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Different pathways to parenthood exist for lesbians and gay men, including adoption and sperm or egg donation. Data from the National Longitudinal Study of Adolescent Health showed few differences in terms of adjustment between adolescents living with opposite-sex couples and those living with same-sex couples. Recommendations for clinical work with children of lesbian and gay parents are given.

There is a paucity of literature on direct treatment outcomes for impoverished minority populations. The current study supports the feasibility of successfully treating women for depressive symptoms in community settings where they typically seek care, adding to the small but growing direct knowledge base in this area. The sample of the 2-site study consisted of 91 women seeking treatment for depressive complaints at a homeless shelter program and a municipal hospital psychiatric clinic for Latino patients. Participants were randomly assigned to either a 16-week cognitive--behavioral group or a 16-week supportive/exploratory group for depression. Best-practice features with this population were integrated throughout. Findings showed that both treatment conditions were equally effective in decreasing depressive symptoms (BDI, CES-D) up to 4 months after treatment termination. These changes were paralleled by improvements in self-reported physical health (Duke Physical Profile). No significant differences between treatment conditions were found. Directives for next steps in the current research agenda are offered in efforts to broaden the direct evidence base for treating vulnerable urban women at high risk for depression and other forms of mental illness. Keywords: depression treatment, clinical outcomes, minority women, Hispanic women, homeless women

With plans underway for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the debate between proponents of an atheoretical, descriptive approach of mental disorders versus an etiologically based classification system has been revitalized. This paper critically reviews findings from three related research areas that have begun to question the atheoretical, descriptive approach to mental disorders of DSM-III and its successors: (a) research concerning the underlying assumptions of DSM, (b) findings from treatment research, and (c) recent biopsychosocial research. Research on depression is used as a paradigmatic example, but the extent to which these findings may generalize to other disorders is also discussed. Strengths and weaknesses of the current DSM approach versus a more etiologically based classification system are considered. This review shows that although an etiologically based classification system of mental disorders seems more promising than a purely descriptive approach, the time seems not yet ripe for such a radical shift in psychiatric diagnosis. Further research oriented towards developing a more etiologically based approach to diagnosis is urgently needed, taking into account research, clinical, and policy implications that such a change in the diagnosis of mental disorders would bring.

Objectives: The study was aimed at evaluating facets of psychiatric inpatient care of patients with schizophrenia in a German and a Japanese hospital. Methods: Based upon a sample of 865 inpatients of the Psychiatric State Hospital Regensburg (BKR) and 50 inpatients of the Tokyo Women's Medical University (TWMU) admitted in 1997, data of a psychiatric basic documentation system (BADO) were analysed with regard to essential process and outcome indicators. Results: Despite dissimilarities between both patient groups with respect to schizophrenic subtype, duration of illness as well as severity of illness and psychosocial functioning, the differences regarding therapeutic treatment and outcome were marked. In 1997, the rate of atypical neuroleptics was 18% at the BKR and 12% at the TWMU. Inpatients of the TWMU were given benzodiazepines and anticholinergic drugs significantly more frequently. Male patients of the TWMU showed more severe side-effects. Psychotherapy and sociotherapy were less frequently applied at the TWMU. Although the patient groups did not differ with regard to suicidal behaviour and overt aggressions during hospitalisation, we found a higher rate of mechanical restraints at the TWMU. In 1997, the average length of stay was significantly higher at the TWMU (153 days) than at the BKR (52 days), but inpatients of the TWMU improved only slightly better with regard to global psychosocial functioning (GAF) and severity of illness (CGI). Conclusions: The revealed differences in treatment are likely due to differences in service provision and national practices in Germany and Japan and provide clues for quality improvements. The BADO is a useful tool for continuous quality management and an ongoing international exchange concerning psychiatric inpatient care. Key words: documentation, hospital comparison, outcome, process, quality assurance, schizophrenia

This article is a retraction of the conclusions drawn in a previous article, published as part of a special October 2001 issue of the Journal of Clinical Psychology on Thought Field Therapy (TFT). I decided to write this retraction after reconsidering a number of issues raised in the critiques of the articles. Additionally, subsequent misinterpretations of the literature on heart rate variability (HRV) by Roger Callahan, which led to further questioning of his premises and claims regarding TFT and HRV as represented in the articles, are discussed. I conclude that the burden of proof is on TFT proponents to demonstrate its efficacy and that well-designed controlled studies using standardized assessment measures and long-term follow-up must be performed to allow the scientific community to take claims made for TFT seriously. Keywords: Thought Field Therapy; Heart Rate Variability; retraction

Short-term heart rate variability (S-HRV) is a valid and reliable measure of health and therapy effectiveness. Pignotti makes critical assertions about S-HRV with no evidence or authoritative support for these curious assertions. Short-term measures have advantages over long-term measures. The power of Thought Field Therapy (TFT) is demonstrated through unprecedented HRV improvements as well as other physiologic indices such as skin color, microscopic measures, and increases in T-cell numbers after successful TFT. Bilchick and associates' hypothesis (2002), 'Each increase of 10 ms in standard deviation of normal-to-normal (SDNN) conferred a 20% decrease in risk of mortality (p = .0001 ),' is a bold and speculative position that appears to have general, if not highly specific, merit when applied to all groups investigated with HRV. Keywords: Thought Field Therapy (TFT); Heart Rate Variability (HRV); improving HRV; short-term HRV; SDNN

Residential eating disorder treatment involves emotional, financial, and time commitments from clients, staff, and the health care system. At discharge, most clients have made substantial nutritional, social, and psychological changes. However, maintaining these changes when intensive support is no longer available represents a significant challenge, and it is common for individuals to slip back into previous eating disorder patterns. Interviews with 32 individuals were conducted 6 months after discharge. Qualitative analyses revealed a pattern of factors that facilitated and hindered recovery. These factors were integrated with past research findings to develop a conceptual model about how changes are maintained. Recommendations regarding ways that health care professionals can assist with the transition from intensive treatment to community living are discussed.

Psychiatry surely has many challenges and problems to face nowadays. Managed care seems to limit treatment options, including our opportunity to provide psychotherapy. National economic problems reduce public sector funding [...]