Axis I comorbidity in adolescent inpatients referred for treatment of substance use disorders

<p>Abstract</p> <p>Background</p> <p>To assess comorbid DSM-IV-TR Axis I disorders in adolescent inpatients referred for treatment of substance use disorders.</p> <p>Methods</p> <p>151 patients (mean age 16.95 years, SD = 1.76; range 13 - 22) were consecutively assessed with the Composite International Diagnostic Interview (CIDI) and standardized clinical questionnaires to assess mental disorders, symptom distress, psychosocial variables and detailed aspects of drug use. A consecutively referred subgroup of these 151 patients consisting of 65 underage patients (mean age 16.12, SD = 1.10; range 13 - 17) was additionally assessed with the modules for attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) using The Schedule for Affective Disorders and Schizophrenia for school-aged children (K-SADS-PL).</p> <p>Results</p> <p>128 (84.8%) of the 151 patients were dependent on at least one substance, the remaining patients fulfilled diagnostic criteria for abuse only. 40.5% of the participants fulfilled criteria for at least one comorbid present Axis I disorder other than substance use disorders (67.7% in the subgroup additionally interviewed with the K-SADS-PL). High prevalences of present mood disorder (19.2%), somatoform disorders (9.3%), and anxiety disorders (22.5%) were found. The 37 female participants showed a significantly higher risk for lifetime comorbid disorders; the gender difference was significantly pronounced for anxiety and somatoform disorders. Data from the underage subgroup revealed a high prevalence for present CD (41.5%). 33% of the 106 patients (total group) who were within the mandatory school age had not attended school for at least a two-month period prior to admission. In addition, 51.4% had been temporarily expelled from school at least once.</p> <p>Conclusions</p> <p>The present data validates previous findings of high psychiatric comorbidity in adolescent patients with substance use disorders. The high rates of school refusal and conduct disorder indicate the severity of psychosocial impairment.</p

Cells and tissues in the vegetative sporophytes of early land plants

Remarkable preservation in coalified and pennineralized fossils from Upper Silurian and Lower Devonian sediments deposited some 420 to 390 million years ago provides insight into the major anatomical innovations associated with the early stages in the colonization of the land by higher plants. Using uniformitarian principles, such information, combined with gross morphology, can then be used to reconstruct the pioneers as growing, metabolizing and reproducing organisms, as well as allowing assessment of affinity, although apart from the lycophytes, they have no close relationship with extant groups. In considering vascular tissues, diversity is exemplified by descriptions of the metaxylem in protosteles of Zosterophyllopsida and Drepanophycopsida (putative lycophytes), of Psilophyton (Trimerophytopsida), of the Rhyniaceae (including Rhynia gwynnevaughanii, certain Taeniocrada spp., Sennicaulis) and of Cooksonia pertoni, a Lower Devonian representative of the organization found in the oldest pteridophyte-like land plants. Aglaophyton major is included as a plant with bryophyte-like vascular tissues in a branching sporophyte with cuticle, stomata and intercellular space system typical of the homoiohydric tracheophyte. In all water-conducting cells, interpretation of the primary and secondary wall results from comparisons involving the anatomy and chemistry of extant examples and an understanding of taphonomic processes. Phloem is only rarely preserved and usually identified from its position around the xylem. In contrast, dermal features are better known, because of penetration of the resilient cuticle between epidermal cells. They appear conservative. Thus stomata with two guard cells look remarkably similar to extant forms in surface view, and by consideration of their relationship with surrounding epidermal cells and of extent of cuticularization, seem to have operated in a similar way to those in certain mosses and ferns. Cuticular ornamentation (papillae, striations) and epidermal outgrowths (unicellular and multicellular) are described and their adaptive significance conjectured. Ground tissue systems are best preserved in Rhynie Chert permineralizations where zonation of the cortex is tentatively related to photosynthetic and structural roles. The latter function is also attributed to thick-walled, outer cortical cells recorded in many zosterophylls and in Psilophyton, although the chemical nature of the walls themselves remains equivocal. Problems of identification of roots in plants possessing axial organization with exarch xylem, and in leafy plants with smooth lateral branching systems are briefly addressed. Finally axis apices in Rhynia givynne-vaughanii and sections showing stages in the maturation of Asteroxylon stems are described from the Rhynie Chert