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OBJECTIVE: To point out the proportion of intellectually disabled women (IDW) who are sterilised, and the medical and social factors associated with an increased probability to be sterilised. STUDY DESIGN: A population-based study among 97% of IDW aged 18-46, attending government-accredited institutions in the region of Brussels-Capital and the province of Walloon Brabant (Belgium). RESULTS: Among the IDW included in this study, 22.2% are sterilised, which is superior to the 7% in the general Belgian population. Factors associated with an increased probability to be sterilised are: living in an institution, having a higher intellectual quotient (IQ), being enrolled in an institution where sexual intercourse is authorised and attending an institution where contraception is required. The last three factors are significant only among women living in institutions and the last two, only in women with severe disability. Among IDW using contraception, no factor was associated with a greater probability to be sterilised. CONCLUSION: The prevalence of sterilisation among IDW is three times higher than that in the Belgian population and it is mainly correlated with factors related to the institution where these women live, especially the severely disabled.

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The contraception of women with intellectual disability (ID) is a major concern for caregivers. However, the prevalence of contraception and the frequency of use of different methods (e.g. sterilization) remain generally unknown. Moreover, indications specific to women with ID are controversial. The present authors conducted a population-based study among 97% of the women with ID aged between 18 and 46 years attending government-funded facilities in Brussels and the nearby province of Walloon Brabant in Belgium. Out of 397 subjects, 40.8% did not use any contraceptive method, 22.2% were sterilized, 18.4% used an oral contraceptive agent, 17.6% used depotmedroxyprogesterone acetate and 1% used an intrauterine device. These figures differ widely from those of the general Belgian population. Binary logistic regression for 'contraceptive utilization' showed the strong influence of institutional factors such as sleeping environment (i.e. institutional or parental), sexual relationship policy and contraception policy. Having or having had a boyfriend is also correlated with a stronger probability of contraceptive use. Other factors have a smaller influence (e.g. a milder level of ID). Very few factors, none of which are medical, are correlated with an increased use of a specific method. The present results are discussed in the light of the general medical application of contraception and the commonly assumed specific indications for women with ID.

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A population of 127 alcoholics of both sexes, hospitalized and weaned (DSM III diagnose: Alcohol Abuse and Alcohol Dependence) received Acamprosate (n = 63) or placebo (n = 64) in a double blind randomized therapeutic trail. The patients were followed during three months and anamnestic as well as biological data were recorded. It appeared no significant differences between the two groups of patients. This negative result could perhaps be explained by the heaviness of the pathology of this hospitalized alcoholic population.

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In clinical practice with alcoholics we frequently encounter a phenomenon whereby the subject claims he is able to cope with a situation, whereas in reality he cannot. This discrepancy between the claimed and the actual capacity for "control" led us to devise a study which would permit a better understanding of the phenomenon. We gave patients two questionnaires which deal with the concept of control. Comparison of the MHLC (Multidimensional Health Locus of Control, Wallston, 1978; a questionnaire which investigates the subjective degree of control in relation to health) and the GEFT (Group Embedded Figures Test, Witkin, 1971; a questionnaire which focuses more on actual behaviour and field-dependency) allowed us to test the hypothesis that alcoholics have a "pseudointernal" locus of control, that although, in what they say, they evince a strongly internal subjective locus of controls, in reality they are particularly external and dependent. The data confirm that the tendency towards an "internal" selfportrayal on the MHLC which is not backed up by the GEFT is significantly higher in alcoholics than in nonalcoholic subjects. Thus, all in all, this supports the hypothesis of a "pseudointernality" syndrome in alcoholics.

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The authors report a follow-up study about 73 ex-addicted patients who have been through a 6-months stay in a therapeutic community. The results analysed and discussed demonstrate the importance of the duration of the in-patients period and point out some patient features that are correlated to the current success or failure of treatment.

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30 alcoholic patients were studied during a detoxification period of 14 days in the hospital. Variable doses (maximum 300 mg) of potassium clorazepate allowed to achieve an harmless and rather comfortable detoxification, evaluated through internationally used skates (SSA and HSCL).

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The authors are comparing anorexia nervosa and addiction, from the points of view of the evolution and of family features. They propose the denomination of "toxicorexia" for these intricate pathologies where an anorexic or bulimic problem is associated to a drug, alcohol or medication abuse. Finally, a few guide-lines for the treatment are established.

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