bluuebunny/crossref_metadata_2025 huggingface dataset:
Attempted Suicide Among the Irish-Born Population in Birmingham
Authors: Burke Aggrey W.
Published: August 2008

The epidemiology of attempted suicide among Irish immigrants in Birmingham is described from data concerning 352 (138 male, 214 female) hospital admissions made during the period 1969 to 1972.

Admissions from the Irish Republic and from Northern Ireland were similarly distributed, but were both grossly over-represented. The average annual rate of admission (222 male, 362 female) was probably higher than the rates in Dublin, Belfast and Edinburgh. The female patient rate (286) was greater than that of Edinburgh, but the male rate (143) was not. Fewer Irish than British admissions gave a history of previous attempted suicide or repeated this attempt. Indices of stress among immigrants were, however, greater. The importance of sociocultural factors is discussed.
The Reasons People Give for Taking Overdoses
Authors: Bancroft J. H. J. , Skrimshire A. M. , Simkin S.
Published: August 2008

This study investigates the reasons people give for taking overdoses of drugs. A representative sample of 128 subjects were interviewed immediately after their recovery from an overdose. During the interview they were given alternative reasons for taking overdoses and asked to choose any that applied to them. Spontaneous comments about suicidal intent were also recorded. Of the subjects, 44 per cent indicated that they had wanted to die. On the basis of their choices 33 per cent were ‘seeking help’, 42 per cent ‘escaping from the situation’, 52 per cent ‘obtaining relief from a terrible state of mind’ and 19 per cent ‘trying to influence someone’. The association between these various reasons and other expected effects or feelings associated with the act were examined by means of multidimensional scaling analysis. In addition, the characteristics of those expressing suicidal intent and other reasons were studied, together with such consequences as toxic effects and psychiatric after-care. The possibility is discussed that a large proportion of those indicating suicidal intent do so either to gain social acceptability for their act or to influence helping agencies.
How Common is Anorexia Nervosa? A Prevalence Study
Authors: Crisp A. H. , Palmer R. L. , Kalucy R. S.
Published: August 2008

During 1972–74 nine populations of schoolgirls were surveyed in respect of the occurrence of anorexia nervosa. As well as the current school year, previous years (going back variously 3–6 years) were also carefully studied within seven of the schools. Anorexia nervosa was only identified as present or having been present if the diagnosis was unequivocal: for instance, seemingly evident and severe cases which could not be traced were excluded. The condition in severe form was found to be relatively common in the independent sector of education, probably implying a social class factor. In all such schools, the prevalence was one severe case in approximately every 200 girls. In those aged 16 and over it amounted to one severe case in about every 100 girls. Overall, these schools encountered one ‘new’ severe case in every 250 pupils aged 16 years and over. The condition is likely to be even more common than this study allows because of the stringent limits set here on inclusion of cases and the age-band studied. It is concluded that severe anorexia nervosa is a common condition and is probably getting more common.
Anorexia Nervosa After the Menopause
Authors: Kellett John , Trimble Michael , Thorley Anthony
Published: August 2008

A patient is described who developed the classical syndrome of anorexia nervosa at the age of 52. Her illness occurred in relation to the marriages of her daughters and showed an extreme preoccupation with her body shape and a determination to slim by diet, purging and vomiting, and the hiding of food to the extent of rendering herself too weak to cope with the demands of her life.

It is suggested that anorexia nervosa, though predominantly a disease of onset in adolescence, may present at any age and should be considered in the differential diagnosis of anorexia in patients over the age of 50.
Anxiety and Depression After Infectious Mononucleosis
Authors: Cadie M. , Nye F. J. , Storey Peter
Published: August 2008

Thirty-six patients who had had infectious mononucleosis (IM) were followed up a year later and assessed by the Middlesex Hospital Questionnaire and by interview or (in five cases) by postal questionnaire. The results support the view that IM leads to depression in a considerable number of cases, but in this series only women were so affected.
The Classification of Depressions: A Review of Contemporary Confusion
Authors: Kendell R. E.
Published: August 2008

During the last fifty years, and particularly the last twenty, innumerable different classifications of depressive illness have been proposed, and several disputes are smouldering away between the protagonists of rival schools. Much of this is too well known to need, or bear, repetition. But the conflicting claims and proposals are now so numerous, and methodological problems loom so large, that those who are not intimately involved have increasing difficulty in understanding what is going on; while those who are involved are mostly too intent on developing and promoting their own particular schema to review the overall situation in any broader context. This article is an attempt to describe the main elements in a confusing situation, to outline the important problems, and to indicate the areas of agreement that are beginning to emerge, without advocating any particular solution.
The Relationships Between Obsessional Personality, Obsessions in Depression, and Symptoms of Depression
Authors: Vaughan M.
Published: August 2008

The relationships between obsessional personality, obsessions in depression, and symptoms of depression were investigated by means of a retrospective study of case notes and item sheets. One hundred and sixty-eight cases of depression, aged 20 to 29 years, were rated for obsessional personality as defined by Ingram (1961). The presence of previous obsessions, of obsessions in depression and of eight symptoms of depression was assessed from the item sheets.

Obsessional personality was found to be significantly associated only with a decreased frequency of objective apathy, although it seemed to act to reduce the anxiety experienced by those with obsessions in depression. Obsessions in depression were associated with rapid changes of mood, anxiety, agitation and overactivity and with a relative absence of retardation.
A Comparison of Two Psychiatric Screening Tests
Authors: Goldberg David , Rickels Karl , Downing Robert , Hesbacher Peter
Published: August 2008

A comparison is made between the General Health Questionnaire (GHQ) and the Symptom Checklist (SCL) as psychiatric screening tests in community-based research projects. Both are shown to correlate equally well with independent clinical assessment, and the differences between them mainly reside in the form of their response scales. The GHQ works best as a screening test, since it has fewer false positives associated with its use, but it may miss those with long-standing disorders. The SCL tends not to miss long-standing disorders and furnishes diagnostic sub-scales if these are required. Both tests function better with men than with women and with whites than with blacks, but neither is affected by social class or age of the respondent. The study revealed high correlations between the symptoms of anxiety and depression, and indicated some possible differences between the symptom clusters seen in whites and in blacks.
Effect of Sodium Valproate on Tardive Dyskinesia
Authors: Linnoila M. , Viukari M. , Hietala O.
Published: August 2008

The effect of sodium valproate, a drug which has been demonstrated to increase gamma-aminobutyric acid levels in the CNS, on tardive dyskinesia and psychiatric symptoms was investigated in a double-blind cross-over study on 32 chronic psychiatric patients. The oro-facial dyskinesias were totally or significantly relieved in 17 cases. During the active treatment period the involuntary movements of the extremities and dystonic spasms were also significantly relieved in 7 out of 9 patients. In two patients, however, the extrapyramidal symptoms became slightly worse. A significant improvement was noted in the psychiatric symptoms of 14 out of 32 patients during sodium valproate administration. The psychiatric state of 4 out of 32 patients deteriorated. There was no correlation between the serum concentration of sodium valproate and its effect on the dyskinesia or on the psychiatric symptoms. Some of the elderly subjects showed a slight accumulation of the drug.
The Influence of Family and Social Factors on the Course of Psychiatric Illness
Authors: Vaughn Christine E. , Leff J. P.
Published: August 2008

This study is a replication and extension of past work carried out by Brown, Birley and Wing (1972) concerning the influence of family life on the course of schizophrenia. In the original research the index of emotion expressed by a key relative about the patient at the time of key admission proved to be the best single predictor of symptomatic relapse in the nine months after discharge from hospital. In the present study this main finding of Brown et al has been replicated for two clinically different groups of psychiatric patients. The expressed emotion of the relative again seems to be associated with relapse independently of all other social and clinical factors investigated. In addition, important additive effects between various social influences and pharmacological treatments have been revealed which make it possible to predict relapse patterns in schizophrenia with considerable precision. The patterns of these relationships with relapse are different for the two clinical groups studied, patients with schizophrenic psychosis and with depressive neurosis.
Cluster Analysis Applied to Symptom Ratings of Psychiatric Patients: An Evaluation of its Predictive Ability
Authors: Williams George W. , Barton Gail M. , White Andrew A. , Won Hosik
Published: August 2008

Ratings on 39 symptoms were examined for patients admitted to the Neuropsychiatric Institute of the University of Michigan Medical Center. A detailed evaluation was made of the clusters derived by a hierarchical clustering algorithm, using complete linkage and a simple matching coefficient on the binary variables of presence or absence of symptoms. The four groups of patients suggested by the cluster analysis can be characterized as follows: (1) generalized multiplicity of symptoms; (2) capacity to cope except for orientation apart from generally held norms; (3) activity level and thought processes speeded up, intensified, and unselected; (4) inwardly punitive, slowed down and distressed. It is shown that these groups received significantly different treatment and that the effect of treatment was significantly different, while no such differences were noted for groups defined in terms of diagnoses. By means of linear discriminant functions, rules are suggested for assigning other psychiatric patients to one of these four groups.
The Differentiation of Paranoid from Affective Psychoses by Patients' Premorbid Characteristics
Authors: Kay D. W. K. , Cooper A. F. , Garside R. F. , Roth Martin
Published: August 2008

Various premorbid characteristics of a group of patients aged 50 or over suffering from paranoid psychoses (N = 54) were compared with those of patients of similar age suffering from affective psychoses (N = 57). (The diagnoses were those of the consultants.) The presence of deafness was investigated in the manner described by Cooper et al (1974). Using the discriminant function method, the diagnostic groups were highly significantly differentiated by six independent variables, which in combination predicted 40 per cent of the variance. These were: a ‘schizoid personality’ factor, the number of surviving children, precipitating events, deafness, family history and social class.
Whole Blood Adenosine Triphosphate in Manic-Depressive Illness
Authors: Naylor G. J. , Worrall E. P. , Peet M. , Dick P.
Published: August 2008

Whole blood cell ATP concentration was estimated in a group of manic and depressed patients and in a group of normal subjects. There were no significant differences between patient and control groups, nor in the patient groups were there any significant changes with recovery.
Thyroid Dysfunction in Female Psychiatric Patients
Authors: Nicholson Geoffrey , Liebling L. I. , Hall R. A.
Published: August 2008

Biochemical screening for thyroid dysfunction in 98 unselected female psychiatric admissions led to the diagnosis of hypothyroidism in three cases which would otherwise have passed unrecognized. It is suggested that female psychiatric patients over the age of 40 should routinely be screened for thyroid disorder.
Marriage and Neurosis in a Modern Residential Suburb: An Application of the Ryle Marital Patterns Test
Authors: Ineichen Bernard
Published: August 2008

The Ryle Marital Patterns Test measures the affection and domination aspects of marriage. Its original administration illustrated a partial association between poor marital adjustment (as measured by low affection scores and non-egalitarian domination scores) and neuroticism (as measured by CMI score). The present paper confirms these associations using a group of suburban women defined as neurotic by their GP. Related studies suggest similar patterns.
Help-Seeking in Depressed Out-patients Following Maintenance Therapy
Authors: Weissman Myrna M. , Kasl Stanislav V.
Published: August 2008

This paper reports on the clinical status, help-seeking and subsequent treatment experiences of 150 women one year after they had completed out-patient maintenance treatment by amitriptyline and/or psychotherapy for a depressive episode.

While the majority of patients were asymptomatic at follow-up, a substantial minority had a return of acute symptoms and 2 per cent made minor suicide attempts during the year. Admission to hospital was rare. However, only 30 per cent of the patients did not seek any treatment during the year and the majority received some psychotropic medication.

The findings support the long-term need for prompt access to treatment by patients who have recovered from an acute depression.
Behaviour Therapy: Recent Trends and Current Practice
Authors: Chesser Edward S.
Published: August 2008

To psychiatrists who entered clinical practice in the decade 1955–65, ‘behaviour therapy’ probably conjures up the names of Eysenck, Lazarus and Wolpe; the invocation of learned maladaptive anxiety as the basis of most neurotic illness; desensitization by graduated exposure in imagination and real life to anxiety evoking situations. Neurotic ‘symptoms' were maladaptive habits and the ‘symptoms' were the disease, not merely outward manifestations of underlying disorder. Eysenck (1959) described behaviour therapy as all methods of treatment which were based on ‘modern learning theory‘. The ‘bell and pad’ treatment for enuresis and aversion therapy for alcoholism were appropriated and refined. Operant conditioning crossed the Atlantic and the application of Skinnerian principles was illustrated by Krasner and Ullman (1965). In the early sixties, at the very least behaviour therapy offered a possible treatment for a small proportion of psychiatric patients, for example those with phobias, tics or alcoholism, a group for whom other treatments were of little value.
Mianserin Hydrochloride: A Novel Antidepressant
Authors: Coppen Alec , Gupta Ramesh , Montgomery Stuart , Ghose Karabi , Bailey John , Burns Bruce , de Ridder J. J.
Published: August 2008

The antidepressant activities of mianserin hydrochloride were investigated and compared with those of amitriptyline. The therapeutic efficacy of the two drugs appeared similar, but the incidence of side-effects was significantly higher with amitriptyline. Plasma levels of mianserin were determined during the trial and were not related to the therapeutic activity of the drug.
Fresh Symptom Emergence After Intensive Behaviour Therapy
Authors: Hafner R. Julian
Published: August 2008

The outcome of a standard four-day intensive symptomatic treatment programme with 39 agoraphobics is examined in relation to the incidence of fresh symptom emergence. Twenty-six patients suffered fresh symptom emergence during follow-up, and there was a significant association of fresh symptom emergence with poorer outcome at one-year follow-up. About 18 per cent of patients were adversely affected by the treatment programme, as judged on a wide range of symptoms and measures of inter- and intra-personal adjustment. Sixteen individually treated patients are then compared with the 39 group-treated patients and differences in drop-out rate are discussed.
Predicting Success in the Treatment of Psychopaths
Authors: Copas J. B. , Whiteley J. S.
Published: August 2008

Factors from the social history of male psychopaths were examined in relation to their success or failure as measured by re-convictions or psychiatric hospital re-admissions 2–3 years after treatment at Henderson Hospital. From these data a weighted prediction formula was calculated and was tested out on a further cohort of patients. As a prediction instrument it was found to be reliable to a degree of significance just above the 1 per cent level. Other aspects of the subsequent career of treated patients are noted, in particular a tendency to early but often short-lived relapse and then longer standing success.
Volunteer Adolescents in Adolescent Group Therapy
Authors: Fine Stuart , Knight-Webb Graham , Breau Karen
Published: August 2008

The effects on patients, volunteers and staff of using volunteer adolescents in adolescent group therapy are examined. From 40 candidates eight volunteers were selected and oriented to the group process. Four volunteers and four patients were placed in each of two groups, and eight patients were placed in the third group. Patients and volunteers were aware of their identities in the first group session. Attendance in the groups with volunteers was better than in the group without. The volunteers themselves gained new knowledge and skills, and their presence was even helpful to the group leaders.
Some Features of ‘New Long-stay’ Male Schizophrenics
Authors: Todd Norman A. , Bennie Ernest H. , Carlisle James M.
Published: August 2008

From an original cohort of 471 admissions of male schizophrenics (260 individuals) to Leverndale Hospital, Glasgow, in the years 1967–70 inclusive, 39 patients were found who in December 1973 had become long-term residents by virtue of over three years' stay. These patients were followed up two years later, when it was found that 33 remained. Three had died and two had been discharged, though one was later admitted elsewhere. Those remaining had an average age of 45.4 years, and an average duration of illness of 15 years. The patients are considered in terms of their clinical state, management problems, accommodation, occupational grade, and social circumstances. It is concluded that they represent a hard core and that very few of them are likely to be suitable for such alternative forms of care as are at present available.
A Cross-National Epidemiological Study of Mania
Authors: Leff J. P. , Fischer Margit , Bertelsen A.
Published: August 2008

An epidemiological study of the first admission rate for mania was carried out in London and Aarhus. The case registers in these two centres were used to conduct a retrospective study of case notes covering several years, and a screening procedure was used for the prospective collection of new cases over the course of one year. The annual incidence of mania was found to be virtually identical in both centres. The retrospective study gave a figure of 2.6 per 100,000 population in both Aarhus and London. But the London sample was found to contain 45 per cent of immigrants in contrast to the Aarhus sample in which only a negligible proportion were born outside Denmark. Male West Indians, in particular, were over-represented in the London sample.
A Fatal Case of Pancytopenia Due to Levomepromazine
Authors: Garzotto N. , Burti L. , Tansella M.
Published: August 2008

A fatal pancytopenia occurred in a patient with an history of depression with hypomanic rebounds, admitted for a manic episode and treated with levomepromazine, diazepam and lithium carbonate.
Seasonal Patterns of Suicide, Depression and Electroconvulsive Therapy
Authors: Eastwood M. R. , Peacocke J.
Published: August 2008

This study examined the hypothesis that there are seasonal variations for suicide, hospital admissions for depressive illnesses and electroconvulsive therapy and that these are inter-related. It was found that the seasonal variations did coincide, with peaks occurring in the Ontario spring and autumn. The importance of depression as a cause of suicide and the effect of electroconvulsive therapy upon the suicide rate are discussed.
Comparison of Antipsychotic Depot Injections in the Maintenance Treatment of Schizophrenia
Authors: Carney M. W. P. , Sheffield B. F.
Published: August 2008

122 Schizophrenic patients treated with injections of fluphenazine ethanate, 97 with fluphenazine decanoate and 199 with flupenthixol decanoate were followed up for mean times of 41, 33 and 21 months respectively. Their progress was compared by examining reasons for discontinuing injections and outcome in three separate groups defined according to first preparation given; relating the events causing patients to discontinue injections or be readmitted to patient-months spent on each drug; and analysing reasons for inter-drug transfers 43 per cent, 24 per cent and 23 per cent respectively of these three groups of patients discontinued the injections. Severe extrapyramidal effects were most frequent with fluphenazine ethanate, intermediate with fluphenazine decanote, and least frequent with flupenthixol. Lack of cooperation was rather more frequent with flupenthixol than with the other drugs. Severe depression occurred with all three. More patients on fluphenazine injections were transferred for any reason to flupenthixol than vice-versa. A case of ‘irreversible’ movement disorder was seen with each preparation. It is suggested that current maintenance doses of flupenthixol decanoate are too low.
Generalization of Behaviour Therapy with Psychotics
Authors: Liberman Robert Paul , McCann Michael J. , Wallace Charles J.
Published: August 2008

Generalization of improvement in the behavioural treatment of psychotic patients must be planned in after-care settings, and for durability over time. The transfer of clinical gains is not an automatic by-product of treatment with severely and chronically impaired mental patients. Treatment strategies that facilitate generalization from hospital to community are illustrated in a case study using empirical data. Systematic and specific treatment programmes were co-ordinated between a state hospital ward and a community-based day hospital. Setting step-wise and limited goals is a feature of successful outcomes. Maintaining consistency in reinforcement contingencies from hospital to community settings, using natural reinforcers, pinpointing functional behaviours as therapeutic goals, over-learning, and training natural caregivers are methods that promote generalization.
A Psychosocial Study of Accidental Poisoning in Egyptian Children
Authors: Okasha Ahmed , Bishry Zeinab , Osman Nadia M. , Kamel M.
Published: August 2008

One hundred and twenty-seven accidentally poisoned children from the emergency room of the Islamic Girls College, Cairo, were compared with an equal number of controls.

The highest age incidence for both sexes in poisoned children was 36 months. Males outnumbered females at a ratio of 3:2. Behavioural problems such as hyperactivity, temper tantrums, aggression, stubbornness, nocturnal enuresis and impulsiveness occurred more often in poisoned children than in controls and more often in those (24 patients) referred with accidental poisoning on more than one occasion. The families of poisoned children differed significantly from the controls in their large size, low level of education, disturbed home atmosphere and the accessibility to the child of the poisonous substance.
Recruitment of Problem Drinkers
Authors: Cameron Douglas , Spence Mary T.
Published: August 2008

As the first phase of a project designed to institute controlled drinking as a therapeutic goal for alcoholics, it was decided to recruit volunteers who were dissatisfied with their present mode of drinking but who had not previously sought help. This was done by requesting them to phone a private number. When these volunteers had been recruited it was proposed to modify their drinking habits to their own requirements, using non-averse training, drinking practice and ongoing group psychotherapy. This project however has not been implemented because of a paucity of volunteers. The methods of recruitment are listed and those drinkers who volunteered are described. The reasons for the low rate of response are discussed.
Elongation of Pause-Time in Speech: A Simple, Objective Measure of Motor Retardation in Depression
Authors: Szabadi E. , Bradshaw C. M. , Besson J. A. O.
Published: August 2008

A sample of ‘automatic speech’ (counting from 1 to 10) was tape-recorded and the times taken up by phonation and pauses measured. In four healthy volunteers, both phonation times and pause times remained constant over a period of two months. In four moderately depressed patients, with no history of manic illness and with no obvious clinical signs of motor retardation, the pause times were significantly elongated while the patients were depressed compared to pause times measured after recovery. The phonation times were constant throughout the period of observation (4–6 months). Other tests for motor retardation (tapping time; Nurses' rating scale; Hamilton Retardation Scores) did not give consistent results. It is concluded that the simple test described here may reveal a degree of motor retardation in cases where other tests fail to do so.
Behavioural Types of Rape
Authors: Gibbens Trevor , Way Cynthia , Soothill Keith
Published: August 2008

The previous and subsequent convictions of all thosechargedwith rape in 1961 were studied, together with circumstances of the criminal offence. The proportion of victims whose names were published in newspapers was high (26 per cent), and a high proportion of accused were acquitted (22 per cent). They fell fairly obviously into paedophiliac rapes of girls under 14 (30 per cent), ‘aggressive’ rapists (20 per cent) with a record of other aggressive offences, and ‘others' (50 per cent) with few if any other convictions. Various aspects of the records of these groups are considered. The paedophiles tended to have a wider age range and more often pleaded or were found guilty, and more of them received a medical disposal, rare in others. A small but similar proportion of acquitted and convicted were subsequently convicted of another rape.
Smooth Pursuit Eye Movements of Schizophrenics and Normal People Under Stress
Authors: Březinová V. , Kendell R. E.
Published: August 2008

Eye movements while watching an oscillating pendulum were recorded in 24 chronic schizophrenics and 24 matched normal controls. As others have reported previously, abnormal tracking movements were significantly commoner in the schizophrenics. However, in a series of experiments with normal subjects it was found that conditions designed to distract attention, or to produce declining arousal and attention, produced abnormal tracking movements indistinguishable from those observed in schizophrenics. As chronic schizophrenics are known to perform badly on a variety of psychomotor tasks and there is evidence that this is due to impaired attention or heightened distractibility, it seems likely that these same factors are responsible for their poor eye-tracking performance.
Cyclic AMP in the CSF of Patients with Schizophrenia
Authors: Biederman J. , Rimon R. , Ebstein R. , Belmaker R. H. , Davidson J. T.
Published: August 2008

The dopamine hypothesis of schizophrenia proposes that schizophrenia is associated with increased brain dopaminergic function. Because dopamine is thought to stimulate the production of cyclic AMP in the brain, we hypothesized that CSF cyclic AMP would be increased in schizophrenia. Cyclic AMP in the CSF was determined in 19 schizophrenic patients who had not received neuroleptic treatment in the preceding two weeks. No significant difference could be shown between CSF cyclic AMP in these patients and CSF cyclic AMP in 10 psychiatrically normal controls.
Slow and Rapid Psychobiological Alterations in a Manic-depressive Patient: Clinical Phenomenology
Authors: Stoddard Frederick J. , Post Robert M. , Bunney William E.
Published: August 2008

A distinctive pattern of clinical change during eight affective episodes is reported in a rapidly cycling manic-depressive patient. After a rapid switch to near maximal intensity of affective symptoms, slow changes in symptomatology were documented by significant slopes and correlation coefficients over the course of each episode. Decreases in depression, anxiety, drowsiness, helplessness/hopelessness, anger, and sadness preceded the switches into mania; decreases in mania, euphoria, seeking others, and talking preceded the switches into depression. Psychologically important events appeared to regularly precede rapid mood switches. It is suggested that the consistent, slow clinical changes which occur during affective episodes may reflect part of an underlying rhythmic biological process and that environmental events may be capable of triggering a final common pathway for the mood switch during a vulnerable period.
The Role of Mental Concepts in Explaining Neurotic Behaviour
Authors: Howard Christopher
Published: August 2008

This paper attempts to define the areas of applicability of behavioural and mentalistic explanations of neurotic behaviour. It is argued that intentional behaviour requires mental concepts for its explanation on the grounds that the statement of reasons which form the basis of intentions cannot be submitted to a stimulus-response analysis. This argument applies to situations in which the therapist uncovers the reasons for purposeful action of which the agent may initially be unaware. It is further argued that behaviour of this kind is rule-conforming and not law-abiding and therefore is not susceptible to explanations of the kind that are available in other areas of science. It is nevertheless argued that causal explanations can be given in terms of reasons for action.
The Discharge of Mentally Handicapped Patients to Residential Care
Authors: Spencer Douglas A.
Published: August 2008

The present policy of reducing the number of patients in hospitals for the mentally handicapped involves the discharge of many patients to residential care outside hospital. This paper considers 89 patients discharged from a hospital in the five years 1971–75. 64 (70%) went to facilities controlled by the Social Services Department, ten to other residential homes, eleven to lodgings and four to other institutions. Thirty five (40%) were subnormal (WAIS Full Scale IQ 55–69); the remainder, an unexpectedly high proportion, severely subnormal (WAIS Full Scale IQ, under 55). The majority of the patients discharged were the normal-looking mentally handicapped, few of whom had a specific cause for their condition. The suitability of patients for discharge in relation to the services available was more relevant than their ages or their years in hospital.
Plasma Levels of Antidiuretic Hormone in Patients Receiving Prolonged Lithium Therapy
Authors: Padfield P. L. , Park S. J. , Morton J. J. , Braidwood A. E.
Published: August 2008

Among 18 patients receiving prophylactic, long-term lithium treatment for manic-depressive psychosis, a high incidence of increased thirst and frequency of micturition (60–70 per cent) was noted on direct questioning. Symptoms arose at varying times after the start of lithium therapy; in no patient did symptoms antedate the use of the drug.

Plasma levels of antidiuretic hormone were found, on average, to be higher than in normal control subjects for a given level of plasma osmolality, although the scatter of results was wide. It is suggested that elevation of antidiuretic hormone occurs as a compensatory mechanism for the polyuria which is a common feature of long-term lithium treatment. The more florid form of nephrogenic diabetes insipidus occasionally seen in lithium takers seems likely to be due to a different mechanism from the more common mild polyuria.
Family Suicide
Authors: Dabbagh Fakhri
Published: August 2008

Five suicides in one family, mainly by burning, are reported. The ritualistic manner, closeness of events in time and absence of serious exogenous factors suggest the term ‘family suicide’.
Obsessional Personality Disorder and Remembering
Authors: Reed Graham F.
Published: August 2008

Patients suffering from obsessional personality disorder (anankasts) have been described as possessing ‘superior memories', because of the detailed precision of their accounts. At the same time, such classical phenomena as doubt, checking and rumination imply faulty recall. This paradox is discussed, and some predictions drawn from a hypothesis regarding the cognitive characteristics of obsessional disorder. Findings are presented which indicate that, by comparison with matched psychiatric controls, anankasts do not excel in the long-term recall of factual information or meaningful anecdotal material. But they show the following mnemonic features:

(a) Superiority of immediate memory span, reflecting high levels of attention.

(b) Superior recall of ambiguous anecdotal material, reflecting a tendency to the pointless ‘rehearsal’ of such material.

(c) Weak redintegration in personal reminiscence.

It is suggested that anankasts' doubts about their remembering refer not so much to the correctness of what is being recalled as to the quality of the recalling itself.
The Husbands of Agoraphobic Women: Assortative Mating or Pathogenic Interaction?
Authors: Hafner R. Julian
Published: August 2008

Symptom and personality profiles of 33 agoraphobic women and their husbands are examined, revealing some evidence for assortative mating. The implications of this are discussed, and predictions are made about the changes required within a marriage in order to permit the effective symptomatic treatment of the female partner.
Psychiatric Morbidity in a Sample of Accidents
Authors: Holding T. A. , Barraclough B. M.
Published: August 2008

The coroner's records of no accidental deaths resulting from poisoning, drowning and falling were examined for evidence of mental illness. Sixty per cent were classified as mentally ill before they died, depression, drug dependence and alcoholism accounting for over three-quarters of the diagnoses. Deaths given accident verdicts should be included in the study of the mortality of the mentally ill.
The Content of Ward Rating Scales for Long-Stay Patients
Authors: Hall J. N.
Published: August 2008

Although ward behaviour rating scales for use with long-stay psychiatric patients by nurses have been in existence for many years, their content tends to reflect the opinions of psychiatrists and psychologists rather than those of nurses. An analysis of five commonly used rating scales illustrates the lack of agreement on what should be included. The opinions of 76 nurses from four separate hospitals were sought, using a 34-item questionnaire, to establish what areas of content were considered important in nursing practice. Apart from agreement on general content, consideration should also be given to the presentation of individual items of ward rating scales.
Mathematical Models for Describing the Clustering of Sociopathy and Hysteria in Families
Authors: Hutchinson T. P. , Satterthwaite S. P.
Published: August 2008

The fitting of the multifactorial model of disease transmission to the familial clustering of hysteria and sociopathy by Cloninger et al (1) involved an approximation. This note reports the results of fitting the bivariate Normal model exactly and also two other distributions.
Haloperidol in the Treatment of Stuttering
Authors: Murray T. J. , Kelly Patrick , Campbell Lynda , Stefanik Kathy
Published: August 2008

Haloperidol treatment for stuttering was examined in a double-blind cross-over study of 26 adult volunteers with long-standing stuttering. Most had had unsuccessful speech and drug therapy. During the three-month study, their speech and stuttering patterns were repeatedly evaluated from videotaped readings of a standard passage and during spontaneous speaking. Of the 18 patients completing the trial 11 were significantly more improved on haloperidol than on placebo, three benefited equally from both, and four were unchanged. Improvement over placebo was indicated by fewer dysfluencies, increased speed of speaking, and reduced secondary 'struggle’ phenomena. Side effects were common on a dosage of 3 mg haloperidol daily. Poor concentration, akathisia and dystonic movements caused 8 patients to discontinue the trial despite significant improvement in 5 of them. Although 'statistically significant’ improvement occurred in most patients on haloperidol, the ‘clinical significance’ of this form of therapy will be limited by the partial response, the need for continuous medication, the side effects of haloperidol and the attitude of stutterers to this type of therapy.
Psychiatric Decision Making
Authors: Mayou Richard
Published: August 2008

Questionnaire replies from 43 experienced psychiatrists showed wide variation in the ways they would manage a common type of neurotic problem. There were considerable differences in the nature and duration of treatment and in the use of other members of the psychiatric team. The conclusions have implications for training and for the use of health care resources.
Reflective Processes and Anxiety
Authors: Spitzer Stephan P.
Published: August 2008

Three hypotheses are abstracted from Laing's writings on the interrelationships between self-consciousness, anxiety, and self-evaluation. Indicators of self-consciousness are obtained from an open-ended instrument which requires the respondent to provide twenty answers to the question (asked of himself): ‘Who am I ?’ Statements indicative of self-consciousness are those on which the respondent inserts a self-reference into the statement made about himself and are distinguished from statements in which no explicit self-reference is found. The data indicate that the mark of the self-conscious person is anxiety and that anxiety is largely restricted to those statements devoid of self-consciousness. The structure of a system likely to produce this configuration is considered by drawing upon Kierkegaard's conjectures on the joint emergence of consciousness and anxiety. Equating self-consciousness with ‘reflection’, it is suggested that while reflection brings about anxiety in a system as a whole, the act of reflection deters the emergence of anxiety at the particular points within the system upon which it is deployed. Thus the function of reflection is two-fold, creating anxiety at the same time (but not at the same place) as anxiety is reduced.
The Plasma Cholinesterase Variants in Mentally Ill Patients
Authors: Whittaker Mary , Berry Maureen , Whittaker Mary , Berry Maureen
Published: August 2008

The distribution of the plasma cholinesterase variants found in 1,374 mentally ill patients differs from that of a random control sample. The patients are more likely to have a rare phenotype than an individual from the normal population. None of the diagnostic groups have been shown to differ in the distribution of the E1agene, but there is strong statistical evidence that Group IV (psychosis) patients have a higher frequency of the E1fgene than the other groups. The overall frequency of the electrophoretic variant C5+ did not differ significantly from that observed in a Caucasian population, with the exception of the increase observed in Group IV c2.

Twenty-eight unrelated patients with Huntington's chorea were found to have a significantly altered incidence of the C5+ variant and six patients from this group were found to have the rare E1fgene. Our results indicate that the plasma cholinesterase variants may provide some insight into the inheritance of Huntington's chorea.
Rehabilitation of the Institutionalized Patient: Description of a Programme and Follow-up of 60 Patients
Authors: Baker G. H. B. , Woods T. J. , Anderson J. A.
Published: August 2008

The programme in an intensive rehabilitation unit in a large psychiatric hospital is described. Features include the use of non-medical staff as primary therapists, the use of a mini-bus to facilitate regular visits by patients to their home areas, the inclusion of the mini-bus driver on weekly staff conferences, the use of sociodrama, the re-organization of hospital money payments to patients, the promotion of relations with community-based facilities through occasional ‘teach-in’ days, and a special liaison social worker providing intensive follow-up after discharge. Rehabilitation was prolonged (average stay about one year) and about half of those selected for rehabilitation from the long-stay wards were discharged. Follow-up showed that these patients benefited from discharge, in spite of a relatively high incidence of psychopathology and of social problems. Those transferred back to long-stay wards showed increased institutionalization.
Clinic Attendance and Opiate Prescription Status of Heroin Addicts over a Six-Year Period
Authors: Thorley Anthony , Oppenheimer Edna , Stimson Gerry V.
Published: August 2008

Home Office records were used to trace the current status of a sample of 128 persons for whom heroin was prescribed in 1969 at Drug Dependence Clinics in London. In October 1975, after a mean time since self-reported first use of heroin of 11 · 25 years, 51 per cent were attending clinics, 40 per cent alive and not attending, and 9 per cent dead. One third of the sample were still receiving heroin on prescription, and 23 per cent appeared to have received heroin without interruption since 1969. The report points to the need for career studies of addicts' lives and the need for follow-up interviews, especially for the 40 per cent no longer attending clinics.
Schizophrenia in a 46,XY Male with the Noonan Syndrome
Authors: Krishna N. Rama , Abrams Richard , Taylor Michael A. , Behar David
Published: August 2008

We report for the first time the case of a male patient with the Noonan syndrome (Turner phenotype with a normal karyotype) who also had a psychiatric disorder which satisfied research criteria for schizophrenia.
Eighteen Years of Community Psychiatric Service in the Island of Samsø
Authors: Nielsen Johannes , Nielsen Jørgen Achton
Published: August 2008

An analysis has been made of patients aged 15 + referred to the community psychiatric service in a Danish rural population during 18 years. The mean referral rate per year was 17·9 per 1,000.

The majority of the patients (79 per cent) were referred to the clinic by the general practitioners, and it is stressed that a close and good co-operation between the psychiatrists and the local physicians is one of the most important factors in establishing a good community psychiatric service.

Only 11 per cent of all referrals were admitted to a psychiatric hospital. The admission frequency for psychoses was only 19 per cent, and it was estimated that it would have been approximately 44 per cent higher, if the service had been of the usual hospital-oriented type. Forty-three per cent of the patients were visited by the psychiatrist in their home at least once and 42 per cent of all 6,000 consultations were home visits.

When evaluating the treatment possibilities it was considered that approximately 50 per cent of all patients referred could be treated by the local physicians after examination by psychiatrists and discussion of the cases with them.
The Phenomenology of Severe Obsessive-Compulsive Neurosis
Authors: Dowson J. H.
Published: August 2008

The case histories are examined of 41 patients who were admitted to hospital for the first time with a diagnosis of obsessive-compulsive neurosis. Aspects of the phenomenology are reported which presented between the first appearance of obsessive-compulsive symptoms and discharge from the first admission.

The mean age for admission was 31·6 years (SD 14·3) and 68 per cent of the sample were women. The women showed significantly higher incidences of contamination phobia and of compulsive cleaning behaviour than did the men. Cleaning behaviour and avoidance of feared stimuli were the most frequently encountered manifestations of compulsive behaviour.
Marital Stability Following the Birth of a Child with Spina Bifida
Authors: Tew B. J. , Laurence K. M. , Payne H. , Rawnsley K.
Published: August 2008

The matrimonial stability of 142 families where a child with neural tube malformation (mostly spina bifida) was born between 1964 and 1966, including 56 families with a surviving spina bifida child, was examined in January 1976. The divorce rate for families with a surviving child was found to be nine times higher than that for the local population and three times higher than for families experiencing bereavement of their spina bifida child. Marriages which followed a pre-nuptial conception resulting in a spina bifida child were particularly vulnerable and had a divorce or separation risk of 50 per cent. All the divorced fathers had remarried, but only one of the mothers. It is concluded that a handicapped child adds greatly to the strain on a marriage, especially when this has not been cemented before the arrival of a child. This strain is diminished by the child's early death.
Assessing Dangerousness in Criminals
Authors: Scott P. D.
Published: August 2008

This article formulates a definition of the term dangerousness, indicates why the commission of dangerous offences cannot be reliably predicted, and then reviews the several factors which have been or might be used by those who have to make decisions about dangerousness in criminals. It suggests that these factors are useful insofar as they help to illuminate the individual's capacity to feel sympathy and to learn by experience. Since the accuracy of prediction varies inversely with time, the maintenance of personal relationships and good communication seems the inescapable requirement in the management of potentially dangerous criminals.
Correlation Between Plasma Chlorpromazine and its Metabolites and Clinical Ratings in Patients with Acute Relapse of Schizophrenic and Paranoid Psychosis
Authors: Phillipson O. T. , McKeown J. M. , Baker J. , Healey A. F.
Published: August 2008

Nine patients diagnosed as having acute schizophrenic psychosis were treated with chlorpromazine. Their clinical response to drug treatment was measured by the use of a clinical rating scale developed from the Present State Examination, and a nurses rating scale. Plasma levels of chlorpromazine (CPZ), 7-hydroxychlorpromazine (7OHCPZ), monodesmethylchlorpromazine (NOR1CPZ) and chlorpromazine sulphoxide (SOCPZ), were monitored during the period of hospital treatment. Correlations were made between the increase in plasma levels of drug or metabolites and improvement in the different PSE scores. These showed that the most significant correlations occurred when symptoms with high diagnostic significance for schizophrenia (Group 1) and symptoms rating perceptual disorders (P) were correlated with plasma 7OHCPZ levels in plasma samples taken before the first morning dose of CPZ. The ratio of 7OHCPZ to CPZ in these samples increased significantly as clinical ratings improved, this correlation being most highly significant against the Group 1 and P scores. The ratio of 7OHPCZ to SOCPZ increased significantly only in the case of Group 1 and P scores. This indicates a preferential shift of CPZ metabolism towards the formation of the active 7OHCPZ during the period of clinical improvement.