases involving sexual abuse; Assertions on repression, a method of forgetting certain experiences.

Presents a letter to the editor reporting on the acquired immunodeficiency syndrome (AIDS) epidemic, published in the 'Journal of the American Medical Association'.

The article presents a commentary of the two papers published within the special issue on the role of endophenotypes in eating disorders (EDs). According to the authors, the papers use techniques of genetic epidemiology to examine EDs, with an eye towards refining etiologic hypotheses and influencing nosology. One paper demonstrates that various anxiety disorders coaggregate with anorexia nervosa in families and the other one reviews candidate endophenotypes that may underlie EDs.

Presents a letter to the editor about traumatic memories in patients with posttraumatic stress disorder.

No abstract available Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Illicit methamphetamine abuse represents a major problem in many countries worldwide, including the United States. Prolonged regular smoking or injection of methamphetamine can cause a psychosis, typically characterized by paranoid delusions and auditory hallucinations and often associated with disturbances in mood. These symptoms may persist long after methamphetamine is discontinued and may prove refractory to antipsychotic medications. The authors describe a patient who developed a typical methamphetamine psychosis that persisted despite months of abstinence from methamphetamine and weeks of treatment with antipsychotic medication but that responded promptly to electroconvulsive therapy (ECT) on two separate occasions: on initial presentation and again a year later when the patient relapsed into methamphetamine abuse and developed psychosis again. The authors review the large international literature on methamphetamine psychosis, much of which is from Japan and has not previously been summarized in English. Persistent methamphetamine psychosis has been widely reported in Japan for more than 50 years but is rarely discussed in the American literature, possibly because some such cases are misdiagnosed in the United States as primary psychotic disorders. Given the growing public health problem of methamphetamine abuse in the United States, the distinction between persistent methamphetamine psychosis and a primary psychotic disorder has grown increasingly important. Thus, American clinicians should be alert to the possibility of methamphetamine psychosis and may wish to consider ECT in refractory cases. [ABSTRACT FROM AUTHOR]

Objective: Body image disorders appear to be more prevalent in Western than non-Western men. Previous studies by the authors have shown that young Western men display unrealistic body ideals and that Western advertising seems to place an increasing value on the male body. The authors hypothesized that Taiwanese men would exhibit less dissatisfaction with their bodies than Western men and that Taiwanese advertising would place less value on the mate body than Western media. Method: The authors administered a computerized test of body image to 55 heterosexual men in Taiwan and compared the results to those previously obtained in an identical study in the United States and Europe. Second, they counted the number of undressed male and female models in American versus Taiwanese women's magazine advertisements. Results: In the body image study, the Taiwanese men exhibited significantly less body dissatisfaction than their Western counterparts. In the magazine study, American magazine advertisements portrayed undressed Western men frequently, but Taiwanese magazines portrayed undressed Asian men rarely. Conclusions: Taiwan appears less preoccupied with male body image than Western societies. This difference may reflect 1) Western traditions emphasizing muscularity and fitness as a measure of masculinity, 2) increasing exposure of Western men to muscular male bodies in media images, and 3) greater decline in traditional male roles in the West, leading to greater emphasis on the body as a measure of masculinity. These factors may explain why body dysmorphic disorder and anabolic steroid abuse are more serious problems in the West than in Taiwan. [ABSTRACT FROM AUTHOR]

Presents a study that examined the effects of media images on men's attitudes toward their body image and appearance. Review of related literature; Methodology used; Limitations of the study.

We mailed questionnaires inquiring about a range of personal and professional attributes to 972 North American psychiatrists at five leading medical schools in the United States and Canada. Of these, 49% (435 psychiatrists) responded. Of the respondents, 90.9% reported being exclusively heterosexual, 3.5% predominantly heterosexual, and 5.6% bisexual/homosexual. Analyses were performed to assess the relationship between sexual orientation and other variables. We found that exclusive heterosexuals were more likely than other psychiatrists to be Jewish (p =. 002), to have first-degree relatives with psychiatric illness (p = .015), and to have conducted research after residency training (p = .034). Exclusively heterosexual psychiatrists were less likely to have used recreational drugs (p =. 025), or to prescribe psychotropic medications to none of their patients (p = .017). Sexual orientation was not correlated with a variety of other personal and professional characteristics. The findings suggest that gay men and lesbians are represented within psychiatry at rates comparable to their estimated representation in society. Moreover, the data invite several hypotheses--for example, that medical students may be drawn to psychiatry for specific reasons such as feeling marginalized due to being gay or bisexual. [ABSTRACT FROM AUTHOR]

Previous studies have reported that patients with bulimia often display nonsuppressed response to the dexamethasone suppression test (DST), suggesting that bulimia may be associated with hypercortisolism. To further evaluate the hypothalamic-pictuitary-adrenal axis in bulimia, 24-hour urinary free cortisol (UFC) levels and response to the 1 mg dexamethasone suppression test (DST) were assessed in 7 normal-weight women with bulimia by DSM-III. All displayed normal UFC and nonsuppressed response to the DST. [ABSTRACT FROM AUTHOR]