bluuebunny/crossref_metadata_2025 huggingface dataset:
Adrenoleukodystrophy initially presenting with symptoms of dementia
Authors: TAMAGAKI Chiharu , MURATA Akira , OHARA Tokio , SAKATA Tetsuji , TAKASE Katsunori , OKUGAWA Gaku , NOBUHARA Kenji , KINOSHITA Toshihiko
Published: November 2007

There is growing consensus that dementia caused by white matter alterations is called ‘white matter dementia’. Because the symptoms of adrenoleukodystrophy (ALD) are associated with diffuse white matter dysfunction, ALD is categorized as white matter dementia. Herein, we describe the case of a 47‐year‐old man affected by ALD whose symptoms first appeared a few years earlier in the form of deteriorating personality and memory disturbances, heralded by neurological symptoms. On neuroimaging, a discrepancy was found between magnetic resonance imaging and single photon emission computed tomography in the early stage of the disease process. We suggest that this discrepancy may be an important finding in the diagnosis of early stage white matter dementia.
Progressive prosopagnosia at a very early stage of frontotemporal lobar degeneration
Authors: NAKACHI Ryoko , MURAMATSU Taro , KATO Motoichiro , AKIYAMA Tomoko , SAITO Fumie , YOSHINO Fumihiro , MIMURA Masaru , KASHIMA Haruo
Published: November 2007

Background:  The present paper describes a patient with a right temporal lobe variant (RTLV) of frontotemporal lobar degeneration (FTLD).

Methods:  The study was undertaken when the patient was completely independent in her environment and had not complained of any cognitive problems.

Results:  Under general neuropsychological assessment, the patient showed no notable deficit other than a difficulty in recognizing famous people by looking at photographs of their faces. Subsequent in‐depth evaluation indicated prosopagnosia: the patient presented with an impaired ability to recognize the faces of famous people and family members, whereas her visuospatial abilities were intact. Because the patient was able to recognize familiar people by their voices, the impairment was not a general loss of knowledge about people, but an inability to access this knowledge from visual stimuli (i.e. via the visual modality). The patient also exhibited a ‘within‐category’ learning deficit; however, her ability to learn from ‘across‐category’ visual stimuli remained intact.

Conclusions:  Overall, the results of the present study support the proposed model of RTLV of FTLD, where the first sign would be the disruption of face recognition components, leading to a selective form of associative prosopagnosia. Further, the co‐occurrence of face and ‘within‐category’ object learning deficits favor an interpretation in which a more generalized deficit occurs ‘earlier’ in the sequence of events associated with the object recognition process.
Structure of schizophrenic symptomatology and its changes over time: prospective factor‐analytical study
Authors: Salokangas R. K. R.
Published: November 2007

A representative sample of 156 new schizophrenic patients (DSM‐III) were examined at the time of their first treatment contact for psychosis, and reexamined 2 and 5 years thereafter. The symptom variables, assessed by the Comprehensive Psychopathological Rating Scale (CPRS), were factored and compared with each other. The following major dimensions were found: (i) a fairly stable negative dimension with affective and speech impoverishment and withdrawal; (ii) a delusional dimension; (iii) hallucinatory dimensions; (iv) a disorganization dimension; and (v) a depressive dimension with unreal experiences. The negative dimension was more prevalent in unmarried patients. Neither the two‐syndrome model of negative and positive symptoms nor the three‐syndrome model of psychomotor poverty, disorganization and reality distortion proved to be satisfactory. In a representative sample of schizophrenic patients, the syndrome structure described by symptom dimensions appears to be more complex and varies considerably according to the duration of the illness.
Psychosocial factors and completed suicide in personality disorders
Authors: Heikkinen M. E. , Isometsä E. T. , Henriksson M. M. , Marttunen M. J. , Aro H. M. , Lönnqvist J. K.
Published: November 2007

The aim of the present study was to investigate the relationships between personality disorders (PD) and various psychosocial factors in a random sample (n= 229) of suicides with psychological autopsy‐based DSM‐III‐R diagnoses representing the total 1‐year suicide population in Finland.

Background social factors and social interaction factors for 56 suicide victims with a PD diagnosis were compared with those of 56 age‐ and sex‐matched non‐PD suicide victims. The groups were similar with regard to marital status, socio‐economic status, parental divorce, broken home before the age of 16 years, parental suicide attempts, and proportion of subjects living with parents. The PD suicide victims had more commonly had a companion of the opposite sex, lived alone, and resided in an urban area, but had less often experienced parental psychiatric hospitalization during their childhood. Although the groups did not differ with regard to complaints of loneliness before suicide, the lonely PD suicide victims had experienced more interpersonal loss and/or conflict than the lonely non‐PD suicide victims. The PD suicide victims were very similar with regard to psychosocial factors, irrespective of sex, age, Axis‐I comorbidity, or the cluster type of the PD. Only living alone was more common in young PD suicide victims, and male PD subjects had less often had confidants or friends with whom they shared common interests.
A critical review of genetic studies of schizophrenia. II. Molecular genetic studies
Authors: Portin P. , Alanen Y. O.
Published: November 2007

Recent molecular genetic studies of schizophrenia have, until now, been unable to demonstrate any specific major gene for schizophrenia. On the contrary, linkage and association studies have yielded almost exclusively negative or contradictory results. Such studies have involved certain candidate genes, such as the genes, for dopamine receptors and other brain neurotransmitters. Some of these candidate genes have now actually been excluded as specific aetiological factors in schizophrenia. Similarly, studies searching for a major gene for susceptibility to schizophrenia involving the whole human genome or large parts of chromosomes have not yielded unambiguously positive results. However, the most recent empirical evidence suggests that many polygenes, acting together, could constitute a risk factor for schizophrenia. It is thus most probable that genetic susceptibility to schizophrenic psychoses is polygenic, and that their effects are dependent on interaction with physical and psychosocial environmental factors.
The validity of screening for post‐traumatic stress disorder and major depression among Vietnamese former political prisoners
Authors: Smith Fawzi M. C. , Murphy E. , Pham T. , Lin L , Poole C. , Mollica R. F.
Published: November 2007

The aim of this study was to investigate the validity of the Harvard Trauma Questionnaire (HTQ) and the depression sub‐scale of the Hopkins Symptom Checklist‐25 (HSCL‐25) in screening for post‐traumatic stress disorder (PTSD) and major depressive disorder (MDD) among Vietnamese former political prisoners (POWs). The study population included Vietnamese POWs (n= 51) who migrated to the Boston metropolitan area between January 1990 and July 1992 under the Special Released Re‐education Center Detainees Resettlement Program. The criterion validity of the HTQ in assessing PTSD and of the depression sub‐scale of the HSCL‐25 in assessing MDD is supported by the results. Consideration of an appropriate cut‐off score should include examination of the utility of a given screening instrument for PTSD or MDD within different settings, such as refugee camps vs. countries of third asylum.
Contacts of suicide attempters with GPs prior to the event: a comparison between Stockholm and Bern
Authors: Michel K. , Runeson B. , Valach L. , Wasserman D.
Published: November 2007

The aim of this study was to investigate patterns of contact made with GPs by subjects in two cities prior to attempting suicide, in order to determine whether differences in the health care systems could be a possible factor influencing the help‐seeking behaviour of people experiencing suicidal crises. Structured interviews were conducted with suicide attempters from geographically defined catchment areas in two countries with private and national health care systems, respectively. The subjects were suicide attempters, admitted consecutively, aged ≥15 years and living either in Stockholm (n=202) or in Bern (n=66). Patients living in Bern had seen their GPs more regularly and more frequently throughout the year. There was an increase in the number of visits to the GP prior to the suicide attempt in both cities, but it was greater in Stockholm than in Bern. However, in Stockholm fewer patients who saw their GP in the week before the attempt talked about their suicidal thoughts. The differences in help‐seeking behaviour between the two patient samples may be related to the higher number of practising GPs and a more personal and consistent patient‐doctor relationship in Bern. It is possible that the private medical care system in Switzerland lowers the threshold enabling patients to talk to their GP about their suicidal plans. The results suggest that in both cities there is scope for improving communication of the suicidal patient with his or her doctor.
Ethnicity, social factors, illness and suicide: a follow‐up study of a random sample of the Swedish population
Authors: Johansson L. M. , Sundquist J. , Johansson S.‐E. , Bergman B.
Published: November 2007

The aim of this longitudinal study was to determine the influence of ethnicity, social factors and self‐reported long‐term somatic and psychiatric illness on suicide in a random sample of the Swedish population. The study is based on face‐to‐face interviews conducted between 1979 and 1985 with a random sample of the Swedish population consisting of 47 762 Swedish‐born subjects and 4407 individuals born elsewhere. The sample has been followed via register data concerning cases of suicide (suicides and undetermined deaths) until 31 December 1993. In total, 102 males and 46 females committed suicide prior to this date. Living alone and self‐reported somatic illness with impaired health status were very strong risk factors for suicide, with risk ratios of 2.15 (CI, 1.51–3.05) and 1.80 (1.19–2.72), respectively. Ethnicity, defined as being born outside Sweden, had a risk ratio of 1.87 (1.18–2.97) in a model controlled for sex and age. However, this risk decreased with increasing age in the final model. Furthermore, an increased risk of suicide was found among female subjects living in rented flats and among male subjects irrespective of form of tenure, as well as among residents of large urban areas. Respondents with a self‐reported long‐term psychiatric illness with impaired health status also had a high risk of suicide, which decreased with increasing age. The main finding of this study is that somatic diseases and psychiatric disorders, which are known risk factors for suicide, may be revealed in surveys conducted by interviewers without medical training. Thus self‐reported psychiatric and somatic illness appear to have a good potential for predicting suicide, even if the prevalence of psychiatric disorders is to some extent underestimated.
Utilization of psychiatric in‐patient care among new patients in a comprehensive community‐care system: a 3‐year follow‐up study
Authors: Saarento O. , Nieminen P. , Hakko H. , Isohanni M. , Väisänen E.
Published: November 2007

Utilization of psychiatric in‐patient care among 537 new patients was studied in the Department of Psychiatry in Oulu, Finland, during a 3‐year follow‐up period. Hospitalization during the second and third years of the follow‐up was predicted by hospitalization and number of emergency out‐patient contacts during the first year of the study, diagnosis of functional psychosis or personality disorder, and previous in‐patient care. In total, 5% of the cohort fulfilled our criteria for ‘revolving‐door’ patients. The ‘revolving‐door’ phenomenon was associated with in‐patient care at the first contact with the psychiatric services and diagnosis of psychosis or personality disorder. In total, 2% of the cohort became long‐stay hospital patients, and this was predicted by psychosis diagnosis. The clinical implications of these findings are that increased attention should be paid to the first assessment of new patients and to the interaction between psychiatric services and patients during the first year of care.
A comparison of paroxetine, clomipramine and placebo in the treatment of panic disorder
Authors: Lecrubier Y. , Bakker A. , Dunbar G. , Judge R. ,   The Collaborative Paroxetine Panic Study Investigators
Published: November 2007

The aim of this 12‐week, double‐blind, parallel group, placebo‐controlled study was to compare paroxetine with clomipramine in 367 patients with DSM‐III‐R defined panic disorder. Efficacy assessments included the daily panic attack diary, the Clinical Global Impression Scale, the Hamilton Anxiety Rating Scale, the Marks Sheehan Phobia Scale and the Sheehan Disability Scale. Paroxetine produced significant improvements compared with placebo in various measurements of panic attack frequency, and was as effective as clomipramine. However, paroxetine appeared to have a more rapid onset of action than clomipramine in reducing the number of panic attacks to zero. There was an equivalent improvement with both paroxetine and clomipramine in the supportive efficacy variables which assessed associated aspects of therapeutic improvement. Significantly more adverse effects were reported in the clomipramine group compared with the paroxetine group, while there was no difference between the paroxetine and placebo groups.
Organic delusional disorder in psychiatric in‐patients: comparison with delusional disorder
Authors: Lo Y. , Tsai S.‐J. , Chang C‐H. , Hwang J.‐P. , Sim C.‐B.
Published: November 2007

Organic delusional disorder (ODD) is rarely diagnosed in psychiatric in‐patients, and may be misdiagnosed as delusional disorder (DD) from a similar clinical presentation. The aim of the present study was to investigate the characteristics of ODD and to make a comparison with those of DD patients. Patients who conformed to DSM‐III‐R criteria for ODD were recruited from an 8‐year psychiatric in‐patient database. Matching controls were DD patients admitted over the same time period. The prevalence of ODD according to DSM‐III‐R criteria was 0.4% of total admissions and 2.9% of organic mental disorders. Compared to DD patients, ODD patients less often had a family psychiatric history, and had an older age of onset of psychiatric disorder, longer hospital stays and lower treatment dosage of antipsychotic drugs. It is suggested that a detailed medical history and examination are needed in patients with delusion, especially in patients with a late onset of psychiatric symptoms and no family psychiatric history.
Pharmacogenetics of antidepressants: clinical aspects
Authors: Bertilsson I. , Dahl M.‐L. , Tybring G.
Published: November 2007

Plasma concentrations and response to antidepressants vary considerably between patients treated with similar dosages. Most antidepressants and also antipsychotics are metabolized by the polymorphic debrisoquineisparteine hydroxylase. i.e., cytochrome P450 (CYP)2D6. About 7% of Caucasians are poor nietabolizcrs (PM), and such patients might dcvclop adverse drug reactions when treated with recommended doses of, for example, tricyclic antidepressants. In contrast, ultrarapid metabolizers with multiple CYP2D6 gencs might require high doses of such drugs for optimal therapy. The mean CYP2D6 activity is lower in Oriental than in Caucasian populations, because of a frequent mutation causing decreased enzyme activity. Drugs metabolized by the same enzyme may interact with cach other. For example. the potent CYP2D6 inhibitor fluoxetine increases the plasma concentrations of tricyclic antidepressants. Another enzyme catalyzing the metabolism of antidepressants is the polymorphic S‐mephenytoin hydroxylase. CYP2C19, which catalyses the metabolism of, for example, citalopram, clomipramine and moclobemide. Various probe drugs may be used for phenotyping CYP2D6 (debrisoquine, dextromethorphan and sparteine) and CYP2Cl9 (mephenytoin and omeprazole). Allele‐specific polymerase chain reaction (PCR)‐based methods are now available for genotyping using leukocyte DNA. A major advantage of genotyping compared with phenotyping is that the former may be performed in blood samples from patients irrespective of treatment.
The aftermath of an industrial disaster
Authors: Elklit Ask
Published: November 2007

An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general outlook, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES‐score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an ‘audience position’ than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES ≥ 19).
Prediction of depressive relapse in remitted bipolar patients using corticotrophin‐releasing hormone challenge test
Authors: Vieta E. , Gasto C. , Martinez de Osaba M. J. , Nieto E. , Canto T. J. , Otero A. , Vallejo J.
Published: November 2007

Abnormalities in corticotrophin (ACTH) and Cortisol levels before and after corticotrophin‐releasing hormone (CRH) stimulation have been reported in depressed bipolar patients. The ACTH and free Cortisol response to the injection of 100 ug of synthetic human CRH and plasma cortisol‐binding globulin (CBG) levels were measured in 42 lithium‐treated patients suffering from RDC bipolar‐I disorder in remission, and in 21 age‐ and sex‐matched control subjects. A 1‐year follow‐up was conducted in order to assess any possible relationship between outcome and the hormonal response. Bipolar patients showed higher baseline and peak ACTH concentrations than controls. A lower net area under the ACTH concentration curve after CRH stimulation predicted depressive relapse within 6 months by multiple regression analysis. The CRH challenge test could be a potentially good predictor of depressive relapse in remitted bipolar patients.
Maternity blues in Brazilian women
Authors: Rohde L. A. , Busnello E. , Wolf A. , Zomer A. , Shansis F. , Martins S. , Tramontina S.
Published: November 2007

In this prospective study, a sample of 86 postpartum women was compared with a sample of 75 women from a random period of 8 consecutive days out of puerperium. Symptoms were evaluated each day using the Blues Questionnaire. Postpartum women and women out of puerperium showed a different distribution of percentile scores on the scale on the third, fourth and fifth days. The postpartum symptom peak occurred on the fifth day. Symptoms more significantly associated with the third, fourth and fifth postpartum days were overemotionalism and oversensitivity. It is concluded that maternity blues in Brazilian women appear to be characterized by maternal mental state alterations occurring on the third, fourth and fifth days postpartum. MB seems to be better defined as an emotional oversensitivity syndrome of cross‐cultural dimension than as depression.
The Nithsdale Schizophrenia Surveys. XV. Social adjustment in schizophrenia: associations with gender, symptoms and childhood antecedents
Authors: MacEwan T. H. , Athawes R. W. B.
Published: November 2007

The aim of this study was to examine the relationships between childhood social adjustment and personality and adult social adjustment and symptoms in a population of schizophrenic patients. Adult social adjustment was assessed in 43 patients by means of the Social Adjustment Scale Self‐Report, and symptoms were assessed using the Positive and Negative Syndrome Scale and the Subjective Deficit Syndrome Scale. Childhood social adjustment and personality were assessed by means of interviews with patients' mothers. Patients displayed poorer adult social adjustment than a normal population, but no significant differences existed between the sexes. A strong association was found between childhood and adult social adjustment in male subjects. Stronger correlations between social adjustment and current symptoms, particularly positive symptoms, were found in females than in males. Associations in males were stronger for negative symptoms. We observed significant correlations between poor adult social adjustment and severity of illness and abnormalities of personality and social adjustment in childhood. There were substantial differences between the sexes in these associations.
Dose escalation vs. continued doses of paroxetine and maprotiline: a prospective study in depressed out‐patients with inadequate treatment response
Authors: Benkert O. , Szegedi A. , Wetzel H. , Staab H. J. , Meister W. , Philipp M.
Published: November 2007

In view of the fact that controlled prospective studies on the benefits of dose escalation of the selective serotonin re‐uptake inhibitor (SSRI) paroxetine are lacking, we conducted a double‐blind, randomized, parallel‐group multicentre study designed to compare the possible benefits of dose escalation of paroxetine and maprotiline in patients suffering from major or minor depression according to modified Research Diagnostic Criteria (RDC) with inadequate treatment response. The study sample consisted of 544 out‐patients with different degrees of severity of depression. Patients received either 20 mg paroxetine (n=271) or 100 mg maprotiline (n=273) for the first 3 weeks in a double‐blind manner. Response after 3 weeks was defined using explicit operationalized criteria. Patients with inadequate treatment response (paroxetine group, n=86; maprotiline group, n=88) were again randomized to either continuation of the previous dosage (paroxetine, n=36; maprotiline, n=48) or increased doses, i.e. 40 mg paroxetine (n=50) or 150 mg maprotiline (n=40), respectively. Intention‐to‐treat and completer analyses were performed. Defining response as a reduction in Hamilton Depression Rating Scale (17‐item version) (HAMD‐17) score of at least 50% from baseline, no significant benefits of dose escalation were found for either paroxetine or maprotiline. Stratification according to baseline severity of depression also revealed no significant benefits of dose escalation. After dose escalation, new adverse events that had not been present during treatment with lower doses rarely occurred. Our results support the view that a dose of 20 mg paroxetine is optimal for the acute treatment of depression in the majority of patients.
Personality and personality disorders predict development and relapses of major depression
Authors: Alnæs R. , Torgersen S.
Published: November 2007

The aim of this study was to investigate the role of personality deviations in the development and relapses of major depression. The study is based on an investigation of an initial sample of 298 psychiatric out‐patients, who were re‐evaluated after 6 years when the sample included 253 patients. SCID‐R was used for assessment of possible relapses and new cases, and a logistic regression analysis was used to determine the best prediction of the recurrence of depression. Borderline personality disorders and dependency predicted relapses. In addition, borderline personality disorders, together with avoidant personality disorders, predicted the development of new cases. Comorbid clinical syndromes appear to be of no importance. These findings suggest that the comorbidity with personality deviations accounts for the chronicity and poor prognosis in major depression.
Development and validation of a computerized screening test for personality disorders in DSM‐III‐R
Authors: Neal L. A. , Fox C. , Carroll N. , Holden M. , Barnes P.
Published: November 2007

The available self‐report instruments designed to measure personality disorder (PD) are time‐consuming to administer and/or score and can be impractical for routine clinical use. There is a need for a computerized method of personality assessment based on contemporary systems of classification. A computerized DSM‐III‐R‐based questionnaire was developed and validated against the structured clinical interview for DSM‐III‐R Axis‐II disorders on a sample of 60 subjects. The computerized test showed moderate validity as a diagnostic instrument (mean kappa coefficient=0.47). With adjusted cut‐off scores it was valid as a screening instrument (mean sensitivity=0.87). Antisocial, borderline and avoidant PD scores were strongly correlated across measures and not subject to significant observer bias.
Fertility in schizophrenia: results from a contemporary US cohort
Authors: Nimgaonkar V. L. , Ward S. E. , Agarde H. , Weston N. , Ganguli R.
Published: November 2007

To investigate procreation in schizophrenia, as well as gender‐related differences, female patients with schizophrenia (n= 79, DSM‐III‐R criteria) were compared with screened female controls (n= 124) and subsequently with male patients (n=86). Two outcomes were investigated: (i) the proportion of subjects with one or more children (an index of fertility) and (ii) the number of children per subject among those with one or more children (an index of fecundity). Multivariate analysis was used to control for confounding variables. No significant differences in fertility between female patients and controls were detected, but reduced fecundity was noted among female patients past the reproductive period. Male patients showed a significant reduction in both fertility and fecundity compared to female patients. These results suggest that there is a relatively small impairment of fecundity among female patients compared with controls, but that there are more significant gender‐related differences in both fertility and fecundity. The latter have important implications for the genetics of schizophrenia.
Paroxetine efficacy in the treatment of generalized anxiety disorder
Authors: Rocca P. , Fonzo V. , Scotta M. , Zanalda E. , Ravizza L.
Published: November 2007

Recently, there has been a renewed interest in alternatives to the benzodiazepines for the treatment of generalized anxiety disorder (GAD). The aim of the present study was to compare the efficacy of paroxetine vs. imipramine and 2′‐chlordesmethyldiazepam in 81 patients with a DSM‐IV diagnosis of GAD. Approximately two‐thirds of the patients who completed the study improved greatly or moderately on all three active drugs. During the first 2 weeks of treatment, 2′‐chlordesmethyldiazepam treatment resulted in the greatest improvement in anxiety ratings. Both paroxetine and imipramine treatment resulted in more improvement than 2′‐chlordesmethyldiazepam by the fourth week of treatment. Paroxetine and imipramine affect predominantly psychic symptoms, whereas 2′‐chlordesmethyldiazepam affects predominantly somatic symptoms. Our results suggest that paroxetine is effective for the treatment of GAD.
Group therapy for somatization disorders in general practice: effectiveness of a short cognitive‐behavioural treatment model
Authors: Lidbeck J.
Published: November 2007

The objective of this study was to evaluate the effect of a short cognitive behavioural group therapy programme for somatization disorder in primary care. The treatment model was focused on patient education and stress relaxation. A controlled and prospective study design was used with repeated assessments of the patients’ perception of their psychosocial problems, psychological distress and medication usage. The results were analysed up to 6 months after treatment and showed the treated patients to be moderately but significantly improved with respect to physical illness and somatic preoccupation, hypochondriasis, and medication usage. In a control group of untreated patients no such improvements were observed. In summary, the short group treatment programme used in this study may be beneficial for patients with somatization disorders. With some modifications it might be useful to practitioners in primary care for the management of psychosomatic disorders.
The recollection of parental rearing styles in patients with panic disorder
Authors: Wiborg I. M. , Dahl A. A.
Published: November 2007

Studies of the mental image of parents assessed by means of the Parental Bonding Instrument (PBI) in patients with panic disorder (according to DSM‐III‐R) have shown conflicting results. We examined 45 patients with panic disorder with and without agoraphobia and 116 controls using the PBI. As a group, patients with panic disorder reported significantly less care and more protection from parents than the controls. This difference was shown by the patients who had panic disorder with major agoraphobia, while those with minor agoraphobia did not differ from the controls. The present study supports the findings that low levels of care and high levels of protection, rather than affectionate constraint, were the predominant mental image reported by patients with panic disorder, using the PBI.
Successful use of a selective serotonin reuptake inhibitor in a patient with multiple chemical sensitivities
Authors: Andiné P. , Rönnbäck L. , Järvholm B.
Published: November 2007

A 53‐year‐old man with multiple chemical sensitivities (MCS) received the selective serotonin reuptake inhibitor (SSRI) citalopram for treatment of depression. The treatment was successful and, in parallel to the remission of the depressive symptoms, all MCS symptoms vanished. This suggests that a subgroup of MCS patients may have an atypical depression, that they should be psychiatrically evaluated, and that antidepressive pharmacological treatment may be considered in cases of MCS.
Double‐blind randomized controlled study of the efficacy and tolerability of two reversible monoamine oxidase A inhibitors, pirlindole and moclobemide, in the treatment of depression
Authors: Tanghe A. , Geerts S. , Van Dorpe J. , Brichard B. , Bruhwyler J. , Géczy J.
Published: November 2007

The aim of this double‐blind randomized study was to compare the efficacy and the tolerability of moclobemide (300‐600 mg daily) and pirlindole (150‐300 mg daily), two reversible inhibitors of MAO‐A (RIMAs), in the treatment of depression. In total 116 patients were included in the trial, 111 patients (52 patients on pirlindole and 59 patients on moclobemide) were evaluable for efficacy and safety, and 77 patients completed the whole study (42 days of administration). Both treatments produced highly significant improvements in the Hamilton Depression Rating Scale (HDRS) score, the Hamilton Anxiety Rating Scale (HARS) score and the Montgomery‐Asberg Rating Scale (MADRS) score from day 7 to day 42. The pattern of development of the three scores in the two groups did not differ significantly. After 42 days of treatment, an improvement of ≥50% in the HDRS score was noted in 80% and 67% of patients in the pirlindole and moclobemide groups, respectively. A total of 30 (58%) patients on pirlindole and 33 (56%) patients on moclobemide experienced side‐effects that were considered to be possibly or probably related to the medication. The differences between the two drugs were non‐significant for all types of side‐effect, with the exception of dry mouth and tachycardia, which were significantly more frequent with moclobemide.
Prediction of outcome and early vs. late improvement in OCD patients treated with cognitive behaviour therapy and pharmacotherapy
Authors: de Haan E. , van Oppen P. , van Balkom A. J. L. M. , Spinhoven P. , Hoogduin K. A. L. , van Dyck R.
Published: November 2007

In this study, follow‐up results of cognitive‐behaviour therapy and of a combination of cognitive‐behaviour therapy with a serotonergic antidepressant were determined. The study also examined factors that can predict this treatment effect, both in the long term and in the short term. In addition, it investigated whether differential prediction is possible for cognitive‐behaviour therapy vs. a combination of cognitive‐behaviour therapy with a serotenergic antidepressant. A total of 99 patients were included in the study. Treatment lasted 16 weeks, and a naturalistic follow‐up measurement was made 6 months later. Of the 70 patients who completed the treatment, follow‐up information was available for 61 subjects. Significant time effects were found on all outcome measures at both post‐treatment measurement and follow‐up. No differences in efficacy were found between the treatment conditions. Effectiveness at post‐treatment measurement appears to predict success at follow‐up. However, 17 of the 45 non‐responders at the post‐treatment measurement had become responders by the follow‐up. The severity of symptoms, motivation for treatment and the dimensional score on the PDQ‐R for cluster A personality disorder appear to predict treatment outcome. No predictors were found that related specifically to cognitive‐behaviour therapy or combined treatment. These results indicate that the effectiveness of cognitive‐behaviour therapy or a combination of cognitive‐behaviour therapy and fluvoxamine at the post‐treatment measurement is maintained at follow‐up. However, non‐response at post‐treatment does not always imply non‐response at follow‐up. Patients with more severe symptoms need a longer period of therapy to become responders. Although predictors for treatment success were found, no evidence was found to determine the choice of one of the treatment modalities.
One‐year prevalence of long‐term functional psychosis in three different areas of Uppsala
Authors: Widerlöv B. , Lindström E. , van Kitarring L.
Published: November 2007

The 1‐year prevalence of long term functional psychoses (LFP) in Uppsala was found to be 0.73%, with a clear gradient from the central city area (0.87%) to the rural area (0.60%). The highest prevalence was found in the 35–54 years age group (1.01%), and the lowest prevalence in the 18–34 years age group (0.45%). There were no pronounced sex differences. The majority of the LFP patients were diagnosed as having schizophrenia. The 1‐year prevalence of schizophrenia was 0.42%, with a clear gradient from the central city area to the rural area (0.53%, 0.44% and 0.30%, respectively). The same gradient was not observed with regard to the other diagnostic subgroups relating to LFP.
Living situation, social network and outcome in schizophrenia: a five‐year prospective follow‐up study
Authors: Salokangas R. K. R.
Published: November 2007

A representative sample of 227 first‐contact schizophrenic patients (according to DSM‐III) was followed up for 5 years. The psychiatric teams responsible for the treatment of the patients conducted detailed standardized interviews with the patients at entry and at the end of the first, second and fifth years. Changes in patients’ clinical and functional outcome were analysed according to their living situation and social network. Positive changes in clinical state and functional ability were most prominent among patients who were living with their spouse. The social and functional outcome of men living with their parents was better than that of women in the same situation, while among patients living alone or with some other person the gender difference was reversed. Family environment can be of great importance to schizophrenic patients, supporting their clinical and functional recovery from psychosis. Patients living outside families — and men in particular — are at great risk of poor outcome, perhaps because they often lose their social contacts. In the treatment of such individuals a more active strategy of out‐patient and rehabilitative care is therefore needed.
A multidisciplinary clinical study of patients suffering from illness associated with mercury release from dental restorations: psychiatric aspects
Authors: Bågedahl‐Strindlund M. , Hie M. , Furhotf A‐K. , Tomson Y. , Larsson K. S. , Sandborgh‐Englund G. , Torstenson B. , Wretlind K.
Published: November 2007

The aim of this study was to map the psychological/psychiatric, odontological and medical aspects of patients with symptoms allegedly related to the side‐effects of mercury in dental fillings. A total of 67 consecutive patients and 64 controls matched for age, sex and residential area were included in the study. The most striking result was the high prevalence of psychiatric disorders in the patients (89%) compared to the controls (6%), predominantly somatoform disorders. The personality traits differentiating the patients according to the Karolinska Scales of Personality (KSP) were somatic anxiety, muscular tension, psychasthenia and low socialization. More patients than controls showed alexithymic traits. The prevalence of diagnosed somatic diseases was higher, but not sufficiently so to explain the large difference in perceived health. The multiple symptoms and signs of distress displayed by the patients could not be explained either by the odontological data or by the medical examination. Our data indicate that the patients show sociodemographic and clinical patterns similar to those of somatizing patients. The medicalization of the suffering of these patients and the neglect of psychiatric problems prevent the use of appropriate psychotherapeutic approaches.
Are immunological markers, social and personal resources, or a complaint‐free state predictors of progression among HIV‐infected patients?
Authors: Eich‐Höchli D. , Niklowitz M. W. , Lüthy R. , Opravil M.
Published: November 2007

Predictors of disease progression were studied in 89 asymptomatic HIV‐infected patients who were prospectively evaluated for psychosocial variables and the development of clinical symptoms over a period of 2 years. The subjects were assessed for symptoms, laboratory measures, demographic variables, social and personal resources, mental status, alcohol, nicotine and drug use, sexual activity and risk behaviour, and sexually transmitted diseases. After 1 year, 17% of the patients had developed HIV‐associated symptoms (symptomatic disease or AIDS), and after 2 years, 32% had developed symptoms or had died. In the multivariate analyses, the baseline CD4 count was the only significant predictor of disease progression during both observation periods. Psychosocial measures did not predict the progression of HIV infection.
Efficacy of venlafaxine in depressive illness in general practice
Authors: Lecrubier Y. , Bourin M. , Moon C. A. L. , Schifano F. , Blanchard C. , Danjou Ph. , Hackett D.
Published: November 2007

A double‐blind, placebo‐controlled study of 229 patients with a Research Diagnostic Criteria diagnosis of major, minor or intermittent depression was used to compare the clinical profiles of venlafaxine and imipramine in general practice. Venlafaxine produced a significant improvement compared to placebo in symptoms of depression and anxiety as rated by the total MADRS and percentage of responders, the CGI improvement, the CGI severity of illness, the BSA psychic anxiety item and the HSCL. On a number of these measures, venlafaxine was also significantly more effective than imipramine. Venlafaxine was significantly superior to both imipramine and placebo for the SARS total score and the items 'socialeisure’and‘extended family.’A similar proportion of patients discontinued treatment in each group, but fewer patients on venlafaxine discontinued treatment because of an unsatisfactory response.
Changing patterns of distress during the adjustment of recent immigrants: a 1‐year follow‐up study
Authors: Ritsner M. , Ponizovsky A. , Ginath Y.
Published: November 2007

A sample of 419 recent immigrants from the former Soviet Union to Israel was assessed, with a 1‐year follow‐up of 199 of these subjects. The Immigration Related Stressors Scale, Talbieh Brief Distress Inventory and Multidimensional Scale of Perceived Social Support were employed to measure the level and sources of distress, as well as the sources of social support. Three major patterns of change in distress level were distinguished, and their 1‐year prevalence rates were established. In total, 44% of the respondents demonstrated the‘normal’pattern, with a permanent low distress level, 33% displayed the‘positive’pattern, with either persistent moderate or decreasing distress, and 23% displayed the‘negative’pattern, with either persistent high or increasing distress. Among the immigrants who demonstrated the positive pattern of change in distress, rates of stressors such as‘anxiety about the future’, ‘uncertainty in the present’, ‘depressive state’, ‘insufficient knowledge of Hebrew’and‘malevolence of Israelis’decreased during the study period. In those who showed the negative pattern, rates of stressors such as‘personality characteristics’and‘lack of acceptance of the host culture/mentality’have increased. Immigrants who showed the normal and positive patterns had greater total social support than those who showed the negative pattern. The level of family support tended be higher among immigrants with the normal pattern, while support by friends tended to be greater among those with the positive pattern of change in distress.
The relationship between seasonal mood change and personality: more apparent than real?
Authors: Jang K. L. , Lam R. W. , Livesley W. J. , Vernon P. A.
Published: November 2007

A number of recent research reports have reported significant relationships between seasonal mood change (seasonality) and personality. However, some of the results are difficult to interpret because of inherent methodological problems, the most important of which is the use of samples drawn from the southern as opposed to the northern hemisphere, where the phenomenon of seasonality may be quite different. The present study examined the relationship between personality and seasonality in a sample from the northern hemisphere (minimum latitude=49°N). A total of 297 adults drawn from the general population (112 male and 185 female subjects) completed the Seasonal Pattern Assessment Questionnaire, and the results obtained confirmed most of the previously reported relationships and showed that these are reliable across (i) different hemispheres, (ii) different measures of personality and (iii) clinical and general population samples. However, the impact of the relationship seems to be more apparent than real, with personality accounting for just under 15% of the total variance.
Co‐administration of fluoxetine and sumatriptan: the Canadian experience
Authors: Joffe R. T. , Sokolov S. T. H.
Published: November 2007

Major depression and migraine are commonly comorbid. Therefore, there is considerable opportunity for serotonin reuptake inhibitors, which are commonly prescribed for the treatment of depression, to be used at the same time as sumatriptan, an anti‐migraine treatment. As both of these drugs increase serotonin transmission, the potential for drug interaction is considerable. Adverse event reports were obtained from the post‐marketing surveillance of fluoxetine in Canada. Of 22 adverse event reports obtained, six showed varying degrees of evidence of a drug interaction between fluoxetine and sumatriptan, suggesting that this combination is not entirely free of side‐effects and should be used with caution when indicated.
Mortality and causes and manner of death among drug addicts in Stockholm during the period 1981–1992
Authors: Fugelstad A. , Annell A. , Rajs J. , Ågren G.
Published: November 2007

A cohort of 1640 hospitalized drug addicts was studied over an 8‐year period, and consisted of 678 heroin users, 578 amphetamine users and 384 users of other drugs. In total, 234 addicts were HIV‐positive, most of them heroin users. During the observation period, 214 deaths occurred in the cohort. The total mortality was 2.2% annually. Death linked to injection of heroin was the main cause of death not only among heroin users but also among subjects classified as users of amphetamines or other drugs. During the observation period, a total of 222 addicts (115 of whom were HIV‐positive) entered the methadone programme. No deaths occurred among the HIV‐negative subjects who were participating in the methadone programme. A total of 15 HIV‐positive subjects died while taking part in the programme —13 of these subjects from natural causes (mostly HIV/AIDS).
Hospital Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample
Authors: Lisspers J. , Nygren A. , Söderman E.
Published: November 2007

The Hospital Anxiety and Depression Scale (HAD) was evaluated in a Swedish population sample. The purpose of the study was to compare the HAD with the Beck Depression Inventory (BDI) and Spielberger's State Trait Anxiety Inventory (STAI). A secondary aim was to examine the factor structure of the HAD. The results indicated that the factor structure was quite strong, consistently showing two factors in the whole sample as well as in different subsamples. The correlations between the total HAD scale and BDI and STAI, respectively, were stronger than those obtained using the different subscales of the HAD (the anxiety and depression subscales). As expected, there was also a stronger correlation between the HAD and the non‐physical items of the BDI. It was somewhat surprising that the factor analyses were consistently extracting two factors,‘depression’ and ‘anxiety’, while on the other hand both BDI and STAI tended to correlate more strongly with the total HAD score than with the specific depression and anxiety HAD subscales. Nevertheless, the HAD appeared to be (as was indeed originally intended) a useful clinical indicator of the possibility of depression and clinical anxiety.
Platelet monoamine oxidase activity in relation to alleles of dopamine D4 receptor and tyrosine hydroxylase genes
Authors: Garpenstrand H. , Ekblom J. , Hallman J. , Oreland L.
Published: November 2007

Human personality characteristics and vulnerability to psychopathology are to a large extent dependent upon genetic factors which have yet to be fully defined. The allele distribution of the dopamine D4 receptor (D4DR) and thrombocyte monoamine oxidase (trbc MAO) activity have both been associated with personality traits which are supposedly related, namely 'sensation seeking’according to Zuckerman and‘novelty seeking’according to Cloninger, respectively. In this report, the D4DR allele distribution and trbc MAO activity were studied in 31 psychiatric patients and 21 control subjects. Trbc MAO activity is a biochemical marker of personality that has been shown to be under strong genetic influence. However, no association between the D4DR alleles and trbc MAO could be observed in this material. To our knowledge, this is the first report comparing these two markers, and based upon the results obtained, we speculate that they may be connected with different types of overlapping personality characteristics. The allele distribution of the tyrosine hydroxylase (TH) gene was also determined. TH is the rate‐limiting enzyme in the biosynthesis of catecholamines, and it is believed to be involved in different kinds of psychopathology. No covariation between TH gene alleles and trbc MAO activity or D4DR alleles was observed in this material.