bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide in Young Doctors
Authors: Richings J. C. , Khara G. S. , McDowell M.
Published: August 2008

Fifty-five cases of suicide by doctors under the age of 40 were studied because of concern about deaths among anaesthetists in training. The excess mortality of doctors from suicide was confirmed, suggesting that risk factors associated with being a member of the medical profession continue to operate, although mortality for young male doctors from accidental poisoning is falling. Analysis of the branches of medicine in which the doctors were working showed no definite specialty predominance. There was a somewhat greater risk for women doctors born overseas.
Relationship of Mood Alterations to Bingeing Behaviour in Bulimia
Authors: Kaye W. H. , Gwirtsman H. E. , George D. T. , Weiss S. R. , Jimerson D. C.
Published: August 2008

Twelve women with bulimia participated in a study in which they binged and vomited on the day after hospital admission. Caloric intake, time spent bingeing and vomiting, and selfreported mood ratings demonstrated much variation from subject to subject. Both subjective and objective ratings of mood indicated that anxiety decreased more frequently and to a greater extent than depression, both during and after bingeing and vomiting. The present data, obtained in a controlled setting, tend to confirm previous information on binge episodes obtained by self-report from bulimic patients. Bingeing and vomiting episodes may provide bulimic patients with a physiological mechanism for temporarily relieving a dysphoric mood state.
Koro in an Israeli Male
Authors: Modai Ilan , Munitz Hanan , Aizenberg Dov
Published: August 2008

The Koro syndrome, a “special cultural psychiatric syndrome’, is encountered in South China, Malaysia and Indonesia, especially among people of Chinese origin. There are only eight case reports of Koro from the Western hemisphere. We present a typical primary Koro patient from Israel. Jewish cultural mores are a possible contributory factor.
Anorexia Nervosa in a Woman Totally Blind Since the Age of Two
Authors: Yager Joel , Hatton Cynthia A. , Ma Lawrence
Published: August 2008

A 28 year-old woman, blind since the age of two, had become anorexic at 21. She had eating problems as a child, and weight preoccupation from her teens onwards. Psychiatric admission with other anorexic patients preceded the illness. Inability to see oneself does not pretect against anorexia nervosa.
Aspects of the Epidemiology of Schizophrenia
Authors: Hare E.
Published: August 2008

Reasons are given why the hospital diagnosis of schizophrenia may be accurate enough for the proper study of certain aspects of its epidemiology. Studies in the seasonality of admissions and of births in schizophrenic patients have produced consistent results in different countries and at different times. The results are summarized, and causal hypotheses based on them are discussed. The idea that schizophrenia is a relatively recent disease is compatible with these hypotheses.
The Nithsdale Schizophrenia Survey V. Follow-up of Tardive Dyskinesia at3-1/2 years
Authors: Robinson A. D. T. , McCreadie R. G.
Published: August 2008

The point-prevalence of tardive dyskinesia in schizophrenics from a discrete geographical area (Nithsdale, in Dumfries and Galloway Region) in 1981, 1982, and 1984 was 31%, 27%, and 30% respectively. This suggests that the prevalence of tardive dyskinesia in a community of schizophrenics has reached a plateau. In 12% of patients there was persistent dyskinesia, i.e. abnormal involuntary movements were present at all three assessments. Persistent dyskinesia was more common in older patients. The severity of tardive dyskinesia fluctuated between assessments in 41 % of patients, indicating that it is only a transient feature in some cases.
Munchausen’ s Syndrome and Drug Dependence
Authors: London M. , Ghaffari K.
Published: August 2008

A man with Munchausen's syndrome was treated for drug dependence, which allowed him to establish and sustain a bond with a hospital, but eventually brought about an ethical dilemma.
Subcortical Dementia Neuropsychology, Neuropsychiatry, and Pathophysiology
Authors: Cummings J. L.
Published: August 2008

Subcortical dementia refers to a clinical syndrome characterised by slowing of cognition, memory disturbances, difficulty with complex intellectual tasks such as strategy generation and problem solving, visuospatial abnormalities, and disturbances of mood and affect. The syndrome was first described by Kinnier Wilson, but further progress in development of the concept has occurred only within the past ten years. Subcortical dementia occurs in degenerative extrapyramidal disorders and has also been identified in inflammatory, infectious, and vascular conditions. Histologic, metabolic, and neurochemical investigations implicate dysfunction primarily of subcortical neurotransmitter systems and subcortical structures or subcortical-frontal connections in the genesis of the syndrome. Subcortical dementia contrasts neuropsychologically and anatomically with disorders such as dementia of the Alzheimer type that affect primarily the cerebral cortex. The clinical characteristics of subcortical dementia reflect the interruption of fundamental functions (motivation, mood, timing, arousal) mediated by phylogenetically and ontogenetically early maturing structures.
Assessing and Treating Attention Deficit Disorder in Adolescents
Authors: Kutcher S. P.
Published: August 2008

Psychiatric assessment strategies that integrate research findings with daily practice are necessary and clinically useful. This paper uses the example of an attention deficit disordered adolescent to illustrate how double-blind placebo controlled and multi-dose adjustment designs can be successfully implemented in routine clinical practice. These designs are especially valuable In evaluating the therapeutic effect of methylphenidate because of biases that may lead to clinical misuse of this stimulant medication.
Trazodone-induced Mania
Authors: Knobler Haim Y. , Itzchaky Samson , Emanuel Doron , Mester Roberto , Maizel Shmuel
Published: August 2008

Two bipolar depressed patients and one unipolar depressed patient developed manic Symptoms after receiving trazodone. The Symptoms resolved when the treatment was discontinued or reduced. We believe the two bipolar patients are the first cases of this reaction reported in the literature.
Changes in the Incidence of Schizophrenia?
Authors: Strömgren Erik
Published: August 2008

In general, results of epidemiological studies on schizophrenia performed during the last century have the remarkable feature that no significant differences in expectancies and incidences have been found, neither between different populations nor over time. Recently, however, some studies have tended to show a noteworthy decrease in the incidence, as measured by statistics of first admissions. Possible sources of error are discussed, partly on the basis of recent Danish investigations. Although it is uncertain whether a true change in the incidence of schizophrenia has occurred, one feature is becoming evident: under modern treatment and care of-schizophrenics the natural history of the disease is becoming increasingly different between the two sexes. This fact, in combination with one of the hardest facts in schizophrenia research, namely the higher age of onset in females, may be useful starting points for hypotheses on aetiology, or at least necessary components of such hypotheses.
Neuroleptic Malignant Syndrome Superimposed on Tardive Dyskinesia
Authors: Haggerty John J. , Bentsen B. Steven , Gillette Gregory M.
Published: August 2008

A 30-year-old man with a 3-year history of tardive dyskinesia developed a neuroleptic malignant syndrome while having reserpine and lithium; his symptoms worsened following three doses of neuroleptic medication and improved with bromocriptine. The pre-existing dyskinesia made the presentation confused, and delayed proper diagnosis.
Cotard's Syndrome in a Mentally Handicapped Man
Authors: Kearns Anthony
Published: August 2008

A mentally handicapped man with Cotard's syndrome is described, and the usefulness of electroconvulsive therapy in his management discussed. Even the more uncommon psychiatric syndromes such as this can be found in people with lower intellectual functioning, with clinical features little modified.
Senile Dementia and Parietal Lobe Dysfunction
Authors: Gilleard C. J. , Spain E. , O'Carroll R. E.
Published: August 2008

Two samples of patients suffering from senile dementia were administered the Kew tests for parietal lobe function and aphasia. No evidence emerged of any clinical heterogeneity; parietal lobe test performance was found to be more a function of degree of impairment rather than of age.
Alcohol-related Psychiatric Emergencies: Their Characteristics and Care at a Walk-in Clinic
Authors: Mendelson Eric F.
Published: August 2008

Fifty cases attending a walk-in psychiatric emergency clinic with alcohol-related problems were studied retrospectively. Results confirm that this group represents a sizeable load on the clinic – about 15% of all assessments. Other psychiatric problems were common, and many patients had recently attempted or threatened suicide.
Life Events, Vulnerability and Onset of Depression
Authors: Brown G. W. , Bifulco A. , Harris T. O.
Published: August 2008

A prospective study of 400 largely working-class women with children living at home has once again demonstrated the major importance of long-term severe threatening life events in provoking caseness of depression. However, it again shows that only about one out of five women experiencing such an event go on to develop depression at a case level. This paper demonstrates that more sensitive characterisation of severe events can greatly increase the size of this association. This is done both by improving the description of the event itself and by taking into account various ways in which the event can ‘match’ characteristics of the women present at the first interview, well before the occurrence of the event or any onset of depression.
Prediction of Outcome in Depressive Illness by the Newcastle Diagnosis Scale
Authors: Carney M. W. P. , Edeh James , Reynolds E. H. , Toone B. K. , Thomas C. , Sheffield B. F.
Published: August 2008

The Newcastle scores of a group of 64 and subsample of 52 severely depressed inpatients were not normally distributed. Evidence for discontinuity in these distributions was adduced from the contrast in outcome between the endogenous and neurotic patients thus defined, the endogenous consistently doing better than the neurotic group. The unipolar/bipolar system failed to predict different results for endogenous and neurotic patients unless unipolar was subdivided into endogenous and neurotic subgroups. The DSM-III criteria for major depression and melancholia failed to identify subgroups of differing prognoses.
Factor Study of a Psychiatric Child Rating Scale
Authors: Thorley G.
Published: August 2008

Symptom rating sheets completed by psychiatrists over a 9-year period on 2602 intellectually normal child and adolescent clinic attenders were subjected to factor analysis (principal components). Two types of factor sets were derived, one for younger subjects (3–11 years) and another for older subjects (12–18). Both had three factors in common: conduct disturbance, relationship problems and emotionality, but differed on the fourth – developmental immaturity for the younger group, depression for the older. A factor solution was also derived for the whole clinic sample with three scales: conduct, emotionality and immaturity. Both types of factor solutions were subjected to MANOVA for age and sex effects, both of which proved to be of significant influence. Good correspondence was found between the symptom factors identified and conceptually similar clinical diagnoses.
A Test of the Social Support Hypothesis
Authors: Parker G. , Barnett B.
Published: August 2008

As a test of the social support hypothesis, highly anxious primiparous mothers were assigned in the post-natal stage to either a professional intervention, a lay intervention or to a control group. It was hypothesised that those receiving an active intervention (be it lay or professional assistance) would become less anxious as a consequence of a central therapeutic ingredient – social support. Improvement was assessed by measuring state anxiety levels at baseline and at 12 months, while the degree to which therapists were incorporated into the social network was assessed by the Interview Schedule for Social Interaction (ISSI), given at baseline and at 12 months. While we established that anxiety levels were significantly lowered in those receiving the professional intervention and moderately (but not significantly) lowered in those receiving the lay intervention, ISSI scores for the separate groups appeared stable over the study. Reasons are considered why ISSI scores remained unchanged while intervention groups showed a reduction in anxiety levels.
Biological and Neuropsychological Approaches to Childhood Autism
Authors: Prior Margot R.
Published: August 2008

There is growing conviction that childhood autism is a biologically based disorder. The evidence that has accrued in a variety of areas pertaining to biological abnormality in autism suggests that, with the possible exception of genetic factors, very few data are available that illuminate the autistic disorder specifically. Neurological models which might be useful in guiding further research are discussed and reasons for the slow progress in this important aspect of the study of autism are identified.
Changes in Auditory P3 Event-related Potential in Schizophrenia and Depression
Authors: Blackwood D. H. R. , Whalley L. J. , Christie J. E. , Blackburn I. M. , Clair D. M. St , McInnes A.
Published: August 2008

Event-related potentials during a two-tone discrimination task were recorded in 24 schizophrenic patients, 16 depressed patients and 59 control subjects. Recordings were made when patients were medication-free. Fourteen schizophrenic and 13 depressed patients were retested at 1 and 4 weeks after the start of treatment, and 13 schizophrenic patients were also tested between 6 and 24 months after the initial recordings. In the schizophrenic group, the P3 latency was significantly prolonged compared with that in the control and the depressed groups, and remained unchanged both after 4 weeks treatment with therapeutic doses of neuroleptic drugs and at long-term follow-up. In the depressed group, the P3 latency did not differ from that of controls. P3 amplitude by contrast was reduced in both the acutely depressed and schizophrenic groups and following treatment became normal in the depressed group but remained reduced in the schizophrenic group. It is suggested that a prolonged P3 latency and reduced P3 amplitude indicate an impairment of auditory information processing in some patients with schizophrenia which is independent of the presence of acute psychotic symptoms and is not influenced by neuroleptic medication.
The Effect of Carbamazepine and Lithium on Remission from Affective Illness
Authors: Watkins S. E. , Callender K. , Thomas D. R. , Tidmarsh S. F. , Shaw D. M.
Published: August 2008

Times in remission from affective illness were prolonged during treatment with lithium carbonate and carbamazepine, but lithium was the more effective. Similar global scores for the two drugs suggested that other factors may determine their acceptability.
Suicide and Parasuicide Among Further Education Students in Edinburgh
Authors: Platt S. D.
Published: August 2008

During the period 1979–1982 the incidence of suicide and parasuicide for students aged 15–24 years was found to be lower than that of others of the same age in Edinburgh. A comparison of student parasuicides with matched non-student parasuicides shows similar parasuicide repetition rates, but some differences in respect of precipitants (twice as many students reporting no major event prior to the episode), agent of poisoning (analgesics more commonly used by students; hypnotics, tranquillisers and barbiturates, by controls), and social and clinical characteristics (a greater proportion of controls reporting parasuicide in the family, a criminal record and being the victim of violence).
Influence of Emotional Distress among Supporters on the Outcome of Psychogeriatric Day Care
Authors: Gilleard C. J.
Published: August 2008

From a sample of consecutive referrals for psychogeriatric day care, the influence of the supporters' emotional distress and self-reported strain, together with the number of problems presented by the patient, was examined in relation to outcome, 6–7 months after initial attendance. A higher level of problems and the failure to achieve any reduction in reported distress were both found to contribute to the breakdown of community care and to the subsequent institutionalisation of the patient. Day hospital care was associated with a significant reduction in emotional distress for the majority of relatives, although for relatives whose distress was not alleviated by their dependents' attendance, admission to long-term care did produce such a reduction.
Life Events and Mania
Authors: Ambelas A.
Published: August 2008

Fifty patients in their first manic episode were compared retrospectively with groups of (a) manic patients in other than first admissions and (b) acute surgical cases. They were then followed up for 3–8 years. First manic admissions were linked to life events far more frequently – 66%vs20% and 8% respectively for the other groups. Within-group comparisons showed patients with life events were much younger. The link between life events and manic episodes appeared immediate and selective, a view further supported by the findings of the follow-up. Later episodes precipitated by life events seem to require smaller amounts of stress. The possible role of life events in relation to mania is discussed.
Fictitious Epilepsy associated with Amnesia
Authors: Jones J. R. , Horrocks F. A.
Published: August 2008

Epilepsy can occur in patients without any changes apparent in the electroencephalogram. Thus the diagnosis of epilepsy is essentially made on clinical grounds. The clinical features of epilepsy are rela tively easy to learn to mimic. Feigned epilepsy can occur in adulthood or it may occur in childhood, as part of a Munchausen syndrome by proxy as described by Meadows (1984). We would like to describe a case of feigned epilepsy with global amnesia, and several other symptoms of aberrant illness behaviour.
Suicide in England and Wales, 1975–1984
Authors: McClure G. M. G.
Published: August 2008

An investigation of the suicide rate in the decade 1975–1984 in England and Wales revealed an increase in rate for males of all ages, and a small decrease for young females. The increase for males has been greatest in the 25–54 years group. There has been a decrease in the number of suicides by poisoning with solids and liquids (including overdoses) for both sexes. Rates for poisoning by vehicle exhaust gas and by hanging, strangulation and suffocation have increased substantially during this period. In males, suicides by these methods now exceed those due to poisoning by solids and liquids.
The Dexamethasone Suppression Test and Prediction of Outcome in Patients Receiving ECT
Authors: Katona C. L. E. , Aldridge C. R. , Roth Martin , Hyde J.
Published: August 2008

Twenty-six in-patients satisfying DSM-III criteria for major depressive episode were assessed using the Newcastle Diagnostic and ECT Predictor Scales and the dexamethasone suppression test (DST), prior to commencing a course of electroconvulsive therapy (ECT). The Newcastle ECT Predictor Scale was successful in predicting both immediate outcome and outcome over the 6 months following ECT; the DST was unsuccessful in predicting either immediate or 6-month outcome.
Huntington's Chorea: Some Psychodynamics seen in those at Risk and in the Responses of the Helping Professions
Authors: Martindale B.
Published: August 2008

The autosomal dominant mode of inheritance of Huntington's Chorea (HC) has been established for over 100 years. Strong psychological defences against the acceptance of this knowledge are commonly found both in professionals and in Huntington families and relatives who are at risk. One consequence of maintaining these defences is the continuing transmission of the gene, and therefore the disease, to succeeding generations. The defences of professional persons protect them from the difficult and unsettling task of providing genetic counselling to healthy relatives at risk. An increase in awareness of the psychodynamics involved may lead to constructive thinking about the current deficiencies in care and counselling services provided for these families.
Five-year Outcome and Prognosis in Schizophrenia: A Report from the London Field Research Centre of the International Pilot Study of Schizophrenia
Authors: Prudo R. , Blum H. Munroe
Published: August 2008

A sample of 100 schizophrenic patients admitted to London area psychiatric hospitals were examined as part of the International Pilot Study of Schizophrenia. Clinical and social outcome were variable. At 5-year follow-up, 49% had good symptomatic outcome and 42%, good social outcome. Poor social functioning at inclusion was predictive of poor symptomatic outcome. Illness history (IH), occupational functioning (OF), social relationship functioning (SRF), negative and non-specific symptoms (NNS) at initial evaluation, and their interaction with sex and race accounted for 32% of the 5-year symptomatic outcome variance (n = 84; F=3.48; P<0.001). OF, SRF, housing status, NNS and their interaction with sex, race and age accounted for 47% of the social outcome variance (n = 62; F=2.62; P<0.007).
Clomipramine and ‘Drive’ in People with Anorexia Nervosa: An In-patient Study
Authors: Crisp A. H. , Lacey J. H. , Crutchfield M.
Published: August 2008

Drugs can sometimes be helpful within the overall treatment and management of anorexia nervosa. In this study we have examined the impact of clomipramine on food and activity in anorectics engaged in a treatment programme enabling them to regain normal body weight. Consumption of the drug was associated with increased appetite, hunger and calorie consumption during the early stages of treatment. There was no impact on ultimate outcome. In this study it was evident that the drug was unnecessary for weight gain, but it may be helpful in other programmes, both short and long term, where the patient has sufficient trust (to tolerate the enhanced hunger experience) but is not involved in the same behavioural constraints. However, its possible value in such programmes has not been proven here. Meanwhile, we take our findings as further evidence that clomipramine increases drive behaviour and appetite in humans and may be beneficial in the treatment of affective disorders because of this effect.
Asperger's Syndrome and Aminoaciduria: A Case Example
Authors: Miles S. W. , Capelle P.
Published: August 2008

An 18-year-old male, originally diagnosed as suffering from infantile autism but with a developmental history and clinical picture in keeping with Asperger's syndrome, and showing current signs of impairment of higher cerebral functioning, is presented. The subject and several males of his family present behavioural disturbances of an enduring type. An aminoaciduria was discovered in the subject and his father. A possible relationship between the metabolic disturbance and the neurological and behavioural disturbance is raised. Mechanisms for this relationship are discussed, including sporadic hyperlysinaemia.
Neuropsychiatry
Authors: Rogers D.
Published: August 2008

The last 20 years have seen a rapidly growing interest in disorder of brain function in psychiatric illness but this is only the latest phase in a steady development of ideas over the last three centuries. Throughout this time, biological and psychological formulations of psychiatric disorder have co-existed and, at different periods, one or other has been the focus of attention. Thomas Willis, who coined the word ‘neurology’ 300 years ago, felt that psychiatric disorder represented brain disorder, but it was only during the nineteenth century, as understanding of brain function made its first real progress, that this opinion became more explicit and accepted. By the second half of the century, it was axiomatic that psychiatric disorder was synonymous with brain disorder (Griesinger, 1845; Maudsley, 1873; Ferrier, 1878); all that was lacking was the actual neurophysiological basis of mental disorder.
Anticonvulsant Medication in a Mental Handicap Hospital: 1972–1982
Authors: Sheppard L. C. , Ballinger B. R. , Fenton G. W.
Published: August 2008

The prescription sheets for all patients in a mental handicap hospital on one day in 1972 and on the same date in 1982 were examined to identify trends in anticonvulsant medication over a 10-year period. There was a reduction in size of the hospital population associated with fewer very young and milder handicapped persons. Prescription of anticonvulsants fell slightly during the decade under study with a dramatic fall in the use of phenobarbitone, and a parallel increase in the prescription of carbamazepine. Other changes included the use of sodium valproate in a significant minority of patients and the occasional use of clonazepam in 1982, while phenytoin remained a first-rank anticonvulsant throughout the period under review. The proportions of patients on polytherapy did not change over the 10-year period, though the contribution of phenobarbitone to the combined drug regimes was significantly reduced.
Classification of Parasiticide by Cluster Analysis
Authors: Kurz A. , Möller H. J. , Baindl G. , Bürk F. , Torhorst A. , Wächtler C. , Lauter H.
Published: August 2008

A Classification of suicidal behaviour was derived by cluster analysis from descriptive data on parasuicide patients. The grouping was meaningful in terms of clinical interpretation and had both therapeutic and prognostic implications. The sample was broken down into three groups, identified as repeated, serious and non-serious attempts. The repeated attempters had the worst prognosis at 1 -year follow-up. When the sample was classified into five groups according to seriousness of the attempts, the repeater and non-serious groups were retained, while the serious attempts were split into three subtypes, which differed on nosological characteristics, treatment disposal and outcome. An excessively high successful suicide rate was found in a small group of elderly attempters.
Five Risk Factors for Depression
Authors: Roy A.
Published: August 2008

Significantly more of 300 patients with non-endogenous depression compared with 300 matched controls were unemployed and had a poor marriage before the onset of depression, had a first-degree relative who had been treated for depression, had experienced separation for one year or more from a parent before 17 years of age and had three or more children under 14 years of age at home. However, significantly more of 44 patients with endogenous depression, than their 46 controls, also had a poor marriage before the onset of depression and 43% of them had a first-degree relative who had been treated for depression. Thus a family history of depression and a poor marriage before the onset of depression are associated with both non-endogenous and endogenous depression but unemployment, separation for one year or more from a parent before 17 years of age, and having three or more young children at home may be risk factors for non-endogenous depression.
A Schoolgirl with Onset of Anorexia Nervosa during a Concealed Pregnancy
Authors: Foster J. E. , Jenkins M. E.
Published: August 2008

In anorexia nervosa, amenorrhoea and endocrine disturbance make pregnancy unlikely while the patient's weight is low. Bulimics may conceive at quite a low weight, and anorexics who have regained weight may become pregnant but typically relapse following delivery (Crisp, 1980). Anorexia has also been reported following termination of pregnancy (Thomas & Harris, 1982). Cases of onset of anorexia nervosa with weight loss during pregnancy are rare in the literature, although there are isolated reports (e.g. Weinfeld et al, 1977; Strimling, 1984). Strimling described a treated anorexic who restarted dieting during pregnancy in response to weight gain before she realised that she was pregnant. We report on a schoolgirl who became pregnant at 14 years, whose anorexia began when she was 5 months pregnant and whose pregnancy was not discovered until she was in labour.
Specific and Non-specific Effects of Educational Intervention with Families Living with a Schizophrenic Relative
Authors: Smith J. V. , Birchwood M. J.
Published: August 2008

A brief educational intervention with families living with a schizophrenic relative is described and evaluated in terms of benefits for relatives' well-being and patient recovery. Education led to considerable knowledge gains and to reductions in relatives' reported stress symptoms and fear of the patient. There was a trend for relatives to be more optimistic concerning their role in treatment. At 6 months follow-up, only knowledge gains were maintained; however, relatives' perceptions of family burden were significantly reduced. The evidence suggests that family education may be useful both as a cost-effective intervention in its own right and in facilitating a more receptive attitude to subsequent family intervention.
Compensation Psychosis
Authors: White A. C. , Armstrong D. , Rowan D.
Published: August 2008

Kennedy (1946) stated that “A compensation neurosis is a state of mind, born out of fear, kept alive by avarice, stimulated by lawyersand curedby a verdict”. This theme, supported by Miller's influential paper in 1961, has ensured that genera tions of patients havebeenregardedwith suspicion if they daredto presentwith psychologicalsymptoms following an accident. The view remained un challenged for over a decade and is still often presentedto, and acceptedby, our Courts, despite the fact that Miller reached his conclusions after examiningpatientwsho presentefdorlegarleports in whose casesit was not surprising that he found a relationship betweencompensation and psycho logical sequelae The psychological effects of proceeding litigation on the victim of an accident remain a matter of current debate. McKinley et al (1983), reported differences betweenthose patients suffering a severeblunt headinjury claimingcompen sation and those not claiming compensation. The reports givenby relativesof changesin both patients werevery similar. However, reports given by patients themselves differed with claimants reporting slightly more symptoms than non-claimants. In a study by Whitein 1981, the author followed up 163 victims of accidents admitted to the Birmingham Accident Hospital (76 burns and 87 general accidents). One year after their accident, psychological sequelaewere found in approximately two-thirds of the group, one third being moderately-to-severely psychologically affected. There was no statistical difference between those victims in whom the accident had given rise to litigation and in whom the case was still proceeding and those victims where compensation was not an issue.
Depression in the General Population: Comparability of Survey Results
Authors: Craig T. K. J. , Brown G. W. , Harris T. O.
Published: August 2008

Bebbington (1986) draws attention to a possible cause for concern regarding the comparability of recent epidemiological research utilising the PSE-ID-CATEGO system of psychiatric caseness deter mination. In taking issue with our observation that cases in our recent community survey (Brown et al, 1985) were broadly similar in terms of severity to those reported in a recent series of out-patients (Sashidharan, 1985), he makes the point that such conclusions are only justifiable when it can be con fidently assumed that thresholds for symptom in clusion are applied uniformly between research centres. He argues that this assumption may well be invalid and marshalls two arguments to suggest that the Bedford team may have adopted less stringent rating thresholds. Firstly, he draws attention to the very different population prevalences of disorder reported in recent surveys, contrasting one-year prevalence figures for the Bedford College survey in Islington (Brown elal, 1985) withthelowerrates reported for other investigations in Edinburgh (Dean eta!, 1983) and Camberwell (Bebbington et al, 1981). Secondly, he reminds us of the body of evidence which suggests that psychiatrists operate stricter criteria for PSE symptoms than their lay colleagues (Wing et al, 1977a; Sturt et al, 1981).
Depressive Disorder in Primary Care
Authors: Blacker C. V. R. , Clare A. W.
Published: August 2008

Since the pioneering study of psychiatric morbidity in primary care by Shepherdet alin 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeperet al,1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment?
The Prognosis of Primary Depressive Illness
Authors: Bowie P. C. W. , Beaini A. Y. , Bowie L. J.
Published: August 2008

We followed up 30 recovered depressives for an average of 2 years. At 18 months, despite prophylactic medication, 30% had relapsed. Persistent DST suppression during the index illness was found to be a predictor of good prognosis.
Depression Assessment in Brazil
Authors: Dratcu L. , da Costa Ribeiro L. , Calil H. M.
Published: August 2008

Cross-cultural investigation in psychiatry is revealing the need for standardised instruments in diagnosing and assessing depression. Recently, a new instrument was developed to evaluate depressed patients, namely the Montgomery-åsberg Depression Rating Scale (MADRS). The present study introduced the MADRS in Brazil, comparing it to the Hamilton Depression Rating Scale, the Visual Analogue Mood Scale (a self-rating scale), and with the global clinical assessment of independent Brazilian psychiatrists. The results show correlation between MADRS and the three other assessments, indicating that it is a useful and operational instrument to evaluate depressed patients. They also support the application of the MADRS in cross-cultural studies of depression in Brazil and other countries. These results are critically discussed.
Mental Health and Psychological Well-being Among the Old and the Very Old Living at Home
Authors: Morgan K. , Dallosso H. M. , Arie T. , Byrne E. J. , Jones R. , Waite J.
Published: August 2008

Using four brief assessment scales, profiles of mental health and psychological well-being were obtained from 507 old (aged 65–74 years) and 535 very old (aged 75 +) individuals randomly sampled from the community. Assessments of dementia and depression were subsequently validated against diagnostic ratings made by experienced psycho-geriatricians. Levels of agreement between psychometric and clinical ratings of dementia x = 0.83) and depression (x = 0.66) were satisfactory. The old and very old groups reported similar levels of anxiety and personal disturbance, and showed a similar prevalence of depression. However, those aged 75+ showed higher levels of dementia and significantly lower levels of social involvement and morale.
Range of Mental Illness Among the Elderly in the Community
Authors: Copeland J. R. M. , Dewey M. E. , Wood N. , Searle R. , Davidson I. A. , McWilliam C.
Published: August 2008

A sample of 1070 elderly persons aged over 65 living in the Liverpool community was interviewed using the community version of the Geriatric Mental State (GMS) and the findings processed to provide a computerised diagnosis by AGECAT. Levels of organic disorder, probably dementia, reached 5.2%, intermediate between those of London and New York derived from previous studies. Levels for depressive illness overall were below those of other studies at 11.3% while levels for neurotic disorder were much the same at 2.4%. The rise in the prevalence of dementia with age was further confirmed. The GMS AGECAT Package provides a method for standardising both the collection of data and the diagnostic process for comparative epidemiological studies and other research.
Psychiatric Disorder in the Community and the General Health Questionnaire
Authors: Surtees P. G.
Published: August 2008

Goodchild & Duncan-Jones (1985) have proposed a new scoring method for Goldberg's General Health Questionnaire (GHQ) in which increased weight is given to item responses considered to indicate current (but chronic) affective disorders. This report examines both their revised and the conventional scoring of the GHQ in the context of a longitudinal general population study of psychiatric disorder among women. Sensitivity estimates based upon advised cut-points were found to be higher for the revised than for the conventional scoring scheme, and this difference remained when allowance was made for the duration for which disorders had been present prior to assessment with the GHQ. However, Relative Operating Characteristic (ROC) analysis revealed that while both forms of scoring the GHQ discriminated affective conditions (with or without allowance for their duration) there was no significant difference in their ability to do so. The justification therefore for the post-hoc interpretation of certain item responses as indicators of enduring affective states remains controversial and an issue for future research.
Infantile Autism in Children of Immigrant Parents
Authors: Gillberg Christopher , Steffenburg Suzanne , Börjesson Birgitta , Andersson Lena
Published: August 2008

A population-based study of infantile autism from western Sweden has been completed. Urban children with autism more often than age-matched children in the general population had immigrant parents from ‘exotic’ countries. No such trend was seen in rural children with infantile autism.
A Study of Schneider's First-Rank Symptoms of Schizophrenia in Nigerian Patients
Authors: Gureje Oye , Bamgboye E. A.
Published: August 2008

A prospective evaluation of Schneider's first-rank symptoms in 56 Nigerians with RDC schizophrenia gave a prevalence of 73%. The presence of first-rank symptoms was unrelated to schizophrenic subtypes, duration or severity of illness. While some of the symptoms correlate with age of patients, the pattern of inter-correlations among them supports previous views about their empirical heterogeneity.
Anorgasmia from Clomipramine in Obsessive-Compulsive Disorder
Authors: Monteiro W. O. , Noshirvani H. F. , Marks I. M. , Lelliott P.T.
Published: August 2008

Forty-six patients with obsessive-compulsive disorder undergoing a double-blind controlled study of clomipramine and placebo were interviewed to assess changes in sexual function. Of 33 patients with previously normal orgasm, nearly all of the 24 on clomipramine developed total or partial anorgasmia; none of the 9 on placebo did so. Anorgasmia persisted with minimal tolerance over the five months that clomipramine was taken. Men and women were equally affected. Sexual side-effects are easily missed without a structured interview, and can detract from the value of drug treatment.
Outcome in Bipolar Affective Disorder After Stereotactic Tractotomy
Authors: Lovett L. M. , Shaw D. M.
Published: August 2008

Nine patients have been treated by subcaudate stereotactic tractotomy for bipolar affective disorder resistant to drug treatments. In the majority, after the operation there was a reduction in frequency and severity of depressive and manic episodes. There was a trend for the operation to have more effect on the manic than on the depressive phases. Drugs which had been inert previously sometimes became therapeutically useful after surgery.
Psychological Correlates of Unemployment Among Male Parasuicides in Edinburgh
Authors: Platt S. D. , Dyer J. A. T.
Published: August 2008

Variations in clinical features associated with unemployment among a sample of male parasuicides were examined. Employed and unemployed persons did not differ in mean scores on the Suicidal Intent Scale, but the unemployed were rated significantly worse on measures of depression (Beck Depression Inventory) and hopelessness (Hopelessness Scale). A covariance analysis showed that hopelessness, rather than depression, is the important discriminator. Different patterns of relationships between the three clinical measures were observed in the two groups. Hopelessness may be a key social-psychological variable for inclusion in any model of the pathways which link unemployment with parasuicide.
Cerebral and Brain Stem Changes After ECT Revealed by Nuclear Magnetic Resonance Imaging
Authors: Mander A. J. , Whitfield A. , Kean D. M. , Smith M. A. , Douglas R. H. B. , Kendell R. E.
Published: August 2008

Nuclear magnetic resonance images of the brain were obtained in fourteen patients with major depression during a course of ECT. The T1, relaxation time rose immediately after the fit reaching a maximum 4–6 h later. The T1, values then returned to their original level; no long-term increase occurred over the course of treatment. These results are consistent with an extensive but temporary breakdown of the blood-brain barrier during ECT.
CSF Monoamines in Autistic Syndromes and Other Pervasive Developmental Disorders of Early Childhood
Authors: Gillberg C. , Svennerholm L
Published: August 2008

Spinal fluid concentrations of the three major monoamine metabolites were examined in 25 infantile autistic children and 12 children with other childhood psychoses, and were contrasted with results obtained in normal children and in groups of children with neurological and neurodevelopmental disorders. Autistic children showed absolute and relative increases of the dopamine metabolite homovanillic acid. The group with other childhood psychoses also showed an increase in HVA level; in this group there were also indications of high levels of serotonin and norepinephrine metabolites. The results are discussed in the context of a pathogenetic model for autism involving hyperfunction of dopaminergic nerve fibres in the brain stem-mesolimbic system.
Abnormal Auditory Brain-stem Responses in Hallucinating Schizophrenic Patients
Authors: Lindstrom L , Klockhoff I. , Svedberg A. , Bergstrom K.
Published: August 2008

Abnormal auditory brain-stem responses (ABRs) were recorded in 10 out of 20 schizophrenic in-patients. The response abnormalities did not show any correlation to the degree of psychopathology, sub-group of schizophrenia, age, sex, or cerebral ventricular enlargement. Nor was there any correlation to previous neuroleptic treatment: a pathological ABR was recorded in 5 of the 8 patients who had never received such medication. A statistically significant relationship was found between ABR pathology and auditory hallucinations: 9 of the 11 patients who admitted having hallucinations exhibited brain-stem response abnormality, whereas ABR abnormality was recorded in only 1 of the 9 patients who denied having hallucinations. The data imply that brain-stem dysfunction is involved in the psychopathology of schizophrenia, and that interference with the auditory pathways in the brain-stem may induce auditory hallucinations in schizophrenic patients.
The Symptoms of Chronic Schizophrenia
Authors: Liddle Peter F.
Published: August 2008

The relationships between symptoms in 40 schizophrenic patients, selected for persistence of symptoms, were examined. The symptoms segregated into three syndromes: psychomotor poverty (poverty of speech, lack of spontaneous movement and various aspects of blunting of affect): disorganisation (inappropriate affect, poverty of content of speech, and disturbances of the form of thought): and reality distortion (particular types of delusions and hallucinations). Both the psychomotor poverty and disorganisation syndromes were associated with social and occupational impairment; in particular, the psychomotor poverty syndrome was associated with impairment of personal relationships, and the disorganisation syndrome with poor self-care and impersistence at work.
Expressed Emotion in Individual and Family Settings: a Comparative Study
Authors: Szmukler George I. , Berkowitz Ruth , Eisler Ivan , Leff Julian , Dare Christofer
Published: August 2008

Expressed emotion ratings were performed, in two separate settings, on the parents of 20 children suffering from anorexia nervosa. Ratings were made on conventional individual interviews and on videotapes of a family interview. Comparison of ratings in the two settings showed a very high correlation for ‘critical comments'. Findings on the other scales were harder to interpret, but significant correlations as well as differences were noted. Expressed emotion rated in family interviews provides new possibilities for the study of families.
Brief Psychotherapy in the Treatment of Anorexia Nervosa
Authors: Hall A. , Crisp A. H.
Published: August 2008

Thirty out-patients with severe anorexia nervosa were randomly allocated to either 12 sessions of dietary advice or 12 sessions of combined individual and family psychotherapy. At one-year follow-up both groups showed significant overall improvement, and the dietary advice group showed significant weight gain. A similar mean weight gain for the psychotherapy patients did not reach statistical significance, but this group made significant improvements in sexual and social adjustment.
Hereditary Agoraphobia and Obsessive-Compulsive Behaviour in Relatives of Patients with Gilles de la Tourette's Syndrome
Authors: Comings D. E. , Comings B. G.
Published: August 2008

We present 11 pedigrees in which a propositus with Gilles de la Tourette's syndrome had first or second-degree relatives with obsessive-compulsive behaviour or agoraphobia with panic attacks, but only partially expressed the TS gene (i.e. had only motor tics or vocal tics, or neither). Of 90 females over the age of 18 presenting with TS, or with motor or vocal tics alone, nine had severe agoraphobia with panic attacks. There may be genetic subtypes of both obsessive-compulsive disorder and agoraphobia with panic attacks that are due to partial expression of the TS gene.
Monoamine Oxidase Inhibitors and Narcotic Analgesics
Authors: Browne B. , Linter S.
Published: August 2008

There has been a recent renewal of interest in the use of monoamine oxidase inhibitors, but the concurrent administration of narcotic analgesics is often a cause for concern. This review clarifies the different types of MAOi/narcotic interactions and offers guidelines for the use of narcotic analgesics in the presence of MAOIs. The MAOI/pethidine interaction has two distinct forms: an excitatory and a depressive form. Pethidine must never be used in the presence of MAOIs because of the risk of a fatal excitatory interaction. Morphine does not cause this excitatory interaction, and is the drug of choice provided an allowance is made for possible potentiation of the depressive narcotic effect. It is inevitable that strong analgesia will occasionally be required as an emergency measure in patients on MAOIs, and insufficient attention is paid in psychiatric textbooks to the two different types of interactions and their therapeutic implications.