bluuebunny/crossref_metadata_2025 huggingface dataset:
Certificated Incapacity and Unemployment in Alcoholics
Authors: Saad E. S. M. , Madden J. S.
Published: August 2008

Seventy-three male alcoholics permitted information to be obtained from official sources about time recorded as lost from work in receipt of sickness or unemployment benefits and about their weekly state insurance contributions. The average yearly time loss was 121.7 working days per person, comprising an average yearly loss through sickness of 86.1 and through unemployment of 35.6 working days respectively. By contrast the recorded national sickness loss for men in a comparable twelve months period averaged 15.9 working days per person.

Thirteen alcoholics showed over five years, prolonged deficiency in work attendance. State benefits to the subjects, over twelve months during the early 1970s, totalled £18,434.80. Diagnoses on their medical certificates underestimated incapacity from alcoholism.
A Trial of Fenfluramine in the Treatment of the Chronic Alcoholic Patient
Authors: Krasner N. , Moore M. R. , Goldberg A. , Booth J. C. D. , Frame A. H. , McLaren A. D.
Published: August 2008

In a double blind trial, 50 male chronic alcoholic patients were treated with either fenfluramine in a dose of 60 mg or 120 mg daily, or with identically prepared placebo tablets. Patients were interviewed on admission to the trial and then at four-weekly intervals for a period of one year and blood levels of delta-aminolaevulinic acid dehydratase (ALAD) and gamma-glutamyl transpeptidase (γGT) and fenfluramine were determined. The efficacy of fenfluramine at the two dose levels was compared with placebo on the basis of the number of lapses indicated by the clinical history and also by alterations in the biochemical indices.

Twenty-seven patients completed the period of observation, there being 9 in each of the three groups. Those receiving 120 mg fenfluramine daily showed significantly fewer lapses than either of the other two groups (p < 0.01) on biochemical but not on clinical criteria. Overall assessment revealed that 3 of the 9 patients receiving the high dose of fenfluramine had a good result during the period of the trial, but there were none in the 60 mg group or in those receiving placebo. More extensive trials of fenfluramine in the treatment of chronic alcoholism are indicated.
Physiological Dependence on, and Symptoms of Withdrawal from, Chlormethiazole
Authors: Reilly Terence M.
Published: August 2008

The uses of chlormethiazole (Heminevrin) are briefly mentioned. Differing views of its potential for producing dependence are discussed. The consensus opinion is taken to be that a risk of psychological dependence does exist, but only one case has appeared in the medical literature to date of physiological dependence on chlormethiazole, with withdrawal symptoms. This case is re-examined. A second case is described in which the features of increasing dosage and withdrawal were followed by confusion, disorientation, delusions, hallucinations and muscular spasm and coarse jerking. This is taken as confirmation of the potential of chlormethiazole to produce physiological dependence. Some personal opinions of the author regarding indications for use and incidence of abuse are briefly mentioned.
Evaluating Signs and Symptoms: Comparison of Structured Interview and Clinical Approaches
Authors: Carpenter William T. , Sacks Michael H. , Strauss John S. , Bartko John J. , Rayner Judy
Published: August 2008

Are research interview techniques adequate in assessing signs and symptoms? This question is investigated by obtaining two sets of interview schedule ratings on 49 patients, one by a research psychiatrist applying the interview and one by the patient's psychiatrist using all available information. The latter was considered a clinical standard with which a cross-sectional research interview could be contrasted.

These two data sets were subjected to several types of analysis commonly undertaken with research interview ratings. Results indicated that the research interview adequately represents symptom data, but is seriously lacking in the assessment of observed behaviour. The effect of this difference depends on the goals of the study and the nature of the data analysis. If overall group findings are desired, or if analysis relies primarily on symptom data, results with a research interview may be similar to results based on a far more extensive evaluation. On the other hand, if conclusions are to be drawn on individual patients, or if data analysis relies heavily on observed behaviour, then data derived from research interviews are questionable.
Heroin Misuse and Delinquency in a New Town
Authors: Mott Joy , Rathod N. H.
Published: August 2008

The subjects of this study were eighty misusers of heroin who lived in the New Town of Crawley, West Sussex. The relationship between their criminal histories and their histories of drug misuse were examined. It was found that more of the heroin misusers than would be expected had been convicted of criminal offences before they began to misuse drugs, while the reduction or cessation of heroin use during a four-year follow-up period was accompanied by a reduction in convictions. Some social characteristics of the male heroin misusers were compared with those of two other Crawley groups—a group of juvenile offenders who did not misuse heroin and their control group of non-delinquents. Characteristics commonly associated with maladjustment did not distinguish the heroin misusers from the juvenile offenders, nor were they found to be associated with the continued use of heroin. Analysis of the data in epidemiological terms suggested that among the necessary conditions for an outbreak of drug misuse in a particular community the availability of drugs together with socializing drug users were more important than the presence of predisposed individuals.
Six Cases of Gilles de la Tourette's Syndrome
Authors: Fernando S. J. M.
Published: August 2008

Six cases of Gilles de la Tourette's syndrome are discussed in the light of conflicting views on the aetiology of the condition. It is hypothesized that the onset of coprolalia in patients with persistent childhood tics indicates a disturbance of the normal balance between a need for tension relief by swearing and a capacity to control such vocal activity. Some conclusions are drawn on the management of the syndrome by the use of butyrophenones, massed practice of tics, and the promotion of personality development. A flexible approach geared to the individual patient's particular needs is recommended.

Some conclusions are drawn on the management of the syndrome by the use of butyrophenones, massed practice of tics, and the promotion of personality development. A flexible approach geared to the individual patient's particular needs is recommended.
Psychiatric Problems in Systemic Lupus Erythematosus
Authors: MacNeill A. , Grennan D. M. , Ward D. , Dick W. C.
Published: August 2008

Four patients with systemic lupus erythematosus (SLE) are described in whom there were major psychiatric complications. Two of these patients had cerebral lupus with psychiatric manifestations of the disease together with other features of disease activity and responding to treatment with high dose steroids. The first of these had had a ten-year history of recurrent episodes of depression before other features of the disease became evident; in the second patient recurrent psychotic episodes occurred after the onset of typical multi-system disease. The third patient had had a minor cerebro-vascular accident four years before other features of SLE became manifest, and cerebral deterioration later on in her life was probably due to hypertensive cerebro-vascular disease secondary to the renal disease of SLE. The fourth patient, a young man, had had recurrent episodes of depression and aggressive behaviour for several years and committed suicide at the age of 33.
Crohn's Disease: A Psychosomatic Illness?
Authors: Sheffield B. F. , Carney M. W. P.
Published: August 2008

We investigated the psychological status of Crohn's disease patients because 10 such patients had been referred to our psychiatric out-patient department over a period of six years, whereas if there were no association between the disease and psychiatric morbidity, the expected referral rate would be one case in 20 to 100 years. We found an association between episodes of psychiatric and physical symptoms in the case histories. We administered the Eysenck Personality Inventory and the Manifest Anxiety Scale to 28 out-patients with Crohn's disease (8 psychiatrically and 20 non-psychiatrically referred), 17 with chronic non-psychosomatic medical diseases, 43 with psychosomatic diseases and 100 with neurosis. Crohn's disease patients were significantly more anxious, neurotic and introverted than both the test norms and the non-psychosomatic medical out-patients and did not differ appreciably from the psychosomatic patients in these respects.
A Job Rating Scale for use in Psychiatric Rehabilitation
Authors: Philip Alistair E. , Moore John W.
Published: August 2008

Work has been a highly valued feature of psychiatric rehabilitation programmes. The performance of patients has often been the object of scrutiny and assessment, but the jobs performed by these patients have not been so assessed. This paper describes the development and use of a job rating scale which parallels the use of patient assessment instruments.
New Long-Stay Patients in a Hospital for Mental Handicap
Authors: Spencer Douglas A.
Published: August 2008

Better Services for the Mentally Handicapped (1971) forecasts a diminution in the number of beds in hospitals for mental handicap. It can be achieved only by the admission of fewer new long-stay patients. This paper considers 50 new long-stay cases admitted to a hospital for mentally handicapped in the five years 1970 to 1974. Of these admissions 42 per cent were children, and of all the admissions 54 per cent had Wechsler intelligence quotients under 25. Further, 62 per cent of the admissions were for behaviour problems and 38 per cent were for physical infirmity and helplessness. It is concluded that there are some mentally handicapped people who have problems with which only a hospital can cope. The high nursing dependency and the profound mental retardation of a majority of the new long-stay patients present a formidable challenge.
Influence of Coroners' Officers and Pathologists on Suicide Verdicts
Authors: Barraclough Brian , Holding Trevor , Fayers Peter
Published: August 2008

Three-hundred-and-thirty cases of unnatural death, leading to 110 open verdicts, 110 verdicts of suicide and 11o of accident, from the Inner West London Coroner's District have been examined to see if particular coroner's officers or pathologists were associated with disproportionate numbers of suicide verdicts. No significant deviations from the expected numbers were found. Coroner's officers probably share common ideas about the features defining suicide, and so do pathologists.
A Double-Blind Comparison of Lithium Carbonate and Maprotiline in the Prophylaxis of the Affective Disorders
Authors: Coppen Alec , Montgomery S. A. , Gupta R. K. , Bailey J. E.
Published: August 2008

A double-blind prospective study was carried out comparing the prophylactic effect of maprotiline and lithium carbonate over a period of one year in patients suffering from recurrent affective disorders. The average Affective Morbidity Index was lower, but not significantly so, in patients treated with lithium. A further analysis, based on dividing patients into those with no affective morbidity and those who showed some affective morbidity during the study, demonstrated lithium carbonate to be significantly superior to maprotiline both in the group as a whole and in unipolar depressives. A correlation between high plasma maprotiline concentration and low morbidity was observed and was in line with an earlier report. A highly significant negative correlation (r = −0.97; p < 0.001) was found between plasma maprotiline concentration and body weight. Although the results showed lithium carbonate to be superior to maprotiline in the study, it should be emphasized that the plasma levels of lithium were constantly monitored and maintained at what is considered to be its optimum concentration, whereas the maprotiline treated patients were kept on a fixed dosage regime irrespective of plasma levels.
Dyskinesias Associated with Tricyclic Antidepressants
Authors: Fann William E. , Sullivan John L. , Richman Bruce W.
Published: August 2008

Hyperkinetic movement disorders may occur as side effects of antipsychotic drugs; and a hyperdopaminergic state induced by the neuroleptic compounds is thought to be a cause of extrapyramidal disorders such as tardive dyskinesia. We have observed two cases of the dyskinetic syndrome in patients receiving tricyclic antidepressants (TCA). Because the TCA are known to have little effect on striatal dopamine but do share with the neuroleptics potent anticholinergic activity, these cases appear to support the hypothesis that the drug-induced hyperkinetic disorders are related to a diminution of CNS acetylcholine activity as well as to an increase in dopamine activity.
Psychiatric Priorities in Developing Countries
Authors: Giel R. , Harding T. W.
Published: August 2008

Many psychiatrists assert that an expansion of mental health services in the developing countries is overdue. This will only take place if: (i) the tasks of mental health care are undertaken by a wide range of non-specialist health workers, including those responsible for primary health care; and (ii) services are directed initially at a very limited range of priority conditions. The method of priority selection is discussed, and the process required for translation of priority decisions into health action is exemplified by two illustrations.
A Clinical Evaluation of Depressives Found in a Rural Survey in India
Authors: Nandi D. N. , Ajmany S. , Ganguli H. , Banerjee G. , Boral G. C. , Ghosh A. , Sarkar S.
Published: August 2008

Those who were labelled as depressives in a rural survey were randomly divided into a Medicine group (who received antidepressive drug treatment), a Placebo group (who received placebo) and a Natural Process group (who received no treatment). The depth of their depression was assessed by Hamilton's Depressive Rating Scale before the beginning of the trial, on the 14th day and on the 28th day of trial. They were compared with a matched group of healthy controls and again with a matched group of depressives who attended an urban clinic for treatment.

The results indicate that the rural depressives who never sought treatment voluntarily were not different from those who sought treatment in clinics, so far as their response to treatment is concerned.
Efficacy and Side Effects of Nitrazepam and Thioridazine as Sleeping Aids in Psychogeriatric In-patients
Authors: Linnoila Markku , Viukari Matti
Published: August 2008

The efficacy and side effects of 10 mg of nitrazepam and 25 mg of thioridazine as sleeping aids were measured in 20 psychogeriatric in-patients during the 14th night and morning of drug administration. The trial used a double blind, cross-over design. The effect of nitrazepam was slightly faster than that of thioridazine. After thioridazine, but not after nitrazepam, the patients slept significantly longer than after placebo. Nitrazepam, but not thioridazine, significantly impaired patients' abilities to move and to conduct everyday activities. It is concluded that thioridazine is a suitable sleeping aid for psychogeriatric patients, but that nitrazepam should be avoided.
The use of Selected Questions from the Symptom-Sign Inventory with Long-Stay Psychiatric Patients
Authors: Gomez Joan , Priest R. G.
Published: August 2008

The Symptom-Sign Inventory was administered to 57 long-stay psychiatric in-patients with the object of selecting a group of questions which would stimulate the production of delusional or other psychotic material. The scoring of the responses as positive was made on verbal affirmative and other specific behaviours which were thought to indicate emotional impact. It was found that the ten questions selected compared favourably with longer questionnaires in discriminating schizophrenic from normal subjects and from those with organic brain disease. It is suggested that these questions might be included in brief assessment interviews on which day-to-day management decisions are made.
Lithium Carbonate Prophylaxis Failure
Authors: Dunner David L. , Fleiss Joseph L. , Fieve Ronald R.
Published: August 2008

Data from non-rapid-cycling bipolar (manic-depressive) patients who were receiving long-term treatment with lithium carbonate were analysed by the life table method to determine when lithium carbonate prophylaxis failures occurred. Forty-four of 96 patients failed to keep well in spite of maintenance lithium therapy. The analysis revealed an early, rapid failure rate during the first six months of treatment, which was followed by a slower rate of failure. Several clinical factors were assessed to determine if any of them predicted which patients would experience their initial failure in the early or late interval, but none of these factors, which included age, sex, age of onset, rate of affective attacks, family history, and the nature of the preceding episode, were found to have any predictive value regarding lithium prophylaxis failure. We found, however, that patients who had early failures tended to have a subsequent early failure in spite of continued maintenance with lithium carbonate.
Seasonal Variation in the Incidence of Mania
Authors: Symonds R. L. , Williams P.
Published: August 2008

The seasonal variation of admissions to hospital with a diagnosis of mania (296.1) in England and Wales was examined. The results indicated that for females there was a significant seasonal trend, the peak being in August–September, while for males there was no significant seasonal pattern. The possible reasons for these findings are discussed.
Patients Have Been Let Out of Wards; Why Not Nurses Too?
Authors: Morgan Roger
Published: August 2008

Tradition retains the practice of attaching mental nurses to wards rather than to groups of patients, even though the wards are increasingly empty as patients come to lead more active lives in hospital. A system is described which enables nurses to relate more fully to the people in their care instead of having to confine their activities to the place in which only a part of the care is provided. This system involves all ward nurses in leaving their wards empty in ‘working hours', being relieved of the care of their intercurrently ill patients and undertaking in exchange the complete day care of their fitter patients in both wards and workplaces. The consequences of these changes are attractive to many nurses and helpful to many patients.
Some Possible Childhood Indicators of Adult Schizophrenia Inferred from Children of Schizophrenics
Authors: Hanson D. R. , Gottesman I. I. , Heston L. L.
Published: August 2008

Prospective developmental data on 33 children of consensus diagnosed schizophrenic parents were compared to control samples of children of other psychiatric patients and children of normal parents. Contrary to several reports, the children of schizophrenics, observed from birth to age seven, were remarkably normal on a host of pregnancy and delivery variables, neurological examinations, physical growth measures, and psychological tests. However, a combination of three indicators characterized five of the 116 children, and all five were offspring of schizophrenics (17 per cent of the high risk sample), thus matching the expected lifetime risk for schizophrenia previously observed in such samples. Case histories show that all five children have enduring patterns of maladjustment and exhibit behaviours often reported in the premorbid histories of schizophrenics. Most have family histories heavily loaded with schizophrenia. In terms of a diathesis-stress model, these five children appear especially vulnerable to future schizophrenia in the absence of rational methods of prevention.
Trainees’ Competence in Psychiatric Case Writing
Authors: Kiernan W. E. S. , McCreadie R. G. , Flanagan W. L.
Published: August 2008

An assessment was made of 100 case records written by junior medical staff working in a psychiatric teaching hospital. Thirty-nine items were rated, and considerable gaps were found in the records. The Mental State was more poorly recorded than the History; the Formulation and Summary were more satisfactory. Possible reasons for the findings are discussed, including methodological difficulties, administrative considerations, and attitudes of junior staff. The implications for the training and assessment of junior psychiatrists are explored.
Sigmund Freud's Views on the Sexual Disorders in Historical Perspective
Authors: Hoenig J.
Published: August 2008

The study of the sexual disorders has made considerable strides during the past 90 years since Krafft-Ebing published hisPsychopathia Sexualisin 1886. There were earlier beginnings which had provided very important insights into the nature of abnormal sexual behaviour, but it fell to Krafft-Ebing to bring sex research into the discipline of medicine, thereby giving it a methodology and a framework within which to unfold. The subsequent history has been described by Wettley and Leibbrand (1959) and constitutes the development of the basis of modern ‘sexology'—a translation of the term ‘Sexualwissenschaft’ created by Iwan Bloch in 1906. The period from thePsychopathia Sexualisto the time of the First World War saw the development of ideas which are still important for modern sexology, although the discipline has since matured into an experimental science using the methodologies of the biological as well as the behavioural sciences—psychology, sociology and anthropology.
Deafness and Psychiatric Illness
Authors: Cooper A. F.
Published: August 2008

Review of the literature concerning the relationship between deafness and psychiatric disorder reveals differences in the pattern of illness depending on the severity of deafness and the age of onset. In particular, the prevalence of schizophrenia in the prelingually deaf is similar to that found in the normal population, whereas the hard of hearing are over-represented among samples of patients suffering from paranoid psychoses in later life.

Possible modes of action of long-standing hearing loss in the aetiology of paranoid illnesses are considered: the psychological and social consequences of deafness, the possible contribution of sensory deprivation phenomena, and the interference of hearing loss in attention, perception and communication. Finally, possible future lines of research are suggested.
Physique, Personality and Mental Illness in Southern Chinese Women
Authors: Singer K. , Lieh-Mak F. , Ng M. L.
Published: August 2008

A number of anthropometric measurements were made on Southern Chinese women. These were 317 schizophrenics, 44 with affective disorder, 47 neurotics and normal controls. All groups and sub-groups compared were matched for mean age and socio-economic status. It was found that the intercorrelations between body build, personality and type of mental illness were on the whole similar to those reported for Caucasians.
The Aftermath of Parental Suicide for Children
Authors: Shepherd D. M. , Barraclough B. M.
Published: August 2008

Thirty-six children between the ages of 2 and 17 bereaved by the suicide of a parent were followed up after 5 to 7 years. The children's home life before bereavement had been abnormal because of mental illness, and family disruption and pre-suicide stresses were significantly related to present functioning. An incidence of psychological morbidity greater than that of a comparison group was observed. Some children appear to cope with the experience of parental suicide without serious consequences; for a few there was relief from an insupportable situation.
Schizophrenia and the Theories of Thomas Szasz
Authors: Roth Martin
Published: August 2008

Anyone acquainted with Dr Thomas Szasz's previous writings about mental disorder, the nature of its relationship to the Law and to the problems of drug dependance (Szasz, 1961, 1963, 1970, 1972, 1975) has learned to look in the first instance for the dualism, the poles of which are to be demonstrated as irreconcilable. For, as Glazer (1965) has pointed out, one of Dr Szasz's main conceptual devices is ‘the dichotomy game‘. A phenomenon may belong to category (x) or another category (y) but not to both. As a first step it is as well to examine the definitions of the categories in question. They are liable to prove inconsistent or idiosyncratic or just to be omitted. In other cases, as Professor Stone (1973) has shown in his detailed and telling dissection of the tortuous and confused logic pursued by Dr Szasz in The Myth of Mental Illness, the definitions are incomplete or erroneous and the implied anti-thesis dubious or false. Beginning with the equation that a lie is to a mistake as malingering is to hysteria, Szasz manages, following a maze of tortuous and self-contradictory arguments, to emerge at the conclusion that it would be ‘… more accurate to regard hysteria as a lie than as a mistake‘.
Personality and Symptom Pattern in Depression
Authors: Paykel E. S. , Klerman G. L. , Prusoff B. A.
Published: August 2008

This paper reports relationships between symptoms and premorbid personality in a varied sample of depressed patients. Symptoms were rated by a psychiatrist at clinical interview; personality was rated by patients on self-report after clinical improvement, using the Maudsley Personality Inventory and an inventory of obsessive, hysterical and oral personality. Additional ratings on the latter were obtained at interview with a relative. The most prominent finding was that patients with premorbid neuroticism also showed a neurotic rather than an endogenous symptom pattern. Additional relationships were relatively weak but consistent with previous studies. Depressives with neurotic rather than endogenous symptom pattern showed more evidence of oral dependent personality and less obsessionality. Patients with hysterical personalities tended to be less severely ill and to show a pattern characterized by mixed depression and hostility with less evidence of anxiety.
Circadian Body Temperature in Chronic Schizophrenia
Authors: Morgan R. , Cheadle A. J.
Published: August 2008

The 24-hour oral temperatures of 51 chronic schizophrenic patients, 19 non-schizophrenic chronic psychiatric patients and 14 non-patients have been measured and compared. The chronic schizophrenics have an earlier peak temperature and differ significantly from the other groups. Compared with the non-schizophrenic patients their hourly mean temperatures reach significantly higher levels in the morning. Compared with the non-patients their mean temperatures fall to significantly lower levels in the evening after 5.00 pm.
Mental Disorder and Season of Birth—A Southern Hemisphere Study
Authors: Parker Gordon , Neilson Megan
Published: August 2008

Studies on the relationship between season of birth and mental disorder have been substantially confined to northern hemisphere regions. Such studies have generally found an excess of winter births of schizophrenics, and variably an excess of winter births of manic-depressive and mentally retarded patients. In the present study information on sex, diagnosis and date of birth was obtained on all 20,358 patients first admitted to psychiatric facilities in New South Wales between July 1970 and June 1974 and born in New South Wales. The collective 1962–71 monthly live-births for New South Wales were used as a control. A significant winter excess was found for the female schizophrenic group, while a significant spring excess was found for neurotic patients, most marked in those with anxiety neurosis. It is hypothesized that the relationship between schizophrenia and winter birth is consequent upon a greater sensitivity of schizophrenics to those physiological factors which determine conception in the general population.
Personality, Expectancies and Group Psychotherapy
Authors: Caine T. M. , Wijesinghe B.
Published: August 2008

The paper reports an extension of work into the relevance of personality and pre-treatment expectancies for allocation and response of patients to group psychotherapy. The results show that subjects who are internally directed in interest and who have a liberal attitude to a variety of social issues and a ‘psychological’ set to treatment are more responsive to group psychotherapy as seen by their therapists as well as by themselves. Those who are externally directed in interest and who have a conservative attitude to life and a more ‘medical-physical’ set to treatment are more likely to be referred for behaviour therapy; if referred for group psychotherapy they are likely either to drop out or to show very limited response to treatment.
Prenatal Progesterone and Educational Attainments
Authors: Dalton Katharina
Published: August 2008

Children whose mothers received prenatal progesterone have been shown to be advanced in development at one year and to have greater academic achievement at 9–10 years. This study compares the educational attainments at 17–20 years of 34 progesterone children with 37 normal and 12 toxaemic controls. More progesterone children continued schooling after 16 years compared with controls; a higher proportion left school with ‘O’ level and ‘A’ level passes, the average number of passes per child was greater at both levels and more obtained a university place. The best academic results were in those whose mothers had received over 5 grams of prenatal progesterone, and for whom administration commenced before the sixteenth week and treatment lasted longer than eight weeks.
Respiratory Ventilation and Carbon Dioxide Levels in Syndromes of Depression
Authors: Mora J. Damas , Grant L. , Kenyon Patricia , Patel M. K. , Jenner F. A.
Published: August 2008

The breathing rate and PCO2in end-tidal air have been studied in controls and in patients with endogenous depression (retarded and non-retarded), with neurotic depression, and with schizophrenia. It has been shown that breathing rate goes up and PCO2down in non-retarded and neurotic depression. Schizophrenia gives more anomalous results. The fact is emphasized that such changes must lead to alterations in pH and other variables. Studies showing some small chemical differences between these clinical entities and control subjects might therefore be explained by these findings.
The Hla System and the Clinical Response to Treatment with Chlorpromazine
Authors: Smeraldi E. , Bellodi L. , Sacchetti E. , Cazzullo C. L.
Published: August 2008

A group of 33 schizophrenic patients were typed for HLA-SD antigens and their qualitative clinical responses to chlorpromazine therapy determined. A highly significant positive correlation was found between response to chlorpromazine and HLA-A1 positive, while HLA-A2 positive subjects showed a significant negative correlation to chlorpromazine treatment.

In a second group of 17 patients the clinical responses to chlorpromazine were evaluated quantitatively, by WPRS, in HLA-A1 positive and HLA-A1 negative patients. There were no pre-treatment differences in the scores. After treatment the scores of positive patients were significantly lower, indicating that they responded to a greater degree.

Since the frequency of HLA-A1 in hebephrenic patients is higher than that in other schizophrenics this may explain our earlier finding that hebephrenics, as a group, respond better to chlorpromazine than do other schizophrenics.
Treatment Adherence
Authors: Blackwell Barry
Published: August 2008

A large part of medical practice is complicated by two problems; the degree to which treatments are specific (the placebo problem) and the extent to which they are implemented (the adherence problem). Depending on setting and circumstance, up to half of the benefits of treatment are either non-specific or never obtained. This review considers the problem of adherence in the context of use of medication in psychiatry.
Height and Personality Characteristics of 47, XYY Males in a Sample of Tall Non-Institutionalized Males
Authors: Dorus Elizabeth , Dorus Walter , Telfer Mary A. , Litwin Samuel , Richardson Claude E.
Published: August 2008

A sample of 471 enlisted men 183 cm or taller serving in the US Navy, Coast Guard, and Marine Corps was screened for Y-chromosome aneuploidy by use of quinacrine fluorescence of peripheral blood smears. Two 47, XYY males were detected, resulting in a prevalence of .00425 or approximately 1 in 236. The prevalence of 47, XYY males (.00331) in a number of samples of tall, non-institutionalized males is significantly higher than the incidence in newborn males (.00091), indicating that 47, XYY males are disproportionately represented in tall male populations. The 47, XYY males had significantly higher scores than 46, XY males on the Schizophrenia, Schizophrenia + 1K, and Prejudice scales of the Minnesota Multiphasic Personality Inventory and significantly lower scores on the Dominance scale. Since the probability that a randomly selected pair of subjects in the sample had four or more scale scores significantly different from the remainder of the group was greater than .05, it is possible that the differences between the 47, XYY and 46, XY males occurred by chance. On the other hand, one or more of these scales may measure personality dimensions on which non-institutionalized 47, XYY males may, in fact, differ from 46, XY males.
Mourning, Mummification and Living with the Dead
Authors: Gardner Alan , Pritchard Michael
Published: August 2008

Six cases are reported in which the bereaved kept the deceased's body for periods ranging from one week to ten years.

Some relevant anthropological and psychoanalytical observations are discussed. This phenomenon does not appear to have been reported in the literature of Western psychiatry.
Cultural and Temporal Variations in Schizophrenia: A Speculation on the Importance of Industrialization
Authors: Cooper J. E. , Sartorius N.
Published: August 2008

A speculative hypothesis is presented which links the late development of modern concepts of schizophrenia with social and familial effects of industrialization. It is suggested that the social and family structures found historically in pre-industrial societies and currently in developing countries exert a comparatively benign effect upon patients with schizophrenia, and that these effects are lost during and after industrialization. Thus the severe and chronic forms of the illness became prominent and therefore recognized in the segregated institutions of Europe in the latter part of the nineteenth century.

Possible mechanisms are examined by which industrialization could influence the structure of communities and families and the development of individuals to produce the postulated changes in the individual's response to the schizophrenic illness. It is suggested that three major areas of interest for the identification of these mechanisms are (i) the rapid increase in size of towns and communities, (ii) changes in perinatal and infant mortality and morbidity, and (iii) changes in family structure. Some ways of testing the hypothesis and its implications are outlined.
Capgras' Syndrome and Cerebral Dysfunction
Authors: Hayman Martin A. , Abrams Richard
Published: August 2008

Two cases of Capgras' syndrome in association with coarse brain disease are presented. The authors suggest that prosopagnosia (face non-recognition) may be the primary expression of a specific cerebral dysfunction which forms the basis for a delusional elaboration resulting in Capgras' syndrome.
Another Style of Psychogeriatric Service
Authors: Baker A. A. , Byrne R. J. F.
Published: August 2008

This paper describes a psychogeriatric service in Gloucestershire. Agreement on policies was reached with general practitioners, Social Services, other psychiatrists and hospital nursing staff. The day hospital is regarded as the preferred area of treatment for a wide variety of patients, including the severely demented. In this service less than five per cent of admissions appear to become long-stay. With emphasis on day hospital and community support the number of beds for this type of patient recommended by DHSS may be excessive.
Neurological Investigation of Dementia
Authors: Victoratos G. C. , Lenman J. A. R. , Herzberg L.
Published: August 2008

Fifty-two patients thought to be suffering from dementia when first seen as neurological out-patients were fully investigated.

Four of them were found to have tumours, whilst in five the dementia was due to a treatable cause.

Neither a long history nor an age above sixty-five precludes a dementia being due to a treatable cause.
Folie à Quatre
Authors: Sims A. C. P. , Salmons P. H. , Humphreys Philippa
Published: August 2008

A case of folie à quatre is described affecting a proband and his wife, sister and brother. The three family members retained their symptoms of paranoid schizophrenia. The wife was not mentally ill and her delusions disappeared in time (folie imposée). Coincidentally, there were several cases of Huntington's chorea amongst her relatives. Different categories of folie à deux are demonstrated in the various family members and relationships.
Usefulness of Saliva Lithium Estimation
Authors: Verghese Abraham , Indrani N. , Kuruvilla K. , Hill Peter G.
Published: August 2008

Estimation of lithium in 24 samples of serum and saliva show that there is a very high correlation between the lithium levels in serum and saliva (r= +0·88). The ratio found in our patients is very similar to that reported from North America. Estimation of lithium in saliva at different periods of time show there is a good degree of stability for saliva lithium levels. Thus saliva can be used as a substitute for serum for lithium monitoring. The practical advantages of this are discussed.
Seriousness of Suicide Attempt in Relation to Personality
Authors: Pallis D. J. , Birtchnell J.
Published: August 2008

From a sample of psychiatric referrals who had completed the MMPI the following three groups, matched for age and sex, were derived: 42 patients with a history of a serious suicide attempt, 42 patients with a history of a non-serious attempt, and 126 patients who had neither attempted nor contemplated suicide. Non-serious suicide attempters were shown to be the most deviant group and differed to a significant extent from each of the other two groups on the Dependency, Hostility and Unconventionality scales. Male non-serious attempters showed the most disturbed personality profile. This implies that there is, for males, a higher personality threshold for making a non-serious attempt, which may account for the fact that suicide attempts, most of which are non-serious, are commoner among females.
The EEG as a Measure of Cerebral Functional Organization
Authors: Shaw J. C. , O'Connor K. P. , Ongley C.
Published: August 2008

Evidence suggests that anomalies of functional organization in the brain may be present in some psychiatric disorders and that EEG differences between psychiatric patients and appropriate control groups may depend on them. It is therefore of practical importance to develop further ways of examining the association between the EEG and such organization. The change in inter-hemisphere coherence (a measure of EEG synchronicity) in the alpha frequency band when carrying out a task is shown to discriminate a group of 11 right from 11 left preferent normal individuals. Since right and left preference is associated with differences in cerebral functional organization, the coherence measure may be a useful way of studying this feature of psychiatric illness.
Hostility, Crime and Drug Dependence
Authors: Gossop Michael , Roy Alec
Published: August 2008

In a study of male addicts attending a London drug dependence unit, it was found that convicted addicts tended to score more highly on measures of hostility than non-convicted subjects. The differences in hostility between the convicted and non-convicted groups were most clearly seen on the violent crimes variable, although addicts convicted of drug-possession and of non-drug crimes were also more hostile than non-convicted subjects. It is suggested that hostility acts as a personality factor which predisposes the individual towards criminal behaviour, and that the more hostile subjects may also be more likely to be apprehended and convicted.
Electrical Aversion Therapy with Alcoholics: A Comparative Follow-up Study
Authors: Glover J. H. , McCue P. A.
Published: August 2008

A group of alcoholics treated by partially reinforced electrical escape conditioning were found to have a significantly better outcome on follow-up than a selected control group, who showed a parallel level of motivation, and were treated by conventional methods. No sex differences in outcome were found for either group. In the experimental group, better prognosis was associated with higher social class and older age, and poorer prognosis with single marital status. There were no variations in outcome for age in the control group. In the age range 20–40 aversion therapy showed no better results than conventional therapies, but with subjects above this age range it was very significantly superior. The results are discussed with reference to the application of aversion therapy to alcoholism.
A Danish Twin Study of Manic-Depressive Disorders
Authors: Bertelsen A. , Harvald B. , Hauge M.
Published: August 2008

The existence of a nation-wide twin register and central psychiatric register has made possible a catamnestic investigation of an unselected and representative sample of twins with manic-depressive disorders.

From a total population of 11,288 same-sexed twin pairs born 1870–1920 in Denmark 126 probands from no pairs were ascertained. Among the co-twins of 69 monozygotic probands there were found 46 with manic-depressive disorders, and a further 14 had presented other psychoses or marked affective personality disorders or had committed suicide, yielding a proband rate of strict concordance, C1= 0·67 and of broad, partial concordance, C2= 0·87. The corresponding direct pairwise concordance rates were 32/55 = 0·58 and 46/55 = 0·84 respectively. For the dizygotic twins the proband concordance rate of C1was 11/54 = 0·20 and of C220/54 = 0·37, and the direct pairwise rates were 9/52 = 0·17 and 18/52 = 0·35 respectively. The differences between the pairwise rates for the monozygotic and dizygotic twins are significant (P < 0·001 at χ2analysis). This finding is in accordance with previous twin studies of manic-depressive disorders and confirms the evidence of a strong genetic factor. The concordance with respect to unipolar and bipolar forms was not in contradiction to recent evidence of a genetic difference between the bipolar and unipolar form, the latter probably related to the female sex.
The Impact of an Abnormal Child upon the Parents
Authors: Gath Ann
Published: August 2008

Thirty families with a newborn mongol baby were matched with thirty families with a normal baby. Both groups were followed for eighteen months to two years and interviewed six times. Few differences could be found in the mental or physical health of the two groups of parents, but marital breakdown or severe marital disharmony was found in nine of the mongol families and in none of the controls.
The Making and Breaking of Affectional Bonds
Authors: Bowlby John
Published: August 2008

An account is given of how a clinician guided by attachment theory approaches the clinical conditions to which the theory is held to apply, which include states of anxiety, depression and emotional detachment. Assessment of a patient is in terms of the patterns of attachment and caregiving behaviour which he commonly shows and of the events and situations, both recent and past, which may have precipitated or exacerbated his symptoms. The problems posed by relevant information being suppressed or falsified are noted.

Viewed in this perspective a psychotherapist is seen to have a number of interrelated tasks: (a) to provide the patient with a secure base from which he, the patient, can explore himself and his relationships; (b) and (c) to examine with the patient the ways in which he tends to construe current interpersonal relationships, including that with the therapist, and the resulting predictions he makes and actions he takes, and the extent to which some may be inappropriate; (d) to help him consider whether his tendencies to misconstrue, and as a result to act misguidedly, can be understood by reference to the experiences he had with attachment figures during his childhood and adolescence, and perhaps may still be having.
Aspects of Outcome in a Therapeutic Community Setting
Authors: Kennard D. H. W. , Clemmey W. R. L. , Mandelbrote B. M.
Published: August 2008

How patients are seen by themselves and others close to them may influence the process of re-integration in the community after discharge. In a study in a psychiatric admission unit employing a therapeutic community approach, patients who sought little or no contact with the unit after discharge saw themselves, and were seen by others, as less ‘pleasant’ but less ‘ill’ than those who continued more regular contact. Perceptions were measured with the semantic differential technique. Patients' social class and household position were found to have a marked effect on the level of contact and on its association with how patients were seen. Diagnosis did not appear to influence hospital contact.
Kibbutz Civilian Population Under War Stress
Authors: Kaffman Mordecai
Published: August 2008

During the Arab-Israeli war of 1973 measures had to be taken by the kibbutz civilian population in Israel to cope with the stresses of war. The measures adopted, and the specific characteristics of an organized cohesive group, appear to have succeeded in reducing the severity of the reactions to stress and in lowering the incidence of psychiatric casualties among children and adult members of the kibbutzim.
Survival of Nieces and Nephews of Schizophrenic Patients
Authors: Buck Carol , Simpson Helen , Wanklin James M.
Published: August 2008

Evidence was found against the hypothesis that heterozygous carriers of a schizophrenic gene have a reproductive advantage through enhanced fertility. In consequence an investigation was made of the possibility that an advantage is gained through diminished early mortality among the offspring of carriers. The results were equivocal. While an observed deficit of infant deaths was attributable to under-reporting, the possibility of a true advantage could not be ruled out, because of the statistical unreliability of the findings in a sample of the size available. A plea is made for a collaborative effort to settle the issue.
The Effect of Varying the Rate of Presentation on the Information Transmission of Schizophrenic and Control Groups
Authors: Wijesinghe O. B. A.
Published: August 2008

Groups of subjects were tested on a paced serial reaction-time task in order to study the effect of varying the rate at which information was presented. The groups were: two groups of patients with acute schizophrenia but differentiated on the basis of primary symptoms, a group of institutionalized schizophrenic patients, a group of neurotic patients and a normal group. All groups showed a reduction in efficiency when the presentation rate was increased. The groups most adversely affected were the non-integrated and institutionalized schizophrenic patients. The integrated schizophrenic and the neurotic groups were affected to a lesser degree, the normal groups being least affected. These results favour a dimensional view of personal illness, in which deficits are most marked in patients with non-integrated schizophrenia.