bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective, longitudinal study of children registered for adoption : A 15‐YEAR FOLLOW‐UP
Authors: Bohman M. , Sigvardsson S.
Published: August 2007

A cohort of 624 children, candidates for adoption as infants, were investigated at 11 and 15 years of age. At 11 years these children ran a greater risk than classmates of developing nervous disturbances and symptoms of maladjustment, regardless of whether they were growing up in adoptive home, a foster home or with their biological mother. At 15 years there was little difference in adjustment between the adopted children and their classmates, whereas children growing up in foster homes or with their biological mothers displayed a high proportion of social maladjustment and/or underachievement at school. The implications of these findings for child placement policies are discussed.
Social and clinical correlates of the ‘new’long‐stay
Authors: Babiker I. E.
Published: August 2007

Out of a total admission cohort of 1,934 patients 162 and 101 patients remained continuously in hospital for 6 months and 1 year respectively. The study describes the characteristics of these patients and at each stage compares them with those who were discharged on a number of social and clinical variables. The findings confirm the importance of social factors in determining continued retention and support the suggestion of a process of early selection of “new” long‐stay patients put forward by Mann & Sproule (1972). The findings are discussed and a case is argued in favour of continuing to provide for such patients in hospital.
Unilateral and bilateral ECT in elderly patients A COMPARATIVE STUDY
Authors: Fraser R. M. , Glass I. B. , Fraser R. M. , Glass Ilana B.
Published: August 2007

Twenty‐nine depressed elderly patients receiving ECT were randomly assigned to a unilateral or bilateral group; post‐ictal recovery times, memory changes, and clinical improvement during and after each course were measured by blind and independent observers. All patients but one showed full recovery on testing 3 weeks after treatment. There was no significant difference between the unilateral and bilateral groups either in terms of improvement or the number of treatments needed in each course.

A good outcome was predicted by the presence of pathological guilt, impairment of work and interests, agitation, subjectively depressed mood, psychic anxiety and greater overall severity. Longer duration of illness predicted a relatively poor outcome.

Memory functions showed uniform impairment before treatment, but during treatment all improved, with some changes reaching high statistical significance; on testing 3 weeks after treatment memory functions in all patients had reached normal values. There was no difference between the two groups.

Post‐ictal recovery times were significantly longer in the bilateral than in the unilateral group after the first treatment and after the fifth treatment more than three times as long. Recovery time showed a significant decrease during courses of unilateral treatment.

There was a very low incidence of side‐effects, and all were relatively mild.

We conclude that unilateral ECT is a safe and highly effective treatment for selected elderly patients suffering from depression, but that there is nothing to be said for the continued use of bilateral ECT.
Hospital and outpatient care for psychotic patients during the last three decades SUBSEQUENT HOSPITAL AND OUTPATIENT TREATMENT OF PSYCHOTIC PATIENTS HOSPITALIZED FOR THE FIRST TIME IN 1949–50, 1959–60 OR 1969–70
Authors: Salokangas R. K. R.
Published: August 2007

The study deals with the development in the extent of hospital treatment and trends concerning outpatient visits for psychotics in Turku hospitalized for the first time in 1949‐50 (period of shock therapy), 1959–60 (period of neuroleptics) or 1969–70 (period of intensified outpatient treatment).

The bed capacity for psychiatric patients increased in Turku in the 1950's, but has declined slowly since then. The number of hospitalized cases nevertheless continued to rise up to the 1970's. The number of caretaking personnel in the outpatient sector has increased five‐fold and the extent of outpatient visits 20‐fold over the 25 years covered by the study.

After the introduction of neuroleptics, first hospitalizations became shorter, as fewer and fewer patients remained in long‐term hospital treatment. At the same time the annual extent of hospital treatment declined, whereas rehospitalizations became more frequent. Along with intensified outpatient treatment first hospitalizations became still shorter, but the total need for hospital treatment was not reduced. During intensified outpatient treatment, rehospitalization was rapid and, at first, frequent; subsequently rehospitalizations became less frequent compared to the period of neuroleptics. In the 1970's, intensive outpatient treatment provided immediately after the first hospital stay appears to be most clearly associated with a reduction in the number of hospital treatment days of schizophrenics. In the case of psychoses of old age an increased extent of outpatient treatment did not lead to a decline in the need for hospital treatment.
Psychiatric disorders in a U.S. community THE APPLICATION OF RESEARCH DIAGNOSTIC CRITERIA TO A RESURVEYED COMMUNITY SAMPLE
Authors: Weissman M. M. , Myers J. K.
Published: August 2007

Point prevalence rates of psychiatric disorders, risk factors, and treatment sought for the disorders are presented, based on a 1975–1976 follow‐up of a community probability sample originally surveyed in 1967. These data, while preliminary because of the limitations of a follow‐up study, demonstrate the first application to a community sample of new psychiatric diagnostic techniques (SADS‐RDC), which are being used with increasing frequency in the United States. The forthcoming DSM‐III will be based on these diagnostic techniques.

These results, consistent with other reports, show that depression is the most common psychiatric disorder in the community; that schizophrenia and bipolar disorders both have low frequency; and that psychiatric disorders are heterogeneous by age, sex, race, social class, marital status. While persons with a psychiatric disorder tend to use the health care system in the United States, they do not specifically seek help for emotional problems. Since the majority of psychiatric disorders are untreated in the mental health system, prevalence rates of psychiatric disorders based on cases receiving treatment in psychiatric facilities are a gross underestimate.
Prevalence of mental disorders in a 70‐year‐old urban population
Authors: Persson G.
Published: August 2007

The prevalence of mental diseases and abnormalities in a representative, systematic sample of 70‐year‐olds in Gothenburg, Sweden, is presented. Out of 460 selected subjects, 392 (85.2 %) took part and the responders and non‐responders were similar in several respects. A case was defined by cut‐off points on symptom and/or sign rating scales and diagnoses were defined operationally but as closely as possible to the ICD‐classification.

The total psychiatric morbidity, excluding personality deviations, was 16.9% in men and 26.1% in women, and excluding also mild neuroses 12.7% in men and 15.5% in women. The prevalence of psychoses was 3.0% in men and 3.5% in women, of neuroses of moderate‐severe degree 6.6% in men and 11.5% in women, of neuroses of mild degree 4.2% in men and 10.6% in women, of alcoholism 3.0% in men and 0.0% in women and of oligophrenia 0.0% in men and 0.4% in women. The prevalence of demential syndromes of a psychotic degree was 2.4% in men and 1.3% in women, of a neurotic degree 4.2% in men and 1.8% in women and the total prevalence of demential syndromes was thus 6.6% in men and 3.1% in women. Indications of previous alcohol problems and no or a low current consumption of alcohol were noted among 18.1% of the men.
Changing patterns of suicide in Australia, 1910–1977
Authors: Burvill P. W.
Published: August 2007

Presented for the period 1910‐1977 were the sex specific annual age standardised suicide rates for Australia, together with age‐sex specific rates and methods of suicide. During this time there were marked changes in male rates, the changes mainly occurring during four periods – 1910‐19, 1925‐40, 1940‐49 and 1955‐77. The changes in female rates were less marked and confined chiefly to 1955‐77. There has been a drop in suicide rates since the mid 1960's in all age groups, except in males aged 15–29 years whose rate has steadily risen. Methods of suicide have changed considerably during the period 1910–77. There was no evidence found to sustain the hypothesis that elimination of a common suicide method resulted in a sustained lower overall suicide rate. Current theories of suicide causation were often found to be inadequate to explain many of the findings. It is suggested that we need to develop radically different approaches to the aetiology of suicide.
Intramuscular haloperidol decanoate for neuroleptic maintenance therapy Efficacy, dosage schedule and plasma levels AN OPEN MULTICENTER STUDY
Authors: Deberdt R. , Elens P. , Berghmans W. , Heykants J. , Woestenborghs R. , Driesens F. , Reyntjens A. , Wijngaarden I. van
Published: August 2007

Thirty‐eight hospitalized chronic psychotic patients were injected (i.m.) every 4 weeks with haloperidol decanoate using different dosage schedules which were calculated from the previously prescribed daily oral dose of haloperidol multiplied by a factor of 30, 20 or 10.

The 20‐fold schedule appeared to be adequate in most of the patients. All patients were well stabilized on their optimal dose schedule and several symptoms improved even further during treatment.

No increase of extrapyramidal or other side‐effects was reported in any of the patients. Antiparkinson medication could be omitted in 37 patients without problems. There was neither pain nor irritation at the site of injection.

Plasma levels of haloperidol reaching a steady state after the second injection of haloperidol decanoate were about two times higher than during the previous oral treatment with haloperidol. No accumulation was observed.

Haloperidol decanoate injected every 4 weeks proved to be as safe and therapeutically reliable as orally administered haloperidol.
Hypnagogic and hypnopompic hallucinations during amitriptyline treatment
Authors: Hemmingsen R. , Rafaelsen O. J.
Published: August 2007

Four cases of hypnagogic or hypnopompic visual hallucinations in patients during amitriptyline treatment are reported. The hallucinations were clearly delineated, projected to the outer objective space and were for a short time experienced as real. The patients rapidly realized the unreality of the “sights”, probably because they regained the full criticism and coherent thinking of an un‐psychotic awake individual. There may be a relation between the effects of amitriptyline in brain, the changed pattern of sleep and the clinical recovery. Patients should be informed about the benign character of this type of hallucinatory phenomena so that treatment is not terminated at an undue time.
Relation between early parental death and life event ratings among 70‐year‐olds A TEST OF A SENSITIZATION THEORY
Authors: Persson G.
Published: August 2007

A subsample of 151 subjects from the population study “70‐year‐olds in Gothenburg” were given a questionnaire for life event ratings to be returned by mail. The 24 life events to be rated were events that are fairly common in advanced age. The subjects were instructed to record how an event would affect them personally. The ratings of subjects who had lost a parent by death before they were 16 were compared with those of subjects who had grown up together with both parents until they were 16. Bereaved men had lost their parent at 6.9 years of age and bereaved women at 9.9 years on average. Bereaved men attributed significantly less weight to five of the events and there were tendencies in the same direction for another three events. Bereaved women, on the other hand, attributed similar weights to the events as non‐bereaved women. As possible explanations for the relation between bereavement and life event ratings, it is suggested that early bereavement might (a) cause a change in personality, with avoidance of involvement, (b) lead to a strong development of the defence mechanism denial, or (c) result in a very high standard of comparison.
Influence of maternal distress during pregnancy on postnatal development
Authors: Blomberg S.
Published: August 2007

Children of women whose applications for legal abortion in 1960 had been refused were compared with the next same‐sexed children born in the same delivery wards, whose mothers were of similar age, parity and social class. The postnatal somatic and psycho‐social development in 90 pairs thus matched was followed up to 15 years of age using school grades, the school health card and the register of the social welfare authorities.

The initially unwanted children had a more insecure childhood with more cases of divorce. They performed worse at school and displayed more psychosomatic symptoms, they were more often registered with the social welfare authorities and in need of psychiatric treatment. When the 48 pairs that were formally equivalent as to having lived with their biological parents were compared the difference in school achievement remained. The result may be seen as support of the hypothesis of a negative prenatal influence.
Effect of availability and acceptability of lethal instruments on suicide mortality AN ANALYSIS OF SOME INTERNATIONAL DATA
Authors: Farmer R. , Rohde J.
Published: August 2007

Suicide mortality in the 5 years 1969–73 in 11 countries is examined in relation to the methods used. Some countries have substantially high suicide rates for each method, others have increased mortality for certain specific methods. In this latter group it is suggested that some of the variations in total suicide mortality can be explained by variations in either the availability or the acceptability of certain specific instruments for causing death, particularly domestic gas, firearms and hanging.
Delirium tremens: Some clinico‐chemical features A STUDY OF ALANINE‐AMINOTRANSFERASE, ALCALINE PHOSPHATASE, PROTHROMBINE AND ENOLASE
Authors: Hemmingsen R. , Kramp P. , Dissing J.
Published: August 2007

The relationship between variables reflecting liver disease (serum‐alanine‐aminotransferase (SGPT), serum alcaline phosphatase and plasma prothrombine) and the clinical signs and symptoms during delirium tremens (DT; grade 3) and related clinical states (grade 2) was studied. Furthermore, it was investigated whether the two isoenzymes of enolase which predominate in brain tissue were present in plasma or cerebrospinal fluid (CSF) in DT patients.

A correlation between SGPT and clinical state was not observed, which indicates that a causal relationship does not exist between acute liver cell damage and clinical state during DT of grade 3 or 2. In grade 2 patients, but not in grade 3 patients, both SGPT and serum alcaline phosphatase decreased between admission and recovery. This difference between the groups may be due to a higher alcohol consumption and a shorter interval between last drink and admission in grade 3. The difference in recent drinking history may also account for the finding of a higher plasma prothrombine index in grade 3 compared with grade 2, because chronic ethanol intoxication may be accompanied by enhanced hepatic protein synthesis.

“Brain‐enolase” was not present in detectable amounts in blood or CSF during DT thus suggesting that brain cell damage resulting in leakage of this enzyme from the cells did not prevail during DT.
Videotape recording in psychiatry and psychopharmacology : REVIEW AND PRESENTATION OF A NEW METHOD
Authors: Fischer‐Cornelssen K. A. , Abt K.
Published: August 2007

After a review of publications concerning the use of television in psychiatry a new method of audiovisual evaluation of psychotropic drugs is demonstrated: SAPE (Standardized Audiovisual Psychiatric Evaluation). The procedure requires a pre‐treatment and post‐treatment videotaped interview with each patient (15 min). These interviews are later rated and scored by 10 to 20 or more raters (using a Symptom Check List). Data are evaluated by a fully automated computer program in four steps. The main advantages of the method are: 1) Uniform homogeneous information available to all participating raters. 2) Reduced number of patients and shorter duration of trial. 3) Participation of as many raters as desired. 4) Better comparability and standardization than with usual methods. 5) Inter‐rater and intra‐rater reliability tests for every study possible. 6) Stabilized baseline values for each symptom. 7) Homogeneity of raters’assessments resulting from the increased number of raters participating. 8) Improved basis and conditions for the use of parametric statistical evaluation techniques. 9) Homogeneity of the rater evaluation for each subsequent control. 10) A statistical assessment of the homogeneity of a study as a whole is possible. 11) Double‐blind method only for treating doctor (not video‐rating), the nurses and patients but not for the television interviewer and raters (if contact with ward and patients is avoided).
Cerebrospinal fluid endorphins in schizophrenia
Authors: Rimón R. , Terenius L. , Kampman R.
Published: August 2007

Opioid‐receptor‐active material, endorphins, has been measured in cerebrospinal fluid samples obtained from schizophrenics. A chromatographic procedure isolated the Fraction I endorphin which was quantitated in a receptorassay.

At least two cerebrospinal fluid samples were obtained from each patient, at Day 0 with no medication and at Days 30 and 60 after medication with fluphenazine under standardized conditions. Three series of patients were included: acute schizophrenics (n = 11); re‐entry schizophrenics (n = 7) who have previously been treated with neuroleptics but were readmitted to hospital usually as a consequence of stopped medication, and chronic schizophrenics (n = 9) who had been without neuroleptics for at least 2 weeks prior to Day 0.

At Day 0, 6/9 acute cases, 4/6 of re‐entry and 2/9 chronic cases had endorphin levels above the range of healthy volunteers. The levels in chronic cases were significantly lower than those in acute cases. Treatment with neuroleptics significantly lowered the endorphin levels in acute cases. These results confirm and extend previous observations.
Socio‐demographic correlates of schizophrenia, affective psychoses and neuroses in a clinic in India
Authors: Varma V. K. , Wig N. N. , Murthy R. Srinivasa , Misra A. K.
Published: August 2007

Of a total of 5,343 patients seen during four calendar years at the adult psychiatric outpatients’clinic of a teaching hospital in India, patients with schizophrenia, affective psychoses and neuroses were compared with one another regarding distribution of socio‐demographic variables. Women with an urban background and higher socio‐economic status were proportionately more numerous amongst neurotics. Schizophrenics were youngest and more often single. Patients with affective psychoses were older, usually married, had the lowest educational level and most often a rural background, and were from relatively lower socio‐economic strata. Also the Sikh religion and Jat caste were significantly more preponderant amongst affective psychotics. This finding is consistent with the reported distribution of ABO blood groups in affective psychotics and in Jat Sikhs, and suggests a genetic basis for the greater representation of Jats and Sikhs amongst affective psychotics.
Psychiatric and primary health services
Authors: Dilling H.
Published: August 2007

A field‐study of need for psychiatric help was conducted in a rural smalltown area. About one‐fifth of the population was found to need care due to psychiatric symptoms. Fifteen percent of the sample was judged to need treatment by psychiatrists or psychotherapists, but less than two percent were actually cared for in psychiatric services. It would be unwise, however, to extent psychiatric services to solve all needs for psychiatric treatment in the community. Instead, the position of the general practitioner should be strengthened to avoid separation of psychological treatment and somatic treatment. We recommended that general practitioners receive more education in psychological medicine so that they can be responsible for treatment of all primary psychiatric problems. Then, it would only be necessary to double the ambulatory psychiatric services and number of psychiatrists in practice in addition to development of better social psychiatric services in order to meet the needs of the community.
Primary health care in child psychiatry
Authors: Graham P.
Published: August 2007

Those involved in primary health care for children, especially family doctors and public health nurses, are already providing psychological, psychiatric and counselling services. A study of child consultations with family doctors suggested that in nearly half the attendances a significant psychosocial component was involved. Surveillance programmes currently recommended for implementation in the United Kingdom should result in early identification of severe parent‐child relationship problems and early management difficulties. It is uncertain whether effective prevention and treatment strategies exist to deal with these problems, however, but some reports are promising in this respect. The organisation and training of primary health care workers with children, to ensure their psychological needs are met, is also problematic. Greater awareness of the size of the problem could be learned at under‐graduate level and the holding of multi‐disciplinary courses for those already trained would also be helpful.
Problems in teamwork between a social service psychiatric unit and a psychiatric hospital
Authors: Madsen A. Meldgaard
Published: August 2007

The report focuses on teamwork in social psychiatry rather than in a hospital‐based institution staffed with psychiatrists, psychologists and social workers. Work in social psychiatry must be based on a social medicine model of sickness rather than on the classic “mechanical failure” model. More is done in social psychiatry to evaluate a patient's life‐ situation than a patient's symptoms, since successful treatment often requires an understanding of the individual's total social situation. If psychiatric treatment is to produce better results in the future, it will be necessary to work in terms of district psychiatry with attention to community‐oriented services. Problems of confidentiality must be considered carefully. Institutions of social psychiatry should be established which can promote interdisciplinary teamwork, function as training departments and bridge the gap between psychiatric hospitals and the social services. Social psychiatry should not become an independent speciality to which “social cases” are referred from psychiatric wards. On the contrary, social psychiatry should be integrated as a natural and important part of a psychiatrist's training and function.
Psychiatry and primary health services in developing and developed countries
Authors: Nimb M.
Published: August 2007

In most developing countries, psychiatric and other mental health services are in a very weak position, not only in relation to other branches of medicine, but tend to have followed European institutional models, which only respond poorly to the overall mental health needs of the people. It is difficult to visualize any broad coverage of mental health services unless these become despecialized, decentralized and deinstitutionalized and from the ground level integrated with existing or planned general primary health services.

In developed countries existing institutions have been upgraded and modernized to a considerable extent over the last decades. But the mental health component of the primary health services still leaves much to be desired. Much of the primary mental health services in industrialized countries are today being taken care of by the administrators and practitioners of the social welfare system. These services would have much to gain through a closer collaboration with the psychiatrists, who have so far had little influence in this important sphere.
Mental health and primary care in the seventeenth century
Authors: Shepherd M.
Published: August 2007

Mental ill‐health at the primary care level is closely associated with social factors. Historical research can elucidate their relationship. Data collected by a seventeenth century physician are presented to illustrate the process. Their implications are discussed.
The use of rating scales exemplified by a comparison of the Hamilton and the Bech‐Rafaelsen Melancholia Scale
Authors: Bech P. , Rafaelsen O. J.
Published: August 2007

A psychiatric rating scale is a method directed towards standardization of the recording of clinical data. Depending on the various levels of information such scales can be divided into questionnaires, observer scales and interviewing or case‐recording scales.

The most commonly used observer scale is the Hamilton Depression Scale (HDS) which consists of 17 items or symptoms. The sum of the scores of each item is intended to give the rating for the patient's state. However, our previous work with the HDS has shown that the scale is not a one‐dimensioned measure of the depressive state. Our statistical evaluation of summing the HDS‐items will include both homogeneity (the consistency of a scale across items) and transferability (the consistency of a scale across patients). On this background the construction of our own depression scale will be discussed.
The description and classification of social disability by means of a taxonomic hierarchy
Authors: Cooper J. E.
Published: August 2007

Many schedules for the description of various forms of disability and handicap have been developed, but even the more satisfactory ones have a limited coverage, and virtually all separate disabilities and handicaps due to physical causes from those with psychological causes. Since the end result of interference with social life is often the same whatever the cause, there is a case for trying to develop a classification of disability and handicap which can be applied to patients with any form of illness. Impairments, disabilities and handicaps, however defined, are all aspects of interference with behaviour, so we are really seeking to classify performance of behaviour. To do this satisfactorily, we first need a general and comprehensive classification of human behaviour.

This paper, therefore, attempts to provide a conceptual basis for the development of such a general classification of human behaviour upon which a classification of disabilities and handicaps could be based. The problem is approached in the following steps:

a) A brief summary of conclusions about current progress in the classification of behaviour and social disability in social psychology, ethology and psychiatry.

b) A discussion of the most successful method of classification in biology, technically known as a taxonomic hierarchy.

c) An outline of a taxonomic hierarchy of human behaviour, which makes it clear how the effects of physical and psychological disorders can be encompassed within the same scheme.

d) A discussion of how this framework can be used to describe and classify physical and social disabilities and handicaps, and psychiatric symptoms.
Psychiatric case identification in general practice: Self‐rating versus interview
Authors: Katschnig H. , Berner W. , Haushofer M. , Barfuss M. , Seelig P.
Published: August 2007

Sixty‐four general practice patients diagnosed by a general practitioner as psychiatrically disturbed and 42 patients judged by the general practitioner as psychologically healthy, were interviewed by psychiatrists by means of the “Schedule for a Standardized Assessment of Depressive Disorders” (SADD) developed by WHO. A subsample of 77 patients also filled out the “General Health Questionnaire” (GHQ) by Goldberg. A relatively high agreement between the “General Health Questionnaire” and the psychiatrist's judgement (after interviewing the patient with the SADD) was found. The agreement between the GHQ and the psychiatrist's diagnosis was higher for the psychiatrist's diagnosis of depression than for his diagnosis of “general psychiatric disturbance”. It is recommended to use the “General Health Questionnaire” as a screening tool in general practice.
MMPI in a study of unemployment
Authors: Lajer M.
Published: August 2007

A random sample of active members from the bricklayers’ trade union in Aarhus was interviewed and MMPI tested. Unemployment data were collected up to six years previous to the date of interview. For the same period the number of days of absence due to illness, additional education, military service etc. (out days) were registered.

The bricklayers were distributed according to age, marital status and unemployment. For the 14 basic validity and clinical scales of the MMPI, the relations between the score and the three variables were examined. Several scales had scores correlated to unemployment.
Assessment of handicaps in mentally retarded children: Preliminary findings from a study using the Schedule of Children's Handicaps, Behaviour and Skills
Authors: Liepmann M. C. , Ort M.
Published: August 2007

Preliminary findings are reported from a study in Mannheim, using in translation the Schedule of Children's Handicaps, Behaviour and Skills (HBS‐Schedule) developed by Wing (1973). This instrument yields distinctive profiles of handicap which may be valuable in assessing children's special needs for care and education. Scores derived from joint interviews with the mothers of 15 children showed very good agreement between trained interviewers. On the other hand, a generally lower level of agreement was found between the information obtained from the mothers and that supplied at separate interviews by the children's class‐teachers. These findings are discussed in relation to the problem of assessing validity.
Do neuroticism inventories measure personality traits or psychosocial stress?
Authors: Ormel J.
Published: August 2007

This study was carried out to determine the influence of environmental factors and of personality factors on a person's responses to a neuroticism inventory. In 1970, 1976 and 1977, a sample of approximately 300 Dutchmen aged 15–60 years completed a number of questions from Wilde's neuroticism and neurosomaticism inventories. In addition, a psychiatric interview was conducted to obtain information about their life situation, stressful life events, and long‐term difficulties. The results indicate that neuroticism, and to a lesser extent neurosomaticism scores, reflect personality traits rather than psychosocial stress or a person's reactions to it. The relation between emotional disturbance and high scores on the inventories suggests that people with high scores are poor copers both psychological (defense) and in instrumental behavior and problem‐solving.
The MRC Handicaps, Behaviour & Skills (HBS) schedule
Authors: Wing L.
Published: August 2007

Assessments of mentally retarded people are needed for diagnosis, and planning services. Standardized psychological tests are of limited value, so rating scales have been devised. The HBS schedule is a clinical interview designed to elicit details concerning many aspects of development, including social interaction, non‐verbal and verbal communication, imaginative play; and abnormalities of behaviour, including repetitive routines found in early childhood psychosis. Levels of agreement between trained interviewers are very high. Those between informants from different environments are less good, but still acceptable. The schedule has been used to sub‐group mentally retarded children on patterns of abnormality of psychological funtion. A syndrome of severe impairment of social interaction, communication, and imaginative development has been identified and found to have implications for service provision. Comparative studies have been completed in Camberwell and Salford, in England, and Aarhus in Denmark. A brief version for large suveys is available.
A census study with special regard to long‐stay psychiatric patients
Authors: Kastrup M. , Bille M.
Published: August 2007

The use of the psychiatric services in Randers and its neighbouring municipalities with a total population of 114,650 was analyzed by a census on March 1, 1977. 76% of the population (87,108 persons) were at least 15 years old. 716 of these persons were in psychiatric treatment, with 18% in institutionalized outpatient care, 8.4% in non‐institutionalized outpatient care, 36.9% in an alcohol clinic, 4.3% in psychiatric day‐patient care, 16.1 % in inpatient hospital care, 15.9% in psychiatric nursing homes and 0.1% at psychiatric consultant service. The prevalence of psychiatric treatment of males and females was 8.40 and 8.05 per 1,000, respectively. Peak prevalence for both sexes was found in age group 35–44 years, due mainly to the high number of patients treated as outpatients or at an alcohol clinic. The prevalence of males and females in continuous psychiatric treatment for more than one year was 2.12 and 1.18 per 1,000, respectively (143 patients in all). Of these, 55% of males and 27% of females were treated at an alcohol clinic. Only 41 patients had been long‐term inpatients. The presence of psychiatrists in private practice did not reduce the number of patients treated by other services. The private psychiatrist saw mainly the same categories of patients as were seen by psychiatrists at the outpatient clinic, but many patients probably would not have received psychiatric treatment had no private psychiatrists been available.
The Anglo‐American geriatric studies
Authors: Mann A. H.
Published: August 2007

Four comparative studies of the elderly population of the cities of New York and London are reviewed. Health problems in this age group occur with similar frequency but the services offered for them differ in each city. The methods used in these studies for assessment of elderly patients are described.
Sheltered workshops and economy
Authors: Bille M. , Salling‐Poulsen Aa. , Videbech Th.
Published: August 2007

The study concerns the sheltered workshops in Randers, a town with 65,000 inhabitants, 35 km north of Aarhus, Denmark. The purpose of the investigation is to review the patients attending the sheltered workshops in Randers, to investigate the extent to which patients, who had been without employment, could become productive again with the help of sheltered workshops, and to review the social economical funtion of these workshops. The problem is of interest on account of the great number of persons pensioned at an early age.

A description is given of the privately owned institution for rehabilitation in Randers. The present Danish legislation regarding sheltered workshops is reviewed. There is no quota arrangement in Denmark which requires employers to engage disabled persons. It is shown that the three sheltered workshops in the privately owned institution for rehabilitation in Randers receive very moderate subsidies from public funds compared with their turnover and that the machine factory “Viva” is run with a social profit. The 45 persons who were employed on January 7,1976 in the three sheltered workshops of the privately owned institution for rehabilitation are described socially and medically by means of tables. It is shown that disablement is a relative expression.

It is concluded that sheltered workshops are reasonable and sensible establishments which should be extended for the sake of handicapped and for the society as a whole. Even if quota arrangements are made, there will always be persons whose handicap is so pronounced that they will only be able to work in sheltered workshops.
Information in mental health services: a tripartite system
Authors: Brooke E. M.
Published: August 2007

In recent years many countries have developed national statistics of persons treated for mental disorders and handicaps. These usually give numbers and rates of people admitted to or discharged from psychiatric hospitals, the patients being described in terms of those sociodemographic characteristics which were thought likely to shed light on the epidemiology of mental disorder, provide clues to etiology and indicate high risk groups. It is now realised that what was being provided was “service utilisation statistics!” When the mental health services were provided and administered independently of general health services, “care” was an acceptable concept, but with the integration of the services, “cure” is what is being sought. Data on what happens to individual patients who pass through, or get caught up in, various forms of services, have therefore become necessary. Meanwhile the cost of health services has risen, hospital management has developed into a science, input, output and cost‐benefit are new and significant words in the vocabulary of hospital administrators. Information must therefore be provided to show what resources exist and how they are being used in relation to cost. This information must be produced as quickly and cheaply as possible. It is with this objective in view that the following tripartite system for basic data collection is proposed, consisting of periodic censuses, cohort studies and cost analysis.
Selection of variables in a prospective study of young men at high risk for alcoholism
Authors: Knop J.
Published: August 2007

The Danish adoption studies on alcoholism have established a considerable genetic factor in the development of alcoholism.

The basis for the present prospective high risk study is a consecutive birth cohort born 1959–1961 in Copenhagen (n= 9,000). The extensive pre‐and perinatal data include information about admissions in psychiatric departments for all 18,000 parents.

We have selected 250 boys, who have a parent treated for alcoholism (high risk group). They have been matched with boys from the same birth cohort, whose parents have not been registered as alcoholics (low risk group).

The boys are just entering the age of risk for development of alcoholism, and no abnormalities found at the present time can be described as consequences of heavy drinking.

The study is multidisciplinary in its approach, and we have selected neurophysiological, psychophysiological, neuropsychological, metabolic, psychiatric, psychological and social variables to test the most solid hypotheses about alcoholism. The hypotheses and variables are described in this paper.

In 10–15 years, when all severe cases of alcoholism will have manifested themselves, we will go back to the 1979 data and see which constellation of variables was most predictive.
An epidemiological survey of suicidal behavior in a Danish county (Funen)
Authors: Juel‐Nielsen N. , Kolmos L.
Published: August 2007

An epidemiological survey of suicide and attempted suicide in a representative Danish population of the county of Funen was initiated in 1978 in connection with the planning of a joint Nordic project on suicidal behavior in Scandinavia. The data obtained so far on sex‐ and age‐specific rates for suicide and attempted suicide (events/persons) are presented and discussed. Plans for a prospective survey, to be started in 1980, are outlined.
Suicidal areas: Cluster analysis profiles of urban environments
Authors: Welz R.
Published: August 2007

For a 12 year period from 1966–1977 epidemiological data on attempted suicide will be presented for the city of Mannheim, Germany. In the line with Durkheim's theory of social disintegration within the tradition of ecological studies like Faris & Dunham's“Mental Illness in Urban Area” or Sainsbury's“Suicide in London”, we have done an ecological study on attempted suicide in Mannheim. The ecological study was based on the level of municipal wards, on the level of smaller enumeration districts and even on the level of streets and small neighborhood areas.

As the results of the eclogical study it was found that the strength and the direction of correlations between attempted suicide rates and ecological properties of social disintegration varied with the level of the ecological unit. At the level of streets and small neighborhoods a high concentration of attempted suicide was found. Within the street with the highest rate any 10th inhabitant has attempted suicide within the 12 years’ period. The cluster analysis profiles show two types of areas with high rates of attempted suicide, where both, social anomie and social disintegration, are high.
Estimates of the prevalence of bipolar affective disorder METHODS BASED ON TREATMENT WITH LITHIUM
Authors: Eastwood R. , Stiasny S. , Tice S.
Published: August 2007

During this century the epidemiology of the affective disorders has been studied, several classifications have been described and effective treatment measures have been introduced. Difficulties have been encountered in the epidemiology area due to inconsistent use of the terminology of measurement and varying types of classification; although it is possible to arrive at a broad consensus of agreement if the data are examined restrictedly.

The clinical need for accurate rates of illness has become greater since the inception of the prophylactic drug lithium carbonate. While not used specifically for bipolar affective disorder, it is only for this disorder that its use has been demonstrated beyond doubt. The occurrence of mania in this disorder enables this aspect of the condition to be used as a marker. This paper describes three measures of the period prevalence of bipolar affective disorder, based upon treatment with lithium, two of which are of the ‘unobtrusive’ type. Agreement was found between the three approaches and the utility of these for general use is discussed.
Effects of brief hospitalization on psychiatric patients' behaviour and social functioning
Authors: Platt S. D. , Hirsch S. R. , Knights A. C.
Published: August 2007

224 newly admitted inpatients were randomly allocated to two treatment groups: standard care (length of stay determined by the clinical team) and brief care (acute treatment aimed at effecting the patient's discharge after about a week). Using a new research instrument (the Patient Behaviour Assessment Schedule), information was gathered from the patient's closest relative or friend on a subsample of 99 patients (the “target group”), which actually showed shortened length of hospitalization for brief care patients. There were no significant differences between groups at the two follow‐up evaluations on measures of behavioural disturbance and limited social functioning. Results for the whole “target” group reveal that although there was significant improvement in both behaviour and social functioning 2 weeks after admission, there was little subsequent change thereafter. Overall, individual patients demonstrated more improvement in behavioural disturbance than in social functioning at the follow‐up interview.
Hemispheric quantitative EEG changes following emotional reactions in neurotic patients
Authors: Hoffmann E. , Goldstein L.
Published: August 2007

Twenty‐four right‐handed patients undergoing primal therapy served as subjects in the study. They all showed symptoms of tension, anxiety, and/or depression. The patients’ right and left temporal EEGs were recorded immediately before and after a therapy session. Recordings were done while the patients were resting, and while they were performing a verbal and a visual task with their eyes closed.

The EEG data were analyzed off‐line with a computer, using quantitative amplitude analysis in the 1.5 to 30 Hz frequency band. A “high intensity” group (n= 13) having high ratings of emotional activity in their therapy session was compared with a “low intensity” group (n= 11) with low ratings. The results showed that only in the “high intensity” group was there a significant increase in mean amplitude and amplitude variance in the right hemisphere, measured across conditions. A between‐group comparison revealed that the “high intensity” group showed a significantly larger increase in right hemisphere variance and in right over left variance ratio, relative to the “low intensity” group, in which these variables were almost unchanged. These results indicate a greater involvement of the right hemisphere in emotional activity. It is also suggested that the EEG changes found in the “high intensity” group, following a therapy session, reflect a general deactivation of the brain and a functional improvement of the right hemisphere.
A double‐blind comparison of nomifensine and amitriptyline in the treatment of depression
Authors: Ong S. B. Y. , Lee C. T.
Published: August 2007

A double‐blind study was carried out to compare the efficacy and tolerability of nomifensine and amitriptyline in 17 Malaysian patients with moderate to severe depression. The two drugs did not differ with regard to antidepressant effect but nomifensine‐treated subjects report fewer side‐effects with no complaints of palpitations. Nomifensine also increases capacity for work and activity.
Haloperidol, thioridazine and placebo in mentally subnormal patients – serum levels and clinical effects
Authors: Väisänen K. , Viukari M. , Rimón R. , Räisänen P.
Published: August 2007

A randomized cross‐over trial was conducted in 30 restless mentally subnormal patients by increasing the dosage of haloperidol from 10 to 60 mg and that of thioridazine from 100 to 600 mg daily. The clinical effects of drug holidays on placebo and serum drug levels were also examined. There were more relative drug‐responders than nonresponders or negative responders. Correlation between clinical response and drug serum levels was poor, probably owing to the heterogeneity of disorders treated. Mesoridazine and other metabolites had 5–6 times higher serum levels than the parent compound, and relatively high serum levels are achieved already with moderate doses. The observed differences between haloperidol and thioridazine treatment were surprisingly few. Serum cholesterol was higher (P < 0.05) at the end of the thioridazine than of the haloperidol administration.
Lithium treatment and kidney function
Authors: Vestergaard P. , Amdisen A.
Published: August 2007

Two years after a survey of the kidney function in 237 patients given long‐term lithium treatment the patients were invited for re‐examination. Of 184 patients who came for the reexamination 147 had continued lithium treatment; in 37 patients the treatment had been discontinued. The lithium‐treated patients were compared with a group of 68 manic‐depressive patients who were about to be given prophylactic lithium treatment but who had not yet started.

Neither the patients who continued nor the patients who had discontinued lithium showed any deterioration of glomerular filtration rate as assessed through determination of the 24‐h creatinine clearance and the serum creatinine concentration; mean values in the lithium‐treated patients were the same as mean values in patients not yet given lithium. Impairment of renal water reabsorption, revealed by increased 24‐h urine volume and decreased urine osmolality after DDAVP, had progressed in the patients who continued lithium treatment, and multiple regression analysis revealed the duration of treatment and the serum lithium level to be significant predictor variables. In the patients who had discontinued lithium the changes in renal water handling had decreased. The urine volume was the same as that found in the patients not yet given lithium; maximum urine osmolality had not become fully normalized.

Side effects such as thirst, nycturia, tremor, diarrhoea, oedema, and weight gain were found with the same frequency at the second as at the first examination in the patients who had continued lithium. In the patients who had discontinued lithium they were infrequent or absent.