bluuebunny/crossref_metadata_2025 huggingface dataset:
The epidemiology of psychotropic use in the City of São Paulo
Authors: de Jesus Mari Jair , Almeida-Filho Naomar , Coutinho Evandro , Andreoli Sergio Baxter , de Miranda Claudio Torres , Streiner David
Published: July 2009

Synopsis

This is a cross-sectional community study conducted to assess the one-year prevalence of psychotropic use in the city of São Paulo. A representative stratified sample of the city was drawn from three sub-districts selected on the basis of their health indicators (Ramos & Goihman, 1989). The probability of a psychiatric disorder was estimated by means of the Adult Psychiatric Morbidity Questionnaire (QMPA) developed by Santana (1982). The total sample comprised 1742 subjects: 11·7% of males and 24·6% of females were probable cases in the QMPA, at the cut-off point 7/8. The overall psychotropic consumption was 101·6 persons/1000 inhabitants. The rate of psychotropic use was higher for females (142·3 persons/1000 inhabitants) than males (50·0 persons/1000), a difference statistically significant (χ2 = 18·0, 1 df, P < 0·001). The highest rate of consumption was for tranquillizers (80·4/1000 inhabitants) and the general physician was found to be the leading prescriber (46·9%), being followed by cardiologists (15·3%). A log-linear model was constructed to study the combined effect of sociodemographic factors on the probability of being a tranquillizer user. Women were found to take more tranquillizers than men, consumption increased with age, and the positives in the QMPA were more likely to be users than were the negatives. The higher the family income per capita the higher the risk of being a tranquillizer user. These findings applied regardless of the sub-district, marital status, and migration status of the subjects. These results are discussed in the light of the alternative possible interventions by general practitioners.
Normality, deviance and minor psychiatric morbidity in the community
Authors: Anderson Jeremy , Huppert Felicia , Rose Geoffrey
Published: July 2009

Synopsis

This paper investigates factors affecting the distribution of psychiatric morbidity in the community. It identifies a close relationship between mean Chronic General Health Questionnaire (CGHQ) scores in subdivisions of a large random sample of the community (the Health and Lifestyle Survey, N = 6317) and the prevalence in these groups of abnormal, above-threshold CGHQ scores. The frequency distributions of CGHQ scores in these different populations move up and down as a whole: like other physiological and behavioural attributes, these mental health outcomes in individuals are associated with characteristics of the populations in which they arise. Populations thus carry a collective responsibility for their own mental health and well-being. This implies that explanations for the differing prevalence rates of psychiatric morbidity must be sought in the characteristics of their parent populations; and control measures are unlikely to succeed if they do not involve population-wide changes.
Urban–rural differences in the associations between social deprivation and psychiatric service utilization in schizophrenia and all diagnoses: a case-register study in Northern Italy
Authors: Thornicroft Graham , Bisoffi Giulia , De Salvia Domenico , Tansella Michele
Published: July 2009

Synopsis

Service utilization measures from the psychiatric case registers for urban South-Verona and rural Portogruaro in North East Italy for the period 1983–9 were used to identify associations with socio-demographic variables from the 1981 census in schizophrenia and related disorders as well as in all diagnoses. The patterns of service use were broadly similar, except that Portogruaro has significantly more community contacts, and has about twice the treated incidence and prevalence of schizophrenia. The census data showed that unmarried and unemployed people were more likely to live alone in the urban than in the rural area. In South-Verona the most strongly associated predictor variables, both for schizophrenia and all diagnoses, are: living alone, unemployment, percentage of the total population who are dependents and the percentage who are divorced, separated or widowed. In contrast, in Portogruaro there were no consistent associations between census and service use variables. Stepwise multiple regression models using three census predictor variables accounted for over 85% of the variance in South-Verona utilization rates. The results indicate that the strongly predictive associations previously described in England hold in urban South-Verona, but not in rural Portogruaro, and may be related to the effect of cities in clustering seriously disabled psychiatric patients in areas of low-cost housing where they live in relative social isolation.
Cognitive disorders and negative symptoms as correlates of motivational deficits in psychotic patients
Authors: Schmand B. , Kuipers T. , Gaag M. Van Der , Bosveld J. , Bulthuis F. , Jellema M.
Published: July 2009

Synopsis

The problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.

The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a ‘computational’ but of an ‘energetical’, i.e. motivational nature.
Are cities bad for your mental health?
Authors: Lewis Glyn , Booth Margaret
Published: July 2009

Synopsis

A study was conducted using data from the Health and Lifestyle Survey, a population based community survey of England, Wales and Scotland in which psychiatric morbidity was assessed using the General Health Questionnaire. An association was found between urban residence and the prevalence of psychiatric morbidity (odds ratio 1·54, 95% CI 1·32–1·80) which persisted after adjustment for various confounding factors (odds ratio 1·34, 95% CI 1·13–1·58). The discussion mentions the need for further study into the psychologically harmful elements of urban life.
Patterns of cortical activity in schizophrenia
Authors: Schroeder J. , Buchsbaum M. S. , Siegel B. V. , Geider F. J. , Haier R. J. , Lohr J. , Wu J. , Potkin S. G.
Published: July 2009

Synopsis

Eighty-three patients with schizophrenia and 47 healthy controls received positron emission tomography (PET) with 18F-2-deoxyglucose uptake while they were executing the Continuous Performance Test (CPT). The entire cortex was divided into 16 regions of interest in each hemisphere, four in each lobe of the brain, and data from corresponding right and left hemispheric regions were averaged. Data from the schizophrenic patients were subjected to a factor analysis, which revealed five factors that explained 80% of the common variance. According to their content, the factors were identified and labelled ‘parietal cortex and motor strip’, ‘associative areas’, ‘temporal cortex’, ‘hypofrontality’ (which included midfrontal and occipital areas) and ‘frontal cortex’. Hemispheric asymmetry was only confirmed for the temporal cortex. Factor weights obtained in the schizophrenic group were applied to the metabolic data of the healthy controls and factor scales computed. Schizophrenics were significantly more hypofrontal than the controls, with higher values on the ‘parietal cortex and motor strip’ factor and a trend towards higher values in the temporal cortex. A canonical discriminant analysis confirmed that the ‘hypofrontality’ and ‘parietal cortex and motor strip’ factors accurately separated the schizophrenic group from the healthy controls. Hemispheric asymmetry was only confirmed for the temporal lobe. Significantly higher factor scores for the left temporal lobe in schizophrenics than in normals were obtained when calculated for the right and left hemisphere separately. Taken together, our results confirm the importance of hypofrontality as a pattern of cortical metabolic rate and point to the potential importance of parietal and motor strip function in schizophrenia.
Memory functions, alprazolam and exposure therapy: a controlled longitudinal study of agoraphobia with panic disorder
Authors: Curran H. V. , Bond A. , O'Sullivan G. , Bruce M. , Marks I. , Lelliot P. , Shine P. , Lader M.
Published: July 2009

Synopsis

Benzodiazepines (BZs) produce transient anterograde amnesia when given to normal subjects. The present longitudinal study assessed whether BZs impair memory functions in a clinically anxious group. Eighty-two agoraphobics with panic disorder were randomly allocated to one of four treatment groups resulting from a combination of two drug treatments (alprazolam or placebo) and two psychological treatments (exposure or relaxation). Of these, 38 subjects were assessed on a range of objective and subjective indices of memory and mood at three time points: before treatment, after 8 weeks of treatment and again at 24 weeks when patients had been free of medication from 5–8 weeks.

Alprazolam produced pronounced impairments on a word recall task. At the 24-week medication-free follow-up, alprazolam patients were still impaired on the task compared with placebo patients. Alprazolam did not impair performance on an implicit memory task and did not affect digit span. Differences between psychological treatments emerged mainly in subjective memory effects. Findings are discussed in terms of the specificity of BZ-induced amnesia and differential tolerance to the varying effects of BZs. Implications are drawn out for the patient's ability to function optimally in daily life while taking alprazolam.
Neurasthenia in a longitudinal cohort study of young adults
Authors: Merikangas K. , Angst J.
Published: July 2009

Synopsis

This study examines the concept of neurasthenia in a longitudinal cohort of young adults selected from a community sample of the canton of Zurich, Switzerland. The major focus is on the validity of the case definition of neurasthenia. Close approximations of the proposed descriptive and research definitions of the ICD-10 are employed as well as the concept of ‘irritable weakness’ as described in 1831 by Kraus (1926–1932).

The prevalence of neurasthenia defined according to the ICD-10 criteria was: 1% across 10 years and 0·9% in 1988 for a duration criterion of ≥ 3 months; and 8·1% across 10 years and 12% in 1988 for a duration criterion of ≥ 1 month. The duration criterion of ≥ 3 months appeared to be excessively restrictive to represent individuals with neurasthenia in the community. Subjects with 1 month episodes of neurasthenia exhibited sufficient differences from controls and similarities to subjects with anxiety or depressive disorders to justify a 1 month duration criterion for neurasthenia in community samples.

The clinical significance of neurasthenia was indicated by the magnitude of subjective distress, and occupational and social impairment reported by the majority of the cases. Prospective assessment of the longitudinal course of neurasthenia revealed that approximately 50% of the cases continued to exhibit this disorder at follow-up. Our findings suggest that neurasthenia is equally likely to represent an early manifestation of affective illness as it is a consequence in those neurasthenic subjects who exhibited comorbid affective disorders. The magnitude, chronicity, impairment, longitudinal stability and distinction from anxiety and depression associated with this condition in the general population, suggest that neurasthenia is an important diagnostic entity for which additional validation studies should be undertaken.
Perceptual distortion of body image in adolescent girls: distortion of body image in adolescence
Authors: Halmi Katherine A. , Goldberg Solomon C. , Cunningham Sheila
Published: July 2009

synopsis

Body image estimations in 86 normal-weight adolescent girls showed (a) a tendency to overestimate body width and underestimate body length and (b) an association between the younger ages and the extent of overestimation of body width. In particular there is a sharp drop in overestimation between ages 10 and 11 and thereafter a more gradual and non-significant decline. These age-specific normative data are useful in assessing body image distortions in a variety of medical and psychiatric disorders.
Epileptic seizures induced by psychotropic drugs
Authors: Toone B. K. , Fenton G. W.
Published: July 2009

synopsis

On the basis of information abstracted from case histories, 41 patients who had experienced epileptic seizures thought to be due either to treatment with psychiatric drugs or to withdrawal from sedative drugs were compared with a control group of patients. Those who had experienced seizures were more commonly first born and had a history of post-natal brain damage. During the week preceding the seizure there had been a marked increase in drug prescribing. The implications for drug management are discussed.
Neurotic illness in the families of children with asthma and wheezy bronchitis: a general practice population study
Authors: Davis J. B.
Published: July 2009

synopsis

In a controlled population study 111 families of children with asthma and wheezy bronchitis were screened. The mothers of asthmatics suffered more depressive illness than controls. This correlates with the severity of the child's asthma. There was no difference in immunological status between depressive and non-depressive mothers of asthmatics.
The characteristics of psychiatric patients readmitted within a month of discharge
Authors: Marks Frances M.
Published: July 2009

synopsis

From the Camberwell Register it was found that 9–14% of all admissions in the years 1965–70 were readmissions within a month of discharge. The characteristics of these patients were compared with the total population admitted. No particular diagnostic category was associated with rapid readmissions but the rapidly readmitted group contained a high proportion of young patients and divorced or separated patients.

The case notes of rapidly readmitted patients were examined and compared with the case notes of a control group. The circumstance which predisposed patients to require rapid readmission was the degree of socially disruptive behaviour of the patient.

Patients benefited from readmission and the reasons for this are discussed.
The biochemical basis of relapse and drug response in schizophrenia: review and hypothesis
Authors: Van Kammen Daniel P.
Published: July 2009

SYNOPSIS

This review of the literature suggests that antipsychotic drug response is determined by dopamine (DA) turnover and norepinephrine (NE) activity prior to treatment. The data suggest that NE modulates the DA system. Drug-free psychotic patients with relatively increased DA and NE activity, including release, are more likely to be treatment responsive, while patients who show evidence of enhanced DA and NE activity during treatment with antipsychotic drugs are likely to relapse soon after neuroleptic withdrawal. Basal release of DA and NE is decreased and associated with residual positive and negative symptoms. Improvement during neuroleptic treatment is associated with decreases in DA and NE phasic or stimulus induced release. The variable response to antipsychotic drugs is most likely to be a result of dysregulated DA and NE release, i.e. under state-dependent control, rather than evidence of a heterogeneous aetiology. Because catecholamines regulate gain, signal-to-noise ratio and gating in the brain, this model allows for environmental factors to interact with biochemical state and drug treatment. The author proposes that impaired homeostasis of NE and DA in schizophrenia causes instability in NE and DA neuronal firing and release, presumably related to mechanisms down-stream from the receptors, such as G proteins. This instability of catecholamine release may explain the observed variability in clinical states and drug response in schizophrenia.
Dysphoric mood and symptomatology in schizophrenia
Authors: Norman Ross M. G. , Malla Ashok K.
Published: July 2009

SYNOPSIS

The relationships between depression, anxiety and positive and negative symptoms of schizophrenia were examined in a study of 95 schizophrenic patients who were receiving out-patient care. Various measures of depression and anxiety showed a pattern of interrelationships which suggested that they were measuring a general state of dysphoria rather than separate dimensions of anxiety and depression. Dysphoria was found to be more reliably related to level of positive symptomatology than to negative symptoms.
Talents and preoccupations in idiots-savants
Authors: O'Connor Neil , Hermelin Beate
Published: July 2009

SYNOPSIS

The question was asked whether a diagnosis of autism or a tendency to repetitive behaviour and preoccupation with a restricted area of interest, were crucial features of idiot-savant talents. Answers by caretakers to a questionnaire on these topics revealed that autistic and non-autistic savants resembled each other closely in preoccupation but differed from controls matched for IQ and diagnosis. In addition, the mentally handicapped showed fewer repetitive tendencies than did autistic controls. It is concluded that independent of diagnosis, preoccupations and repetitive behaviour appear to be closely associated with the manifestation of idiot-savant talents.
Does recurrent depression lead to a change in neuroticism?
Authors: Duggan Conor F. , Sham Pak , Lee Alan S. , Murray Robin M.
Published: July 2009

SYNOPSIS

The hypothesis that recurrent or chronic depressive illness produces a long-term change in neuroticism was examined in a sample (N = 34) from a consecutive series of 89 depressed patients admitted to the Maudsley Hospital in 1965/6. The Eysenck Personality Inventory (EPI) was administered at the time of the index illness both when the patients were depressed and on recovery, and then again at follow-up 18 years later. The change in the neuroticism (N) score over the 18-year-period was compared in good and poor outcome groups defined variously by a global rating of outcome, frequency of episodes, extent of subsequent hospitalization and the presence or absence of subsequent chronicity. The mean N score for the sample as a whole did not change significantly over the 18 years, and no differential change in the N score was observed between any of the good and poor outcome groups. Thus, the hypothesis was not supported.
Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures
Authors: Hogan T. P. , Awad A. G.
Published: July 2009

SYNOPSIS

The schizophrenic patient's early psychological response to neuroleptic treatment has been demonstrated to be a significant predictor of treatment response. The validity of the construct of subjective response is evaluated by comparison of two measures. Fifty-five recently admitted and unmedicated schizophrenic patients were randomly allocated to chlorpromazine or haloperidol. Subjective responses at 24 and 48 hours as assessed by two different scales, the Van Putten & May scale and the self-administered Drug Attitude Inventory, were strongly correlated with outcome at three weeks. Early emergence of extrapyramidal symptoms was not related to subjective response, but dysphoric patients had a greater incidence of EPS by the end of treatment than did non-dysphoric patients. The two measures showed high concordance in identification of early drug dysphoria.
Cognitive deficit and the prediction of rehabilitation success in a chronic psychiatric group
Authors: Wykes Til , Dunn Graham
Published: July 2009

SYNOPSIS

This paper describes the second stage (years 4, 5 and 6) of a prospective follow-up of a sample of chronic patients which was designed to investigate the in service use. It also tested the relative predictive power of variables which included demographic, symptomatic and behavioural factors as well as a novel reaction time variable which reflects response processing time.

During the six years of the study 91% of the patients in the sample changed either the degree of their day and/or night care. Many moved to more independence but, a number did also become more dependent on psychiatric services. There were no differences in outcome between a schizophrenic group and patients with other diagnoses. These results suggest a level of flexibility in outcome even in a severely disabled chronic group.

The main predictor of future service use at each stage of the follow-up for the whole group was chronicity at entry to the study. But, when the group was divided into schizophrenic patients and ‘others’, the response processing measure was a significant predictor of service use in the schizophrenic group and accounted for between 17% and 30% of the variance. For the ‘other’ diagnostic group, the age of the patient seemed to be the major determinant of care.

The reaction time variable seems to be an extra class correlate of a strict diagnosis of schizophrenia. It may also be a stable or episodic vulnerability factor, but as well as these promising hypotheses, which have yet to be justified, this measure does seem to have pragmatic value in predicting outcome in a rehabilitation network.
Psychosocial correlates of clinical depression after psychiatric in-patient treatment: methodological issues and baseline differences between recovered and non-recovered patients
Authors: Veiel Hans O. F. , Kühner Christine , Brill Gerhard , Ihle Wolfgang
Published: July 2009

SYNOPSIS

General methodological and design issues in research on psychosocial outcome predictors of clinical depression are discussed, and the first stage of a study of discharged depressed in-patients is presented. It involved 115 recovered and 75 non-recovered such patients who were compared regarding stress factors, social support, personality and coping styles. While there were few differences between recovered and non-recovered patients with respect to stable personality traits, recovered patients were less likely to have had severe long-term life difficulties, and their coping style differed: it was characterized by more negative appraisals of stressful situations, greater problem avoidance, less palliative activities, and a lesser inclination to solicit social support. Whereas among women without partners, as well as men, non-recovery was also associated with less support from friends, in particular psychological-emotional support in crises, non-recovered women with partners had much more such support. The results are discussed with reference to the existing literature on outcome correlates of clinical depression.
Environmental risk factors for Alzheimer's disease: their relationship to age of onset and to familial or sporadic types
Authors: Henderson A. S. , Jorm A. F. , Korten A. E. , Creasey H. , McCusker E. , Broe G. A. , Longley W. , Anthony J. C.
Published: July 2009

SYNOPSIS

Data from a case-control study of Alzheimer's disease (AD) were analysed in relation to age of onset and familial/sporadic status. The analyses were restricted to environmental exposures which might injure the brain. Later-onset AD was found to be positively associated with starvation/malnutrition and with nose-picking and negatively with analgesics, while earlier-onset was associated with physical underactivity and nervous breakdown more than 10 years before. Sporadic AD was associated with starvation/malnutrition and with head injury. These analyses merit replication in other large case-control studies of AD.
Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers
Authors: Lewis Glyn , Pelosi Anthony J. , Araya Ricardo , Dunn Graham
Published: July 2009

SYNOPSIS

Many of the standardized interviews currently used in psychiatry require the interviewer to use expert psychiatric judgements in deciding upon the presence or absence of psychopathology. However, when case definitions are standardized it is customary for clinical judgements to be replaced with rules. The Clinical Interview Schedule was therefore revised, in order to increase standardization, and to make it suitable for use by ‘lay’ interviewers in assessing minor psychiatric disorder in community, general hospital, occupational and primary care research.

Two reliability studies of the revised Clinical Interview Schedule (CIS-R) were conducted in primary health care clinics in London and Santiago, Chile. Both studies compared psychiatrically trained interviewer(s) with lay interviewer(s). Estimates of the reliability of the CIS-R compared favourably with the results of studies of other standardized interviews. In addition, the lay interviewers were as reliable as the psychiatrists and did not show any bias in their use of the CIS-R. Confirmatory factor analysis models were also used to estimate the reliabilities of the CIS-R and self-administered questionnaires and indicated that traditional measures of reliability are probably overestimates.
The common cold, pattern sensitivity and contrast sensitivity
Authors: Smith Andrew P. , Tyrrell David A. J. , Barrow G. Ian , Higgins Peter G. , Bull Susan , Trickett Susan , Wilkins Arnold J.
Published: July 2009

SYNOPSIS

Results from two studies involving challenge with respiratory syncytial viruses showed that volunteers who developed colds were more sensitive to a visually distracting pattern presented prior to virus challenge than were volunteers who did not get a cold. Volunteers with sub-clinical infections reported more illusions after virus challenge than they had done before, whereas uninfected volunteers and those with colds tended to report fewer illusions on the second test. These effects did not occur when volunteers were challenged with either a coronavirus or rhinovirus. Overall, the results confirm that behavioural measures may be related to susceptibility to subsequent illness, and that viral infections may influence visual perception. They also show that the effects vary according to the nature of the infecting agent, which agrees with results from studies looking at other aspects of behaviour.
Rapid development of hyponatraemic seizures in a psychotic patient
Authors: Grainger David N.
Published: July 2009

SYNOPSIS

A 60-year-old woman with a history of recurrent psychotic illness developed severe hyponatraemia after a short period of compulsive water drinking. The case provides a rare illustration of the rapidity of development of dangerously low levels of serum sodium. On discovery of mild hyponatraemia it is essential to repeat measurement of the serum sodium level should the patient's clinical condition change, in order to detect any further deterioration of serum osmolality which may result in severe and possibly fatal cerebral symptoms.
The seventeenth-century transformation of the hysteric affection, and Sydenham's Baconian medicine
Authors: Boss Jeffrey M. N.
Published: July 2009

Synopsis

Before 1600 the ‘hysteric affection’ was a paroxysmal ailment of women explained as primarily due to the condition or malposition of the womb. During the seventeenth century attention shifted from the womb to the brain. Then Thomas Sydenham's clinical method yielded a view of hysteria which comprehended a wide range of illness with a mental component, and which was related to the whole person. In the course of this paper the relation of the hysteric affection to witchcraft, demonic possession, St Vitus' dance (chorca), hypochondria and melancholy is also noted.
Physiological and pharmacological basis for the chemotherapy of enuresis
Authors: Stephenson J. D.
Published: July 2009

Synopsis

Enuresis is a disorder of micturition occurring in the absence of an organic urinary tract lesion. To understand its possible causation, the mechanisms controlling micturition are described together with the possible sites of action of various anti-enuretic agents, particularly imipramine. It is concluded that further research into the central control of micturition is required before the precise actions of centrally-acting anti-enuretic agents can be elucidated. Knowledge of these may give insight into the nature of the defect causing enuresis.
The Eating Attitudes Test: an index of the symptoms of anorexia nervosa
Authors: Garner David M. , Garfinkel Paul E.
Published: July 2009

Synopsis

Data on the development of a 40-item measure of the symptoms in anorexia nervosa are reported. The scale (EAT) is presented in a 6-point, forced choice, self-report format which is easily administered and scored. The EAT was validated using 2 groups of female anorexia nervosa patients (N = 32 and 33) and female control subjects (N = 34 and 59). Total EAT score was significantly correlated with criterion group membership(r = 0·87, P < 0·001), suggesting a high level of concurrent validity. There was very little overlap in the frequency distributions of the 2 groups and only 7% of the normal controls scored as high as the lowest anorexic patient. Female obese and male subjects also scored significantly lower on the EAT than anorexics. Recovered anorexic patients scored in the normal range on the test, suggesting that the EAT is sensitive to clinical remission.
Attitudes of families to some aspects of Huntington's chorea
Authors: Barette Jeanne , Marsden C. D.
Published: July 2009

Synopsis

One hundred and fifty-three completed questionnaires received from families with a history of Huntington's chorea were analysed to discover their attitudes towards the disease. Of special interest were: (a) how and when they were first informed about their illness; (b) what effects the knowledge of the hereditary aspects of the disease had on them and on their children; and (c) their reaction to a possible future predictive test
Determinants of the ability of general practitioners to detect psychiatric illness
Authors: Marks J. N. , Goldberg D. P. , Hillier V. F.
Published: July 2009

Synopsis

This study of psychiatric illness among 4098 patients attending 91 general practitioners compares 2 methods of case identification: ‘conspicuous morbidity’ by the doctor's own assessments, and ‘probable prevalence’ by the patients' responses to the General Health Questionnaire (GHQ). In general, the latter gives somewhat higher estimates than the former, but there are wide variations in morbidity between practices. The ability of each general practitioner to detect psychiatric illness was measured by computing Spearman's correlation coefficient between his assessments and the GHQ scores of his patients. The mean correlation coefficient was +0·36, but the range was very wide (0·09–0·60).

The first part of the study deals with various demographic characteristics of the patients themselves which are associated with an increased likelihood of the doctor detecting a psychiatric illness; such factors include unemployment, female sex, and marriages which have ended by separation, divorce or death.

The second part of the study examines characteristics of the doctors themselves in an attempt to account for the wide variation between them in their ability to detect psychiatric illness. A research psychiatrist made detailed observations on 2098 interviews carried out by 55 general practitioners. Each doctor's verbal and non-verbal styles were recorded minutely, and in addition various global ratings were made. The doctors completed personality inventories and supplied details of training and professional background. It was possible to account for 67 % of the variance of correlation coefficient mainly in terms of 2 dimensions: ‘interest and concern’ and ‘conservatism’. The way in which the doctor interviews his patients is shown to be important, but there are interactions between interview style and the doctor's personality.
Variations in referral pattern to the psychiatric services by general practitioners
Authors: Robertson Norma C.
Published: July 2009

Synopsis

Referral rates to psychiatric services in North-East Scotland by 147 individual urban and rural general practitioners were calculated. Among city doctors, the greater the number of years since qualification the more patients were referred. Single-handed city doctors also had very high referral rates. Subsequent interviews were conducted with 76 general practitioners. Topics covered included reasons for referral to psychiatric services. Psychotics, severely depressed patients, alcoholics and violent patients were the most frequently referred groups.
Illness behaviour and rehospitalization in bipolar affective disorder
Authors: Joyce Peter R.
Published: July 2009

Synopsis

Fifty hospitalized patients with bipolar affective disorder were interviewed on discharge from hospital. Over the subsequent 12 months, 36 of these patients were readmitted to hospital. Compared with the remainder, those readmitted had had more past hospital admissions and on interview were rated as being less able to recognize and respond to early symptoms of relapse and were less accepting of medication.
Multiple memory deficits in Alzheimer-type dementia: implications for pharmacotherapy
Authors: Kopelman Michael D.
Published: July 2009

Synopsis

This paper investigates the memory disorder of Alzheimer-type dementia by comparing the performance of Alzheimer patients on selected memory tests with that of Korsakoff patients and healthy controls. Alzheimer patients have deficits in both primary and secondary memory, and this finding is compared with that which pharmacological studies predict would occur on the basis of cholinergic depletion. The deficits in primary memory are unlikely to be accounted for in terms of cholinergic depletion, and provide a possible explanation for the disappointing results of trials of cholinergic replacement therapy in this disorder. On the other hand, the pattern of deficit in secondary memory is entirely consistent with that expected from cholinergic depletion.
Psychological correlates of coronary heart disease
Authors: Tennant Christopher C. , Langeluddecke Pauline M.
Published: July 2009

Synopsis

The Type A behaviour pattern and other measures of psychological traits and symptom states were assessed in 92 subjects (predominantly male) presenting for coronary angiography. These measures were correlated with three angiographic indices of coronary heart disease (CHD) severity and two clinical indices (angina and the duration of CHD). The only psychological measures associated with atherosclerosis (assessed by angiography) were indices of personality: Type A (the Jenkins Activity Survey), trait tension, trait anxiety and suppression of anger. It was concluded that these traits may have some role in the pathogenesis of coronary atherosclerosis. None of the measures of psychological symptoms showed a significant association with angiography indices. However, depressive symptoms and expressed hostility were associated with the severity of angina and duration of heart disease. It was concluded that these affects are the consequences of the physical disability of CHD.
A comparison of the validity of two psychiatric screening questionnaires (GHQ-12 and SRQ-20) in Brazil, using Relative Operating Characteristic (ROC) analysis
Authors: De Jesus Mari Jair , Williams Paul
Published: July 2009

Synopsis

The General Health Questionnaire (GHQ-12) (Goldberg, 1972) and the Self Report Questionnaire (SRQ-20) (Hardinget al.1980) were simultaneously validated against the criterion of the Clinical Interview Schedule (CIS) (Goldberget al.1970) in three primary care clinics in the city of Sao Paulo, Brazil. A comparison between the two screening instruments was carried out. The product-moment correlation between the two sets of scores was +0·72, and the validation coefficients for the GHQ-12 and the SRQ-20 were respectively: sensitivity 85% and 83%; specificity 79% and 80%; overall misclassification rate 18% and 19%.

The two screening instruments were further compared by the application of Relative Operating Characteristic (ROC) analysis and, again, were found to be very similar in performance. The area under the ROC curve was 0·87 for the GHQ and 0·90 for the SRQ-20 (Z = 0·92, NS). Both psychiatric screening instruments were therefore found to be acceptably valid when assessed against the CIS in three primary care settings in Brazil.

The application of ROC analysis to studies of this kind was feasible and straightforward. It was found to be superior to the conventional method of presentation of validity data. It is recommended that the application of ROC analysis to psychiatric screening studies be further utilized and explored.
Attentional deficit in the siblings of schizophrenics
Authors: Wood Rodger L. , cook Mark
Published: July 2009

Synopsis

A study of attentional deficit in the relatives of schizophrenics and in a matched control group is reported, in which the relatives are found to have poorer scores on a vigilance test and on a choice reaction time test. It is concluded that this deficit points to one of the primary symptoms of schizophrenia, and suggestions for further research are made
Survival on home haemodialysis: its relationship with physical symptomatology, psychosocial background and psychiatric morbidity
Authors: Farmer C. J. , Bewick M. , Parsons V. , Snowden S. A.
Published: July 2009

Synopsis

An entire group of 32 home dialysis patients from one hospital renal unit was assessed for psychiatric morbidity on a standardized interview of proven reliability. A rating of physical symptomatology and an enquiry into the childhood and psychosocial background were made at the same time. Psychiatric morbidity, physical symptomatology and a history of good relationships with both natural parents in childhood were inter-related. They were all related to survival on haemodialysis 3½ years later. Survival was also associated with a coping spouse and full-time employment or housework by the patient. These findings are discussed in the light of current concepts of the psychosocial setting for physical illness.
Interactions in contingency tables: a brief discussion of alternative definitions
Authors: Everitt B. S. , Smith A. M. R.
Published: July 2009

Synopsis

The purpose of this note is to indicate how the disagreement between Tennant & Bebbington and Brown & Harris has arisen. The difference between the 2 pairs of authors is due, at least in part, to their use of different models for the analysis of the data in question. There can be no final answer as to which model is correct – the data are simply open to more than one interpretation. Nevertheless, it is interesting that the use of a multiplicative model, seemingly ignored by Brown & Harris, leads to a simple description of the data in which the ‘vulnerability factor’ and the ‘provoking agent’ may be considered to act independently on the response. Consequently, in stating that their data contain an interaction so obvious that it can be detected by ‘visual inspection’, Brown & Harris may have been somewhat rash.
Psychiatric journals and the evolution of psychological medicine
Authors: Shepherd Michael
Published: July 2009

SYNOPSIS

The history of psychiatric journals is outlined from their inception in the late eighteenth century. In the development of psychological medicine they serve as intellectual markers of the complex relations between institutional psychiatry, neurology, the psychosocial sciences and the psychotherapeutic movement. Their current status is briefly discussed.
The International Pilot Study of Schizophrenia: five-year follow-up findings
Authors: Leff J. , Sartorius N. , Jablensky A. , Korten A. , Ernberg G.
Published: July 2009

SYNOPSIS

A five-year follow-up of the patients initially included in the International Pilot Study of Schizophrenia was conducted in eight of the nine centres. Adequate information was obtained for 807 patients, representing 76% of the initial cohort. Clinical and social outcomes were significantly better for patients in Agra and Ibadan than for those in the centres in developed countries. In Cali, only social outcome was significantly better.
Depressive symptomatology and cognitive functioning: an epidemiological survey in an elderly community sample in France
Authors: Fuhrer R. , Antonucci T. C. , Gagnon M. , Dartigues J.-F. , Barberger-Gateau P. , Alperovitch A.
Published: July 2009

SYNOPSIS

As part of a 5-year, prospective, epidemiological survey of normal and pathological ageing, this cross-sectional analysis examines the relationship between depressive symptomatology (CES-D) and cognitive functioning (MMS) in a community sample of 2792 non-institutionalized persons (age ≥ 65) living in Southwest France. Of the sample, 13·4%, report depressive symptoms above the cut-off. A significant association was found between CES-D and MMS scores, but after adjusting for age, living arrangements, and especially functional limitations, the relationship remained strong only for women.
A rating scale for aggressive behaviour in the elderly – the RAGE
Authors: Patel Vikram , Hope R. A.
Published: July 2009

SYNOPSIS

A 21-item rating scale for measuring aggressive behaviour in psychogeriatric in-patients is described. This scale is designed to be completed by ward staff. It should prove valuable in treatment studies and in studies which aim to investigate the correlates of aggressive behaviour. Studies using the scale demonstrate that when used in conjunction with a ward check list the scale has high reliability and validity.
Social language use in parents of autistic individuals
Authors: Landa R. , Piven J. , Wzorek M. M. , Gayle J. O. , Chase G. A. , Folstein S. E.
Published: July 2009

SYNOPSIS

Social language use (pragmatics) in parents of autistic individuals and controls was compared. Autism parents displayed atypical pragmatic behaviours more often than controls. Preliminary factor analysis suggested three parsimonious groupings of pragmatic abnormalities: Disinhibited Social Communication, Awkward/Inadequate Expression, and Odd Verbal Interaction. The pragmatic features observed in some autism parents are milder but conceptually similar to the social language deficits of autism. Possible reasons for familial aggregation of pragmatic language deficits are discussed.
Changes in rates of depressive symptoms in a Japanese working population: life-table analysis from a 4-year follow-up study
Authors: Kawakami N. , Roberts R. E. , Lee E. S. , Araki S.
Published: July 2009

Synopsis

To investigate the effects of demographic variables on changes in rates of depressive symptoms in a non-clinical population, a 4-year follow-up study was conducted on a total of 6378 employees of a Japanese electrical company. Data were collected five times at 1-year intervals (T0—T4) using a questionnaire that included the Zung Self-rating Depression Scale (SDS). Of the non-depressed (i.e. having a SDS score of 47 or less) at baseline (N= 4857), 14% were found depressed at least once during T1—T4. Younger, never married, female and blue-collar workers were significantly at greater risk for becoming depressed during the follow-up period (P< 0·05). Of the depressed at baseline (N= 505), 20% were depressed every time during T1—T4. Younger workers were significantly at greater risk for persistence of depressive symptoms during the follow-up period (P< 0·05). The results suggested that age is associated with both occurrence and persistence of depressive symptoms, while gender, marital status and occupation are associated only with the occurrence.
The phenomenology and explanatory models of common mental disorder: a study in primary care in Harare, Zimbabwe
Authors: Patel V. , Gwanzura F. , Simunyu E. , Lloyd K. , Mann A.
Published: July 2009

synopsis

In order to describe the explanatory models and the etic and emic phenomena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional healers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Schedule.

Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of illness. Spiritual factors were frequently cited as causes of mental illness. Subjects who were selected by traditional healer, reported a greater duration of illness and were more likely to provide a spiritual explanation for their illness.

The majority of subjects were classified as ‘cases’ by theeticcriteria of the CISR. Most patients, however, showed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform toeticcriteria of ‘caseness’ and they may represent a unique category of psychological distress in Zimbabwe. A wide variety of emic phenomena were elicited that have been incorporated in an indigenous measure of non-psychotic mental disorder.Kufungisisa, or thinking too much, seemed to be the Shona term closest to the Euro-American concept of neurotic illness.
The Psychogeriatric Assessment Scales: a multidimensional alternative to categorical diagnoses of dementia and depression in the elderly
Authors: Jorm A. F. , Mackinnon A. J. , Henderson A. S. , Scott R. , Christensen H. , Korten A. E. , Cullen J. S. , Mulligan R.
Published: July 2009

SYNOPSIS

The Psychogeriatric Assessment Scales (PAS) provide an assessment of the clinical changes seen in dementia and depression. Principal components analysis and latent trait analysis were used to develop a set of scales to summarize these clinical changes. There are three scales derived from an interview with the subject (Cognitive Impairment, Depression, Stroke) and three from an interview with an informant (Cognitive Decline, Behaviour Change, Stroke). Results are reported on the reliability and validity of these scales using data from clinical samples in Sydney and Geneva and a population sample from Canberra. The scales were found to have excellent validity when judged against clinical diagnoses of dementia and depression and could distinguish Alzheimer's from vascular dementia. Cut-off points were developed to indicate correspondence between scale scores and clinical diagnoses. Percentile rank norms were developed from the Canberra population sample. The PAS is easy to administer and score and can be used by lay interviewers after training. It is intended for application both in research and in services for the elderly.
Lateralized abnormality of high energy phosphate metabolism in the frontal lobes of patients with bipolar disorder detected by phase-encoded31P-MRS
Authors: Kato T. , Shioiri T. , Murashita J. , Hamakawa H. , Takahashi Y. , Inubushi T. , Takahashi S.
Published: July 2009

SYNOPSIS

High energy phosphate metabolites were measured using phase-encodedin vivophosphorus-31 magnetic resonance spectroscopy (31P-MRS) in both the left and right frontal lobes of 25 patients with bipolar disorder. Eleven patients were examined in the depressive state, 12 in the manic state, and 21 in the euthymic state. Twenty-one age-matched normal volunteers were also examined. The phosphocreatine (PCr) peak area percentage in the left frontal lobe in the patients in the depressive state was decreased compared with that in the normal controls. It was significantly negatively correlated with the Hamilton Rating Scale for Depression score evaluated at the time of31P-MRS examination. The PCr peak area percentage in the right frontal lobe in the patients in the manic and the euthymic states was decreased compared with that in the controls. These results are compatible with previous reports describing reduction of glucose metabolism in the left frontal lobe in depressive patients with bipolar disorder and trait-dependent right hemisphere dysfunction in bipolar disorder.