bluuebunny/crossref_metadata_2025 huggingface dataset:
Clomipramine, Tryptophan and Lithium in Combination for Resistant Endogenous Depression: Seven Case Studies
Authors: Hale A. S. , Procter A. W. , Bridges P. K.
Published: August 2008

Seven patients suffering from severe endogenous depression who had proven resistant to lengthy trials of treatment with tricyclic and other antidepressants are described. Their successful treatment with a combination of clomipramine, L-tryptophan and lithium is discussed in the context of other strategies for the treatment of resistant depression.
Capgras Syndrome: a Case Report from Zimbabwe
Authors: Chawla S. , Buchan T. , Galen N.
Published: August 2008

A case of Capgras syndrome in a black Zimbabwean patient is described. The syndrome occurs in the setting of a schizophrenic illness, but psychodynamic factors are readily identified despite the patient's different cultural background.
Folie à Deux in Down's Syndrome
Authors: Meakin C. J. , Renvoize E. B. , Kent J.
Published: August 2008

A case of folie à deux in a 29 year-old man with Down's syndrome, whose mother had a paranoid psychosis, is described. Successful treatment of the mother's illness also resulted in full recovery of the son without the need for medication.
Psychiatric Presentation of Creutzfeldt-Jakob Disease
Authors: Keshavan M. S. , Lishman W. A. , Hughes J. Trevor
Published: August 2008

A patient with Creutzfeldt-Jakob disease is described. Many alternative psychiatric diagnoses were considered, and the true situation only became apparent late in the clinical course.
Capgras Syndrome – An Unusual Case and Discussion of Psychodynamic Factors
Authors: O'Reilly Richard , Malhotra Ladi
Published: August 2008

A case of Capgras syndrome associated with extreme violent behaviour is described. The patient's psychodynamics support the belief that the Capgras delusion initially arises from an altered affective response towards one or more others and proceeds to intolerable ambivalent feelings. This ambivalence is neutralised through the imagined existence of doubles.
Psychotherapy Today
Authors: Greben Stanley E.
Published: August 2008

Despite swings between over-valuation and rejection of psychotherapy on the part of some psychiatrists, there remains a valid and necessary place for psychotherapy in psychiatry. The essential elements of that place are described.
Unravelling the Relationship between Genetic and Environmental Risk Factors in Psychiatric Disorders
Authors: Goldin L. R. , DeLisi L. E. , Gershon E. S.
Published: August 2008

Murray et al (1985) have proposed a method for using biological markers and information about family history to reduce the heterogeneity in a disease such as schizophrenia. They propose that families which are heavily loaded with illness are most likely to be segregating for a major locus and therefore should be used for studies of genetic marker or other biological traits that are thought to be related to a genetic etiology. They propose that patients without a family history (sporadics) of an illness should be investigated for hypothesised environmental components since they are the cases where environmental factors are most likely to play a large role. They give an example from their own data on Ventricular Brain Ratios (VBR) in a sample of schizophrenic twins (Reveley et al, 1984) where schizophrenic twins without any family history (FH-) of a major psychosis had significantly larger ventricles than did schizophrenic twins with a family history (FH+). They conclude that while there is a genetic determinant to ventricular size within the normal range, large ventricles reflect an environmental aetiology that is more important in sporadic cases than in those with a familial pattern to the illness. Subsequently, Reveley & Chitkara (1985) found that singleton schizophrenic patients who were FH-had a significantly larger VBR than did controls while FH+ patients had a mean midway between FH-patients and controls. While this is an attractive hypothesis for the structural brain changes seen in some schizophrenic patients, results of other studies are not consistent with these findings (Nasrallah et al, 1983; Schulsinger et al, 1984; Owens et al, 1985; DeLisi et al, 1986). For example, in our own data (DeLisi et al, 1986), ‘familial’ schizophrenics had larger ventricles than did controls and risk factors thought to be environmental (head injuries and birth complications) were found to be present in that sample.
The Familial/Sporadic Distinction as a Strategy in Schizophrenia Research
Authors: Lewis S. W. , Reveley A. M. , Reveley M. A. , Chitkara B. , Murray R. M.
Published: August 2008

The rationale and limitations of discriminating between cases of schizophrenia with and without a family history are reviewed. It is concluded from the evidence available that, by identifying subgroups of greater aetiological homogeneity, the strategy can be a useful starting point for research into likely causes.
Expressed Emotion and Relapse in First Episodes of Schizophrenia
Authors: Macmillan J. F. , Crow T. J. , Johnson A. L. , Johnstone E. C.
Published: August 2008

In the preceding paper, Mintz et al have raised a number of criticisms and points relating to our study, to which we are pleased to respond.
Quality of Life for ‘New’ Long-stay Psychiatric In-patients
Authors: Gibbons J. S. , Butler J. P.
Published: August 2008

We observed 15 ‘new’ long-stay patients in wards in a District General Hospital Unit and a mental hospital, and again when they had lived for a year in a new hospital-hostel. There were significant changes in time spent in the community, social interaction, activity and abnormal behaviour. Residents believed they had more freedom and none wanted to return to wards. Six patients remained on wards. They showed no comparable changes and all wanted to live elsewhere.
Brief Psychoses: Do They Contribute to the Good Prognosis and Equal Prevalence of Schizophrenia in Developing Countries?
Authors: Stevens Janice
Published: August 2008

A high incidence of brief schizophrenia-like psychosis in Africa and other parts of the developing world has been repeatedly documented by many psychiatrists working in these regions (Dembovitz, 1945; Carothers, 1953; Jilek & Jilek-Aall, 1970; German, 1972; Leighton et al, 1963). This report does not deny that typical schizophrenia occurs in these countries, but the common culturally based schizophrenia like psychosis may be misdiagnosed as schizophrenia, and thus inflate prevalence and improve prognosis data.
Sexual Aggressivity and Androgens
Authors: Raboch J. , Černá H. , Zemek P.
Published: August 2008

Male sex hormones are ascribed a great importance in the literature from the point of view of sexual activity and aggressive behaviour. Two cases of sexually motivated murder are described, committed by delinquents with low levels of testosterone in plasma: one a patient with Klinefelter's syndrome; the other a man after castration. Even a decreased level of androgens, either primary or secondary, is not an absolute prevention of sexually aggressive behaviour.
De Clérambault's Syndrome in Organic Affective Disorder
Authors: Signer Stephen F. , Cummings Jeffrey L.
Published: August 2008

Two patients with erotomania (de CIérambault's syndrome) associated with epilepsy and head trauma are presented. The delusion appeared during periods of mania or hypomania and partially remitted during depression or euthymia. Erotomania may be seen in a wide variety of psychotic conditions, including those that are organically based.
The Dopamine Hypothesis Survives, but There Must Be a Way Ahead
Authors: Crow T. J.
Published: August 2008

Karl Popper has taught us that no hypothesis can be regarded as proved-merely as having survived the most stringent tests which have so far been devised. Dinan makes a further attempt to overthrow the dopamine hypothesis of the mechanism of the antipsychotic effect, and provides an alternative suggestion. As one time critic and later advocate of the theory, I think he underestimates its explanatory power and capacity for survival. I doubt that his alternative yet poses a serious challenge. I propose below a second (and perhaps more idiosyncratic) alternative. I do not claim it yet has the explanatory power of the dopamine theory, but I think it generates some new approaches.
P300 and CT Scan in Patients with Chronic Schizophrenia
Authors: Romani A. , Merello S. , Gozzoli L. , Zerbi F. , Grassi M. , Cosi V.
Published: August 2008

Twenty chronic male schizophrenic subjects aged 30–50 years were examined by an auditory event-related potential procedure for the evaluation of the P300 component, a CT scan and a neuropsychological test battery. The P300 latency was increased and its amplitude was reduced. CT scan measures showed lateral and third ventricle enlargement, and there was a global neuropsychological impairment. Poor neuropsychological performances were consistently associated with delayed P300 latencies, but not with CT scan measures. Ventricular enlargement was more pronounced among subjects with a negative family history for major psychiatric disorders.
Selective Decreases in MAO-B Activity in Post-Mortem Brains from Schizophrenic Patients with Type II Syndrome
Authors: Owen F. , Crow T. J. , Frith C. D. , Johnson J. A. , Johnstone E. C. , Lofthouse R. , Owens D. G. C. , Poulter M.
Published: August 2008

The activities of the A and B forms of the enzyme monoamine oxidase (MAO, E.C. 1.4.3.4) have been assessed with the substrates 5-hydroxytryptamine and benzylamine respectively in seven areas of the brains of 39 patients with schizophrenia and 44 control subjects. Whereas previous studies have found the enzyme unchanged in brain in schizophrenia, in this study there was a modest but significant decrease in the activity of MAO-B in frontal and temporal cortices and in amygdala. This decrease could not be accounted for by neuroleptic medication, age, sex or post-mortem variables. In a series of 22 patients who had been assessed in life, the reduction in MAO-B activity was found to be associated specifically with the presence of negative symptoms (flattening of affect and paucity of speech). The findings are therefore consistent with other evidence for structural and neurochemical change in the temporal lobe that have been associated with the type II (defect state) syndrome of schizophrenia. The change in enzyme activity is unlikely to be related to a change in monoamine metabolism but may reflect a disturbance in glial function. The change in MAO-B activity in brain in this study is confined to particular areas of brain and a subgroup of patients; it is thought to be entirely unrelated to earlier reports of reductions of enzyme activity in platelets, which are probably attributable to prolonged neuroleptic medication.
Familial Aspects of Obsessive-Compulsive Neurosis
Authors: McKeon Patrick , Murray Robin
Published: August 2008

The first-degree relatives of 50 obsessive-compulsive patients and those of matched controls completed the General Health Questionnaire (GHQ) and the Leyton Obsessional Inventory (LOI). Relatives who were identified as possible ‘cases' by their high GHQ scores, or by their own or informant relatives' reports, were interviewed using the Schedule for Affective Disorders and Schizophrenia. Index relatives had a significantly higher lifetime prevalence of mental illness (36%) than had those of controls (17%), due mainly to an excess of depressive and neurotic disorders. However, only one relative from each group was diagnosed as having definite obsessive-compulsive neurosis. In addition, the LOI scores were similar for the index and control relatives.
Suicide Following Parasuicide in Singapore
Authors: Tsoi W. F. , Kua E. H.
Published: August 2008

Suicide was attempted by 1641 people (502 males and 1139 females) in Singapore during 1980. Eleven of these committed suicide during the following three years, giving a suicide rate of 0.67%. Of the eleven suicides, five had schizophrenia and three depression. The risk of suicide in the year following attempted suicide is lower in Singapore (0.5%) than in Britain (1.6%). High risk factors for the Singapore patients were being Chinese, being male, and having a mental illness.
A Case of Affective Psychosis following
Authors: McLoughlin I. J. , Bhate M. S.
Published: August 2008

Mentally handicapped people are increasingly being subjected to the stresses of everyday life, and bereavement represents a particularly potent stress. This report considers the case of a mentally handicapped woman whose difficulty in mourning and expressing and sharing grief had a profound effect on her recovery from bereavement and led to her developing an affective psychosis.
Neurosyphilis – a Treatable Psychosis
Authors: Brooke D. , Jamie P. , Slack R. , Sulaiman M. , Tyrer P.
Published: August 2008

A patient presenting with mixed affective symptoms was found to have active neurosyphilis after intermittent cognitive impairment suggested an organic cause. Most of these symptoms resolved after treatment with penicillin.
The Grammar of Psychotherapy
Authors: Lieberman Stuart , Cobb John P.
Published: August 2008

This paper describes the development of three self-monitoring forms to enable students to make constructive use of audiotapes of their interviews with patients. Each interactogram is described in detail, with examples where necessary.
The Incidence of Schizophrenia in Nottingham
Authors: Cooper J. E. , Goodhead David , Craig Tom , Harris Michael , Howat John , Korer Jacqueline
Published: August 2008

Attempts were made to identify, and include in a two-year follow-up study, every patient living in the catchment area of the Mapperley group of psychiatric hospitals in Nottingham (population 390 000) who made their first-ever contact with the psychiatric services for a potentially schizophrenic illness during a two-year period (1 August 1978 to 31 July 1980). Screening was based upon symptoms rather than diagnosis, covering both in-patient and out-patient services; a consensus diagnosis using ICD-9 was made by the project team. The Nottingham Psychiatric Case Register was used in a retrospective Leakage Study which added nine cases to the 99 identified by the screening procedures. Incidence rates are given for both broad and narrow concepts of schizophrenia, and for DSM-III diagnosis. The Nottingham incidence rates are similar to those reported from other UK centres, and are near the middle of the range found in the other collaborating centres in the WHO study on Determinants of Outcome of Severe Mental Disorders. At entry to the study, 27 patients were out-patients, and 11 were never admitted to hospital at any time in the two-year follow-up period. Reasons for believing that the Nottingham administrative incidence may be close to the incidence in the community are discussed.
Ecological Structure and the Distribution of Schizophrenia and Affective Psychoses in Nottingham
Authors: Giggs J. A. , Cooper J. E.
Published: August 2008

The 800 census enumeration districts of Nottingham were used as a basis for the production of 12 distinct ‘clusters’ or neighbourhood types. Plotting the place of residence of the 68 patients with ‘certain’ or ‘very likely’ diagnoses of ICD-9 schizophrenia, identified in the World Health Organization Study of Determinants of Outcome of Severe Mental Disorders, showed the expected concentration in central areas of low social status. A more varied distribution was found for 132 patients with a case-register diagnosis of affective psychosis, contacting the psychiatric services for the first time during the same two-year period as the schizophrenic patients. Some of the highest rates for affective psychosis were found in new housing estates of middle and low status at some distance from the town centre.
Self-Appraisal, Anxiety and Depression in Women
Authors: Ingham J. G. , Kreitman N. B. , Miller P. McC. , Sashidharan S. P. , Surtees P. G.
Published: August 2008

Depressive illness is known to be associated with low self-evaluation, but it has been suggested that there may be a reciprocal connection as well, such that low self-appraisal (in the absence of illness) makes the subsequent onset of depression more likely. A prospective study, using a community sample of 376 women, provided data about clinical state over a period of 18 months, and self-appraisal questionnaire scores were determined on two occasions separated by 6 months. There was no evidence that low self-evaluation predicted future episodes of depressive illness, except in women who reported previous psychological episodes for which they had sought medical help, and, even for those with previous episodes, much of the predictive power of low self-esteem was accounted for by individuals who were subsequently recognised to have been in the early stages of illness. Conversely, there was little evidence that prior episodes predicted future illness in people with high self-esteem. One explanation of the findings is that recurrent episodes of illness cause progressive impairment of self-appraisal, but other possibilities are also considered. Women who had recovered from illnesses detected at the first interview still had significantly less self-confidence 6 months later than those who were well throughout.
Marital Problems and Treatment Outcome in Depressed Women
Authors: Corney Roslyn H.
Published: August 2008

In a clinical trial investigating the effectiveness of social work intervention with depressed women patients in general practice, 80 women were randomly allocated to an experimental group for referral to attached social workers or to a control group for routine treatment by their GPs. They were reassessed at 6 and 12 months. The results indicated that women who had major marital problems were more likely to be depressed at follow-up than those with good relationships. However, patients with marital difficulties in the experimental group made more improvement than the controls. Women initially assessed as suffering from ‘acute on chronic’ depression and having major marital difficulties were found to benefit most from social work intervention.
Caring and its Burdens
Authors: Fadden Grainne , Bebbington Paul , Kuipers Liz
Published: August 2008

Spouses of 24 patients suffering from persistent depression were interviewed to find out how they were affected by the patient's illness. These effects were marked, although mainly endured without complaint, and included restrictions in social and leisure activities, a fall in family income, and a considerable strain on marital relationships. Some of the behaviour shown by patients was hard to bear, and ‘negative’ symptoms such as misery, withdrawal, and worrying commonly caused problems. Few relatives, however, know how to deal with difficult behaviour. Despite this, the majority remained committed to staying with the patient. Spouses had a variety of complaints about the way they were handled by hospital staff, particularly about being deprived of information and advice. These results have considerable implications for the way in which relatives should be dealt with as part of the overall management of persistent depression.
Koro Syndrome Associated with Alcohol-Induced Systemic Disease in a Zulu
Authors: Holden T. J.
Published: August 2008

A case report is presented of the genital retraction syndrome, koro, associated with alcoholic hepatitis, avitaminosis and urinary tract infection, occurring in a Zulu male. Treatment of the physical conditions resulted in resolution of the koro symptomatology.

The nosological status of koro is discussed and it is proposed that the condition be regarded as a symptom-complex reaction to a variety of psychological or physical stressors rather than as a purely culture-bound syndrome.
Borderline Personality
Authors: Tarnopolsky Alex , Berelowitz Mark
Published: August 2008

Borderline personality has been, for many years, a discredited diagnostic concept. In 1979 a review of the literature concluded that its validity status was very uncertain. The authors have reviewed research conducted since then and discuss it in terms of the Robins & Guze (1970) criteria. In spite of existing unclear issues, the balance is tipping in favour of the validity of borderline personality, as diagnosed with new research criteria. This development is taking place in the context of a growing interest in the area of personality disorders.
‘The Schizophrenias as Nervous Types' Revisited
Authors: Claridge Gordon
Published: August 2008

In 1972 the author proposed that schizophrenia represents an aberration of central nervous processes that underlie cognitive and personality characteristics which can be observed in many healthy people. The present paper brings the evidence for that theory up to date and concludes that over the past 15 years it has received considerable empirical support. The way in which the theory confronts the question of whether or not schizophrenia is a disease is also clarified.
Mode of Inheritance as Indicated by One-sided and Two-sided Familial Taint: with an Application to Schizophrenia
Authors: Essen-Möller Erik , Lanke Jan
Published: August 2008

Among his various approaches to an understanding of schizophrenic inheritance, whether dominant or recessive, Rüdin (1916) also compared the respective frequencies of one-sided and two-sided familial taint. Essen-Möller (1949) tried the idea on another sample, but neither of us arrived at a definite choice. Lateron Slater (1966) surprisingly demonstrated that unilaterality is typical not only of dominant but also of polygenic transmission. In the present paper we adjust Slater's computation and, in so doing, accentuate his result. We also find a similar preponderance of unilaterality on a recessive model, and offer an explanation for this. The findings substantially reduce the efficacy of laterality of taint as an indicator of mode of inheritance.
Prescriptive v. Exploratory Psychotherapy
Authors: Shapiro David A. , Firth Jenny
Published: August 2008

Prior research suggests that psychotherapeutic techniques which differ in their contents are quite similar in their outcomes. Outcome data are reported from a study designed to maximise sensitivity to technique effects on outcome in a clinically realistic setting, and to permit detailed analysis of the relations between content, immediate impact, and outcome of therapy. Forty professional and managerial workers with depression or anxiety received eight sessions of Prescriptive (cognitive/behavioural) and eight sessions of Exploratory (relationship-oriented) therapy in a crossover design, with each client seeing the same therapist throughout. Outcome was assessed by standard interview and questionnaire methods. The results favoured Prescriptive therapy, although this difference was of moderate extent. The outcome was largely unaffected by the order in which the two methods were offered.
A Study of Firesetters in the South-West of Ireland
Authors: O'Sullivan Geraldine H. , Kelleher Michael J.
Published: August 2008

A survey of 54 firesetters who had been in hospital or prison was conducted. The results confirmed earlier findings on several aspects, such as male predominance, unstable childhood and proclivity to self-injurious behaviour. Revenge emerged as the commonest motive overall and an association with alcohol was found. Only 11% of the fire-raising episodes, whether among hospital or prison groups, were truly trivial. Arsonists in prison and hospital had many features in common and generally were quite psychologically disturbed, which contrasted with those who set fires for profit. A poor outcome was found, with continuing self-harm and a high suicide rate. Our findings suggest that arson recidivism arises in at least 35% of arsonists.
Hysterical Manifestations in Africa and Europe
Authors: Pierloot Roland A. , Ngoma Malanda
Published: August 2008

A group of 30 black African patients and a group of 30 occidental patients, all presenting a hysterical structure, were compared with regard to clinical manifestations, provoking psychosocial stressors and histrionic personality traits. Cultural characteristics in several areas are discussed as possible explanations of the differences found.
Pastoral Psychology
Authors: Marteau Louis
Published: August 2008

Pastoral psychology is the application of modern psychology to the ancient ministry of the pastoral care exercised within the various Christian Churches. Today this care draws on insights and techniques from three primary sources: contemporary understandings of human personality and interpersonal relationships from the human sciences (especially psychology); therapeutic methods from one or more of the current counselling and psychotherapeutic approaches; and biblical, theological, and historical resources from the Judeo-Christian heritage.
The Newcastle Chronic Depression Study
Authors: Scott Jan , Barker W. A. , Eccleston D.
Published: August 2008

Chronic depression is defined as “symptomatic non-recovery for a period of 2 or more years”. Chronic primary major depressives (n = 24) were compared retrospectively with a control group of primary major depressives (n = 20) who had recovered from their illness episode within 2 years. The former had a significantly higher familial loading for affective disorder and showed an increased incidence of independent undesirable life events during the 6 months prior to and 2 years after the onset of their illness. Female chronic depressives also had a significantly greater number of previous illness episodes and a more frequent history of thyroid dysfunction. Personality as measured on the EPQ, psychiatric problems arising as secondary complications of the depressive illness, and developmental object loss did not differentiate chronic from non-chronic depressives.
Electroconvulsive Therapy in Parkinsonism with Affective Disorder
Authors: Atre-Vaidya Nutan , Jampala V. Chowdary
Published: August 2008

The authors report a patient whose Parkinson's disease and mania both responded well to electroconvulsive therapy (ECT) after failing to respond to chemotherapy. The authors review the literature and suggest that ECTis a safe and effective treatment for affective syndromes associated with Parkinsonism. The presence of dementia in these patients appears to be an indicator of poor prognosis. This paper is believed to be the first report of successful use of ECT in mania occurring together with Parkinsonism.
Bulimia in British Blacks and Asians
Authors: Lacey J. Hubert , Dolan Bridget M.
Published: August 2008

This paper describes the demographic and clinical features of five non-white, normal body weight bulimics, all from the same catchment area. Comparisons with white bulimic referrals from the same area showed clinical similarities, but the non-white bulimics gave an account of gross emotional deprivation: all came from broken homes; four had been separated for long periods from their mothers; two had been subjected to incestuous abuse; and four had been cared for by white women. Response to treatment was poor. The ratio of non-white referral to white was at most one tenth of the ratio of non-white to white women in the catchment area.
A Defect in Training
Authors: Yorke Clifford
Published: August 2008

The effectiveness of specialised work in any branch of medicine cannot depend alone on the personal and professional qualities of the entrant into the field. It demands extended and systematic training, not only in the clinical speciality itself, but also in those many disciplines that bear upon it. In the course of his or her studies, the trainee psychiatrist is expected to further his acquaintance with the relevant basic medical sciences (especially neuroscience), and with organic medicine (particularly neurology), and with the application of these to his field of study. His understanding of these and many other subjects, including genetics, biochemistry, sociology, epidemiology, and statistics, is indispensable to his professional development. Extended clinical experience will teach him something of the day-to-day applications of these studies to psychiatric practice in a wide variety of circumstances. He may also acquire knowledge of such specialised areas of work as mental retardation and forensic psychiatry. Although he will be aware of his many limitations, the well-trained consultant will draw, in his general clinical practice, upon these various fields of knowledge with a justifiable measure of confidence.
A Comparison of Melatonin Secretion in Depressed Patients and Normal Subjects
Authors: Thompson Christopher , Franey Christine , Arendt Josephine , Checkley Stuart A.
Published: August 2008

Depressed patients were carefully matched in pairs with normal subjects for the variables which are known to influence the secretion of melatonin in humans. In contrast to the previous literature, nocturnal melatonin secretion was not lower in the depressed group than in the normal group, and there was no difference in the timing of secretion; indeed, the trend was for greater melatonin secretion in the depressed group. The results are discussed in relation to previous studies, none of which has been so carefully controlled for the relevant variables.
ECT in the Treatment of Mixed Depression and Dementia
Authors: Liang Raymond A. , Lam Raymond W. , Ancill Raymond J.
Published: August 2008

Recent work has demonstrated the coexistence of depressive illness in some patients with dementing disorders. Two cases of mixed depression and dementia showed behavioural and mood improvement after treatment with ECT, but without improvement in cognition. The role of ECT in the treatment of affective symptoms in dementia is discussed.
A Study of Sulphatoxymelatonin Excretion and Gonadotropin Status During Weight Gain in Anorexia Nervosa
Authors: Bearn J. , Treasure J. , Murphy M. , Franey C. , Arendt J. , Wheeler M. , Checkley S. A.
Published: August 2008

To clarify a controversy as to whether melatonin secretion is related to body weight, urinary sulphatoxymelatonin (aMT6s) excretion was estimated in 10 patients with anorexia nervosa before and after weight gain, and compared with 10 age-matched controls. There was no change in aMT6s excretion after weight gain, and no significant difference between the patients and control groups at either point. Significant increases in plasma LH, FSH, and estradiol were detected after weight gain in anorexic patients, independent of aMT6s excretion.
Changes in Behaviour in Dementia: A Neglected Research Area
Authors: Fairburn Christopher G. , Hope R. A.
Published: August 2008

Research into the clinical features of dementia has concentrated almost exclusively on the cognitive impairment. Perhaps this is not surprising, since deteriorating cognitive function is the most prominent feature, and a necessary one from the point of view of diagnosis (American Psychiatric Association, 1980; McKhann et al, 1984). However, this emphasis on cognitive function has led to the neglect of the other major feature of the disorder; namely, the changes in behaviour which have long been recognised. For example, Bleuler (1924), describing a sub-group of people with senile dementia, wrote that “the patients are always engaged in an apparent activity”. Some of the behavioural changes in dementia are a major source of distress for the carers of these patients (Argyle et al, 1985; Rabins et al, 1982; Gilleard et al, 1982) and often it is the disturbed behaviour which results both in patients coming to medical attention and in them requiring institutional care (Sanford, 1975; Chenoweth& Spencer, 1986). Frequently encountered examples include aggressive behaviour and ‘wandering’. The disturbed behaviour can take many other forms, including changes in eating, the hoarding and moving of objects, marked sleep disturbance, alterations in sexual behaviour, and incessant trailing behind people.
Psychotherapy – a Last Resort
Authors: Whyte Robert
Published: August 2008

A patient in whom a series of treatments of all sorts had failed was given two trials of psychotherapy over a prolonged period. Although the patient judged the trials of psychotherapy to be a failure, and therapy was terminated, he does seem to have matured, and his disturbed behaviour has ceased. The possible reasons for this are discussed.
Nelson's Syndrome and Behavioural Changes Reversed by Selective Adenomectomy
Authors: Buckler Helen M. , Freeman Hugh , Chetty M. C. P. , Anderson D. C.
Published: August 2008

A man with Nelson's syndrome developed severe associated behavioural and psychiatric problems, which completely resolved following selective resection of his pituitary tumour. It is postulated that ACTH, β-endorphin, or related peptides may have caused these problems.
Feigned Alcohol Abuse
Authors: Caradoc-Davies Gillian
Published: August 2008

A man presenting with factitious alcohol abuse and its alleged complications is described. It is argued that chronic factitious disorders are more logically viewed as part of that spectrum of conditions where there is abnormal illness behaviour, including somatoform disorders and other related conditions, than as separate nosological or diagnostic entities.
Biochemical Aspects of Therapy-Resistant Depression
Authors: Leonard B. E.
Published: August 2008

Despite the relatively high incidence of therapy-resistant depression, there is little clinical evidence to suggest that there are significant biochemical differences between therapy-resistant and therapy-responsive patients. A major problem for investigators is the lack of an internationally recognised definition of resistant depression. Also, it is possible that depressed patients with delusional symptoms or rapidly cycling affective disorders form subgroups that are more likely to be resistant to tricylic antidepressant treatment and are therefore classified as therapy-resistant. Evidence is presented to show that an abnormality in serotonergic function may characterise some therapy-resistant depressed patients.
Risk Factors in Schizophrenia
Authors: Baron Miron , Gruen Rhoda
Published: August 2008

The association between the familial risk for schizophrenia and season of birth was studied in 88 schizophrenic patients. An increased risk for schizophrenia and ‘spectrum’ disorders was demonstrated among the first-degree relatives of winter and spring-born schizophrenic patients. However, patients with a family history of schizophrenia and ‘spectrum’ disorders did not differ from patients with no family history with respect to season of birth. Season of birth was unrelated to the sex of the patient, birth order, age at onset, or clinical subtypes (paranoid vs non-paranoid, as defined by the RDC, and ‘narrow’ vs ‘broad’, as defined by Taylor & Abrams' 1975 criteria). The morbid-risk data support a ‘stress-diathesis' hypothesis whereby environmental factors (in this case a seasonally varying viral insult may be implicated) interact with genetic vulnerability to increase the risk for schizophrenia.
Age Disorientation in Chronic Schizophrenia is Not Associated with Pre-morbid Intellectual Impairment or Past Physical Treatment
Authors: Buhrich N. , Crow T. J. , Johnstone E. C. , Owens D. G. C.
Published: August 2008

Forty-two long-stay hospital patients with chronic schizophrenia were divided into age and sex-matched groups with and without temporal disorientation, and assessed for premorbid academic performance and past physical treatment. The schooling of schizophrenic patients who had cognitive impairment, as identified by gross temporal disorientation, did not differ from those who were cognitively intact. The groups did not differ in past history of ECT, insulin coma, neuroleptic treatment, or psychosurgery. Patients with age disorientation were on lower mean doses of neuroleptic or anticholinergic medication. Gross cognitive impairment thus appears to occur in the course of the disease and is not due to physical treatment.
Psychiatric Morbidity in Spouses of Women Admitted to a Mother and Baby Unit
Authors: Harvey Ian , McGrath Graeme
Published: August 2008

The spouses of 40 women admitted to a psychiatric Mother and Baby Unit were interviewed to detect psychiatric morbidity, and aspects of their social and marital functioning. This group was compared with 25 men whose wives had not shown obvious psychiatric disorder in the puerperium. Psychiatric morbidity, using DSM-III (American Psychiatric Association, 1980) criteria, was present in 42% of the index group, and 4% of the comparison group. The main diagnoses were major depressive episode and generalised anxiety disorder. This was associated with poorer marital and social function in the index group. Male psychopathology after delivery has been studied little but may be significant in the management of postpartum syndromes.
A Decision Model in the Treatment of Obsessive–Compulsive Neuroses
Authors: Hoogduin C. A. L. , Duivenvoorden H. J.
Published: August 2008

The treatment of obsessive–compulsive disorders with a behavioural therapeutic program consisting of response prevention has proved to be rather successful. A prospective study of the potentialities of predicting the outcome of such a treatment program is described. The results of this research could possibly lead to the development of a decision model for use in the treatment of obsessive–compulsive neurosis.
Reshaping the Psyche the Concurrent Improvement in Appearance and Mental State after Rhinoplasty
Authors: Robin A. A. , Copas J. B. , Jack A. B. , Kaeser A. C. , Thomas P. J.
Published: August 2008

Rhinoplasty patients and matched elective-surgery controls completed the Facial Appearance Sorting Test, the General Health Questionnaire, a Repertory Grid and the Masculinity/Femininity Scale. Rhinoplasty applicants perceived appearance similarly to, and downrated their own appearance to the same extent as, controls. Impaired appearance and psychiatric symptoms are integral parts of the ‘rhinoplasty applicant syndrome’, but the degree to which they occur is not positively correlated. Interviews and tests were repeated 6 months after operation, when marked improvement in appearance was reported by the rhinoplasty patients, associated with the reduction of psychiatric-symptom scores. Control subjects showed no change.
Fatal Recurrence of Neuroleptic Malignant Syndrome
Authors: McCarthy Anthony , Bourke Stephen , Fahy J. , Binchy Irene , Fitzgerald M. X.
Published: August 2008

The clinical features of a fatal case of the neuroleptic malignant syndrome are presented. The fatal episode was a recurrence of the syndrome after a milder episode 3 months earlier. Prescription of neuroleptics was continued unchanged following the latter, as a correct diagnosis was not made at the time. The case emphasises the importance of early recognition of the syndrome and the possibility of spontaneous remission of symptoms despite continued neuroleptic treatment.
A Linkage Study of Primary Affective Disorder
Authors: Waters Brent , Sengar Dharmendra , Marchenko Irene , Rock Gail , Lapierre Yvon , Forster-Gibson Cynthia J. , Simpson Nancy E.
Published: August 2008

Marker loci in 113 members of nine unrelated multiplex families identified by a bipolar proband were tested for linkages with primary affective disorder. Linkage was excluded between the disease locus (assuming that it was a single autosomal dominant gene) and the HLA loci at a recombination fraction of 0.2, the ABO, Rh, and Lu loci at almost 0.05 and the Fy and P loci at 0.001.
The use of Naloxone During the Withdrawal Syndrome from Heroin
Authors: Vlissides D. N. , Jenner F. A. , Liappas I. A.
Published: August 2008

Attempts to repeat in human subjects animal studies in which naloxone stopped withdrawal symptoms after prolonged use of heroin failed. Nevertheless, suggestions for further studies are made, as the subjects' subsequent desire for opiates did seem attenuated.
Female Unemployment and Attempted Suicide
Authors: Hawton Keith , Fagg Joan , Simkin Susan
Published: August 2008

Unemployment became more common among females attempting suicide in Oxford between 1976 and 1985, although the rise was less than expected from the increased general-population female unemployment rate. Rates of attempted suicide among unemployed women between 1979 and 1982 were 7.5–10.9 times higher than those of employed women, and were particularly high in women unemployed for more than a year. Many more unemployed than employed women attempting suicide had a history of psychiatric difficulties, were suffering from alcoholism, and made repeat attempts. Two possible explanations are: firstly, the secondary consequences of unemployment increase the risk of suicidal behaviour; and, secondly, women already predisposed to psychiatric difficulties and hence attempted suicide are more likely to become unemployed.
Validity and Reliability of the Chinese Hamilton Depression Rating Scale
Authors: Zheng Yanping , Zhao Jingping , Phillips Michael , Liu Jianbai , Cai Minfang , Sun Shengqi , Huang Miaofeng
Published: August 2008

The reliability and validity of the Chinese version of the 17-item Hamilton Depression Rating Scale (CHDS) was assessed. Interrater reliability was excellent, the item total-score correlations were good, and the internal reliability was satisfactory. The concurrent validity was tested by correlating the CHDS score with the Global Assessment Scale score; the strong negative correlation found indicated that the CHDS reflects the overall level of disability. Five distinct factors were generated by principle-component analysis; these factors account for 52.4% of the total variance. Rigorous evaluation of the numerous translated scales being used in clinical and research settings of non-Western countries is important.
Dysmorphophobic Avoidance with Disturbed Bodily Perception
Authors: Marks Isaac , Mishan Joseph
Published: August 2008

Five chronically disabled dysmorphophobic patients with disturbed bodily perception improved with systematic exposure to avoided situations that evoked dysmorphophobic discomfort, and refraining from behaviours which reduced that discomfort. As avoidance and anxiety improved with exposure, so did associated bodily delusions. Four of the patients had additional problems, for which three cases had drugs at some time. The encouraging pilot results warrant a controlled study of exposure for dysmorphophobic avoidance and anxiety.
Behavioural Disorder in the Mentally Handicapped
Authors: Ghaziuddin M.
Published: August 2008

A retrospective study of 65 consecutive referrals for behavioural disorder of mentally handicapped patients living in the community revealed that 31 of these were associated with life events sustained in the 12 months prior to the referral. These patients were usually mildly handicapped, while those who presented with behaviour disorder without a history of recent life events were usually more severely retarded. The differences between the two groups are discussed and the need for further research emphasised.
The Camberwell Collaborative Depression Study I. Depressed Probands: Adversity and the Form of Depression
Authors: Bebbington P. E. , Brugha T. , MacCarthy B. , Potter J. , Sturt E. , Wykes T. , Katz R. , McGuffin P.
Published: August 2008

The Camberwell Collaborative Depression Study is an investigation of a series of 130 patients (76 female; 54 male) attending the Maudsley Hospital Services with unipolar depression of recent onset (the probands), and of their first-degree relatives. This paper describes the first element of the study, the investigation of the index cases or probands, which was carried out by members of the MRC Social Psychiatry Unit over the period 1982–1985. A description of the methods of the study is followed by an analysis of life events in relation to the symptomatic pattern of the depressive state. An ‘endogenous' group was defined as cases of depression falling within Catego classes D and R, and compared with a ‘neurotic’ group conforming to classes N and A. The hypothesis that the ‘endogenous' group of disorders would be relatively independent of prior life stress was not confirmed. Depressed women were more likely to have experienced life events or difficulties than their male counterparts, and there was some evidence that sex, but not age or social class, influenced the relationship between adversity and the type of depression. Examination of the timing of life events was strongly suggestive of a causal effect, with a pronounced rise in the month before onset. This was not limited to the most severe events. Differences between the ‘endogenous' and ‘neurotic’ groups in the temporal patterning of events before onset are discussed. The findings are interpreted in terms of the literature on the topic.
The Camberwell Collaborative Depression Study II. Investigation of Family Members
Authors: McGuffin P. , Katz R. , Aldrich J. , Bebbington P.
Published: August 2008

Out of a consecutive series of 130 potential probands with recent onsets of depression, 124 were deemed ‘in scope’ for a family interview study of social and genetic influences on depression. We were able to interview first-degree relatives of 83 probands (67% of those families ‘in scope’). Unexpectedly, interviewed first-degree relatives had, on average, a significantly lower occupational status than the depressed probands. However, the rates of depression among the first-degree relatives were high. Based on a PSE-Catego classification, 17.2% of 244 relatives were current ‘cases' of depression at the time of interview. This was significantly greater than the estimated population prevalence. Using a Past History Schedule in combination with the PSE, the lifetime prevalence of depressive illness, expressed as the proportion who had ever fulfilled PSE-Catego case criteria, was 38.9%. High rates of psychiatric treatment were also found in family members. The lifetime prevalence of any form of hospital treatment for depression in 315 first-degree relatives was 15.5%. This gives an age-corrected morbidity risk to age 65 years of 24.6%, as compared with a population estimate of 8.9%. In common with previous studies, significantly higher rates of depression were found among female than among male first-degree relatives for broader categories of disorder, but there was a small and non-significant excess of men among those relatives who had received in-patient treatment for depression. This apparent lessening of sex differences with more severe categories was not supported by an examination of ‘lifetime ever’ depressive symptoms, where severity was expressed as highest ever PSE-Catego-ID level. Here the proportion of women who had ever had depressive symptoms remained higher throughout the upper range of the Index of Definition. The findings raise the possibility that male relatives of depressed probands under-report their symptoms, but that their doctors compensate by adopting a lower threshold of psychiatric referral when faced with depressive symptoms in a man.
Decline in the Diagnosis of Schizophrenia among First Contacts with Psychiatric Services in North-East Scotland, 1969–1984
Authors: Eagles J. M. , Hunter D. , McCance C.
Published: August 2008

Annual age-standardised rates for first contacts with psychiatric services in the Aberdeen area from 1969 to 1984 were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Highly significant declines occurred in the diagnosis of schizophrenia and of depressive neuroses. No concomitant increase occurred. It is concluded that these results probably indicate that there has been a fall in the incidence of schizophrenia in North-East Scotland. This may have arisen due to changes in the mode of expression and/or the severity of all functional psychoses.