Up to 30% of patients with chest pain who undergo coronary catheterization have angiographically normal coronary arteries.1 Several recent prospective studies have shown that patients who are found to have normal coronary arteries score consistently higher than patients with coronary artery disease (CAD) on measures of the personality dimension of neuroticism when measured at catheterization2–4 or 1 year after.5 These findings are based on a diverse set of psychological tests, including the Minnesota Multiphasic Personality Inventory, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Eysenck Personality Questionnaire, Cornell Medical Index, and the Millon Behavioral Health Inventory, attesting to the reliability and validity of the association between normal coronary arteries and neuroticism.

Patients with chest pain and normal coronary arteries (NCA) score higher on measures of neuroticism than patients with coronary artery disease (CAD). This relationship, coupled with findings linking mitral valve prolapse (MVP) and anxiety disorders, led us to examine prospectively the possibility that a greater incidence of MVP among NCA patients accounts for their elevated neuroticism scores. One-hundred-forty-four patients completed psychological tests and a structured interview prior to cardiac catheterization. Forty-one of the 144 patients (28%) had normal coronary arteries. Within the NCA group 29 percent had MVP; within the CAD group only 13 percent had MVP. Despite the significant difference between NCA and CAD groups on measures of neuroticism, there were no differences as a function of MVP status, nor was there an interaction of MVP and coronary arterial status. These findings support the case for an association between NCA and neuroticism independent of the presence or absence of MVP.

Administration of anabolic steroids carries many risks. We present a series of 15 patients with primary hypogonadism who as a group had statistically significant increases in whole body hematocrit and red blood cell volume while on testosterone therapy of 300 mg. intramuscularly every 3 weeks. A small decrease in plasma volume over-all was not significant. Subsequent analyses compared subgroups whose whole body hematocrit during testosterone therapy was either 48% or greater (9) or less than 48% (6). Interaction effects indicated that the subgroups were similar when off testosterone but when on testosterone the former group exhibited an increase in red blood cell volume and a decrease in plasma volume, while the latter group had little change in either measurement. Subsequent to stopping testosterone therapy 2 patients in the whole body hematocrit 48% or greater group suffered strokes and 1 had transient ischemic attacks while on therapy. No one in the whole body hematocrit less than 48% group has had any cerebrovascular symptoms. Clinical implications, as well as cost-effective and practical suggestions for detecting possible dangerous hemoconcentration are discussed.

Much of the research on the postoperative adjustment of penile prosthesis recipients and their partners has been hampered by retrospective designs, unreliable assessment procedures and other methodological limitations. To address these shortcomings and to increase current knowledge regarding postoperative adjustment, we completed a prospective, longitudinal study of 19 implant recipients and their partners. Our results suggest that most patients and partners were satisfied with the prosthesis 1 year postoperatively, although use of the prosthesis sometimes was accompanied by short-term complications. Satisfaction tended to be lower among spouses than patients. Frequency of sexual intercourse increased during the followup period but there were no changes in sexual desire. Neither marital nor psychological adjustment changed significantly during this period.

This study examines the effectiveness of using the Millon Behavioral Health Inventory in conjunction with self-report measures of erectile dysfunction to classify the etiology of erectile dysfunction in males. Subjects were 70 males with erectile dysfunction. The results indicate that 47% of the subjects with psychogenic etiology, 65% with mixed etiology, and 71% of the subjects with organic etiology were correctly classified. These and previous findings indicate that the MBHI is an effective method of assessing the etiology of erectile dysfunction.

Two cases, carefully selected from a longitudinal, prospective investigation of the relationship between psychosocial variables and postsurgical adjustment to a penile prosthesis implantation, were studied intensively. In both cases, the patient and sexual partner were assessed, presurgically, on a number of psychological, marital, and sexual functioning variables; their subsequent satisfaction with the prosthesis, and their psychological, marital, and sexual adjustment were measured at 6 and 12 months postsurgery. Despite many similarities in medical aspects of the surgery, for one couple a successful outcome was evidenced, whereas the other couple demonstrated a therapeutic failure despite the technical success of the surgery. Psychosocial differences between the couples were identified as they may relate to the discordant outcomes observed. Clinical implications of these results are discussed, as are the strengths and weaknesses of our methodological approach.