bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuropeptide Concentrations in the Cerebrospinal Fluid of Depressed Patients Treated with Electroconvulsive Therapy
Authors: Nemeroff Charles B. , Bissette Garth , Akil Huda , Fink Max
Published: October 2008

The CSF concentrations of CRF, somatostatin and β-endorphin were determined in nine patients who fulfilled DSM–III criteria for major depression with psychotic features. CSF samples were obtained at baseline in the depressed state, and again after a course of ECT. Concentrations of both CRF and β-endorphin decreased after ECT, while the concentration of somatostatin increased, although the latter difference did not attain statistical significance. The increase in CSF concentrations of CRF and β-endorphin in depressed patients is therefore seen to be state-dependent.
Mood Disorders in the Year after First Stroke
Authors: House Allan , Dennis Martin , Mogridge Liz , Warlow Charles , Hawton Keith , Jones Lesley
Published: October 2008

An unselected community sample of 128 patients were studied over the 12 months after their first stroke, and compared with a control sample of subjects from the general population. Psychiatric status was assessed using the PSE and BDI. Symptoms of mood disorder were commoner in the stroke patients than the controls, but the differences were not substantial and had largely disappeared by 12 months. Psychiatric problems encountered included agoraphobia, social withdrawal, apathy and self-neglect, irritability and pathological emotionalism. While there was a high cumulative incidence of psychiatric disorder, little of it persisted: only two cases of major depression were present for the whole 12 months. We believe undue emphasis has been placed in the recent literature on major depression as a specific syndrome following stroke.
The Impact of a Child Psychiatry Liaison Service on Patterns of Referral
Authors: McFadyen Anne , Broster Gillian , Black Dora
Published: October 2008

A retrospective study of referrals to a child psychiatry liaison service was carried out in order to assess the impact of the reorganisation of the service. A total of 55% of referrals were of in-patients on the paediatric ward; other in-patients made up 12.5%. Of all referrals, 67% were from paediatricians. Of the children who had not harmed themselves, most were referred either for help with the management of physical illness or for investigation of a non-organic physical complaint. The main finding was that liaison referrals increased significantly in contrast to both the total number of referrals and the number of cases of deliberate self-harm.
Lithium Maintenance: 1. A Standard Education Programme for Patients
Authors: Peet Malcolm , Harvey Norman S.
Published: October 2008

A videotape lecture and written hand-out containing factual information about lithium were given to 30 attenders at a lithium clinic. A further 30 patients acted as a control group and were not given the programme until later in the study. The educational programme resulted in substantial and significant increases in patient knowledge about lithium, such that knowledge increased from a baseline comparable with that of social workers to a level similar to that of community psychiatric nurses. Patients' attitudes to lithium also became more favourable after education.
Lithium Maintenance: 2. Effects of Personality and Attitude on Health Information Acquisition and Compliance
Authors: Harvey Norman S. , Peet Malcolm
Published: October 2008

During a controlled education programme, the medication compliance of 60 attenders at a lithium clinic was tested using reported tablet omissions and intra-erythrocytic lithium levels. Both measures improved, along with patients' knowledge and attitude. These effects were examined and related to aspects of obsessional trait and health locus of control.
Borderline and Schizotypal Disorders in Children and Adolescents
Authors: Meijer Martijn , Treffers Philip D. A.
Published: October 2008

Until recently, research on borderline disorder in children has sought the common denominator of the symptoms. In recent years there have been attempts to circumscribe the definition with the help of DSM–III criteria and the DIB. This approach appears fruitful. The scanty data on schizotypal children suggest that the validity of this diagnosis in childhood should be investigated. In adolescence it is possible to discern those with borderline and schizotypal disorders whose symptoms meet both DIB and DSM–III–R criteria respectively. No data exist, however, concerning the predictive validity of such disorders in adolescents. Classification on an empirical basis is advocated in order to refine the diagnosis of these and related disorders in children and adolescents.
The Psychiatric Symptoms, Diagnoses and Care Needs of 100 Mentally Handicapped Patients
Authors: Ballinger Brian R. , Ballinger C. Barbara , Reid Andrew H. , McQueen Elizabeth
Published: October 2008

One hundred randomly selected residents of a mental handicap hospital originating from Dundee were interviewed using a standardised assessment based on the modified Standardised Clinical Interview Schedule. Information on certain behavioural items and self-care skills was obtained from nursing staff and case records. An ICD–9 diagnosis could be made for 80 individuals, including diagnoses usually reserved for children. Thirty subjects were regarded as needing long-term psychiatric mental handicap hospital care. All but one of the remaining 70 subjects required a staffed residential placement and all but 15 some form of out-patient or short-term in-patient provision from specialist health services. The findings indicate a need for approximately 30 psychiatric mental handicap beds per 100 000 population.
A Survey of Psychiatrically Ill Asian Children
Authors: Jawed Syed Hasan
Published: October 2008

This case-note survey compares a group of Asian children referred to child psychiatry and guidance clinics in Bolton with a control group of white children referred to the same clinics. The proportion of Asian children was less than the proportion of Asian people in the general population. The proportion of Asian children coming from a broken home or a single-parent family was significantly lower than in the control group. Conduct disorders were more common in the control group and somatoform disorders were more common in the Asian group.
Human Leucocyte Antigens and Tardive Dyskinesia
Authors: Brown K. W. , White T.
Published: October 2008

HLA status was asessed in matched groups of schizophrenics, 20 with and 20 without tardive dyskinesia. The antigen frequencies were also compared with that in a control sample. The anticipated excess of HLA-B44 was not confirmed. Pooled data displayed a shortfall of HLA-Cw7 and an excess of HLA-B44 in schizophrenics relative to population controls.
The Distinction of Positive and Negative Symptoms
Authors: Arndt Stephan , Alliger Randall J. , Andreasen Nancy C.
Published: October 2008

The distinction of positive and negative symptoms in describing schizophrenic patients has become popular. It presupposes that symptoms cluster in two dimensions, fitting together not only theoretically but empirically. Factor analysis of three published studies of 93, 62 and 52 schizophrenic patients and a large pooled sample showed that more than two distinct dimensions are required to categorise symptoms in schizophrenia. This result is consistent across methods and samples, and with previous literature. The added dimensionality resulted from a splitting of the positive symptom domain into more distinct factors.
Parietal Signs and Sinister Prognosis in Dementia
Authors: O'Carroll Ronan , Whittick Janice , Baikie Elizabeth
Published: October 2008

Thirty elderly demented subjects were assessed in 1985 using a neuropsychological test battery which included tests of parietal lobe function that are allegedly predictive of outcome. Four years later, 29 out of the 30 subjects were followed up. Twelve had died. There were no differences between survivors and deceased in terms of age, pre-morbid intelligence, years of full-time education, or scores on parietal tests. However, proportionally more of the women had died, and those subjects with more global cognitive impairment in 1985 were significantly more likely to have died by 1989. Those who scored lower on an aphasia measure in 1985 were more likely to have died. None of the variables differentiated between survivors and deceased Alzheimer subjects.
What Happens to Patients Who Frequently Harm Themselves?
Authors: Stocks Ruth , Scott Allan I. F.
Published: October 2008

Between 1982 and 1987, 42 patients were selected who had been admitted three times in one week to the Regional Poisoning Treatment Centre in Edinburgh for the treatment of deliberate self-harm. Most (87%) of these admissions related to drug overdose. Most of the patients were young, unemployed, lacking a partner and from the low social classes. Three-quarters of the sample had at least one known conviction and more than a third were known to have served a prison sentence. There was only one patient in whom mental illness was thought to be relevant to the episode of self-harm, although five patients were mildly mentally handicapped. Case notes were reviewed to assess the outcome one year after the index admission. None of the patients had committed suicide, although 36 repeated self-harm during the follow-up year.
The Bradford Somatic Inventory
Authors: Mumford D. B. , Bavington J. T. , Bhatnagar K. S. , Hussain Y. , Mirza S. , Naraghi M. M.
Published: October 2008

In the development and evaluation of a multi-ethnic inventory (the BSI) of somatic symptoms associated with anxiety and depression, symptoms were derived from psychiatric case notes of Pakistani and indigenous British patients with a clinical diagnosis of anxiety, depression, hysteria or hypochondriasis. The inventory was constructed simultaneously in Urdu and English. A pilot version of the BSI was checked against psychiatric case notes in north and south India, and Nepal. The revised BSI achieved over 90% coverage of all somatic symptoms recorded in each centre. The linguistic equivalence of the Urdu and the English versions was established in a bilingual student population in Pakistan. Conceptual equivalence of the BSI was explored using factor analysis of responses by functional patients presenting to medical clinics in Britain and Pakistan. Four principal factors (head, chest, abdomen, fatigue) were similar in both populations.
Is Autism More Common Now than Ten Years Ago?
Authors: Gillberg Christopher , Steffenburg Suzanne , Schaumann Helen
Published: October 2008

A total population study of children, aged 13 years and under, suggested that there has been an apparent rise in the frequency of autistic disorder and autistic-like conditions (excluding Asperger's syndrome) in one area of western Sweden over the last ten years. The frequency was 4.0/100 000 in 1980, 7.5/10000 in 1984 and 11.6/10000 in 1988 in the city of Göteborg. Even though the prevalence rates refer to slightly different age cohorts, it was concluded that the apparent increase is in part due to better detection, but also to new cases born to immigrant parents. Typical cases of autistic disorder accounted for 75% of cases, and 20% had normal or near-normal IQs.
Psychiatric Diagnoses in Ulcerative Colitis
Authors: Magni G. , Bernasconi G. , Mauro P. , D'Odorico A. , Sturniolo G. C , Canton G. , Martin A.
Published: October 2008

Fifty patients with UC and 50 matched controls with urolithiasis were interviewed with the SADS (lifetime version) and completed the SCL–90. According to information given during the SADS, there was a history of psychiatric disturbance in 11 UC patients (22%) and 8 controls (16%). At the time of the interview a psychiatric disturbance was present in 31 UC patients (62%) and four controls (8%), the most frequent diagnoses in the former being minor depression and generalised anxiety disorder. Patients with UC scored significantly higher than the controls on all the different SCL–90 subscales.
Mr X – A Case of Amnesia
Authors: Domb Yair , Beaman Katja
Published: October 2008

A case of psychogenic amnesia in a 58-year-old man supports the view that complete loss of personal identity can follow a traumatic experience. He regained his memory by being helped to develop an affective link with the painful event.
“Life, Jim, But Not as We Know It”? Transmissible Dementias and the Prion Protein
Authors: Harrison Paul J. , Roberts Gareth W.
Published: October 2008

The spongiform encephalopathies are unusual in several respects. Firstly, they are transmissible, and in some cases inheritable. Secondly, variants of these disorders occur in many species and can be transmitted by consumption of infected material; this has led to concern as to the potential risk from eating contaminated animal products. Thirdly, increasing evidence suggests that a ‘prion’ protein is central to their aetiology and pathogenesis, and that no nucleic acid is involved in the infective process. The role of the prion gene and its protein is outlined and proposed as the basis for an improved classification of the transmissible dementias.
Social Deprivation and Rates of Treated Mental Disorder
Authors: Thornicroft Graham
Published: October 2008

A review of the literature shows that there are strong associations of treated prevalence rates of psychiatric disorder with social class, sex, marital status, ethnic group and living alone; and moderate associations with living in inner-city areas and a high degree of residential mobility. The Jarman-8 index of social deprivation correlates with psychiatric admission rates for patients aged less than 65 years (R2–0.38). Individual census variables can themselves account for up to 0.71 of the variance in the admission rates, while combined in a stepwise multiple regression the census variables will account for over 0.95 of this variation. Multiple regression models using individual census variables and derived indices should be applied next on a wider geographical basis, and to narrower age, sex and diagnosis-specific psychiatric morbidity rates.
Bulimia Nervosa: Family Size, Sibling Sex and Birth Order
Authors: Lacey J. Hubert , Gowers S. G. , Bhat A. V.
Published: October 2008

Family size, sex of siblings and birth order were examined in 225 bulimic patients of normal weight, all stemming from the same circumscribed catchment area. Although bulimia can occur in any size family, all-female sibships were significantly over-represented. In small families at least, the bulimic patient was highly likely to be the only or eldest daughter. In small sibships, a bulimic who was first-born was significantly more likely to have a younger sister; if second-born she was more likely to have an elder brother. Despite the very large sample size, no final conclusion can be made on birth order.
Anorexia Nervosa: Outcome and Prognostic Factors after 20 Years
Authors: Ratnasuriya R. H. , Eisler I. , Szmukler G. I. , Russell G. F. M.
Published: October 2008

Forty-one patients with anorexia nervosa, admitted to the Maudsley Hospital between 1959 and 1966, were followed up after a mean of 20 years. An assessment of general outcome (based on the Morgan-Russell scales) yielded three outcome categories: ‘good’ (n = 12), ‘intermediate’ (n = 13) and ‘poor’ (n = 15). Six patients (15%) had died from causes related to anorexia nervosa; at least 15% had developed bulimia nervosa. There was a general consistency between the follow-up at 20 years and that previously conducted five years after admission, although with a few individual patients there were serious prognostic errors at the earlier follow-up. A poorer outcome was associated with a later age of onset, a history of neurotic and personality disturbances, disturbed relationships in the family and a longer duration of illness.
The Effects of Clozapine on Tardive Dyskinesia
Authors: Lieberman Jeffrey A. , Saltz Bruce L. , Johns Celeste A. , Pollack Simcha , Borenstein Michael , Kane John
Published: October 2008

This article reviews eight published studies that describe clozapine's effects on TD and examines the outcome of 30 patients with TD treated with clozapine for up to 36 months. These data indicate that TD response to clozapine is variable but that approximately 43% of cases, particularly those with dystonic features, improved after clozapine treatment. Methodological limitations of the studies described, however, preclude definitive conclusions, which must await appropriately controlled trials.
A Double-Blind Comparison of the Effects of Gradual Withdrawal of Lorazepam, Diazepam and Bromazepam in Benzodiazepine Dependence
Authors: Murphy Siobhan M. , Tyrer Peter
Published: October 2008

Using a double-blind procedure, 68 patients with putative benzodiazepine dependence were randomly allocated to one of three groups given lorazepam (n= 22), diazepam (n= 23) or bromazepam (n= 23) in doses equivalent to those of the patients' original benzodiazepine. After four weeks the dosage was reduced in 25% quantities until no further benzodiazepines were taken. A total of 23 patients dropped out during the study, ten on lorazepam (one of whom committed suicide), seven on diazepam and six on bromazepam. There were few differences in withdrawal symptoms between the three groups but, despite the higher dropout rate, these symptoms were somewhat less marked in the lorazepam group. Withdrawal symptoms were greater in patients who had taken a benzodiazepine for > 5 years and were most marked in those with personality disorders, predominantly dependent ones.
Management of First Episode Psychotic Illness in Afro-Caribbean Patients
Authors: Chen Eric Y. H. , Harrison Glynn , Standen Penny J.
Published: October 2008

We studied retrospectively a consecutive series of 40 Afro-Caribbean patients and compared them with 40 non-Caribbean patients matched for age, sex, and diagnosis. There was no overall difference in initial or cumulative doses of neuroleptic medication in the early treatment of psychosis. However, a small subgroup of Afro-Caribbean patients received higher peak dosages. Clearly recorded episodes of behavioural disturbance were more frequent in Afro-Caribbean patients generally. They were more likely to be admitted compulsorily, discharged earlier, and prescribed depot medication.
The Search for the Psychosis Gene
Authors: Crow T. J.
Published: October 2008

The major psychoses remain an enigma. Affective and schizophrenic psychoses are apparently present (probably at about the same lifetime prevalence of approximately 2%) in all human societies. Yet their aetiology is obscure. While a genetic contribution is acknowledged by most authorities, few accept that genes are a sufficient explanation of causation because: onset is in adult life; psychosis – particularly schizophrenia – is associated with a substantial fertility disadvantage; and most cases lack a family history of illness. But genetic determination has to be considered because onset is determined by chronological age rather than environmental insult (Crow & Done, 1986), adoption away from a family with schizophrenia does not reduce risk of illness, and no plausible environmental precipitant of psychosis has been identified. The fact that psychosis occurs across widely differing climatic, industrial, and social environments without obvious variations in incidence suggests that the disease is relatively independent of the external milieu. The suggestion that birth injury is relevant has been tested in a prospective study (the National Child Development Study) and found wanting (Done et al, 1991).
Changes in Patient Coping Style Following Individual and Family Treatment for Schizophrenia
Authors: Rea Margaret M. , Strachan Angus M. , Goldstein Michael J. , Falloon Ian , Hwang Sun
Published: October 2008

Changes in relatives' affective attitudes are important contributors to the impact of family psychoeducational programmes on the course of schizophrenia. It remains unclear whether similar changes occur in the interactional style of schizophrenic patients participating in psychoeducational treatment. This study examined changes in the interactional style (coping style) of 33 schizophrenic patients in individual or family treatment. Significant changes were seen in the interactional style of the patients participating in the individual treatment. Similar changes were evident, but not significant, in the family treatment group. The quality of patient interactional style before or after treatment did not predict relapse in either group. Changes in relatives' interactional style early in family treatment are necessary to affect the short-term course of schizophrenia. Modification in patient behaviour during the early phase does not have similar predictive value.
Negative Modes of Relating, Marital Quality and Depression
Authors: Birtchnell John
Published: October 2008

Young married couples, with or without a depressed wife, were divided into three groups according to marital quality. Negative modes of relating were assessed by self-rating and partner-rating questionnaires. The intercorrelation of scores for different modes of relating was higher on partner-rating than on self-rating scales. There was a significant gradient of mean negative-relating scores across the three levels of marital quality. The partner-ratings of depressives and their husbands were higher on all negative-relating scales than those of non-depressed women and their husbands. The self-ratings of the depressives corresponded with these negative ratings while those of their husbands did not. The partner-rating scores differentiated between the depressives with poor marriages and those with better marriages.
Dangerous Mistakes
Authors: Walker Nigel
Published: October 2008

The shortening of the periods of detention for treatment, deterrence or retribution have made a live issue of whether (or when) it is justifiable to detain violent and sexual offenders solely for the protection of others. Anti-protectionist arguments have made ‘dangerousness' a dirty word, but are based either on actuarial statistics of doubtful relevance or on confused moral reasoning. A typology of ‘dangerousness' is tentatively offered, and the impossibility of adequately supervising some dangerous offenders in the community is emphasised. That said, offenders detained solely for the sake of others are entitled to more than merely ‘humane containment’.
Day Care in an Inner City
Authors: Holloway Frank
Published: October 2008

The socio-demographic and clinical characteristics of patients attending psychiatric day care in an inner-urban catchment area were assessed using structured techniques. The overall prevalence of the use of day care was high (164 per 100 000 total population), and 86% of attenders were in prolonged psychiatric contact. Of those in prolonged contact, the clinical and social morbidity of 68 attenders at National Health Service day hospitals was strikingly similar to that of 42 attenders at other units. Users of a ‘community mental health centre’ and two work centres were less disabled than attenders at other day units. Implications of these results for the organisation of day services and training of staff are discussed.
Adoption and Eating Disorders: A High-Risk Group?
Authors: Holden Neil L.
Published: October 2008

Between 1975 and 1985, 3.8% of patients referred to the Maudsley Hospital with anorexia and bulimia were adoptees. This exceeds the rate of adoption (1.5%) in the general population matched for year of birth. The 18 adoptees with eating disorders had significantly more associated behavioural disturbance and lower academic achievement than the 18 matched controls, and different precipitating factors.
Correlation of Negative Symptoms in Schizophrenia with Frontal Lobe Parameters on Magnetic Resonance Imaging
Authors: Williamson P. , Pelz D. , Merskey H. , Morrison S. , Conlon P.
Published: October 2008

Among 24 chronic schizophrenic patients, the 10 with high ratings for negative symptoms had significantly higher left-frontal: temporal–corticalT2ratios. This finding was unrelated to age, dose of medication, length of illness or handedness. NoT1orT2changes were found to be associated with positive symptoms or tardive dyskinesia in the regions examined.
The Founding of Psychiatric Nurse Training and its Aftermath
Authors: Nolan Peter W.
Published: October 2008

The first national training scheme for attendants upon the insane began in 1891. The Medico-Psychological Association considered this initiative as essential if asylums were to have therapeutic credibility and recruit high-quality attendants. The initiative failed because poor pay and conditions of service were obstacles to recruitment and better standards of care. The Association then sought to integrate asylum and general nursing, leading to a double sense of betrayal on the part of the asylum nurses. They felt betrayed by the failure of the training scheme to improve their career structure and by the threat to their jobs posed by the proposed merger with general nurses. They responded by unionisation, so that two decades after the introduction of training, its only major effect had been to politicise nurses and engage them in disputes with their hospital superintendents and employing authorities. Training raised expectations in the attendants which neither the Association nor the institutions had intended to satisfy, and it was not seen by attendants as of benefit either to them or to patients.
The Surrey County Lunatic Asylum (Springfield) Early Years in the Development of an Institution
Authors: Patch Ian Lodge
Published: October 2008

In the mid-19th century, the Commissioners in Lunacy continued the direction of the earlier reform movements, but depended upon local magistrates for the execution of their ideas. The early development of a single county asylum is described from its beginnings, as are some of the personalities involved.
A Controlled Study of the Effect of Therapies Aimed at Adolescent and Family Psychopathology in Anorexia Nervosa
Authors: Crisp A. H. , Norton Kingsley , Gowers Simon , Halek Christine , Bowyer Carol , Yeldham Denise , Levett Gill , Bhat A.
Published: October 2008

Ninety patients with severe anorexia nervosa fulfilling DSM–III–R criteria were assessed in depth in terms of their family developmental psychopathology and then randomly allocated to either one of three treatment groups or to no treatment. In three treatment regimes, a behavioural approach to diet and weight gain was coupled with individual and family psychotherapy directed at the adolescent maturational problems. All three treatment regimes were highly significantly effective at one year in terms of weight gain, return of menstruation, and aspects of social and sexual adjustment. Body weights above those at pubertal onset were achieved for the group mean maximum and one-year follow-up weights for all three treatment groups but not the control group.
Psychiatric Illnesses in Patients with HIV Infection and AIDS Referred to the Liaison Psychiatrist
Authors: Seth Ram , Granville-Grossman Kenneth , Goldmeier David , Lynch Sean
Published: October 2008

All referrals made to the liaison psychiatric service for HIV and AIDS patients over one year were reviewed. ICD–9 and CDC diagnoses were applied to each case at presentation. Sixty HIV-positive patients were assessed, of whom 35 had affective disorder, which was significantly associated with CDC group IV disease (AIDS). Adjustment reaction was seen in nine patients, paranoid states in six, dementia in four, personality changes in four and paranoid schizophrenia in two. CT scans of the brain were performed on 23 of the patients: 17 of these showed abnormalities. The proportion of registered AIDS patients who were referred was five times the proportion of HIV patients.
Group Therapeutic Factors on an Alcohol In-patient Unit
Authors: Lovett Lisetta , Lovett Jonathan
Published: October 2008

Seventy consecutive patients admitted to an alcohol unit were given a modified version of Yalom's therapeutic factor questionnaire at various points during the therapeutic programme. This programme consists of a two-week introductory programme, followed by a treatment programme, which includes psychodynamic groups, life-history reviews and intensive cognitive-therapy sessions. Internal agreement of ranking order of therapeutic factors was high among all patients and was independent of time spent in group therapy. Patients valued most an existential factor (which embraces concepts of personal responsibility and isolation), self-understanding and cohesiveness; they least valued guidance and identification. Therapists also completed the questionnaire: their ranking of therapeutic factors correlated highly with that of patients, but they ranked an existential factor much lower.
Long-Term Outcome in Early-Onset Anorexia Nervosa
Authors: Walford Geraldine , Mccune Noel
Published: October 2008

Fifteen children who developed anorexia nervosa aged 13 years or less were followed up at least three years later (mean 5.3 years). Outcome measures included the Morgan & Russell Outcome Schedule and the PSE. The general outcome was good in seven, intermediate in four, and poor in four, one of whom had died. A high incidence of psychiatric symptoms at follow-up, which has been suggested in other studies, was not confirmed in the 11 subjects who completed the PSE. Where onset was very early (11 years and under) and where hospital stay was prolonged, outcome tended to be poor.
Monosymptomatic Hypochondriacal Psychosis in Developing Countries
Authors: Osman Abdelkarim Ahmed
Published: October 2008

Although a large growing literature indicates that monosymptomatic hypochondriacal psychosis is more common than previously thought, little contribution has been made from psychiatrists working in developing countries. Fifteen patients are described who presented with the delusion of emitting a foul smell.
Head Circumference in Elderly Long-Stay Patients with Schizophrenia
Authors: Jones Gareth H. , Lewis John E.
Published: October 2008

The head circumference of a long-stay population with schizophrenia was compared with that of a population with dementia, matched for sex and year of birth. Schizophrenics had a smaller head circumference, even after correction for height and weight. This confirms earlier but inconclusive and controversial reports, and might be taken as supporting a neurodevelopmental hypothesis of the aetiology of schizophrenia.
Negative Symptoms in Chronic Schizophrenia Relationship to Duration of Illness
Authors: Ring Noreen , Tantam Digby , Montague Linda , Morris Julie
Published: October 2008

The frequency and distribution of negative symptoms in a sample of 40 patients admitted to hospital with RDC-definite schizophrenia were examined. There was a highly significant positive correlation between negative symptom scores obtained using three different rating scales, but the presence of negative symptoms was not significantly related to duration of illness or number of episodes of illness. These findings do not support a model of negative symptoms being the consequence of schizophrenic relapse, but are in favour of their being an integral component of the schizophrenic syndrome, as salient in the first as in later episodes.
Effect of Caffeine Intake on Psychotic In-patients
Authors: Zaslove Marshall O. , Russell Richard L. , Ross Else
Published: October 2008

Psychotic in-patients who consume caffeine may present complications in the course of their illness. Two cases are described which illustrate the clinical profile of such patients, whose caffeine-associated complications are often misdiagnosed.
Computerised Tomography in Alzheimer's Disease
Authors: Burns Alistair , Jacoby Robin , Philpot Michael , Levy Raymond
Published: October 2008

One hundred and thirty-eight patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease (AD) and 36 normal controls underwent cranial CT. A comparison of methods of scan analysis showed good agreement between computer-assisted methods and visual ratings and planimetry. The CT scans of controls differed significantly from patients and a discriminant analysis, based on all CT measures, predicted group membership (control or patient) in 81% of cases. Within the AD group, cortical atrophy correlated with age and duration of illness. Global tests of cognitive function correlated significantly with both cortical atrophy and ventricular size. Subjects who died in a three-year follow-up had more atrophy and larger third ventricles than survivors, but this effect was due entirely to increased age.
‘Schizoid’ Personality in Childhood and Adult Life I: The Vagaries of Diagnostic Labelling
Authors: Wolff Sula
Published: October 2008

The literature is reviewed on children variously described as having ‘schizoid’ personality disorders, Asperger's syndrome, and schizotypal personality disorders, with the aim of clarifying the nature of these clinical syndromes, and in particular the features of those children whose follow-up characteristics are described in the following two papers.
Construction of an Index for Predicting Suicide Attempts in Depressed Adolescents
Authors: Kienhorst C. W. M. , De Wilde E. J. , Diekstra R. F. W. , Wolters W. H. G.
Published: October 2008

A group of 48 adolescents who recently attempted suicide and 66 depressed adolescents were compared on sociodemographic, behavioural, psychological and relational variables. The variables which proved significant were used in different combinations in stepwise logistic regression analyses, resulting in seven variables which served as the content of an index of risk. The sensitivity of the index was 90% and the specificity 83%. At one-year follow-up the occurrence of a suicide attempt correlated with score on the instrument.
Dhat Syndrome – a Useful Diagnostic Entity in Indian Culture
Authors: Bhatia M. S. , Malik S. C.
Published: October 2008

In a prospective study of 144 consecutive male patients with psychosexual disorders, comprising 93 with Dhat syndrome with or without impotence or premature ejaculation, 21 with premature ejaculation, and 30 suffering only impotence, the commonest associated psychiatric illness was neurotic depression (39%) followed by anxiety neurosis (21 %), while 31% did not receive a psychiatric diagnosis. The common presenting symptoms of Dhat syndrome were weakness (71 %), fatigue (69%), palpitations (69%), and sleeplessness (62%). After random allocation into groups, four types of treatment were given: an anti-anxiety drug, an antidepressant, a placebo, or counselling. The best response was seen with the anti-anxiety and antidepressant drugs. Twenty-one patients dropped out of treatment; 15 of whom were from the counselling group.
Depression in Autistic Disorder
Authors: Ghaziuddin M. , Tsai L.
Published: October 2008

Depressive illness in a patient with Down's syndrome and autism responded to fluoxetine. The importance of diagnosing superimposed depression in people with developmental disorders is emphasised.
The Relationship Between Schizophrenia and Immigration are There Alternatives to Psychosocial Hypotheses?
Authors: Eagles John M.
Published: October 2008

Several recent studies have found markedly increased rates of schizophrenia among West Indian immigrants to the UK. Almost exclusively, authors have sought psychosocial explanations for these findings. This paper hypothesises that environmental causes, notably obstetric complications and perinatal infections, provide more plausible aetiological models, especially for the raised rates of schizophrenia among second-generation West Indian immigrants.
The Incidence of Operationally Defined Schizophrenia in Camberwell, 1965–84
Authors: Castle David , Wessely Simon , Der Geoffrey , Murray Robin M.
Published: October 2008

We established first-contact rates of schizophrenia in the defined area of Camberwell between 1965 and 1984. The rate of schizophrenia, whether defined by ICD, RDC, or DSM–III criteria, rose over the period under study. This finding is at odds with reports of an overall decline in first-admission rates for schizophrenia in England, over the same period. The discrepancy was largely accounted for by the influx into Camberwell of individuals of Afro-Caribbean origin, who showed rates of schizophrenia between four and eight times that of their Caucasian counterparts.
Epidemiology of Schizophrenia in Salford, 1974–84 Changes in an Urban Community over Ten Years
Authors: Bamrah J. S. , Freeman H. L. , Goldberg D. P.
Published: October 2008

The prevalence and inception rates of treated schizophrenia in the population of inner-city Salford were compared with those from a similar survey, ten years earlier. Data were obtained from a computerised case register and a postal questionnaire sent to GPs, and case notes rated on the SCL and screened using ICD–9. The point-prevalence rate of 6.26 per 1000 adult population was higher than that previously reported (4.56), despite decreases in total inception rate and in the general population. Changes in rates are presumed to be related primarily to population movements and ageing of the schizophrenic sample. Compared with 1974, the numbers of in-patient days and long-stay in-patients had fallen substantially by 1984, although annual admissions increased over the decade; day-patient and out-patient attendances, and extramural contacts with psychiatrists, community psychiatric nurses, and social workers had also increased. Almost 62% of cases were maintained on depot injections as out-patients in 1984. Over 75% of identified schizophrenic patients were in contact with psychiatrists, but only 7 out of 557 were solely in contact with their GP. In spite of the emphasis on community care, responsibility for schizophrenic patients was still carried overwhelmingly by hospital psychiatric services.
Changes in the Administrative Incidence of Schizophrenia
Authors: Harrison Glynn , Cooper J. E. , Gancarczyk Richard
Published: October 2008

First-admission rates to psychiatric hospitals, and data from certain psychiatric case registers suggest that there may have been a substantial decline in the administrative incidence of schizophrenia in recent years. However, data from the Nottingham case register show that rates for first-onset schizophrenia remained stable between 1975 and 1987. It is suggested that variations in trends between different parts of the UK may be partly explained by differences in the proportion of migrants and their children in the population at risk.
Value of the Fear Questionnaire in Differentiating Agoraphobia and Social Phobia
Authors: Cox Brian J. , Swinson Richard P. , Shaw Brian F.
Published: October 2008

The present study examined responses on the Fear Questionnaire (FQ) of 68 patients suffering panic disorder with agoraphobia, 50 social phobics, 75 subjects with ‘non-clinical’ panic attacks, and 188 non-panicking controls. The FQ agoraphobia and social subscales had satisfactory internal consistency and were accurate (82%) in correctly differentiating the patients. In general, the patient and control groups differed as expected. The highest level of social fear was reported by social phobics and the highest level of agoraphobic fear was reported by patients with panic disorder and agoraphobia. Five items from these two subscales significantly differentiated social phobia from panic disorder with agoraphobia. The results support the reliability and validity of the FQ.
Seasonal Affective Disorder in Adolescence
Authors: Lucas Christopher Paul
Published: October 2008

Two adolescent girls with seasonal affective disorder (SAD) are described. It is suggested that the classic symptom profile seen in adults is not characteristic in younger subjects. Although hypersomnia is prominent, increased appetite and carbohydrate craving are rarely reported. Local meteorological data link the course of the disorder in one case to the hours of sunshine and ambient temperature during the winter months.
Adrenocortical Suppression Presenting with Agitated Depression, Morbid Jealousy, and a Dementia-Like State
Authors: Hassanyeh F. , Murray R. B. , Rodgers H.
Published: October 2008

A 66–year-old woman showed profound neuropsychiatric disturbance after withdrawal from prolonged corticosteroid treatment. Reintroduction of an alternative corticosteroid, at low dose, produced a return to premorbid mental state.
Amnesia in Relation to Fugue States – Distinguishing a Neurological from a Psychogenic Basis
Authors: Kapur Narinder
Published: October 2008

A case of transient amnesia is described in which a patient reported memory loss for five days, during which he had wandered extensively. Analysis showed that he did not have selective amnesia for the public events which had occurred during the five days for which he professed memory loss. This finding was incompatible with our case having a neurologically based global memory disorder during the fugue state. These findings offer support for a distinction between personal and public episodic memory.
Reflex Tics in Two Patients with Gilles de la Tourette Syndrome
Authors: Commander M. , Corbett J. , Prendergast M. , Ridley C.
Published: October 2008

Two patients with Gilles de la Tourette syndrome (GTS) showed tics triggered by external stimuli. This unusual feature is of significance to the aetiology of GTS and in particular the relationship between GTS and the startle response.
Capgras Syndrome in Association with Lithium Toxicity
Authors: Canagasabey Bala , Katona Cornelius L. E.
Published: October 2008

Capgras syndrome in association with lithium toxicity is described in a 74–year-old woman. Lithium toxicity should be considered when new delusions occur during lithium therapy.
The Worcester Development Project
Authors: Turner Richard , Roberts Glenn
Published: October 2008

“The philosophy of Community Care has resulted in the closure of several mental hospitals in this country. The ethos of the Worcester Development Project saw the closure of St Wulstan's and Powick Hospitals, and their replacement by a community-based service. This paper briefly describes the outcome of a three-year retrospective study completed in 1988 following the closure of both hospitals. The findings provide a comparison of the two hospitals, including details of the destination of all the patients. It is suggested that the term ‘hospital replacement’ might be preferable to ‘hospital closure’.”

“The Worcester Development Project began in 1968 when the Department of Health and Social Security brought together the Worcester and Kidderminster Hospital Management Committee and the County Council in a co-ordinated joint planning venture. Powick Hospital was chosen as the location for testing the hypothesis that closing a mental hospital and replacing it with general hospital psychiatric units, supported by a variety of community facilities, would provide a more economical and better service. This paper describes the outcome of this unique opportunity to study the problems involved in closing a mental hospital and its replacement with other facilities.”
The Genetics of Personality Disorder
Authors: McGuffin Peter , Thapar Anita
Published: October 2008

Most measurable aspects of normal personality appear to be at least moderately heritable, with direct evidence coming from family, twin and adoption studies and indirect support deriving from psychophysiological research and breeding experiments on animals. Interestingly, genetic studies also shed light on the environmental sources of variation in personality and suggest that shared family environment rarely, if ever, has any positive effect on similarity between relatives. Despite problems of classification, and variations in the use of terms, a survey of the literature provides reasonably consistent evidence of a genetic contribution to several categories of abnormal personality, which we here divide into three groups, antisocial, anxious/avoidant, and schizoid–schizotypal personalities. However, personality disorders are complex traits that do not show simple mendelian patterns of inheritance and so far molecular genetics has been of no help in understanding their aetiology. Fortunately, techniques are now becoming available that enable the detection and potential localisation of genes of small effect and which may help elucidate the molecular basis even of (probably) polygenic traits such as abnormal personality.
The Fragile-X Syndrome
Authors: Turk Jeremy
Published: October 2008

The fragile-X syndrome accounts for up to 10% of individuals with mental handicap, and 50% of cases of X-linked mental retardation. Knowledge of the genetic basis of mental functioning, psychopathology, and neuropsychology is being furthered by this recently recognised condition. The disorder has considerable significance for psychiatrists, particularly, but by no means exclusively, those working in the field of mental handicap and with children. This review outlines the slow clarification of this complex and important behavioural phenotype and the implications of these advances for identification, diagnosis, genetic counselling and a wide range of management interventions.
Psychodynamics and Psychotherapy on an Acute Psychiatric Ward
Authors: Jackson Murray , Cawley Robert
Published: October 2008

The treatment of severely disturbed patients is strengthened in an important way by listening closely to them and by attempting to understand their experience in the depth that is made possible by the use of psychoanalytic concepts. It follows that the practice of clinical psychiatry in the UK would be greatly improved by the introduction of a psychoanalytic and psychotherapeutic perspective into the acute ward. This paper reviews the work done on a ward at the Maudsley Hospital in which this approach was the practice.
The Facilitation and Evocation of Seizures
Authors: Antebi D. , Bird J.
Published: October 2008

Despite the fact that environmental factors have been demonstrated to be important in the genesis of seizures in people with epilepsy, such factors have received scant attention in the education of clinicians or in the provision of services for managing patients with epilepsy. This paper reviews the history of, and literature about, reflex epilepsy, with particular reference to seizures which occur in response to psychological states or stimuli, and discusses the possible implications for management, and the rationale for the use of psychological interventions which may complement drug treatments in the management of epilepsy.
Sertraline in the Prevention of Depression
Authors: Doogan D. P. , Caillard V.
Published: October 2008

A group of 480 patients, aged 19–78 with an HRSD score of at least 17 and who met DSM–III criteria for major depressive disorder were studied. Patients were given placebo for a one-week single-blind run-in period, after which sertraline was administered for eight weeks. This was followed by 44 weeks in which patients received sertraline or placebo on a double-blind, randomised basis. Patients were assessed periodically using the 17-item HRSD and the Clinical Global Impression scales. During the entire double-blind period 24 (13.0%) sertraline patients relapsed compared with 48 (45.7%) placebo patients (P<0.001). The protective effect of sertraline was maintained throughout the 44 weeks. The study provides evidence that sertraline prevents relapse of the index episode of depression as well as recurrence of further episodes and has few side-effects.
Tardive Dyskinesia and Type II Schizophrenia
Authors: Davis Elizabeth J. B. , Borde Milind , Sharma L. N.
Published: October 2008

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.