bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a review
Authors: Hausmann A. , Fleischhacker W. W.
Published: March 2003

Objective: To review the available literature on depressive symptomatology in schizophrenia in order to establish a diagnostic algorithm of depressive syndromes in schizophrenia.

Method: A literature search was performed using PubMed and Medline. Additional information was gained by cross‐referencing from papers found in the database. Data from controlled studies as well as supplementary information from review articles and psychiatric manuals pertinent to the topic were used. Depressive symptoms were classified with respect to their temporal relationship to acute psychotic symptoms before the background of nosological entities as operationalized by Diagnostic Statistical Manual IV (DSM IV).

Results: Depression is a common and devastating comorbid syndrome in patients suffering from schizophrenic disorder. The paper summarizes the relevant diagnostic steps to guide the clinician towards therapeutic interventions, which differ depending on the nature of the depressive syndrome.

Conclusion: Differentiating depressives states in schizophrenia has consequences in terms of choosing therapeutic strategies. An algorithm which leads the practitioner to a reliable diagnosis and in consequence to a valid therapy is presented.
Schizophrenia in homeless persons: a systematic review of the literature
Authors: Folsom D. , Jeste D. V.
Published: March 2003

Objective: This article systematically reviews studies of prevalence of schizophrenia in homeless persons.

Method: Medline and PsychInfo were searched using the key words: homeless person, mental illness, psychosis, and schizophrenia. The bibliographies of identified articles were also reviewed.

Results: Study designs varied considerably. The rate of schizophrenia in homeless persons reported in the 33 published reports, representing eight different countries, ranged from 2 to 45%. In the 10 methodologically superior studies, the prevalence range was 4–16% and the weighted average prevalence was 11%. In addition, rates were higher in younger persons, women and the chronically homeless. Slightly less than half of the homeless persons with schizophrenia were not currently receiving treatment.

Conclusion: Schizophrenia is much more prevalent among homeless persons than in the population at large. Future research should focus on better ways of meeting the mental health care needs of homeless people with schizophrenia.
The impact of professional and social network support on the burden of families of patients with schizophrenia in Italy
Authors: Magliano L. , Marasco C. , Fiorillo A. , Malangone C. , Guarneri M. , Maj M. ,   the Working Group of the Italian National Study on Families of Persons with Schizophrenia
Published: March 2003

Objective:  (a) To explore burden related to caregiving and support received from professionals and social network in relatives of patients with schizophrenia in Northern, Central and Southern Italy; and (b) to test whether a higher level of family burden is associated with a lower level of professional and social network support.

Method:  Seven hundred and nine patients with schizophrenia and their key‐relatives were consecutively recruited in 30 Italian mental health departments. Data were collected on: (a) patients' clinical status and levels of disability; (b) relatives' burden, social and professional support; (c) interventions received by patients and their families.

Results:  Family burden was found lower in Northern Italy. However, after controlling for psychosocial interventions, differences in family burden among the three geographical areas disappeared. Family burden was associated with patients' levels of disability and manic/hostility symptoms, and with professional and social network support received by the family.

Conclusion:  Professional and social network support represent crucial resources to reduce family burden in schizophrenia.
Major depressive disorder in Parkinson's disease: a register‐based study
Authors: Nilsson Flemming M. , Kessing Lars V. , Sørensen Tine M. , Andersen Per K. , Bolwig Tom G.
Published: March 2003

Nilsson FM, Kessing LV, Sørensen TM, Andersen PK, Bolwig TG. Major depressive disorder in Parkinson's disease: a register‐based study. Acta Psychiatr Scand 2002: 106: 202–211. © Blackwell Munksgaard 2002.

Objective: To investigate whether patients with Parkinson's disease (PD) were at an increased risk of developing major depression compared with patients having other medical illnesses with a comparable degree of disability.

Method: Case register linkage study of Danish Psychiatric Central Register (DPCR)and Danish National Hospital Register (DNHR). Three study cohorts were identified: all patients with PD, osteoarthritis, and diabetes. The rate of discharge diagnosis of depression on re‐admission was estimated using competing risks models in survival analyses. The rates for patients with PD were compared with those of patients with osteoarthritis, and diabetes.

Results: The study sample identified 211 245 patients in the hospital registers with one of the index diagnoses. An increased incidence of developing depression was found for women and men throughout their lifetime when this incidence was compared with the control groups.

Conclusion: The findings support the hypothesis that depression in patients with PD is a consequence of brain dysfunction.
The relationship between post‐traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia
Authors: Kivling‐Bodén G. , Sundbom E.
Published: March 2003

Objective: To investigate the association between life situation factors and post‐traumatic symptoms among refugees from the former Yugoslavia.

Method: Twenty‐six refugees from the former Yugoslavia were examined by the Harvard Trauma Questionnaire during psychiatric treatment, and 3 years later. At follow‐up they also answered a questionnaire regarding their life situations.

Results: A higher post‐traumatic symptom level at follow‐up was associated with a pattern of negative living conditions such as open unemployment, social isolation, and a high dependence on social welfare. Gender differences were found regarding the factors most related to symptom severity.

Conclusion: The results indicate that a main problem in this patient group may be how to break vicious circles of high symptom levels and a poor life situation which suggests a need for integrated rehabilitation efforts.
Hydrophobia as a rare presentation of Cotard's syndrome: a case report
Authors: Nejad A. G.
Published: March 2003

Objective: To discuss a case of Cotard's syndrome in a 65‐year‐old male patient who refused to eat and drink.

Method: A single case is presented.

Results: The patient was especially sensitive to water and showed panic reactions when he was offered a glass of water. These symptoms began when he deluded himself to believe that his stomach shrunk. Diagnosis was major depressive disorder with psychotic feature based on DSM‐IV.

Conclusion: Hydrophobia as a symptom of Cotard's syndrome was not reported before. This symptom is often known as evidence of rabies but may be seen in Cotard's syndrome.
Test–retest reliability of self‐reported age at onset of selected psychiatric diagnoses in general health care
Authors: Barkow Katrin , Heun Reinhard , Üstün T. Bedirhan , Gänsicke Michael , Wittchen Hans‐Ulrich , Maier Wolfgang
Published: March 2003

Objective: To investigate reliability of self‐reported age at onset of frequent mental disorders and its association with patient and disorder characteristics.

Method: A total of 1031 primary care patients with at least one lifetime psychiatric diagnosis were asked to report age at onset of their disorders at baseline and after 1 year. Intraclass correlation coefficients (ICC) for age at onset information were calculated for individual disorders.

Results: ICC were high and lay between 0.6790 (generalized anxiety disorder) and 0.7977 (dysthymia). Factors associated with reliability are different for different disorders: gender for depressive episodes, gross national product per year per inhabitant for dysthymia, age for pain disorder, years of formal education for dysthymia, generalized anxiety disorder, and agoraphobia, and number of lifetime diagnoses for depression and agoraphobia.

Conclusion: Self‐reported age at onset is reliable. Further research on factors associated with reliability should focus on interview conditions and subject parameters during interview.
Childhood maltreatment and personality disorders in adult patients with binge eating disorder
Authors: Grilo C. M. , Masheb R. M.
Published: March 2003

Grilo CM, Masheb RM. Childhood maltreatment and personality disorders in adult patients with binge eating disorder. Acta Psychiatr Scand 2002: 106: 183–188. © Blackwell Munksgaard 2002.

Objective: To examine the association between retrospective reports of different types of childhood maltreatment and current personality disorders (PDs) in patients with binge eating disorder (BED).

Method: A total of 116 consecutive out‐patients with DSM‐IV BED were assessed with diagnostic interviews and completed the Childhood Trauma Questionnaire to assess childhood maltreatment in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect).

Results: Eighty‐two percent of patients reported some form of childhood maltreatment and 30% met criteria for at least one PD. Emotional abuse was significantly associated with cluster C PD overall and specifically with avoidant PD.

Conclusion: Reports of emotional abuse – but not other forms of maltreatment – were associated with greater likelihood of a PDs in patients with BED.
Out‐patient behaviour therapy in alcoholism: treatment outcome after 2 years
Authors: Burtscheidt W. , Wölwer W. , Schwarz R. , Strauss W. , Gaebel W.
Published: March 2003

Burtscheidt W, Wölwer W, Schwarz R, Strauss W, Gaebel W. Out‐patient behaviour therapy in alcoholism: treatment outcome after 2 years. Acta Psychiatr Scand 2002: 106: 227–232. © Blackwell Munksgaard 2002.

Objective: The main aim of the study was the evaluation of out‐patient behavioural approaches in alcohol dependence. Additionally, the persistence of treatment effects and the impact of psychiatric comorbidity in long‐term follow‐up was examined.

Method: A total of 120 patients were randomly assigned to non‐specific supportive therapy or to two different behavioural therapy programmes (coping skills training and cognitive therapy) each comprising 26 weekly sessions; the follow‐up period lasted 2 years.

Results: Patients undergoing behavioural therapy showed a consistent trend towards higher abstinence rates; significant differences between the two behavioural strategies could not be established. Moreover, the results indicate a reduced ability of cognitive impaired patients to cope with short‐time abstinence violations and at a reduced benefit from behavioural techniques for patients with severe personality disorders.

Conclusion: Behavioural treatment yielded long‐lasting effects and met high acceptance; yet, still in need of improvement is the development of specific programmes for high‐risk patients.
Financial loss and suicidal ideation in a rural community sample
Authors: Turvey C. , Stromquist A. , Kelly K. , Zwerling C. , Merchant J.
Published: March 2003

Turvey C, Stromquist A, Kelly K, Zwerling C, Merchant J. Financial loss and suicidal ideation in a rural community sample. Acta Psychiatr Scand 2002: 106: 373–380. © Blackwell Munksgaard 2002.

Objective: To examine the prevalence and correlates of suicidal ideation in a community‐based rural sample.

Method: The sample was a random sample of people living in a single county in Iowa. Participants aged 18 or older (n=1617) were asked about suicidal ideation in the past year as well as mood, alcohol use, social support, and stressful life events.

Results: About 8.2% of the sample reported suicidal ideation. Depressive symptoms, problems resulting from alcohol use, infrequent social contact and financial loss characterized the suicidal group.

Conclusion: Depressive symptoms were the strongest correlate of suicidal ideation in this rural sample. In the multivariate analysis, financial loss rather than low income remained a significant correlate of suicidal ideation after controlling for depression. This suggests that change in financial status rather than chronic poverty poses a risk for suicidal ideation.
Threshold 2: the reliability, validity and sensitivity to change of the Threshold Assessment Grid (TAG)
Authors: Slade M. , Cahill S. , Kelsey W. , Powell R. , Strathdee G.
Published: March 2003

Objective:  This study investigated the psychometric properties of the Threshold Assessment Grid (TAG), a new assessment of the severity of mental health problems.

Method:  A total of 605 patients were recruited from 10 mental health adult and elderly services in London, UK. TAG ratings and other standardized definitions of severe mental illness were completed by referrers. TAG, Global Assessment of Functioning (GAF), Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scale (HoNOS) ratings were completed by mental health service staff. Construct validation on extreme groups was investigated.

Results:  Construct and concurrent validity were good. Referrer TAG scores predicted mental health team view of referral suitability, but not whether assessments were offered. Test–retest reliability was good, interrater reliability ranged from good to poor in different domains (but adequate for total TAG score), internal consistency was appropriate. Sensitivity to change requires further investigation.

Conclusion:  The TAG can be recommended for use by all agencies when making referrals to mental health services.
Examining the utility of a temperament model for modelling non‐melancholic depression
Authors: Parker G. , Roy K.
Published: March 2003

Objective: Depression is currently modelled dimensionally, along severity, duration and recurrency dimensions. An alternative model allows dimensional expressions of temperament and personality to influence risk to onset as well as persistence. Here, we examine the utility of a temperament model.

Method: A questionnaire assessing temperament dimensions and a number of depression variables was administered to a large routine general practice sample and with the temperament measure also completed by a small clinical sample.

Results: `Anxious worrying' and `irritable' dimensions were identified as internalizing and externalizing expressions of a trait anxiety dimension, three other `temperament' dimensions (i.e. `introversion', `self‐centred' and `obsessive') were refined, while a `self‐blame' dimension intruded into the factor analytic solution. High scores on the `anxious worrying' dimension were associated with all depression parameters. The `irritable', `introversion' and `self‐blame' dimensions were less clearly linked with depression variables, while higher scores on the `self‐centred' and `obsessional' dimensions did not appear to increase the chance of depression onset, persistence or recourse to treatment.

Conclusion: A temperament‐based approach appears to have some conceptual utility in modelling depression, and particularly, the non‐melancholic disorders. It is likely, however, to require complementing with refined at‐risk personality dimensions.
Induction of mania and cycle acceleration in bipolar disorder: effect of different classes of antidepressant
Authors: Joffe R. T. , MacQueen G. M. , Marriott M. , Robb J. , Begin H. , Young L. T.
Published: March 2003

Objective: To assess the effect of different antidepressants on induction of mania and cycle acceleration, commonly accepted unwanted effects of antidepressant treatment for acute bipolar depression. There is, however, the suggestion that certain classes of antidepressants may be less likely than others to cause these unwanted effects.

Method: We conducted a prospective, open, naturalistic, life charting study to assess the occurrence of onset of mania and cycle acceleration attributable to two antidepressant classes: selective serotonin reuptake inhibitors (SSRIs) and bupropion.

Results: No difference was found between the two drug classes for either antidepressant‐induced mania or cycle acceleration. Antidepressant‐induced mania was much more likely to occur in bipolar I rather than bipolar II patients. The overall occurrence of induction of mania and cycle acceleration was low across antidepressant classes.

Conclusion: These findings suggest that there is probably no difference in the risk of antidepressant‐induced mania or cycle acceleration across commonly used classes of antidepressants for the treatment of bipolar depression.
Relationship between perfectionism, personality disorders and agoraphobia in patients with panic disorder
Authors: Iketani T. , Kiriike N. , Stein M. B. , Nagao K. , Nagata T. , Minamikawa N. , Shidao A. , Fukuhara H.
Published: March 2003

Iketani T, Kiriike N, Stein MB, Nagao K, Nagata T, Minamikawa N, Shidao A, Fukuhara H. Relationship between perfectionism, personality disorders, and agoraphobia in patients with panic disorder. Acta Psychiatr Scand 2002: 106: 171–178. © Blackwell Munksgaard 2002.

Objective: In earlier reports, we found that perfectionism might be involved in the development and/or maintenance of agoraphobia in panic disorder. The present report extends this work by examining the relationship between perfectionism and comorbidity with personality disorders in panic disorder patients with agoraphobia (PDA) and those without agoraphobia (PD).

Method: We examined comorbidity of personality disorders by Structured Clinical Interview for DSM‐III‐R Personality Disorders (SCID‐II) and assessed perfectionism using multidimensional perfectionism scale in 56 PDA and 42 PD patients.

Results: The PDA group met criteria for at least one personality disorder significantly more often than the PD group. With stepwise regression analyses, avoidant and obsessive–compulsive personality disorders emerged as significant indicators of perfectionism in patients with panic disorder.

Conclusion: These findings suggest that perfectionism in panic disorder patients may be more common in those with comorbid personality disorders, and may be an important target for preventive and therapeutic efforts.
Depression in postpartum and non‐postpartum women: prevalence and risk factors
Authors: Eberhard‐Gran M. , Eskild A. , Tambs K. , Samuelsen S. O. , Opjordsmoen S.
Published: March 2003

Objective:  The aim of the study was to assess the prevalence of depression in postpartum women as compared with non‐postpartum women, and to identify risk factors of depression in both groups.

Method:  A population based questionnaire study was performed among women 18–40 years in two municipalities in Norway in 1998–1999. A total of 2730 women were included, of whom 416 were in the postpartum period.

Results:  The prevalence of depression was higher in non‐postpartum as compared with postpartum women. High scores on the life event scale, a history of depression and a poor relationship to the partner were associated with depression in both postpartum and non‐postpartum women. When controlling for the identified risk factors of depression the odds‐ratio for depression in the postpartum period was 1.6 (95% CI: 1.0–2.6).

Conclusion:  The risk for depression was increased in the postpartum period, when controlling for the uneven distribution of risk factors.
The influence of neurocognitive deficits and symptoms on disability in schizophrenia
Authors: Ertuğrul A. , Uluğ B.
Published: March 2003

Objective: The purpose of the present study was to examine the relationship of disability with neurocognitive deficits and symptoms in schizophrenia.

Method: Sixty patients with schizophrenia and 30 healthy controls matched for age, sex and level of education were included in the study. Neurocognitive tests measuring attention, visual memory and executive functions were given. Severity of symptomatology was assessed by the Positive and Negative Syndrome Scale (PANSS). Disability level of the subjects was assessed by World Health Organisation–Disability Assessment Schedule 2 (WHO–DAS‐2).

Results: PANSS total score and the subscores were all correlated with DAS scores at a significant level. Neurocognitive test scores were not significantly associated with disability level. Regression analysis furthermore showed that symptom severity was predictive of the disability level.

Conclusion: These results suggest that, rather than neurocognitive deficits, symptoms appear to have direct impact on the functioning of patients with schizophrenia in many domains of life.
Screening for major depression in Asian‐Americans: a comparison of the Beck and the Chinese Depression Inventory
Authors: Yeung A. , Neault N. , Sonawalla S. , Howarth S. , Fava M. , Nierenberg A. A.
Published: March 2003

Objective: This study compares the effectiveness of the Chinese version of the Beck Depression Inventory (CBDI) and the Chinese Depression Inventory (CDI) in screening for depression among Chinese Americans.

Method: Five hundred and three Chinese‐Americans in primary care were administered the CBDI and the CDI for depression screening. The results were compared with standard semistructured interview.

Results: With empirically determined cutoff scores of the CBDI (≥13) and the CDI (≥16), both instruments have good sensitivity (0.78) and excellent specificity (0.91 and 0.93, respectively). The correlation between the total scores of the two instruments was high (0.785, P < 0.01). The areas under the Receiver Operating Characteristic (ROC) curve of the CBDI and the CDI were 0.94 and 0.95, respectively, and were not significantly different.

Conclusion: When administered by nterviewers, the CBDI and the CDI have comparable effectiveness. Low participation among Chinese‐Americans with self‐report measures limits both scales as efficient depression screening instruments.
Age‐at‐onset and schizophrenia: reversed gender effect
Authors: Gangadhar B. N. , Panner Selvan C. , Subbakrishna D. K. , Janakiramaiah N.
Published: March 2003

Objective: This study seeks an explanation for reversed gender effect on age‐at‐onset (AAO) in schizophrenia. The hypothesis is older AAO in males would be detected in a sample where higher infant mortality (IMR) prevailed.

Method: Case records of International Classification of Diseases‐10 (ICD‐10) schizophrenia patients from two states (n=70 each) with an IMR of 13 and 67 per thousand were reviewed and AAO was obtained by using the recorded age and duration of illness.

Results: In the sample from the state with lower IMR, AAO did not differ between the two sexes. However, men had older AAO than women in the state with fivefold higher IMR.

Conclusion: Gender differences in AAO may be a function of perinatal complications. In places where infants with perinatal complications are less likely to survive, hence high IMR, a small group of potentially youngest AAO schizophrenic males may be eliminated thus changing the gender effect on AAO.
Recollections of parent–child relationships in patients with obsessive‐compulsive disorder and panic disorder with agoraphobia
Authors: Turgeon L. , O'Connor K. P. , Marchand A. , Freeston M. H.
Published: March 2003

Objective: In previous studies, patients with different psychiatric conditions, as compared with matched controls, have reported that their parents were more protective and less caring towards them when they were children. However, studies investigating associations between parental behaviours and anxiety disorders have yielded inconsistent results. The aim of this study was to compare recalled parental behaviours in out‐patients with obsessive‐compulsive disorder (OCD), in out‐patients with panic disorder with agoraphobia (PDA), and in non‐anxious controls.

Method: The sample included 43 out‐patients with OCD, 38 with PDA, and 120 controls. Participants completed the Parental Bonding Instrument and the Egna Minnen Beträffande Uppfostran or Own Memories of Parental Rearing Experiences in Childhood.

Results: No differences were found between the two anxious groups. However, compared with the control group, anxious patients recalled their parents as more protective.

Conclusion: Our findings suggest that child rearing practices such as overprotection may be a risk factor in the development of anxiety disorders.
Cannabis‐induced psychosis: a cross‐sectional comparison with acute schizophrenia
Authors: Núñez L. A. , Gurpegui M.
Published: March 2003

Objective: The existence of cannabis‐induced psychosis (CP) remains controversial, partly because of methodological problems. We hypothesize that acute schizophrenia (AS) and CP can have distinct demographic, premorbid and clinical features.

Method: We compared 26 patients with CP to 35 with AS, after their cannabis‐consumption status was confirmed by repeated urine screens. Patients with CP were assessed after at least 1 week but not more than 1 month of abstinence. Symptoms were evaluated with the Present State Examination (PSE).

Results: In group CP, male gender, expansive mood and ideation, derealization/depersonalization, visual hallucinations, and disturbances of sensorium were more frequent than in group AS. Premorbid schizoid personality traits were more frequently associated to AS and antisocial personality traits to CP.

Conclusion: The continuous heavy use of cannabis can induce a psychotic disorder distinct from AS. These two clinical entities share some features but they differ in others.
The prospectively observed course of illness among depressed patients who commit suicide
Authors: Coryell William , Haley James , Endicott Jean , Solomon David , Leon Andrew C. , Keller Martin , Turvey Carolyn , Maser Jack D. , Mueller Timothy
Published: March 2003

Objective: These analyses were conducted to describe the course of illness among patients with major affective disorders who commit suicide.

Method: Twenty‐nine patients who entered a long‐term, high‐intensity follow‐up study of major affective disorders and who later committed suicide within 1 year of their last follow‐up interview were individually matched to other patients by age, sex, the presence or absence of lifetime drug or alcohol abuse, time to last interview and polarity. Those who suicided were compared with their controls by depressive and substance abuse morbidity during follow‐up, treatment resistance, treatment compliance, suicidal behavior and psychosocial adjustment.

Results: Among the various measures used to characterize the course of illness during a mean follow‐up of 4.3 years, only those pertaining to suicidal behavior robustly separated the suicide group from their controls. Suicidal behavior in the remote past seemed as predictively important as suicidal behavior during follow‐up.

Conclusion: Of the various features monitored over time in patients with major affective disorder, suicidal behavior itself was the clearest correlate of risk for completed suicide.
Dopamine transporter gene (DAT1) VNTR polymorphism in major psychiatric disorders: family‐based association study in the Bulgarian population
Authors: Georgieva L. , Dimitrova A. , Nikolov I. , Koleva S. , Tsvetkova R. , Owen M. J. , Toncheva D. , Kirov G.
Published: March 2003

Objective: A 40‐bp variable number tandem repeat in the 3′‐UTR of dopamine transporter gene (DAT1) has been examined for association with major psychiatric disorders in several case–control studies. No significant results have been found. We used a new collection of parent–offspring trios to test for association with schizophrenia (SZ), bipolar 1 disorder (BPI) and schizoaffective (SA) disorder.

Method: We genotyped trios from Bulgarian origin where the proband had SZ (178 trios), BPI (77 trios) and SA (29 trios). Alleles ranging from 5 to 11 repeats were observed. The results were analysed with the extended TDT (ETDT).

Results: No preferential transmission of alleles was observed for any diagnostic group. The presence of allele DAT*10 was associated with the severity and frequency of auditory hallucinations, however, this result is not significant if corrected for multiple testing.

Conclusion: Our results are in agreement with previous reports of a lack of association between this polymorphism and major psychiatric disorders.
Self‐rated schizotypal cognitions, psychotic symptoms and the onset of schizophrenia in young people at high risk of schizophrenia
Authors: Miller P. McC. , Lawrie S. M. , Byrne M. , Cosway R. , Johnstone E. C.
Published: March 2003

Objective: To examine the associations between the Rust Inventory of Schizotypal Cognitions (RISC) and psychotic symptoms measured by the Present State Examination (PSE) and to assess the predictive validity of the RISC for later onset of schizophrenia.

Method: A total of 154 subjects at high risk for schizophrenia but who were currently well, 35 well controls and 28 first episode schizophrenic patients were assessed on specified PSE symptoms and completed the RISC. A subsample of the high risk group was subsequently monitored for onset of schizophrenia over 39 months.

Results: RISC scores at entry were significantly higher in subjects with psychotic symptoms on PSE. There were indications that high scorers on the RISC were likely to develop schizophrenia. However, less than half of those falling ill exhibited high RISC scores on entry.

Conclusion: The RISC scale is highly associated with presence of psychotic symptoms on PSE and high scorers may be at increased risk of schizophrenia onset.
Seasonal affective disorder in an Arctic community
Authors: Haggarty J. M. , Cernovsky Z. , Husni M. , Minor K. , Kermeen P. , Merskey H.
Published: March 2003

Objective: To determine the rate of seasonal‐pattern depression in an Inuit community above 70°N.

Method: One‐hundred and eleven people from randomly selected households were surveyed for depression and anxiety and the effect of the seasons on their mood. Eighty‐eight people provided replies on the influence of the seasons.

Results: One in five (22.6%) of the community sample was found to be depressed. Of these, seven (6.3%) had seasonal affective disorder (SAD), with fall onset occurring in six of these (5.4%). Subsyndromal SAD (SSAD) occurred in 11.7%, while any effect of the seasons (seasonality) occurred in 39.6%. Persons with SSAD and seasonality were significantly older than those unaffected by the seasonal effect. No other significant correlation of SAD, SSAD, or seasonality occurred with gender, age, and language preference.

Conclusion: Seasonal mood changes in this Inuit group living in the Canadian Arctic are elevated above the rates found in other studies using similar survey methods.
Public attitude to compulsory admission of mentally ill people
Authors: Lauber C. , Nordt C. , Falcato L. , Rössler W.
Published: March 2003

Objective: Assessing the public attitude to compulsory admission of mentally ill in Switzerland and analyzing the influence of demographic, psychological, and sociological factors.

Method: We conducted a representative telephone survey with 1737 interviewees. In a logistic regression analysis compulsory admission was used as the dependent variable.

Results: More than 70% of the respondents display a positive attitude to compulsory admission. Education, negative stereotypes, and living in the French speaking part of Switzerland are predictors for accepting compulsory admission whereas older age, extreme political opinion, and rigid personality traits show an inverse effect. Negative emotions, anomie, social distance, and contact to mentally ill have no significant influence.

Conclusion: The mostly positive attitude to compulsory admission suggests that the public trust in psychiatry to deal with the assigned responsibility.
Improvement in activities of daily living in elderly following treatment for post‐bereavement depression
Authors: Oakley F. , Khin N. A. , Parks R. , Bauer L. , Sunderland T.
Published: March 2003

Objective: To determine if elderly bereaved depressed subjects display difficulty with activities of daily living (ADL) and if their ADL difficulty improves with psychopharmacologic intervention.

Method: The Assessment of Motor and Process Skills (AMPS), an ADL assessment measuring ADL motor and ADL process skills, was administered to a pilot sample of elderly persons with post‐bereavement depression prior to psychopharmacologic intervention and subsequently during treatment response.

Results: In the pretreatment phase, subjects displayed difficulty with ADL motor and ADL process skills that significantly improved during the treatment response phase.

Conclusion: Results suggest that elderly bereaved depressed individuals demonstrated ADL difficulty that responds positively to psychopharmacologic intervention.
Olanzapine‐induced destabilization of diabetes in the absence of weight gain
Authors: Ramankutty G.
Published: March 2003

Objective: To provide evidence that olanzapine can cause glucose dysregulation by a mechanism other than weight gain.

Method: I report a case of a diabetic patient who developed glucose dysregulation soon after initiation of olanzapine treatment, occurring in the absence of weight gain. I compare this case to previous case reports.

Results: Our patient developed persistent hyperglycaemia within 3 weeks of initiating treatment with olanzapine. Weight recorded just prior to commencement and soon after discontinuation of olanzapine were not significantly different.

Conclusion: Controlled studies are necessary to elucidate the mechanism by which olanzapine can cause dysregulation of glucose homeostasis, and to develop guidelines for the use of olanzapine in patients with known diabetes as well as in patients with risk factors for diabetes.
Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study
Authors: Knapp Martin , Chisholm Daniel , Leese Morven , Amaddeo Francesco , Tansella Michele , Schene Aart , Thornicroft Graham , Vazquez‐Barquero Jose‐Luis , Knudsen Helle‐Charlotte , Becker Thomas ,   EPSILON Study Group
Published: March 2003

Objective: To compare service utilization and cost profiles of people with schizophrenia living in Europe in order to understand differences in treatment and care costs.

Method: Cross‐sectional samples were taken of people with schizophrenia in five European locations. Sociodemographic, clinical and service use data were collected via interviewer‐administered questionnaires. Site‐specific unit costs were obtained, transformed subsequently into a single currency (UK £). Multiple regression analyses were conducted.

Results: There were widespread and considerable differences between sites in service utilization patterns and associated costs. Higher needs, greater symptom severity and longer psychiatric history are associated with higher costs: quality of life and service satisfaction are not. Few differences were found between sites in patterns of association with cost.

Conclusion: Comparative analyses of the use and cost of mental health services can highlight existing variations helpfully in service provision and uptake. Methodological consistency is required if meaningful conclusions are to be drawn from such comparative data.
The importance of the QT interval: a review of the literature
Authors: Elming H. , Sonne J. , Lublin H. K. F.
Published: March 2003

Objective:  QT interval (QTi) prolongation is generally associated with increased risk of ventricular arrhythmias such as torsade de pointes (TdP) and death.

Method:  Literature review based on publications identified by means of electronic and manual search.

Results:  It has recently become apparent that not only antiarrhythmic drugs such as sotalol and quinidine, but also a variety of non‐antiarrhythmic drugs such as certain antihistamines, antimicrobial drugs, psychiatric drugs and cisapride, may have the ability to induce prolongation of the QTi and TdP. Special concern should be drawn to the coadministration of drugs that inhibit the metabolism of these drugs such as ketoconazole, itraconazol and erythomycin. Patients with congenital long QT syndrome, patients with heart disease, with hypokalemia or hypomagnesemia, and women have an increased risk. Every sign of dizziness or syncope should be regarded as a warning sign of possible arrhythmia in patients treated with drugs that potentially prolong the QTi.

Conclusion:  Measurement of the QTi before and during treatment is generally recommended in high‐risk patients.
Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?
Authors: ten Have M. , Oldehinkel A. , Vollebergh W. , Ormel J.
Published: March 2003

Objective:  To investigate whether (1) education predicts the use of care services for mental health problems, independently of mental disorder and functional impairment and (2) education modifies the association between mental disorder and service use.

Method:  Predictors of service use were recorded at baseline, and service use itself at 12‐month follow‐up, in a representative sample (N=7076) of the Dutch population, using the Composite International Diagnostic Interview.

Results:  People with more education were less likely to use primary care but more likely to use mental health care. The effects on both types of care remained significant after adjustment for mental disorder and functional impairment. Lower education tended to strengthen the association between mood or anxiety disorder and primary care use.

Conclusion:  Further research on inequalities in service use will benefit from additional explanatory analyses and from the inclusion of sociopsychological variables, like cost‐benefit considerations in decisions to use services.
Addiction, stigma and movies
Authors: Cape G. S.
Published: March 2003

Objective:  To identify common character stereotypes of alcohol and other drug users as portrayed in motion pictures.

Method:  A selective review of a number of movies prominently portraying alcohol and other drug use and misuse.

Results:  The great majority of popular films portray alcohol and drug use whether as a routinized background, routinized foreground or exceptional foreground. Four main stereotypes of alcohol and other drug users appear to be prevalent – the tragic hero, the demonized user, the rebellious free spirit and the comedic user. A number of movies are selected which portray alcohol and other drug use as a prominent theme.

Conclusion:  Movies, as a medium for mass communication, have a powerful influence on the public and perpetuate popular mythologies regarding alcohol and other drug use.
Life events and depressiveness – the effect of adjustment for psychosocial factors, somatic health and genetic liability
Authors: Romanov K. , Varjonen J. , Kaprio J. , Koskenvuo M.
Published: March 2003

Objective: To study the nature of the relationship of life events with depressiveness.

Method: In 1990, 9947 Finnish adult twins aged 33–60 years participated in a questionnaire study, with no missing data on the analysed variables. The relationship between stressful life‐events and depressiveness, based on Beck Depression Inventory (BDI) classified as normal, mild or moderate, was analysed using multinomial regression for all subjects with adjustment for the effect of age, sex, health status, social support, marital status, social class, and personality variables. These same factors were analyzed among 643 twin pairs discordant for depressiveness.

Results: High BDI score categories were strongly associated with stressful life events in all individuals and equally strongly within discordant twin pairs, both monozygotic and dizygotic. Poor somatic health and lack of social support also increased depressiveness.

Conclusion: The effect of life events predicting depressiveness was independent of social support, somatic disease, sex and genetic liability.
What patient characteristics make clinicians recommend brief treatment?
Authors: Schaefer B. A. , Koeter M. W. J. , Wouters L. , Emmelkamp P. M. G. , Schene A. H.
Published: March 2003

Objective:  Assessing self‐rated items that might have an impact on clinicians recommending brief treatment (BT) over unlimited or long‐term treatment (ULT).

Method:  On the basis of patient self‐report data we compared patients referred by clinicians to BT (n=71) with those referred to ULT (n=145).

Results:  The final multiple logistic regression model indicates that the chance of being allocated to BT increases with: more satisfaction with support, higher self‐esteem, primary education or less, and high desire for support as an intervention. With regard to desire to confess in treatment, low and high scores make the chance of being allocated to BT lower. This is also the case for daily hassles. Finally, some specific target complaints, in particular anxiety, lower the chance of being allocated to BT.

Conclusion:  Using data about patient's complaints and symptoms, stress and support, personality and coping, and request for type of intervention, we built a regression‐model that classified 80% of the patients correctly with regard to allocation to BT or ULT.
Characteristics of HIV patients who attempt suicide
Authors: Roy A.
Published: March 2003

Objective: To examine the risk factors for suicidal behaviour in human immunodeficiency virus (HIV) positive patients.

Method: HIV substance dependent positive patients who had attempted suicide were compared with HIV substance dependent positive patients who had never attempted suicide for suicide risk factors.

Results: Among the 149 HIV positive patients examined almost half had attempted suicide. Significantly more HIV positive patients who had attempted suicide were female. Attempters were significantly younger than non‐attempters. Significantly more of the attempters had a family history of suicidal behaviour. Attempters also reported significantly more childhood trauma, scored significantly higher for neuroticism, had experienced significantly more comorbidity with depression, and more of them had received antidepressant medication.

Conclusion: These data suggest that both distal and proximal risk factors are involved in suicidal behaviour in HIV positive substance dependent patients.
Antipsychotics and QT prolongation
Authors: Taylor D. M.
Published: March 2003

Objective:  To evaluate literature relating to cardiac QT prolongation and the use of antipsychotic drugs.

Method:  Literature searches of EMBASE, Medline, PsychLIT were performed in December 2001 and reference sections of retrieved papers scrutinized for further relevant reports.

Results:  The Cardiac QTc interval is difficult to measure precisely or accurately but appears to be a useful predictor of risk of dysrhythmia (specifically torsade de pointes) and sudden death. It is less clear that drug‐induced QTc prolongation gives rise to similar risks but data are emerging, linking antipsychotic use to increased cardiac mortality. Many antipsychotics have been clearly associated with QTc prolongation. Methodological considerations arguably preclude assuming that any antipsychotic is free of the risk of QTc prolongation and dysrhythmia.

Conclusion:  Available data do not allow assessment of relative or absolute risk of dysrhythmia or sudden death engendered by antipsychotics but caution is advised. Risk of dysrhythmia can very probably be reduced by careful prescribing of antipsychotics in low doses in simple drug regimens which avoid metabolic interactions. Electrocardiographic monitoring may also help to reduce risk but review by specialist cardiologist may be necessary.
Do the Spontaneity and Anger and Aggression subscales of the Ward Atmosphere Scale form homogeneous dimensions? A cross‐sectional study of 54 wards for psychotic patients
Authors: Røssberg J. I. , Friis S.
Published: March 2003

Objective:  The main aim of this study was to examine the psychometric properties of the two subscales of the Ward Atmosphere Scale (WAS), Spontaneity and Anger and Aggression, which measure the level of expressed emotion. We wanted to examine if the items measuring attitude and behavior form different dimensions.

Method:  A total of 550 patients in 54 different psychiatric wards for psychotic patients completed the WAS and the Good Milieu Index.

Results:  Removing, respectively, four items from the Spontaneity subscale, three items from the Anger and Aggression subscale the psychometric properties improved. The two revised subscales were named Spontaneous Behavior (SB) and Angry, Aggressive Behavior (AAB). A new ‘attitude’ subscale, comprising three items, was named Staff Attitude to Expressed Feelings (SAEF).

Conclusion:  For patients the attitude and behavior items seem to form separate dimensions. The three subscales examined are probably of central importance for patient satisfaction.
Methylphenidate and intracortical excitability: opposite effects in healthy subjects and attention‐deficit hyperactivity disorder
Authors: Moll G. H. , Heinrich H. , Rothenberger A.
Published: March 2003

Objective: To test the effects of a standard dosage of the psychostimulant methylphenidate (MPH) – which significantly enhances intracortical inhibition but had no effects on intracortical facilitation in children with attention‐deficit hyperactivity disorder (ADHD) – on intracortical excitability in healthy subjects.

Method: In 12 healthy subjects, aged 20–40 years, intracortical inhibition and facilitation were investigated before and 70 min after the intake of 10 mg MPH using the technique of transcranial magnetic stimulation (TMS) with the paired‐stimulus paradigm.

Results: In comparison of the two TMS measurements, a significant enhancement in intracortical facilitation but no effects on intracortical inhibition could be stated under MPH administration.

Conclusion: This study provides first evidence for opposite effects of MPH on intracortical excitability in healthy adult subjects showing enhanced intracortical facilitation in contrast to ADHD children in whom enhanced intracortical inhibition has recently been shown.
Alterations of rCBF and mitochondrial dysfunction in major depressive disorder: a case report
Authors: Gardner A. , Pagani M. , Wibom R. , Nennesmo I. , Jacobsson H. , Hällström T.
Published: March 2003

Objective:  A mitochondrial disease might be considered when depressive disorder is associated with diabetes mellitus or other symptoms commonly found in mitochondrial disease. Scattered regional cerebral blood flow (rCBF) decreases and increases have been reported in depressive and mitochondrial disorders. A 61‐year‐old male patient with early adult onset of depressive disorder and a slowly developing multiorgan syndrome including diabetes mellitus was investigated.

Method:  99mTc‐HMPAO rCBF SPECT and muscle biopsy to assess mitochondrial functions were performed in the patient.

Results:  Alterations of rCBF were found in the patient, with the most pronounced decreases in the left dorsolateral frontal and inferior parietal lobes, and the most pronounced increases in the bilateral superior parietal lobes. Muscle biopsy revealed myopathy and decrease of mitochondrial adenosine triphosphate production rates (MAPRs).

Conclusion:  The MAPRs decreases support the suspicion of mitochondrial dysfunction in the patient. A subgroup of depressed patients may have mitochondrial dysfunctions.