Debbie Schachter

Fraternal birth order and birth weight in probably prehomosexual feminine boys

The purpose of this study was to confirm a previous finding that homosexual males with older brothers weigh less at birth than do heterosexual males with older brothers. The subjects comprised 250 feminine boys referred to a child psychiatry service because of extreme cross-gender wishes or behavior and assumed, on the basis of previous research, to be prehomosexual, plus 739 control boys and 261 control girls referred to the same service for reasons unrelated to sexual orientation or gender identity disorder and assumed, from base-rate probabilities, to be preheterosexual. The feminine boys with two or more older brothers weighed 385 g less at birth than did the control boys with two or more older brothers (P = 0.005). In contrast, the feminine and control boys with fewer than two older brothers did not differ in birth weight. This finding suggests that the mechanism by which older brothers increase the odds of homosexuality in later-born males operates prior to the individuals birth. We hypothesize that this mechanism may be immunologic, that antimale antibodies produced by human mothers in response to immunization by male fetuses could decrease the birth weight of subsequent male fetuses as well as increase their odds of homosexuality.

Informed consent and tardive dyskinesia. Long-term follow-up.

Informed consent allows patients to make treatment decisions based on the best possible information. The current study examines the long-term impact of the informed consent process on schizophrenic patients. Patients were administered a baseline questionnaire and were given an information form, which was read aloud to them by the investigator. Patients were re-administered the questionnaire at 4 weeks and were randomly assigned to no review (single-session group) or a review of the information (educational review group). All patients were administered the questionnaire at 2-year follow-up. Both the single session and the educational review process significantly increase the schizophrenic patients knowledge about the benefits and risks of neuroleptic medication. No previous study has examined the impact of informed consent for anti-psychotic medication at 2-year follow-up.

Child psychiatry and early intervention: II. The internalizing disorders

This paper uses the concepts introduced in the paper Child Psychiatry and Early Intervention: I. The Aggregate Burden of Suffering to review the internalizing disorders of childhood. This review surveys the internalizing disorders from the point of view of early intervention, for their prevalence, course, risk, early indicators, associated impairment, and responses to intervention. In general, the internalizing disorders have little effect on the community. When coupled with other disorders such as conduct disorder, or when dealing with suicide, the communitys concern for these disorders increases and allocation of resources to target populations who are at risk becomes an important public health goal.

Child psychiatry and early intervention. III: The developmental disorders

This paper is the third in a series of four using the concepts introduced in the paper Child Psychiatry and Early Intervention: I. The Aggregate Burden of Suffering. This paper reviews the developmental disorders of childhood to set priorities for early intervention programs. This review discusses the prevalence, course, risk, early indicators, associated impairments, and responses to intervention. The specific developmental disorders, especially learning disabilities, have a significant impact on community resources. Since the developmental disorders are easily recognized among preschool children, early intervention is feasible. However, successful interventions have yet to be demonstrated. Priority should be given to the development of effective interventions. There is a great need for research studies on the effects and effectiveness of early intervention with these individuals.

Child psychiatry and early intervention: I. The aggregate burden of suffering.

This paper discusses the need to estimate the costs of an illness to properly allocate intervention resources for the various psychiatric disorders of childhood. Disorders that require the most community resources should be given the highest priority for early intervention programs. Factors to consider for estimating disorders which are most costly are discussed here: the incidence of the disorder, its severity, whether it is episodic or stable, and its impact on the individual, family and the community. These factors contribute to the aggregate burden of suffering caused by a disorder.