bluuebunny/crossref_metadata_2025 huggingface dataset:
Who kills whom in Portugal?
Authors: de Castro E. Ferreira , Pimenta F. , Martins I.
Published: August 2007

To clarify the relationship between people who have committed homicide and been convicted (murderers) and homicide victims, and between murderers and suicide victims, their profiles were compared in Portugal from 1970 to 1987. Correlations were found between the age group, marital status and occupation of murderers and homicide victims. Murderers and suicide victims were only correlated by occupation. Since 1983, there has been a trend towards an increasing prevalence of murderers among younger people and single people, and of homicide victims among older people. The correlation between murderers and suicide victims can be explained by alcoholism, and murderers tend to kill their relatives and peers as a result of conflict situations. The emerging trend towards young people murdering old and defenceless people points towards a colder and financially motivated killer, perhaps increasingly among young drug addicts.
Suicide risk in female suicide attempters not responding to a follow‐up study
Authors: Hengeveld M. W. , van Egmond M. , Bouwmans P. M. , van Rooyen L.
Published: August 2007

The 95 patients not responding to a follow‐up study of 227 female suicide attempters differed from the responders in that fewer of them were undergoing psychiatric treatment at the time of the suicide attempt and fewer were referred for psychiatric outpatient aftercare following the suicide attempt. Yet, the subsequent occurrence of suicide was no higher in the group of nonresponders than in the group of responders. This study again underlines the difficulty of predicting recurrent suicidal behaviour, even in a high‐risk group of suicide attempters.
Cycloid psychosis: regional cerebral blood flow correlates of a psychotic episode
Authors: Warkentin S. , Nilsson A. , Karlson S. , Risberg J. , Franze'n G. , Gustafson L.
Published: August 2007

Eight patients meeting Leonhard's criteria for cycloid psychosis were investigated on repeated occasions during a psychotic episode, with regional cerebral blood flow measurements and clinical ratings. The results showed that, at admission to the hospital, when the patients were clinically exacerbated, the mean hemispheric blood flow was significantly elevated compared with values from a normal control group. The hemispheric blood flow level covaried significantly with the degree of clinical symptoms, such that the more elevated the cortical blood flow was, the more behaviorally disturbed was the patient. At discharge from the hospital, the patients had no residual symptoms and the cortical blood flow was normal. These findings differ distinctly from those commonly made in other psychoses, such as schizophrenia.
Psychosexual problems in male childhood malignancy survivors
Authors: Ropponen P. , Siimes M. A. , Rautonen J. , Aalberg V.
Published: August 2007

We studied the development of psychosexuality and object relationships in 58 young males who had survived malignancies in childhood. Using a psychodynamically oriented, semistructured psychiatric interview, we formed 13 criteria for comparisons between patients over and under 18 years of age. Of these 13 criteria, 12 showed that development was equally problematic for the older and younger patients. Our findings indicate that, in many patients, the adolescent process remains problematic during development, with obvious difficulties in establishing the final sexual organization, separating from internalized primary objects, and making contacts with same‐sex and opposite‐sex peers.
Comparison of Composite International Diagnostic Interview and clinical DSM‐III‐R criteria checklist diagnoses
Authors: Janca A. , Robins L. N. , Bucholz K. K. , Early T. S. , Shayka J. J.
Published: August 2007

This article describes a comparison of Composite International Diagnostic Interview (CIDI) diagnostic results and results based on clinicians’ observation of CIDI assessments. Psychiatrists scored a DSM‐III‐R criteria checklist either while observing or after administering 20 CIDI interviews. Overall diagnostic concordance between the checklist and CIDI diagnoses was found to be good (kappa = 0.78). Good diagnostic agreement was also found for 3 groups of DSM‐III‐R disorders: depressive disorders (kappa = 0.84), psychoactive substance use disorders (kappa = 0.83) and anxiety phobic disorders (kappa = 0.76). These results are consistent with the results from a similar comparison between the CIDI and checklist results for ICD‐10 diagnoses.
Cost‐benefit analysis of an educational program for general practitioners by the Swedish Committee for the Prevention and Treatment of Depression
Authors: Rutz W. , Carlsson P. , von Knorring L. , Wälinder J.
Published: August 2007

In 1983–1984 the Swedish Committee for the Prevention and Treatment of Depression launched an educational program on the diagnosis and treatment of depressive disorders for all general practitioners on the island of Gotland. The baseline year chosen was 1982 and the immediate effects were evaluated in 1985. In 1988 the long‐term effects were evaluated. These two evaluations indicated strictly time‐related beneficial effects on the frequency of sick leave and inpatient care for depressive disorders, the pattern of prescription of psychopharmacologic drugs and the frequency of suicide. This article describes a cost‐benefit analysis of the program. The cost of the educational program, changes in drug prescription and inpatient care were calculated as well as indirect costs concerning changes in morbidity and mortality. The calculation of the savings to society was subject to a sensitivity analysis. This shows that the educational program resulted in savings to society on the order of about SEK 155 million (USD 26 million). It is concluded that educational programs of this kind should be repeated every second to third year.
Risk of deliberate self‐harm and factors associated with suicidal behaviour among asymptomatic individuals with human immunodeficiency virus infection
Authors: Gala C. , Pergami A. , Catalan J. , Riccio M. , Durbano F. , Musicco M. , Baldeweg T. , Invernizzi G.
Published: August 2007

The study was aimed at evaluating the risk of deliberate self‐harm (DSH) and factors associated with suicidal behaviour in 213 asymptomatic individuals with human immunodeficiency virus (HIV) infection in 3 transmission categories (68 gay men, 123 intravenous drug users and 22 heterosexuals). The results showed that 12 HIV‐seropositive (HIV +) subjects were involved in DSH after the notification of a positive HIV test result, of which 8 occurred within 6 months and 4 between 6 months and 3 years. HIV + subjects with a past psychiatric history showed a 7.7‐fold increase in the relative risk of DSH, and HIV + subjects with a history of DSH showed a 5‐fold increase in the relative risk of DSH compared with HIV + individuals without a past psychiatric history and a history of DSH. Professionals involved in the care of HIV + individuals need to be aware of this risk, especially in the first few months after notification of HIV status and also at later stages of acquired immunodeficiency syndrome.
Psychosocial and toxicological profile of drug misuse in male army conscripts in Kuwait
Authors: Bilal A. M. , Khattar M. A. , Hassan K. I. , Berry D.
Published: August 2007

The pattern of drug use among 2183 young Kuwaiti conscripts was studied using the Drug Abuse Screening Test (DAST) and urine analysis. Drug misuse rates were low, compared with similar set‐ups elsewhere as independently confirmed by urine test (0.7% amphetamine and 2.8% other street drugs; alcohol was not detected in this sample) and self‐report (7.9% on DAST). This may be attributed to the influence of the Islamic traditions on lifestyles. Significant correlations were seen between self‐report of multiple drug use and positive urine results for both amphetamine and other street drugs, while positive urine amphetamine was associated with families seeking help for treatment, problems with family and/or work and having or being hospitalized for drug‐related medical problems. Amphetamine as the major identified individual misused drug was significantly associated with older age group but negatively correlated with marital status, higher education and employment. The discrepancy between self‐report of drug misuse‐related problems and objective proof of this may reflect the inappropriateness of some of DAST items to this sample, culturally desired responses or both.
Premorbid adjustment of schizophrenic criminal offenders
Authors: Schanda H. , Földes P. , Topitz A. , Fliedl R. , Knecht G.
Published: August 2007

The premorbid psychosocial adjustment of 28 schizophrenic criminal offenders, 23 non‐criminal‐offender schizophrenics (ICD‐9) and 14 nonpsychotic criminals was compared by means of the Premorbid Adjustment Scale (PAS). The schizophrenic groups did not differ regarding age, marital status, diagnostic subgroup or length of illness. PAS scores showed highly significant differences between the schizophrenic groups and the controls on every subscale and on average scores. Yet, aside from 2 items (sociability/withdrawal in adulthood and education), no differences could be found between offender and non‐offender schizophrenics. Furthermore, the PAS scores showed a markedly better premorbid psychosocial adjustment in schizophrenics with offending behaviour (and convictions) before the onset of the psychosis than in schizophrenics without previous convictions, who committed one rather severe crime that was closely connected to psychosis itself.
Distressing behaviour of schizophrenics at home
Authors: Gopinath P. S. , Chaturvedi S. K.
Published: August 2007

The care of mentally ill people at home is being encouraged nowadays. As a result, the family members feel an increased burden of care and find it difficult to cope with the care of a schizophrenic patient at home. We interviewed the relatives of 62 schizophrenics systematically regarding the behaviour of the patients that was perceived to be distressful. This was done using the Scale for Assessment of Family Distress. It was noted that behaviours related to activity and self‐care were perceived to be most distressful, and not aggressive or psychotic behaviour. Distress was more often reported by younger relatives and those with more education. The findings have implications in planning appropriate family intervention methods.
Reciprocated self‐disqualification among parents of schizophrenics
Authors: Wichstrøm L. , Holte A.
Published: August 2007

Is deviant parental communication an interactional phenomenon? If it is, is this interaction stronger or weaker among parents of schizophrenics (S) than among parents of non‐schizophrenic psychiatric controls (NS) and normals (N)? These two questions were investigated by using sequential analysis of parental interaction during Spouse Rorschach. Parents’ deviant communication was measured by the self‐disqualification (SD) category in the Relationship Control Coding System. Results showed that self‐disqualification clearly depended on the quality of the previous parental communication: an SD utterance greatly increased the probability of an SD response from the spouse among S (n= 17), NS (n= 15) and N (n= 14). However, this increased probability was significantly higher among S parents. Furthermore, S parents’ communication was significantly less dependent on their own previous communication than NS and N parents’ communication was. However, the sheer magnitude of parental SD communication was a significant predictor of offspring diagnosis even when the interaction between the spouses was controlled for. Thus, the results indicate that the high rate of deviant communication among S parents is partly due to individual characteristics of the parents and partly due to reciprocation of the other spouse's deviant communication. The results are discussed with reference to possible gene‐environment interaction in both schizophrenia and deviant communication.
Vigilance deficits in schizophrenics and affectively disturbed patients
Authors: Rund B. R. , Ørbeck A. L. , Landrø N. I.
Published: August 2007

Vigilance is a concept associated with the early levels of information processing. Vigilance deficits have repeatedly been found in schizophrenic patients. It has not been clear, however, whether such cognitive dysfunctions are specific to schizophrenics or not. In this study, 28 schizophrenics were compared with 19 affectively disturbed patients and 17 normals on a vigilance test that is a hybridization of a Continuous Performance Test (CPT) and a Span of Apprehension Test (SAT). The results showed that schizophrenics performed significantly below the normals only on target hits on the CPT. There were no differences between the two patient groups, either on number of correct hits or on commission errors. On the SAT measures, normals performed better than the two psychiatric groups on all measures. Schizophrenics had more commission errors than the affectives, but there were no differences between the two groups with respect to target hits. Neither CPT nor SAT deficit, thus, seem to be specific schizophrenic characteristics.
A 10‐year follow‐up study of tardive dyskinesia
Authors: Yassa R. , Nair N. P. V.
Published: August 2007

In a 10‐year follow‐up study of 44 patients with tardive dyskinesia (TD), the majority (22 or 50%) had no change in their TD severity, 9 (20%) had an improvement and 13 (30%) had a worsening of their TD. Little difference was noted in those patients whose medication was decreased (n= 12) and those whose medication remained unchanged (n= 32). Of the women, 26% showed improvement as compared with 11% of the men. Also, patients whose TD improved had lower present neuroleptic dose than those whose TD worsened. These two factors should be studied in larger patient cohorts.
Predicting symptoms of depression from reports of early parenting: a one‐year prospective study in a community sample
Authors: Kerver M. J. , van Son M. J. M. , Groot P. A. de
Published: August 2007

The purpose of this study was to determine whether (reported) parental overinvolvement and lack of affection identify initially healthy subjects at risk for depression. One thousand subjects from the province of Utrecht, the Netherlands were randomly selected by using telephone addresses and asked to participate in a one‐year prospective study on psychological risk factors of depression. From the 108 subjects that finally participated on both occasions, the reports of parental upbringing (Parental Bonding Instrument) of initially non‐depressed subjects with a Zung Self‐rating Depression Scale score below 49 points were used to predict new cases of depression one year later. Initially non‐depressed subjects who reported maternal overinvolvement in the upper quartile of the distribution had an 8.5‐fold increased risk (95% confidence interval 0.9 to 80.6) of becoming depressed one year later. Although initial reports of low paternal affection were positively associated with initial symptoms of depression, this characteristic failed to show predictive value. Parental upbringing deficiencies have frequently been shown in cross‐sectional inpatient studies in which retrospective retrieval from memory because of depressive state characteristics may have caused negative colouring. Our results would suggest that maternal overinvolvement reported in the absence of a depressed mood still proves to be an important psychological risk factor in the aetiology of depression.
Paroxetine and imipramine in the treatment of depressive patients in psychiatric practice
Authors: Øhrberg S. , Christiansen P. E. , Severin B. , Calberg H. , Nilakantan B. , Borup A. , Søgaard J. , Larsen S. B. , Loldrup D. , Bahr B. , Siebuhr N. , Gregersen B. , Jacobsen F. , Liljeström M. , Manniche P. M. , Bech P.
Published: August 2007

A total of 151 outpatients with endogenous or mixed endogenous and reactive depression were included in a 6‐week double‐blind study, with extension for up to 1 year, in psychiatric practice. The results showed trends in efficacy variables and a statistically significant difference in a benefit‐risk ratio in favour of paroxetine (Seroxat®, Paxil®) compared with imipramine. Efficacy was largely maintained in both groups during long‐term treatment. The frequency and severity of side effects in paroxetine patients declined markedly from short‐term to long‐term treatment, whereas changes in imipramine patients were less pronounced. Significantly more imipramine patients gained weight during long‐term treatment. In conclusion, paroxetine is an effective and well tolerated antidepressant, well suited for outpatients in psychiatric practice.
Study of chronic schizophrenics using 31P magnetic resonance chemical shift imaging
Authors: Fujimoto T. , Nakano T. , Takano T. , Hokazono Y. , Asakura T. , Tsuji T.
Published: August 2007

Phosphorus‐31 chemical shift imaging showed regional abnormalities of in vivo31P NMR spectra in the brains of chronic schizophrenic patients. In the left temporal region, the level of % phosphodiesters (PDE) was increased and the level of %γαβ‐ATP (obtained by summation of γ‐ATP, α‐ATP, and β‐ATP) was decreased. In the basal ganglia, the levels of % PDE were decreased and the level of % phosphomonoesters was increased. The levels of %γαβ‐ATP were increased in the right basal ganglia. The level of % phosphocreatine was decreased in the frontoparietal region. These findings may represent different patterns of dysfunction of membrane phospholipid bilayers and high‐energy phosphate metabolism in the specific cerebral regions.
The Swedish version of the Positive and Negative Syndrome Scale (PANSS) for schizophrenia
Authors: von Knorring L. , Lindström E.
Published: August 2007

The Positive and Negative Syndrome Scale (PANSS) has been translated into Swedish and tested in 88 chronic schizophrenic patients. All 4 subscales exhibited a roughly normal distribution. The overall α for the positive, negative and general psychopathology subscales were 0.81, 0.58 and 0.63, respectively. The correlation between the positive and negative subscales was ‐0.17 (NS). The interrater reliability was 0.73–0.75 for the positive, 0.65–0.74 for the negative and 0.75‐0.77 for the general psychopathology subscales. The intraclass coefficients were 0.75‐0.77 for the positive, 0.27‐0.46 for the negative, 0.56‐0.72 for the general psychopathology subscales and 0.66‐0.71 for the total scale. Thus, the validity and reliability of the PANSS (Swedish version) are quite satisfactory.
Recent life events and their role in suicide as seen by the spouses
Authors: Heikkinen M. , Aro H. , Lönnqvist J.
Published: August 2007

The occurrence of recent life events during the last 3 months and their significance in the suicide process as subjectively perceived by the surviving partners were studied among a subpopulation of suicide victims (n= 400) who had a spouse or a cohabitant as the informant. This subpopulation was drawn from a total suicide population (n= 1397) of 1 year in Finland. According to the partners’ reports, life events during the last 3 months were reported in 85% of the suicides. Job problems (33%), family discord (32%) and somatic illness (29%) were most commonly reported. More male than female victims had experienced recent life events, and the mean number of events was higher among men than among women. There were differences between single life events in terms of how often the partners perceived them as precipitants of suicide. Separation was seen as the most critical event: in 68% of suicides with reported separation during the last 3 months the partner also rated it as a precipitant, followed by somatic illness in 57%, family discord in 44%, financial trouble in 44%, unemployment in 34%, death in 29%, job problems in 19% and illness in family in 14%.
Participation in group psychotherapy in a therapeutic community for acute patients
Authors: Isohanni M. , Nieminen P.
Published: August 2007

A total of 2090 treatment episodes from 1977 to 1990 at a therapeutic community for acute patients were assessed for group psychotherapy participation and its associations with some patient and program characteristics, based on polytomous logistic regression analysis. Nonparticipation (4% of all episodes) or passivity (14%) were associated mainly with the program properties (such as the quality of the ward policy, first treatment episode and short treatment time), a diagnosis of personality disorder or typical schizophrenia and inferior outcome (assessed by attainment of treatment goals). The associations of moderate activity (45%) were very active (37%) as a reference, mainly personal properties (such as male gender, young age, low social and professional background and a diagnosis of schizophrenia) and inferior outcome. The results suggest that group participation, therapeutic program, patient properties and attainment of treatment goals are interrelated. The therapeutic program and leaders’ skills should be developed to facilitate individualized group participation.
Long‐term Antabuse treatment of alcohol‐dependent patients
Authors: Kristenson H.
Published: August 2007

Antabuse taken under supervision is effective and useful in the treatment of selected patients in the very long term. Relapses during treatment are the rule rather than the exception as is also illustrated in five case reports, but Antabuse treatment contributes to longer periods of sobriety. Continued support by nurses is necessary in the treatment of alcohol dependent patients and appointments with a psychiatrist are important for patients with alcohol dependence and psychiatric disorders. The personal perception of the severity of the drinking problem seems to be of decisive importance for compliance with the treatment. A high degree of motivation to stop drinking leads to long‐term use of Antabuse, a stronger internal locus of control and a favourable outcome. Measurements of liver enzymes are useful for monitoring the treatment outcome as well as for detecting toxic effects on the liver.
Controlled trials of Antabuse in alcoholism: the importance of supervision and adequate dosage
Authors: Brewer C.
Published: August 2007

Methods of using Antabuse have changed since its introduction over 40 years ago. Several randomised controlled trials have shown that Antabuse can make a statistically and clinically significant contribution to treatment outcome in alcoholism but only if its administration is carefully supervised. The recent literature is reviewed. Adequate dosage is important and the recommended maximum in some countries is often insufficient. Both prescribes and supervisors of Antabuse need to be aware of the ways in which some patients try to evade medication.
The general neurotic syndrome: a coaxial diagnosis of anxiety, depression and personality disorder
Authors: Tyrer P. , Seivewright N. , Ferguson B. , Tyrer J.
Published: August 2007

The validity of the general neurotic syndrome, a combination of anxiety, depression and dependent personality disorder, was examined in a 2‐year study of outpatients with dysthymic, panic and generalized anxiety disorder diagnosed using a structured interview schedule. The general neurotic syndrome, found in a third of the patients, was associated with greater mental disorder and a significantly worse outcome than patients without the syndrome. It did not, however, predict response to treatment. Further analysis revealed that the general neurotic syndrome was a better predictor of short‐ and long‐term outcome than any other variable apart from initial psychopathology score. It is argued that the syndrome may represent a personality diathesis that makes the individual more vulnerable to both anxiety and depressive symptoms.
Suicide and community psychiatric care — a preliminary report
Authors: Cantor C. H. , Burnett P. C. , Quinn J. , Nizette D. , Brook C.
Published: August 2007

A preliminary survey of 34 suicides among patients attending community services for the chronically mentally ill revealed a rate of 520 per 100,000 admitted. In contrast to earlier hospital surveys, no risk variables were identified for patients dying by suicide. Thirty‐four percent of suicides occurred within one week of the last treatment and 59% within 3 months of service entry. It appears that early and intensive follow‐up may be necessary to prevent suicide among patients receiving community psychiatric care.
Rationalizing neuroleptic polypharmacy in chronic schizophrenics: effects of changing to a single depot preparation
Authors: Soni S. D. , Sampath G. , Shah A. , Krska J.
Published: August 2007

This study investigated the effects of transferring patients on combined depot and oral neuroleptics to a single depot preparation; a secondary objective was to assess the effects of transferring patients from one depot neuroleptic to another. It was found that, whereas transferring from one depot preparation (flupenthixol) to another (fluphenazine) had no clear disadvantage for the patients, changing over from a combined oral and depot (fluphenazine) regimen to equivalent doses of depot alone resulted in an unacceptably high rate of relapse. The reasons for this may relate to either the unique pharmacokinetics of these drugs or subtle qualitative differences between them. It is suggested that caution is necessary whenever attempts are made to rationalize polypharmacy in schizophrenic patients.
Low thyroxine levels in female psychiatric inpatients with riboflavin deficiency: implications for folate‐dependent methylation
Authors: Bell I. R. , Morrow F.D. , Read M. , Berkes S. , Perrone G.
Published: August 2007

Intermediates in the folate‐dependent methylation pathways may play a role in the etiology and treatment of such mental disorders as major depression. These pathways include a step dependent on a riboflavin (B2)‐derived coenzyme, flavin adenine dinucleotide (FAD), which is reportedly sensitive to thyroid status and to phenothiazine and tricyclic drug exposure. In a sample of 52 male and female acute psychiatric inpatients, 17% (n= 9) showed B2 deficiency (i.e., insufficient FAD activity) on a functional red blood cell enzyme assay, but only one B2‐deficient individual showed deficiency in another B‐complex vitamin (folate). All patients with B2 deficiency were women, who were also significantly younger than the rest of the sample. The B2‐deficient women had significantly lower thyroxine levels, even when controlling for sex and covarying for age. B2‐deficient patients exhibited a nonsignificant trend toward more unipolar depression (44%vs 14%), but not toward bipolar or schizophrenic disorders. As in a previous study, drug exposure did not show a relationship to riboflavin deficiency in this sample. The findings suggest that B2 (FAD) activity may serve as a sensitive marker of thyroxine status in certain female psychiatric inpatients and that B2 deficiency may play an etiological role in defects of the methylation pathways in a subset of mentally ill individuals.
Inappropriate vasopressin secretion in severe alcohol withdrawal
Authors: Trabert W. , Caspari D. , Bernhard P. , Biro G.
Published: August 2007

Forty‐one male alcoholics suffering from alcohol withdrawal syndrome were investigated to assess the relationship between vasopressin (ADH), water homeostasis and alcohol withdrawal. During 10 d, we found a significant decrease in serum vasopressin, from 3.08 ± 0.61 to 1.71 ± 0.22 pg/nl. There were no concomitant changes in osmolality, so that a general dysregulatory state of vasopressin secretion during alcohol withdrawal cannot be assumed. Only patients with delirium tremens (8/41) had higher vasopressin levels despite lowered serum osmolalities. These findings support the hypothesis of an inappropriate rebound secretion of vasopressin in severe alcohol withdrawal. Furthermore, they may contribute to the pathogenesis of focal alcoholic brain damage, because rapid and/or profound changes in osmolality are suspected to cause circumscribed cerebral demyelinization.
The partners' views on precipitant stressors in suicide
Authors: Heikkinen M. , Aro H. , Lönnqvist J.
Published: August 2007

All suicides (n= 1397) in Finland during 1 year were studied by thorough interviews with the surviving next of kin. We included 388 suicides after which a spouse's or a cohabiting partner's subjective views of precipitant stressors in suicide process during the last 3 months and earlier in life were determined. In 82% of the cases the partner considered life events as precipitant stressors for the suicide. Among men, the most common stressors considered as suicide precipitants were somatic illness (25%), interpersonal discord (22%) and separation (14%). Among women these were mental disorder (28%), interpersonal discord (18%) and death of a significant other (17%). Somatic illness and retirement were more commonly considered as precipitants among older men, whereas interpersonal discord, separation and financial trouble were more common among younger men. Among women, job problems were more commonly considered as precipitants for younger subjects. Among both sexes, childhood adversity was more commonly reported among the younger subjects.
Relationship between personality and debrisoquine hydroxylation capacity
Authors: Llerena A. , Edman G. , Cobaleda J. , Benítez J. , Schalling D. , Bertilsson L.
Published: August 2007

We administered the Karolinska Scales of Personality to 225 healthy subjects in Spain selected from a group of 925 individuals previously phenotyped with regard to their capacity to hydroxylate debrisoquine. A significant relationship was found between the scores in as many as 4 of the 15 subscales (psychic anxiety, psychasthenia, inhibition of aggression and socialization) and the debrisoquine hydroxylation capacity. Poor metabolizers were more anxiety‐prone and less successfully socialized than extensive metabolizers of debrisoquine. This and a previous study among subjects in Sweden suggest that there may be a relationship between personality and the activity of the enzyme hydroxylating debrisoquine (cytochrome P4502D6). This polymorphic enzyme may have an endogenous neuroactive substrate or product, such as a biogenic neurotransmitter amine.
Persistent tardive dyskinesia: demographic and pharmacological risk factors
Authors: Muscettola G. , Pampallona S. , Barbato G. , Casiello M. , Bollini P. , Muscettola Giovanni
Published: August 2007

The demographic, clinical and pharmacological risk factors for persistent tardive dyskinesia (TD) were investigated in a sample of 1745 patients. When simultaneously adjusting for the effects of demographic and pharmacological factors using multivariate logistic regression, female sex and advanced age were positively and significantly associated with increased risk of TD. Interaction between these two variables, investigated by cross‐stratification, was significant. Furthermore, high neuroleptic dose and concomitant use of neuroleptic and antiparkinsonian drugs were both significantly associated with increased risk of TD. The results support the view that both vulnerability factors and high neuroleptic doses contribute to the occurrence of TD and further stress the relevance of a conservative use of antipsychotic medication, particularly in older women.
A controlled Nordic multicentre study of zuclopenthixol acetate in oil solution, haloperidol and zuclopenthixol in the treatment of acute psychosis
Authors: Baastrup P. C. , Alhfors U. G. , Bjerkenstedt L. , Dencker S. J. , Fensbo C. , Gravem A. , Pedersen V. , Eigen K. , Brekke B. , Fredslund‐Andersen K. , Lindholm H. , Lybeck I. , Morawski R. , Nummi K. , Silfverhjelm H. , Vartiainen H. , Wiesel F. A. , Aarvold A.
Published: August 2007

Zuclopenthixol acetate—a new injectable formulation with a duration of action of 2–3 days—was compared with conventional intramuscular and oral formulations of haloperidol and zuclopenthixol in the initial treatment of acutely disturbed, psychotic patients. The patients were stratified into 3 diagnostic categories: acute psychoses (48 patients), mania (22 patients), and exacerbation of chronic psychoses (73 patients). The patients were rated on the Brief Psychiatric Rating Scale (BPRS), the Bech‐Rafaelsen Mania Rating Scale (brmas) (only manic patients) and globally on the Clinical Global Impression (CGI). The study was an open, randomized multicentre trial with a 6‐day treatment period. The zuclopenthixol acetate patients received 1–4 doses, the haloperidol patients 1–26 and the zuclopenthixol patients 1–22 doses. The assessments on the CGI showed that all 3 treatments caused a clear reduction of the severity of illness scores in all 3 diagnostic categories, with no differences between treatments. The ratings of the acute and chronic psychotic patients on the BPRS also showed significant reductions in scores with no differences between treatments. All 3 treatments caused a rapid remission of symptoms on the BRMAS. Haloperidol induced hypokinesia in significantly more patients than zuclopenthixol acetate after 24 h. Later there were no significant differences between treatments. Zuclopenthixol acetate fulfils many desires for an amended neuroleptic formulation for the initial treatment of acutely disturbed psychotic patients.
T‐cells and psychopathology in schizophrenia: relationship to the outcome of neuroleptic therapy
Authors: Müller N. , Hofschuster E. , Ackenheil M. , Eckstein R.
Published: August 2007

Until recently, attention has been focused on the pathogenetic aspects of immunological findings in schizophrenic patients. There has been no mention of the relationship between such findings and schizophrenic symptoms. To study the probable relationship between T‐cells and T‐cell subgroups in the course and prognosis of schizophrenia, immunological and psychopathological parameters were correlated in 55 patients suffering from schizophrenia (ICD‐9: 295.0–295.6) or schizoaffective psychosis (ICD‐9: 257.7) before neuroleptic treatment. The correlations were performed for a second time in 24 of these patients after clinical improvement at a reinvestigation. Positive correlations of the Brief Psychiatric Rating Scale and the Scale for Assessment of Negative Symptoms with the numbers of CD3+ and CD4‐ T‐cells (total T‐ and T‐helper cells), which were enhanced compared with controls, were found at the reinvestigation after clinical improvement, whereas no significant correlation could be detected at the pretreatment investigation. These results show that the cellular immune parameters are related to the course of the psychopathological symptoms in schizophrenia and, possibly, are a marker of the therapeutic outcome of neuroleptic treatment.
One hundred years of suicide in New Zealand
Authors: Deavoll B.J. , Mulder R.T. , Beautrais A.L. , Joyce P.R.
Published: August 2007

Suicide rates were obtained for New Zealand from 1889 to 1988. The overall rate for women has been stable since the 1930s, and the male rate showed marked peaks in the early 1930s and in the 1980s. Analysis of rates by age group revealed that the 1930 male peak was due to increases among the middle‐aged and elderly men, and the current peak is due to increases among young men. Possible explanations for fluctuations in suicide rates over the last century are discussed.
Antidepressant response to sleep deprivation as a function of time into depressive episode in rapidly cycling bipolar patients
Authors: Gill D.S. , Ketter T.A. , Post R.M.
Published: August 2007

Three patients with treatment‐resistant rapidly cycling bipolar disorder were studied with multiple sleep deprivations (SD) during several depressive episodes to assess the effect of phase or duration of a depressive episode on SD response. There was little response to SD early in a depressive episode, but responses were often robust late in an episode, sometimes triggering its termination. In 2 subjects, the duration of antidepressant response to SD increased linearly as time into episode increased. Neither the number of SD given in an episode nor the medication status of the patients appeared to account for the observed increases in antidepressant response. These results suggest that the neurobiological substrates underlying depression may change over the course of an episode, resulting in an increased responsivity to sleep deprivation later compared with earlier in the course of an episode in rapidly cycling patients. The generalizability of these findings to unipolar patients remains to be explored.
Delirium and dementia in acute medical admissions of elderly patients in Iceland
Authors: Kolbeinsson H. , Jónsson A.
Published: August 2007

A prospective study was carried out in a general hospital in Reykjavik to evaluate the prevalence of delirium and dementia among 331 patients 70 years and older who were admitted as an emergency to the medical department. Cognitive function was screened with Mental Status Questionnaire (MSQ) and Mini‐Mental State Examination (MMSE) and diagnosed according to DSM‐III‐R for delirium and dementia. Other information obtained included social and demographic factors, drug consumption, the main condition underlying the delirium and outcome. Severe cognitive dysfunction was present in 32% of all acutely admitted patients 70 years and older, which were diagnosed further as delirium 14% and dementia 18%. At follow‐up, concurrent dementia was found in 70% of the delirium patients. The main causes for delirium were cardiac failure 27%, stroke 22% and sepsis 16% and the mortality rate was 32% compared with 8% in dementia alone. The prognosis of patients with delirium and dementia depends on detecting these disorders, and the clinical skills of physicians working with acutely ill elderly patients can be improved by relatively simple screening questionnaires such as the MSQ and MMSE.
Comparative study of classification of psychosis of childhood and adolescent onset
Authors: Reddy Y. C. Janardhan , Girimaji S. R. , Srinath S.
Published: August 2007

Classification of psychosis in childhood and adolescence has always been controversial due to the possible developmental modulation of symptom expression. Major classificatory systems have no special criteria for children, and recommend the use of adult criteria. Hence, this study aimed to study the nosology of psychosis of childhood and adolescence, using adult criteria (ICD‐9, ICD‐10 and DSM‐III‐R). Fifty subjects between the age of 5 and 16 years who met the ICD‐9 definition of psychosis were studied using the Intake Sheet for Adolescents: cross‐cultural study and the Interview Schedule for Children and Adolescents. Most of the subjects could be classified into one of the major functional psychosis categories, indicating the applicability of adult criteria in children and adolescents.
Compulsory admission of psychiatric patients – an international comparison
Authors: Riecher‐Rössler A. , Rössler W.
Published: August 2007

The frequency of compulsory admissions to psychiatric hospitals varies considerably between countries and regions. However, the differences are partly artificial, as the figures available are not fully comparable; this is mainly owing to differing definitions of “compulsory” and the methodological shortcomings of most studies in this field. In addition, there are also clear real differences, most of which result from different legislation and administrative regulations. Characteristics of the patient that influence the risk of compulsory admission include diagnosis and certain sociodemographic and social factors. Most studies, however, are based on highly selected populations. Furthermore, the results depend heavily on the commitment frequency of a country and therefore eventually also on the restrictiveness of legislation. The lack of methodologically sound studies, internationally comparable data and internationally published information is regrettable, as international comparison and discussion would certainly be valuable, especially for countries that are in the process of re‐evaluating their commitment criteria and mental health legislation.
Circadian variation in plasma 5‐hydroxyindoleacetic acid level during and after alcohol withdrawal: phase advances in alcoholic patients compared with normal subjects
Authors: Sano H. , Suzuki Y. , Yazaki R. , Tamefusa K. , Ohara K. , Yokoyama T. , Miyasato K. , Ohara K.
Published: August 2007

Alcohol withdrawal symptoms in 19 male alcoholics were objectively evaluated and classified and circadian variation in their plasma 5‐hydroxyindoleacetic acid (5‐HIAA) concentrations was determined at 3 different intervals after cessation of drinking. Circadian variations in plasma 5‐HIAA level exhibited phase advances in alcoholic patients compared with normal controls and were different depending on the severity of alcohol withdrawal symptoms. Plasma 5‐HIAA in patients with delirium tremens showed significantly higher levels during the abstention period, possibly suggesting peculiarity in their serotonergic metabolism.
Serotonin and amino acid content in platelets of autistic children
Authors: Rolf L. H. , Haarmann F. Y. , Grotemeyer K.‐H. , Kehrer H.
Published: August 2007

The platelet levels of serotonin and the amino acids aspartic acid, glutamine, glutamic acid and gamma‐aminobutyric acid were measured in 18 drug‐free autistic (DSM‐III criteria) and 14 age‐matched healthy children. Serotonin was significantly increased while the amino acids aspartic acid, glutamine, glutamic acid and gamma‐aminobutyric acid were significantly decreased in comparison with the controls. It is suggested that the decline of the amino acids in platelets from autistic children represents a biochemical marker related to infantile autism.
Mortality in Danish psychiatric long‐stay patients, 1972–1982
Authors: Licht R. W. , Mortensen P. B. , Gouliaev G. , Lund J.
Published: August 2007

By use of the computerized, nationwide psychiatric case register in Denmark, 3 cohorts of psychiatric patients hospitalized for at least one year in 1972, 1977 and 1982, respectively, were identified and followed until April 1, 1988, regarding cause of death. A decline in overall excess mortality compared with the general population was seen from the 1972 cohort to the 1982 cohort irrespective of sex, age group and diagnosis. To analyse cause of death, 298 long‐stay patients at Aarhus Psychiatric Hospital were followed for 5.5 years. Lung diseases caused the highest excess mortality. The authors emphasize that risk of death in long‐stay patients below 50 years of age is still fourfold compared with the general population and point to the necessity of improving medical care.
How well can a few questionnaire items indicate anxiety and depression?
Authors: Tambs K. , Moum T.
Published: August 2007

There is a need for a short form questionnaire with known psychometric characteristics that may be used as an indicator of level of global mental distress. A weighted sum of 5 questions from the Symptom Check List (SCL) anxiety and depression subscales (SCL‐25) correlates at r= 0.92 with the global SCL‐25 score. The alpha reliability for the (5‐item) short form questionnaire was 0.85. Age differences seemed to be trivial, and sex differences were moderate. Descriptive statistics for short form scores in a large, representative sample are given.
Brief family therapy with alcohol‐dependent men in Trinidad and Tobago
Authors: Maharajh H. D. , Bhugra D.
Published: August 2007

This study—the first of its kind in the English‐speaking Caribbean—investigated the efficacy of modified brief family therapy in the treatment of alcoholism. Thirty men were treated with family therapy and milieu therapy and compared with 30 sex‐ and age‐matched patients treated with milieu therapy alone. Follow‐up over a period of 1 year showed significant levels of improvement in those treated with family therapy. The treatment group did not revert to their original drinking pattern. This can be attributed to family therapy. Family therapy was brief and involved seeing all significant members for 3 sessions, each session lasting 90 min. The role of family therapy and importance of culture in management of these patients are discussed. Our study confirms that a time‐limited problem‐solving family therapy approach is of use in these ethnic groups.
The Utrecht comparative study on psychiatric day treatment and inpatient treatment
Authors: Schene A. H. , van Wijngaarden B. , Poelijoe N. W. , Gersons B. P. R.
Published: August 2007

A prospective randomized comparative study on the effectiveness of psychiatric day treatment and inpatient treatment is described. The target population consisted of patients who would normally have been admitted to an open inpatient unit. Outcome indicators were psychopathology, social functioning, interpersonal functioning, social network and social support. No differences in effectiveness were found between the two forms of treatment, although more patients accepted and completed day treatment, and day patients were more satisfied. Although a uniform treatment programme for both departments was established, distinct differences did arise in the actual treatment programme offered to the patients. The duration of treatment for the day patients was considerably longer, and the intensity of treatment was more low‐key. No striking differences in the amount of medication prescribed and in the occurrence of crisis situations (including suicide) were found. Day treatment turns out to be a realistic alternative for 33% of all patients admitted for inpatient treatment. It was not possible to predict which type of patient in particular is suitable for day treatment.
Effect of a long‐lasting gonadotrophin hormone‐releasing hormone agonist in six cases of severe male paraphilia
Authors: Thibaut F. , Cordier B. , Kuhn J.‐M.
Published: August 2007

Six men with severe paraphilia had been treated with depot gonadotrophin luteinizing releasing hormone analogue (GnRHa) (triptorelin 3.75 mg per month intramuscularly). In 5 cases, the treatment ended their deviant sexual behavior and markedly decreased their sexual fantasies and activities without further significant side effects than those related to hypoandrogenism. This clinical improvement was parallel to the gradual decrease of plasma testosterone level to castration values within the first month. The beneficial effect of this treatment had been maintained at follow‐up varying from 7 months to 3 years. One patient interrupted the treatment at the end of the first year and relapsed within 10 weeks. GnRHa treatment, which leads to reversible castration, may constitute a promising treatment of paraphilic behavior and may favor the possibility of concurrent psychotherapy.
The influence of total sleep deprivation on urinary excretion of catecholamine metabolites in major depression
Authors: Müller H.‐U. , Riemann D. , Berger M. , Müller W. E.
Published: August 2007

To elucidate the influence of total sleep deprivation (TSD) on catecholaminergic neurotransmission, which is assumed to be disturbed in depression, 9 depressive patients collected consecutive 24‐h urine samples prior to (baseline), during (TSD) and following total sleep deprivation (post‐TSD). Urine samples were analysed for total MHPG (3‐methoxy‐4‐hydroxyphenylglycol), conjugates of MHPG (glucuronide and sulfate), excretion of HVA (homovanillic acid) and VMA (3‐methoxy‐4‐hydroxymandelic acid). TSD increased the urinary excretion of MHPG‐sulfate as a marker of the central norepinephrine metabolism and the excretion rates of VMA and HVA as indices of the peripheral catecholamine metabolism. Patients with higher VMA values prior to TSD reacted worse, and the VMA increase due to TSD was positively correlated with the response. The results demonstrate that TSD, besides acting as a stimulus on the peripheral sympathetic nervous system, influences central nervous noradrenergic neurotransmission, as reflected by the increase of MHPG‐sulfate.