bluuebunny/crossref_metadata_2025 huggingface dataset:
The Manufacture of Personalities
Authors: Merskey H.
Published: October 2008

Unprecedented numbers of cases of MPD have been diagnosed, mainly in North America, since 1957. Widespread publicity for the concept makes it uncertain whether any case can now arise without being promoted by suggestion or prior preparation. In order to determine if there is any evidence that MPD was ever a spontaneous phenomenon, a series of cases of MPD from the earlier literature has been examined, with particular attention given to alternative diagnoses which could account for the phenomena reported and to the way in which the first alternate personality emerged. The earlier cases involved amnesia, striking fluctuations in mood, and sometimes cerebral organic disorder. The secondary personalities frequently appeared with hypnosis. Several amnesic patients were trained with new identities. Others showed overt iatrogenesis. No report fully excluded the possibility of artificial production. This indicates that the concept has been elaborated from the study of consciousness and its relation to the idea of the self. The diagnosis of MPD represents a misdirection of effort which hinders the resolution of serious psychological problems in the lives of patients.
Timing of Acute Clinical Response to Fluphenazine
Authors: Levinson Douglas F. , Singh Hardeep , Simpson George M.
Published: October 2008

The time course of clinical improvement was studied in 41 schizophrenic and schizoaffective acute in-patients treated for 28 days with 10, 20 or 30 mg/day of oral fluphenazine hydrochloride in a double-blind, randomised study. Significant improvement was seen in the four BPRS factors: thinking disturbance, hostile-suspiciousness, withdrawal–retardation and anxious depression. The first two of these factors were improved by day 5. Significant improvement was seen up to day 22 for three of the four factors, but without significant improvement during the last week (although scores continued to drop). The half of the sample showing greater overall improvement did not improve faster than the sample as a whole. These more improved subjects did not differ significantly from the less improved subjects in the thinking disturbance factor until day 15, suggesting that at least a two-week neuroleptic trial would be necessary to begin to differentiate more and less responsive patients. The longer-term course of improvement cannot be determined from these data. The withdrawal–retardation and anxious depression factors showed their greatest improvement later than the ‘positive’ symptom factors, suggesting that the former may improve as a result of change in the latter.
The Daily Living Programme
Authors: Muijen M. , Marks I. M. , Connolly J. , Audini B. , McNamee G.
Published: October 2008

Patients with a serious mental illness requiring admission were randomised to home care or standard hospital care. Over the initial 18 months, 60 patients entered each group and were studied for a mean of 10 months. Home care reduced hospital use by 80%, with patients being admitted for a mean of 14 days, compared with 72 days for the standard group, but this bed-saving made no difference in direct treatment costs. Home care offers individualised treatment, and many patients require continuing support with the emphasis on areas such as finances and housing.
Factor Analysis of the Level of Expressed Emotion Scale, A Questionnaire Intended to Measure ‘Perceived Expressed Emotion’
Authors: Gerlsma Coby , van der Lubbe Petra M. , van Nieuwenhuizen Chijs
Published: October 2008

When the factor structure and psychometric qualities of the Level of Expressed Emotion scale, an instrument intended to assess patient's perceptions of expressed emotion, were evaluated, three moderately intercorrelated factors emerged, with good internal consistency; these were lack of emotional support, intrusiveness/control, and irritability. This did not quite correspond to thea prioriscales described in the original version. As in the original LEE, the three factors add to a total score intended to measure ‘perceived expressed emotion’.
The Brain Damage Hypothesis of the Seasonality of Births in Schizophrenia and Major Affective Disorders: Evidence from Computerised Tomography
Authors: Sacchetti Emilio , Calzeroni Alessandro , Vita Antonio , Terzi Andrea , Pollastro Franco , Cazzullo Carlo Lorenzo
Published: October 2008

Although the excess of schizophrenic births in the winter and early spring has been replicated and some non-conclusive work supports the same seasonal birth trend in patients with major affective disorders, the aetiopathogenetic foundations of this phenomenon remain uncertain. The primary role of perinatal seasonal factors that predispose to the development of schizophrenia via induction of brain damage has been invoked, as has a tendency for patients to conceive during the spring and early summer. In order to test these two hypotheses, cerebral ventricular size and cortical atrophy in 206 schizophrenics and 107 patients with major affective disorders were assessed by CT and analysed in relation to month of birth. Compared with schizophrenics born during the remainder of the year, those born between December and April, particularly in cases lacking a family history of schizophrenia, showed increased chances for ventricular enlargement, but not for cortical atrophy. No association between season of birth and central or cortical atrophy was found for patients with major affective disorders. This suggests that the brain-damaging effect played by perinatal seasonal factors has both a disease and an anatomical specificity.
Dermatoglyphic Evidence of Fluctuating Asymmetry in Schizophrenia
Authors: Mellor C. S.
Published: October 2008

Fluctuating asymmetry provides a measure of an organism's capacity to buffer adverse factors that could disturb its development. It is estimated from the differences between theoretically identical right- and left-sided structures. Dermatoglyphic fluctuating asymmetry has been recently used to investigate developmental disorders. Fingerprints and palm prints of schizophrenic patients, which had been the subjects of an earlier report of conventional dermatoglyphic trait frequencies, were reanalysed to determine their level of fluctuating asymmetry. A review of the diagnostic protocols and clinical records used in the original study indicated that most of the 482 subjects would have met DSM–III–R criteria for schizophrenia. The schizophrenic sample had significantly higher levels of fluctuating asymmetry on four dermatoglyphic traits, the finger-ridge counts, fingerprint patterns, the palmar atd angles and palmar a-b ridge counts, than controls. This finding supports the results of two earlier studies, and its relevance to the roles of genetics, foetal insults, and developmental anomalies of the brain in the aetiology of schizophrenia is discussed.
Fear and Anger in Delusional (Paranoid) Disorder: The Association with Violence
Authors: Kennedy H. G. , Kemp L. I. , Dyer D. E.
Published: October 2008

We report a series of 15 patients with delusional (paranoid) disorder as defined in DSM–III–R. All were supervised by a forensic psychiatry service after violent or threatening acts. We hypothesised that delusions and actions in these patients would be congruent with an abnormal mood characterised by fear and anger. Informants and the patients indicated a pervasive and persistent abnormality of mood (fear and defensive anger), with delusions and actions that were congruent with this mood during the offence and for over a month before. Other behaviours, such as fleeing or barricading to avoid delusional persecutors, were also consistent with congruence of mood and delusions. In all cases, violent acts and mood were congruent, but in three cases the violent act was unrelated to delusions. Although a study such as this does not demonstrate that the mood abnormality is primary, we believe moods of fear and anger in delusional disorder are not sufficiently recognised as part of the disorder.
The Clinical Evaluation of a New Community Psychiatric Service Based on General Practice Psychiatric Clinics
Authors: Ferguson Brian , Cooper Sylvia , Brothwell Judith , Markantonakis Aristos , Tyrer Peter
Published: October 2008

A new community psychiatric service in Nottingham based on general practice clinics was compared with a conventional hospital-orientated model. Despite providing treatment for an inner-city population of significantly greater social disadvantage, the community service was associated with similar levels of symptom morbidity as assessed by the CPRS and the SFS. It also involved greater use of day-hospital facilities, more extensive multidisciplinary care, and a commitment to longer-term follow-up of chronically ill patients. Such a model is offered as a basis for future developments of urban community psychiatric services.
Parental Expressed Emotion and Psychophysiological Reactivity in Disturbed and Normal Children
Authors: Hibbs Euthymia D. , Zahn Theodore P. , Hamburger Susan D. , Kruesi Markus M. P. J. , Rapoport Judith L.
Published: October 2008

Increased spontaneous fluctuations in skin conductance (SC) in adult schizophrenics have been associated with high expressed emotion (EE) in their relatives. This is the first study in children where parental EE, parental psychopathology, and autonomic activity, indexed by SC levels and reactivity, have been assessed. The subjects were children and adolescents with disruptive behaviour disorders (DBD, n = 35), a psychiatric contrast group with obsessive–compulsive disorders (OCD, n = 42) and normal controls (NC, n = 45). Children living in homes with two high-EE parents had higher SC activity during rest period and slower adaptation to relaxation. Fathers' EE and maternal psychiatric diagnosis were related to higher SC activity, especially for the OCD group.
Moclobemide Versus Clomipramine in Endogenous Depression
Authors: Guelfi J. D. , Payan C. , Fermanian J. , Pedarriosse A. M. , Manfredi R.
Published: October 2008

The effects of moclobemide (300–600 mg/day), a reversible monoamine oxidase inhibitor – A (MAOI-A), were compared in a double-blind, multi-centre trial with those of clomipramine (100–200 mg/day) on 129 in-patients suffering from endogenous depression (according to ICD–9 and the Newcastle Scale). No significant differences in efficacy were seen between the two treatment groups. In the moclobemide group the mean scores on the MADRS were 36.4 on day 0 and 13.2 on day 42 (end-point analysis); scores were 37.4 and 10.9 respectively in the clomipramine group. An earlier onset of antidepressant activity was noted for moclobemide. Tolerability was significantly better for moclobemide, as shown by the Clinical Global Impression of Tolerance (CGIT). Anticholinergic effects, weight gain and orthostatic hypotension were more frequent in the clomipramine group. No biological treatment-related changes were observed.
Hypochondriacal Fears and Beliefs, Anxiety, and Somatisation
Authors: Kellner Robert , Hernandez Juan , Pathak Dorothy
Published: October 2008

Four self-rating scales of hypochondriasis and the Symptom Checklist-90 were administered to 100 general practice (GP) patients and matched non-psychotic psychiatric out-patients. In a stepwise linear regression, self-rated somatic symptoms and anxiety predicted hypochondriacal fears and beliefs; self-rated depression did not appear as a predictor. There were differences between males and females and between psychiatric patients and GP patients in the associations of these constructs. These results varied in part with the scale of hypochondriasis used. Various scales of hypochondriasis appear to measure different features of the hypochondriasis syndrome. Fear of disease (disease phobia) was associated with anxiety, whereas a false belief of having a disease (disease conviction) was associated more with somatic symptoms.
Identity Diffusion Presenting as Multiple Personality Disorder in a Female Psychopath
Authors: Bruce-Jones William , Coid Jeremy
Published: October 2008

A female psychopath presented multiple forms of psychopathology, including features of ‘multiple personality disorder’. It is proposed that a diagnosis of borderline personality disorder, or the psychodynamic features of borderline personality organisation, should be the exclusion criteria for this condition.

British Journal of Psychiatry (1992), 160, 541–544
Do Benzodiazepines Interfere with the Action of Electroconvulsive Therapy?
Authors: Cohen Samuel I. , Lawton Claire
Published: October 2008

A 67-year-old anxious and depressed woman was withdrawn from a long-term course of a benzodiazepine and soon after was given ECT. This proved ineffective, but ECT given some months later was successful. It is suggested that the chronic administration of the benzodiazepine may have induced changes in the brain that interfered with ECT.

British Journal of Psychiatry (1992), 160, 545–546
The Effect of Anticonvulsants on Cognitive Functioning Following a Probable Encephalitic Illness
Authors: Goldstein L. H. , Patel V. , Aspinall P. , Lishman W. A.
Published: October 2008

A 54-year-old man developed an acute encephalitic illness and subsequently suffered from marked memory difficulties. Considerable improvement with anticonvulsant therapy was demonstrated using a ward-based observation programme and serial neuropsychological assessments. The case report highlights the prominent role played by epileptic activity in determining the severity of the patient's amnesia.

British Journal of Psychiatry (1992), 160, 546–549
Chronic Superior Mesenteric Artery Syndrome in Anorexia Nervosa
Authors: Elbadaway Mostafa H.
Published: October 2008

An 18-year-old woman presented with SMAS: an additional diagnosis of anorexia nervosa was later made. Both conditions should be considered when an adolescent presents with weight loss and vomiting.

British Journal of Psychiatry (1992), 160, 552–554
A Cross-cultural Study of Suicide Among the Elderly in Singapore
Authors: Kua Ee Heok , Ko Soo Meng
Published: October 2008

In the general population of Singapore the mean annual suicide rate over 1985–88 was highest in the Indians (20.4 per 100 000), followed by Chinese (15.8 per 100 000), and the Malays (2.4 per 100 000). However, in the elderly population (65 years and over) the rate was highest in the Chinese (61.2 per 100 000) with Indians second (30.5 per 100 000), and Malays still the lowest (3.2 per 100 000). Among elderly Chinese, women had a higher suicide rate than men.

British Journal of Psychiatry (1992), 160, 558–559
Are Polioviruses a Cause of Schizophrenia?
Authors: Eagles John M.
Published: October 2008

Pre-natal infection with polioviruses could contribute to the subsequent development of schizophrenia. The hypothesis draws support from the declining incidence of schizophrenia, the excess of schizophrenic winter births, and the increased rates of schizophrenia among West Indian immigrants. There are parallels with other late sequelae of poliovirus infections. These postulations generate a testable hypothesis of a genetic link between schizophrenia and susceptibility to poliomyelitis.
The Natural History of Neurotic Disorder in an Elderly Urban Population
Authors: Larkin Bernadette A. , Copeland John R. M. , Dewey Michael E. , Davidson Ian A. , Saunders Paul A. , Sharma Vimal K. , McWilliam Christopher , Sullivan Caroline
Published: October 2008

A random community sample of 1070 subjects aged 65 years and over was interviewed at home using the GMS-agecat package and followed up three years later. Neurotic symptoms were common, but symptoms sufficient to reach ‘case’ level were much less frequent. The overall prevalence of neurotic ‘cases' was 2.4% in year 0 and 1.4% in year 3. The incidence was estimated as a minimum of 4.4 per 1000 per year over the age of 65. Women were more likely to be ‘cases' than men but not ‘subcases', and there was a general decline in prevalence with increasing age, particularly for ‘subcases'. Anxiety was the commonest neurotic subtype. After three years, ‘cases' were shown not to persist, but this did not reflect wellness. There was a tendency still to have some symptoms, but the predominant symptom appeared to change, suggesting a possible chronic neurotic disorder with changing presentation over time. Depressive symptoms were closely associated with this presentation, suggesting that depression may be an important and integral part of a general, changing neurotic disorder.
The Northfield Experiments
Authors: Harrison Tom , Clarke David
Published: October 2008

The Northfield Experiments took place at Hollymoor Hospital, Northfield, Birmingham, during World War II. The first experiment was conducted by Bion & Rickman. The second evolved gradually; many people contributed to its success, including Foulkes, Main and Bridger. The experiments were an important landmark in the evolution of theory and practice in group psychotherapy and in the therapeutic community movement. They were not carried out solely as responses to the need for mass treatment of neurotic disorders among army personnel; antecedent factors, the theoretical orientation of the practitioners and the nature of army life were equally important. The two experiments differed in pace and in recognition of the needs of higher-order systems, particularly the military hierarchy. They shared many underlying concepts, including responsibility to society, the therapeutic use of groups (including the hospital community) and an emphasis on process. Lessons learned at Northfield remain relevant to the practice of psychiatry today.
Psychiatric Assessment of Chronic Pain
Authors: Tyrer Stephen
Published: October 2008

The subject of pain used to be considered the province of the physiologist, physician, and surgeon. In a prominent medical textbook written over 20 years ago, pain was simply defined as “that sensory experience evoked by stimuli that injure” (Mountcastle, 1968). This explanation of tissue damage that generates nervous impulses along recognised pain pathways is appropriate for acute pains. But if pain persists beyond the normal time of healing, which is normally less than three months but can be as long as six months, the correspondence between extent of injury and pain sensation is much less precise.
The Psychological Complications of Therapeutic Abortion
Authors: Zolese G. , Blacker C. V. R.
Published: October 2008

Psychological or psychiatric disturbances occur in association with therapeutic abortions but they seem to be marked, severe, or persistent in only a minority (approximately 10%) of women. These consist mostly of caseness depression and anxiety. Psychoses are very uncommon, being repotted in only 0.003% of cases – most of whom have a history of previous psychiatric illness. Certain groups are especially at risk from adverse psychological sequelae; these include those with a past psychiatric history, younger women, those with poor social support, the multiparous, and those belonging to sociocultural groups antagonistic to abortion. This is not to overlook the fact that, adopting a crisis-resolution framework, subsequent termination of an unwanted pregnancy is itself ‘therapeutic‘. A better understanding of the nature of the risk factors would enable clinicians to identify vulnerable women for whom some form of psychological intervention might be beneficial.
Suicide Prevention: Spreading the Gospel to General Practitioners
Authors: Michel Konrad , Valach Ladislav
Published: October 2008

General practitioners were trained in the recognition and treatment of suicide risk either by written text alone or combined with a seminar meeting. They filled in questionnaires before and after training. In the seminar group, knowledge and attitudes changed significantly, while those doctors receiving written material only had similar results to those without training.
Links Between Early Post-partum Mood and Post-natal Depression
Authors: Hannah Patricia , Adams Diana , Lee Angela , Glover Vivette , Sandler M.
Published: October 2008

The Edinburgh Postnatal Depression Scale (EPDS) was used to rate 217 patients at five days and six weeks post-partum. There was a highly significant positive correlation between the two scores, together with similar symptom profiles. Of the 25 women who suffered postnatal depression (6–week EPDS score ≥13), 17 had similar symptoms in the first week postpartum (5–day EPDS score ≥10). Low birth weight of the baby, delivery by Caesarean section, a delivery much more difficult than expected, and bottle feeding were all significantly associated with a high EPDS score in the first week post-partum. Bottle feeding and delivery by Caesarean section were the only factors associated with depression at the sixth week. A recollection of low mood after a previous birth was also associated with post-natal depression after the current birth. This, together with an EPDS score of 13 or more at five days post-partum, increased the risk of post-natal depression at six weeks 85–fold.
Psychosocial Factors, Arousal and Schizophrenic Relapse
Authors: Tarrier N. , Turpin G.
Published: October 2008

This annotation describes psychophysiological research that has examined the hypothesis that autonomic hyperarousal is a possible mediating factor between schizophrenic relapse and psychosocial influences such as expressed emotion (EE) and life events. We review several studies that have measured psychophysiological activity in schizophrenic patients while in the presence of their relatives. The findings from this area of research are compared with those of other psychophysiological studies of schizophrenia which have employed more traditional laboratory tasks such as the electrodermal response-habituation paradigm. Finally, some conclusions are drawn regarding the clinical implications of psychophysiological research, and areas for future investigation are suggested.
Evidence for a Pseudoautosomal Locus for Schizophrenia
Authors: D'Amato T. , Campion D. , Gorwood Ph. , Jay M. , Sabate O. , Petit C. , Abbar M. , Malafosse A. , Leboyer M. , Hillaire D. , Clerget-Darpoux F. , Feingold J. , Waksman G. , Mallet J.
Published: October 2008

Because of an association between sexual aneuploidies and schizophrenia, and because schizophrenic siblings have been found to be more often of the same than of the opposite sex, the susceptibility locus for schizophrenia is thought to lie within the pseudoautosomal region of the sex chromosomes. We analysed 33 sibships comprising 18 pairs, 13 trios, and 2 quartets of affected siblings, and found support for non-random segregation of alleles at the DXYS14 locus in affected siblings. These findings are consistent with the pseudoautosomal hypothesis for schizophrenia and favour a genetic linkage between DXYS 14 and the disease.
No Evidence for a Pseudoautosomal Locus for Schizophrenia
Authors: Asherson P. , Parfitt E. , Sargeant M. , Tidmarsh S. , Buckland P. , Taylor C. , Clements A. , Gill M. , Mcguffin P. , Owen M.
Published: October 2008

Evidence for a pseudoautosomal locus for a schizophrenia susceptibility gene was sought by two forms of analysis of 25 multiply affected families. Firstly, in the sample as a whole there was an excess of same-sex over mixed-sex siblings compared with that expected. Secondly, linkage analysis was performed in six of the families. The genotypes were studied for DXYS14, a highly polymorphic marker in the telomeric pseudoautosomal region. No evidence for positive linkage was found with two-point analysis under eight different genetic models for the mode of transmission. A non-parametric, sibling-pair analysis also failed to detect linkage. Our findings provide no evidence for linkage within the pseudoautosomal region; same-sex concordance must arise from some other mechanism.
A Needs Survey among Patients in Leros Asylum
Authors: Bouras N. , Webb Y. , Clifford P. , Papadatos Y. , Zouni M.
Published: October 2008

The recent exposure of the plight of inmates living in poor conditions at the state asylum on the Greek island of Leros has caused public and professional outrage. If Greece is to avoid mistakes made by other countries, the plans for rehabilitating the patients and closing the hospital should from the outset include identification of the precise needs of patients for support and care. This survey of the patients' characteristics and needs for care found that most patients had no outside friends or relatives, and most were unable to perform basic daily skills. They shared many basic characteristics, however, with a large sample of the long-stay population in the UK, and 25% were thought to be able to live independently.
Disulfiram Treatment of Alcoholism
Authors: Chick Jonathan , Gough Kevin , Falkowski Wojciech , Kershaw Peter , Hore Brian , Mehta Brij , Ritson Bruce , Ropner Richard , Torley Denis
Published: October 2008

To assess the efficacy of supervised disulfiram as an adjunct to out-patient treatment of alcoholics, a randomised, partially blind, six-month follow-up study was conducted in which 126 patients received 200 mg disulfiram or 100 mg vitamin C under the supervision of a nominated informant. In the opinion of the (blinded) independent assessor, patients on disulfiram increased average total abstinent days by 100 and patients on vitamin C by 69, thus enhancing by one-third this measure of treatment outcome. Mean weekly alcohol consumption was reduced by 162 units with disulfiram, compared with 105 units with vitamin C., and the disulfiram patients reduced their total six-month alcohol consumption by 2572 units compared with an average reduction of 1448 units in the vitamin C group. Serum gamma-GT showed a mean fall of 21 IU/I in patients on disulfiram but rose by a mean of 13 IU/I with vitamin C. Unwanted effects in the disulfiram group led to a dose reduction in seven patients and to treatment withdrawal in four (and in one vitamin C patient). Two-thirds of the disulfiram group asked to continue the treatment at the end of the study. There were no medically serious adverse reactions.
Sexual Abuse and the Severity of Bulimic Symptoms
Authors: Waller Glenn
Published: October 2008

In a clinical series of 40 bulimic women, a reported history of unwanted sexual experience was associated with more frequent bingeing and (to a lesser extent) vomiting. These symptoms were more marked when the abuse was intrafamilial, involved force, or occurred before the victim was 14 years old. Further research is required to establish the causal links between the phenomena of sexual abuse and bulimic symptoms.
Coping with Hearing Voices: An Emancipatory Approach
Authors: Romme M. A. J. , Honig A. , Noorthoorn E. O. , Escher A. D. M. A. C.
Published: October 2008

A questionnaire comprising 30 open-ended questions was sent to 450 people with chronic hallucinations of hearing voices who had responded to a request on television. Of the 254 replies, 186 could be used for analysis. It was doubtful whether 13 of these respondents were experiencing true hallucinations. Of the remaining 173 subjects, 115 reported an inability to cope with the voices. Ninety-seven respondents were in psychiatric care, and copers were significantly less often in psychiatric care (24%) than non-copers (49%). Four coping strategies were apparent: distraction, ignoring the voices, selective listening to them, and setting limits on their influence.
The Influence of Family Expressed Emotion on the Course of Schizophrenia in a Sample of Spanish Patients
Authors: Montero I. , Gómez-Beneyto M. , Ruiz I. , Puche E. , Adam A.
Published: October 2008

A sample of 60 Spanish schizophrenic patients was studied to ascertain the relationship between their relatives' expressed emotion (EE) and relapse at follow-up. The relatives' EE and patients' relapse were operationalised following Leff & Vaughn's criteria. At nine months a significant association was not found between the relatives' EE and relapse, but this association became significant on reclassifying the relatives' EE scores after decreasing to four points the cut-off point for critical comments. At 24 months no association was found between EE and relapse. There was a tendency for patients who interrupted their medication or who did not work to relapse more frequently, particularly among the high-EE group.
Psychological Well-Being in Families with a Member Suffering from Schizophrenia
Authors: Oldridge M. L. , Hughes I. C. T.
Published: October 2008

Levels of stress in carers of long-term schizophrenia sufferers attending a depot clinic were assessed. Nine out of 25 carers (36%) were identified as possible or definite cases on either the GHQ or the HAD. However, a substantial proportion of carers managed to cope with the difficulties without suffering psychologically.
Risk for Definite Neuroleptic Malignant Syndrome
Authors: Hermesh Haggai , Aizenberg Dov , Weizman Abraham , Lapidot Margo , Mayor Catherina , Munitz Hanan
Published: October 2008

The occurrence of neuroleptic malignant syndrome (NMS) was studied prospectively in two series of consecutive psychiatric in-patients (n = 223). The first group (n = 120) suffered from schizophrenia and was treated only with haloperidol. The second group (n=103) was treated with diverse neuroleptics. All patients were on a single antipsychotic agent with no anticholinergic drug as prophylaxis. The incidence of full NMS per admission and first neuroleptic exposure was 5/223 (2.2%). Patients with bipolar affective disorder and those treated with injections were significantly over-represented in the NMS group.
Neuroleptic Malignant Syndrome Presenting as Hyperosmolar Non-ketotic Diabetic Coma
Authors: Balzan M. , Cacciottolo J. M.
Published: October 2008

A 50-year-old man presented with hyperosmolar nonketotic diabetic coma associated with the neuroleptic malignant syndrome (NMS) after intramuscular treatment with haloperidol. It is suggested that NMS may occur as a complication of uncontrolled diabetes mellitus with dehydration. Conversely, NMS might precipitate diabetic coma in patients with previously well controlled blood glucose.
Self-neglect in Adult Life
Authors: Vostanis Panos , Dean Christine
Published: October 2008

Two cases of self-neglect in adult patients with no psychiatric diagnosis are reported. The presentation included domestic squalor and hoarding of rubbish, with the patients living alone and having a history of schizoid and paranoid personality traits. Both refused all recommended help. A move to more protected accommodation was the only practical measure that led to a degree of improvement.
Phenomenology
Authors: Mortimer Ann M.
Published: October 2008

In some quarters schizophrenia has gained the reputation of a graveyard of research. Few findings stand the test of time, most of the pieces of this particular jigsaw seem to be missing, and it is not easy to make sense of those that are available. Even ‘hard’ scientific findings fail to be replicated, an example being the status of D2receptors in drug-naive schizophrenics (Wonget al, 1986; Fardeet al, 1987).
Syndromes of Chronic Schizophrenia and Some Clinical Correlates
Authors: Brown K. W. , White T.
Published: October 2008

Subtypes of the features of chronic schizophrenia were investigated. As in previous research, three discrete syndromes were found. These were then related to demographic, psychological, and movement-disorder variables. Possible pathophysiological mechanisms are discussed in terms of known neostriatal functions.
Assessment of DSM–III–R Personality Disorders by Self-Report Questionnaire: the Role of Informants and a Screening Test for Co-morbid Personality Disorders (STCPD)
Authors: Dowson J. H.
Published: October 2008

A modified version of the revised Personality Diagnostic Questionnaire (PDQ–R), based on DSM–III–R personality disorders (PDs), was completed by 60 psychiatric patients. An informant's version was also completed by 60 relatives or friends nominated by each subject. Discrete DSM–III–R PDs were rare; the mean number of PDs per subject was 4.5. Cluster analysis showed that only antisocial PD was a basis for classification of patients, while most patients formed two groups which were mainly distinguished by quantitative differences related to the total scores of positive PD criteria. A shorter version of the questionnaire can be used as a screening test for co-morbid PDs (STCPD) which can predict the number of co-morbid DSM–III–R PDs. The total scores of positive PD criteria from the STCPD were usually (and significantly) higher than the corresponding scores from informants' questionnaires but when an informant's total score exceeded that of the patient, this indicated a subject's under-reporting.
Prenatal Exposure to Influenza Does Not Cause Schizophrenia
Authors: Crow T. J. , Done D. J.
Published: October 2008

Claims have been made that maternal infection with influenza during pregnancy is a cause of schizophrenia in the child. These assertions are based upon some apparently significant associations between the timing of influenza epidemics in the general population and birth rates of people who later suffered from schizophrenia. Such associations have not been present in studies of the 1919 and 1957 epidemics, with sample sizes larger than those on which the claims were made. More decisively, in an investigation of the subsequent psychiatric admissions of people born a few months after the 1957 epidemic, it was found that the children of 945 mothers who actually suffered from influenza during the second trimester of pregnancy were at no greater risk of developing schizophrenia than children of mothers who were not infected. In contrast to the predictions of the influenza hypothesis of 26.5 extra cases by broad diagnostic criteria and 15.8 cases by narrow criteria, the numbers observed in children of mothers exposed to influenza in the second trimester were 3 and 1 cases respectively, close to the expected rate. It is concluded that prenatal influenza and schizophrenia are unrelated.
REM Latency in Endogenously Depressed Adolescents
Authors: Kutcher Stan , Williamson Peter , Marton Peter , Szalai John
Published: October 2008

Twenty-three adolescents with DSM–III major depressive disorder (endogenous subtype) and 23 normal controls were studied polysomnographically (PSG). The depressed group showed significantly shortened REM latencies (P=0.005) and longer sleep latencies (P=0.04). No other PSG measures differentiated the two groups. The implications of these findings for adolescent depression are discussed.
Delusional Infestation Associated with Post-Herpetic Neuralgia and EEG Abnormalities
Authors: Harper Ruth , Moss Gillian
Published: October 2008

An 80-year-old widow with delusional infestation in association with post-herpetic neuralgia and EEG abnormalities in the left anterior parietal lobe responded to combined pimozide and carbamazepine. Aetiological factors are reviewed in relation to the literature.
Cortisol and Prolactin Responses to d-Fenfluramine in Non-depressed Patients with Obsessive-Compulsive Disorder: A Comparison with Depressed and Healthy Controls
Authors: Lucey James V. , O'Keane Veronica , Butcher Gerard , Clare Anthony W. , Dinan Timothy G.
Published: October 2008

Cortisol and prolactin responses to d-fenfluramine were measured in 10 drug-free normothymic patients with obsessive-compulsive disorder (OCD). The results were compared with these responses in 10 healthy controls and in 10 major depressives. The endocrine responses in OCD were significantly attenuated when compared to the healthy controls; however, the results were not specific to OCD as the depressives' responses were similarly blunted.
Carbamazepine-Induced Systemic Lupus Erythematosus
Authors: Schmidt St. , Welcker M. , Greil W. , Schattenkirchner M.
Published: October 2008

A 21–year-old woman suffering from bipolar affective disorder developed systemic lupus erythematosus (SLE) with characteristic laboratory findings, 18 months after starting carbamazepine maintenance treatment. SLE receded after withdrawal of carbamazepine and treatment with anti-inflammatory drugs. Although both the spontaneous occurrence of SLE and the psychosis as a sign of CNS involvement of SLE cannot be excluded, SLE could be considered as an adverse effect of carbamazepine.
The Perception of Emotion by Schizophrenic Patients
Authors: Joseph Philip L. A. , Sturgeon David A. , Leff Julian
Published: October 2008

Studies which have examined the perception of emotion by schizophrenic patients have produced conflicting results, an outcome which may, in part, be due to difficulties in presenting a realistic portrayal of emotion. This study exposed 32 schizophrenic patients in remission and ten controls to five videotaped scenes of emotional situations played by actors. The schizophrenic patients were divided into three groups, namely those living with high-EE relatives, those living with low-EE relatives and those living alone, in order to test the hypothesis that patients in a high-EE environment are less able to identify emotionally charged situations. Measures of electrodermal activity and self-ratings of tension were recorded concomitantly. The schizophrenic patients in all groups were as adept at identifying emotions as were the controls. There was no difference between the groups in electrodermal activity and subjective tension for all video scenes, except for the one which portrayed the only pleasant interaction; the high-EE group was significantly more aroused on both measures, which were independent of each other.
Cannabis and psychotic illness
Authors: Mathers D.C. , Ghodse A.H.
Published: October 2008

In-patients with psychotic symptoms and cannabis-positive urine analysis were assessed by PSE within one week of admission and again at one and six months. Concurrently admitted psychotic patients with drug-free urine analysis were controls. At one week the two groups differed significantly on only five PSE items: changed perception, thought insertion, non-verbal auditory hallucinations, delusions of control, and delusions of grandiose ability. One item (delayed sleep) differed at one month, and none at six months. The symptom cluster at one week is consistent with acute cannabis intoxication. Subjects and controls were mostly single, poorly educated, unemployed people with histories of psychotic disorders, and given major tranquillisers on admission. Compared with controls, subjects were younger, less likely to have psychiatric histories, more often male, Afro-Caribbeans with a history of convictions and compulsory admissions. The commonest diagnosis was schizophrenia. Use of the label ‘cannabis-induced psychosis’ may obscure a diagnosis of paranoid schizophrenia. A short-lived psychotic episode does occur in clear consciousness after cannabis intoxication, but chronic cannabis-induced psychosis was not found.
Factors Associated with Relapse Among Opiate Addicts in an Out-patient Detoxification Programme
Authors: Unnithan Sujata , Gossop Michael , Strang John
Published: October 2008

Relapse is a central problem in the treatment of addictive behaviour, and a specific problem in the out-patient treatment of the opiate withdrawal syndrome. This study investigated factors associated with relapse among 42 opiate addicts receiving out-patient detoxification treatment at a London drug-dependence clinic. All subjects completed a questionnaire about their social, psychological, and environmental circumstances in the week before interview, and were interviewed within the first two weeks of the programme. Forty per cent had lapsed to illicit heroin abuse within the previous week. Interpersonal factors and drug-related cues were associated with lapse to opiate use. Most subjects encountered a range of high-risk situations, such as regularly meeting other drug users and being offered drugs, and persistent negative mood states.
Psychotic Illness in Multiple Sclerosis
Authors: Feinstein Anthony , Boulay George Du , Ron Maria A.
Published: October 2008

Ten patients with multiple sclerosis (MS) and psychosis were assessed using the Present State Examination, and matched retrospectively with respect to age, disability, duration of symptoms, and disease type with 10 MS patients without psychosis. Both groups underwent MRI of the brain. There was a trend for the psychotic group to have a higher total lesion score, particularly around the periventricular areas. This reached statistical significance in the areas around the temporal horn. In all cases, neurological symptoms preceded the onset of psychosis. The psychotic group also had a later age of onset of psychosis than psychotic patients without brain disease. These results point to an aetiological association between the pathological process of MS and psychosis.
Obsessive-Compulsive Disorder and Paraphilia in a Monozygotic Twin Pair
Authors: Cryan Elizabeth M. J. , Butcher Gerard J. , Webb Marcus G. T.
Published: October 2008

We report OCD and paraphilia in two male members of triplets (the two males being monozygotic twins), and discuss the possible aetiological factors for this previously unreported occurrence. We suggest that patients presenting with paraphilia should be examined for OCD and that a detailed sexual history should be obtained in all patients with OCD.
Fluoxetine and Suicidal Behaviour
Authors: Power A. C. , Cowen P. J.
Published: October 2008

“In the practical decisions of life it will scarcely ever be possible to go through all the arguments in favour of or against one possible decision, and one will therefore always have to act on insufficient evidence” Werner Heisenberg (1962).

The development of selective serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitors (SSRIs) has added a new dimension to the pharmacotherapy of depression. Their lack of sedative and anticholinergic effects together with relative safety in overdose, has led some authors to suggest that the older tricyclic antidepressants (TCAs) should not now be considered a first-line treatment (Montgomery, 1988). However, since a report by Teicheret al(1990) of suicidal preoccupation associated with fluoxetine treatment, there has been both intense media interest and animated correspondence in clinical and scientific journals (O'Donnell, 1991).
Comparison of Quality of Life with Standard of Living in Schizophrenic Out-patients
Authors: Skantze Kerstin , Malm Ulf , Dencker Sven J. , May Philip R. A. , Corrigan Patrick
Published: October 2008

Standard of living reflects the objective dimension of how well the basic needs of life are met, while quality of life is the patient's own subjective view of well-being and satisfaction with her/his life. Sixty-one schizophrenic out-patients completed self-report inventories and participated in interviews about quality of life and standard of living. When living standards were met by a well functioning social service system, patients' perceptions of their quality of life and their standard of living appeared to be independent. Subsequent analyses revealed that ‘inner experiences' was one quality-of-life domain frequently reported as unsatisfactory. Moreover, differences in quality of life were found across patients' age, education, and work status.
An Empirical Study of Delirium Subtypes
Authors: Liptzin Benjamin , Levkoff Sue E.
Published: October 2008

Using a structured instrument, 325 elderly patients admitted to a general hospital for an acute medical problem were evaluated daily in order to detect symptoms of delirium. Patients were scored for ‘hyperactive’ or ‘hypoactive’ symptoms, and then the 125 patients with DSM–III delirium were rated as ‘hyperactive type’ (15%), ‘hypoactive type’ (19%), ‘mixed type’ (52%), or ‘neither’ (14%). There were no statistically significant differences between the groups with respect to age, sex, place of residence, or presence of dementia. These definitions of subtypes should be studied further.
Autobiographical Memory in Depression: State or Trait Marker?
Authors: Brittlebank A. D. , Scott Jan , Mark J. , Williams G. , Ferrier I. N.
Published: October 2008

Two cognitive measures were used to assess 22 patients who met DSM–III–R criteria for major depressive disorder: the Autobiographical Memory (AM) test and the Dysfunctional Attitude Scale. They were followed up over seven months. Measurement of dysfunctional attitudes did not predict outcome at seven months. Overgeneral recall on the AM test at initial assessment, especially for emotionally positive memories, was highly correlated with failure to recover from depression and accounted for 33% of the variance in HRSD score at follow-up. Overgeneral recall of emotional memories did not change during follow-up. It is suggested that overgenerality is a trait marker indicating vulnerability to persistent depression.
Reform of the Mental Health Act 1983
Authors: Wood Sir John
Published: October 2008

The title of this paper should not be taken to imply that the Mental Health Act tribunal system is not currently effective. There has been little serious criticism of the work of the tribunals, and they appear to have become accepted as a permanent aspect of the detention of patients. Some doctors appear to regard them as an irritation that distracts from the care of patients, and civil liberties pressure groups tend to question their real effectiveness. Careful, detailed studies have also tended to be critical, pointing out many defects that require attention. Peay (1989) has done some impressive research into the work of tribunals which must form the basis of any future reform. Cavidino (1989) has done a much wider study, but underpinned by a ‘theory’ which detracts from its value for tribunal members, and its treatment of tribunals is peripheral, and therefore superficial.
Assessment of Costs and Benefits of Drug Therapy for Treatment-Resistant Schizophrenia in the United Kingdom
Authors: Davies Linda M. , Drummond Michael F.
Published: October 2008

An analysis was conducted on the basis of available data to assess the economic consequences of clozapine therapy for people with moderate to severe schizophrenia in long-stay institutions or staffed group homes, with a view to providing an estimate of the likely costs and benefits of the drug. Data from a cost-effectiveness study conducted in the US, supplemented by other literature sources, were used to construct a clinical decision tree for likely clinical outcomes for such patients. A panel of UK psychiatrists provided consensus on how these patients would have been managed in the UK. The costs associated with each patient outcome were estimated, and a sensitivity analysis performed to test the assumptions made. For the patients themselves, clozapine would lead to a net gain of 5.87 years of life with no disability or only mild disability. The base case analysis showed that the direct costs of using clozapine were £91 less per annum (or £1333 per lifetime) than for standard neuroleptic therapy, when the effect on all health-care resources was taken into account. In addition, the sensitivity analysis showed that clozapine would be cost-saving or cost-neutral under many different assumptions. A prospective health economic study with clozapine in the management of schizophrenia would be desirable to confirm these results.
A Twin Study of Psychosis and Criminality
Authors: Coid B. , Lewis S. W. , Reveley A. M.
Published: October 2008

Lifetime criminal and psychiatric histories were examined in a consecutive series of 280 individuals of twin birth with a diagnosis of major functional psychosis who were seen and followed up at the Maudsley Hospital between 1948 and 1988. Their 210 co-twins, 35% of whom had a similar diagnosis, were ascertained and followed up over the same period. In the absence of reliable general-population estimates for lifetime conviction rates, co-twins were used as case controls. Among the 220 complete pairs, significantly more probands (25.7%) than co-twins (14.0%) were convicted, although there was no evidence for an independent genetic basis for criminal behaviour. Criminal conviction was significantly related to psychiatric diagnosis. There were specific patterns of offending, particularly among the schizophrenic men, who were also significantly more often convicted (48.6%) than the men with affective psychosis (19.4%), and more likely to receive a prison sentence. The schizophrenic patients were younger at their first conviction (mean age 22.6 years v. 30.8 years) and they had committed more violent offences than the affective group. In both diagnostic groups, ages at first psychiatric contact and first conviction were highly correlated.