Severe Psychiatric Problems Found in Death Row Inmate

Many inmates facing execution are victims of severe psychiatric or neurological problems that were not brought up in trial but could have played a role in sentencing, a team of psychiatrists has found.

The findings, published in the current American Journal of Psychiatry, come two weeks after the U.S. Supreme Court ruled that it is unconstitutional to execute insane people.

"If our 15 subjects are representative of death row inmates, and . . . we believe that they are, then we must conclude that many condemned individuals in this country probably suffer a multiplicity of hitherto unrecognized psychiatric and neurologic disorders," Dr. Dorothy Otnow Lewis of the New York University School of Medicine concludes.

Lewis and her team chose their inmates because of the imminence of execution, not because they were suspected of being mentally ill. All were sentenced between 1976 and 1984. Four of the 15 have since been executed.

In legalizing capital punishment in 1976, the court required that mitigating factors -- such as the inmate's mental condition -- be considered in a separate sentencing hearing.

All the death row inmates in the study -- 13 men and two women -- had suffered at least one major head injury before their crime, the doctors found. Nine had seen psychiatrists as children. Six were found to be "chronically psychotic." One had an IQ of 77.

"Most of the subjects had no idea that the kinds of accidents, injuries, signs and symptoms brought to light during these examinations might be relevant in any way to their criminal behaviors," the doctors said. Fear of Nuclear War Can Lead To Constructive Response

A little bit of fear about nuclear annihilation is a good thing for children, pediatricians were told at their national conference in Honolulu last week.

"Reactions to the threat of nuclear war are similar to psychological responses to terminal illness," Dr. Frank G. Sommers told the American Academy of Pediatrics. "Reactions of denial often prevent constructive action."

Sommers, a psychiatrist with the University of Toronto, surveyed 1,011 Canadian students on their feelings about nuclear war. Ten percent said they thought about it daily, and another 10 percent reported actual anxiety because of their thoughts.

But the youths who most feared nuclear war also believed they had some power to prevent such a conflict.

Those who worried about nuclear war every day also wondered how it would affect their career plans. This is a good thing, Sommers said, because it shows the youths have not given up and are thinking about their future. 'Besieged' Psychiatrists Increase Their Incomes

Psychiatrists have managed to reverse the shrinking of their incomes and no longer trail other physicians as they did in the early 1970s, according to a survey of more than 10,000 therapists.

"They have done so in a discriminatory climate in which over 40 percent of their income comes from patients' out-of-pocket expenditures and in which Medicare and private insurance limits discourage utilization," Drs. Boris Astrachan and Steven S. Sharfstein of the Connecticut Mental Health Center write in the current American Journal of Psychiatry.

"Psychiatrists in recent years have felt besieged," they write. In 1973, when the average doctor was paid $48,600 a year, psychiarists earned $38,400 -- less than all their peers -- according to the American Medical Association. Radiologists were the highest paid, at $59,900, followed by surgeons at $57,400.

In 1982, when the average doctor's salary doubled to $99,500, psychiatrists went ahead of two other specialties -- general practice and pediatrics -- while still trailing most others. The average psychiatrist earned $76,500; the average radiologist, $136,500.

To increase their incomes, psychiatrists have had to work longer hours and increase their fees, the survey found.

Among its other findings: Male psychiatrists spend less time with the average patient than females. The men saw 1.33 patients an hour; the women, 1.05. Psychiatrists' incomes have gone up because "the profession is highly adaptive in the face of economic constraints." In the future, more and more psychiatrists will join group practices. While high-tech fields of medicine may face financial problems, psychiatry, which relies on little technology, will be immune. "The need for psychiatric care . . . is ever present and growing . . ." For Diabetics, Sugar Sparks A Vicious Cycle

A diabetic's high blood sugar level sets off a vicious cycle that makes the body process excess sugar even less efficiently, new research has found.

Doctors have long suspected that excess glucose in the bloodstream desensitizes the insulin-producing beta cells of the pancreas. As a result of this new University of California at San Francisco study, doctors hope to find ways to reverse this desensitization.

There are an estimated 10.8 million diabetics in the United States, about 20 percent of whom require insulin to process glucose. Failure to control the level of glucose in the blood can lead to nerve damage, vision problems and other more serious illnesses.

The California research team removed beta cells from rats and incubated them in a glucose solution. Minute by minute, the amount of insulin produced was recorded. Insulin production jumped when glucose was first added, and increased slowly for two hours, but then leveled off and began to decline.

To the scientists, this means that over time the cells become desensitized to glucose. To the diabetic, it means that a pancreas already having trouble keeping up with the glucose level becomes more encumbered the longer blood sugar is not artifically controlled.

"Close control of glucose levels can do a lot to ameliorate the problems associated with diabetes," said Dr. Gerold Grodsky in announcing his findings. What Are Friends For? Men's, Women's Views Differ

Older men and women differ significantly in what they get and expect out of their friendships.

Men, according to the journal Psychology and Aging, are more likely to form "equitable" friendships, in which neither friend is dependent on the other, while women seem to allow "room for more dependency." This difference, writes Dr. Karen Roberto, stems from the different friendships developed throughout life and persists in old age.

"Equity seems less important to satisfaction in the most intimate, or best-friend, relationships," Roberto and a colleague write. Women's relationships tend to be the most intimate and so they are not concerned with who is getting the most out of the relationship.

"In less intimate friendships -- the type that men are more likely to develop -- equity becomes a more important issue," they write. And if the people are concerned about equity, the friendship is likely to be less satisfying. On the Pulse

Are Americans too weight conscious? A University of California at San Francisco study has found that 80 percent of fourth-grade girls are dieting . . . Parents spend many days deciding what to name their children, but it might not be worth the trouble. About half of all Americans go by some name other than the one on their birth certificate, Psychology Today reports . . . University of Texas doctors are experimenting with a novel way to keep dentures in place -- magnets. Healthy teeth are left in place as anchors, and metal is attached to them. Encased in the dentures is an unusually strong magnet, made from rare earth elements. Results of the study: so far, so good, says Dr. Robert Morrow . . .