bluuebunny/crossref_metadata_2025 huggingface dataset:
Hallucinogenic drugs as precipitants of schizophrenia
Authors: Breakey William R. , Goodell Helen , Lorenz Patrick C. , McHugh Paul R.
Published: July 2009

SYSNOPSIS

The authors have examined the drug-taking histories of 46 schizophrenics and 46 matched controls. They have found that the schizophrenics on average used a wider variety of drugs, in greater amounts. Schizophrenics who had used drugs experienced the onset of symptoms on average four years earlier than non-users and were also admitted to hospital four years earlier, on average. Those schizophrenics who had used drugs had had better premorbid personalities than the non drug-users. These results are indicative of some precipitating role of drug abuse in the onset of schizophrenia.
Reading ability and brain function: a simple statistical model
Authors: Maxwell A. E. , Fenwick P. B. C. , Fenton G. W. , Dollimore J.
Published: July 2009

SYSNOPSIS

This report is concerned with a simple statistical model of the way the brain may function, suggested by the analysis of intelligence test results in two groups of children. The model describes the statistical behaviour of an ideal array of elements, representing the brain, during tests of cognitive ability. Predictions from the model indicate that comparison of the EEC recording taken from groups of children who were good or poor readers would show amplitude differences. These were found between the groups when the eyes were open but not when the eyes were closed–a result explained by the model.
Behavioural measurement and drug response characteristics of unipolar and bipolar depression
Authors: Katz Martin M. , Robins Eli , Croughan Jack , Secunda Steven , Swann Alan
Published: July 2009

Synopsis

This research is part of the NIMH-CRB Collaborative Study on the psychobiology of depression. The main objective of the research programme is to test hypotheses concerning the interaction of neurobiological mechanisms and behaviour in the depressive disorders. Part I of the report describes the rationale and the overall approach to measuring behavioural state and outcome in the research programme. Part II reports on the results of applying the behavioural methods to a comparison of the clinical phenomenology of unipolar and bipolar depression. The behavioural patterns expressed during the episode by the two groups are different. Further, the two types are shown to react differently to treatment with tricyclic drugs, reinforcing the thesis that they are qualitatively distinct forms of the depressive disorders.
Insulin Tolerance Test: human growth hormone response and insulin resistance in primary unipolar depressed, bipolar depressed and control subjects
Authors: Koslow Stephen H. , Stokes Peter E. , Mendels Joseph , Ramsey Alan , Casper Regina
Published: July 2009

Synopsis

Preliminary data from the National Institute of Mental Health – Clinical Research Branch Collaborative Program on the Psychobiology of Depression dealing with the human growth hormone (hGH) response to the Insulin Tolerance Test (ITT) during the pre-treatment (drug-free) period of the study are presented in this paper. Data are reported for 54 unipolar depressed, 21 bipolar depressed, and 40 normal control subjects, who represent approximately 50% of the final subject sample to be studied. In this population the unipolar depressed subjects showed a significantly greater resistance to insulin-induced hypoglycaemia than bipolar and control subjects. After applying the inclusion/exclusion criteria necessary to interpret hGH responses accurately, the data from only 54 subjects were acceptable. Mean peak hGH concentrations were not significantly different among the three groups. There was, however, a significant difference in the distributions of the hGH peak response, with the bipolar depressed population demonstrating greater variability in response than unipolar and control populations. These findings are discussed as they relate to previous reports and theoretical considerations.
The effect of digoxin on the response to lithium therapy in mania
Authors: Chambers Catherine A. , Smith Anne H. W. , Naylor Graham J.
Published: July 2009

Synopsis

Patients suffering from manic-depressive psychosis, manic type (ICD 296·0), were treated with lithium carbonate and randomly allocated to two groups, one received digoxin and the other matching placebo for 7 days. Severity of mania was rated by psychiatrists on the Manic Rating Scale and Analogue Line on days 0 and 7 and by nurses daily on the Hargreaves Rating Scale, Psychotic Rating. Fourteen patients received digoxin and lithium carbonate and 14 patients received placebo and lithium carbonate. Improvement in the placebo lithium group was significantly greater than that in the digoxin lithium group. This trial suggests, therefore, that the effect of inhibition of membrane cation carrier is to reduce the response to lithium. This result is in keeping with our hypothesis that an increase in Na–K ATPase is essential to the therapeutic effect of lithium carbonate. It does not, however, exclude the possibility that the observations resulted from the inhibition by digoxin of lithium entry into the brain.
Early improvement as a predictor of response to amitriptyline and nortriptyline: a comparison of 2 patient samples
Authors: Coryell W. , Coppen A. , Zeigler V. E. , Biggs J. T.
Published: July 2009

Synopsis

This study compared serial severity ratings from 2 methodologically similar tricyclic antidepressant studies. Though the groups resembled each other in terms of diagnosis and baseline severity, response patterns were surprisingly different. In particular, early change was highly predictive of outcome in one group but not in the other. The results of response predictor studies must, therefore, be generalized with caution. These data, nevertheless, do allow some guidelines for predicting response from early changes and severity.
The impact of an expanding community mental health service on patterns of bed usage: evaluation of a four-year period of implementation
Authors: Häfner H. , Klug J.
Published: July 2009

Synopsis

In the city of Mannheim the introduction of an extensive community mental health service has been shown, by means of case-register data over 4½ years, to have led to a considerable increase in utilization, mainly at the out-patient level of care. The rates of admission to hospital increased very little. Due to the simultaneous decline in long-term bed occupancy, the overall need for psychiatric beds remained stable at a rate of about 1·2/1000, a rate which is very low by international standards.

The sharp decline in the ‘old’ long-stay population was followed by a smaller increase in ‘new’ long-stay patients which it has not been possible to prevent. These patients are, however, admitted for a long-term stay significantly later than formerly, and their diagnostic composition has changed significantly.

The increase in the bed requirements for short- and medium-term stay patients resulted from different sources: an increasing morbidity in some groups of disorders, the rising utilization in case of emergencies and severe crises, and the transfer of long-stay patients to alternative care services. The level of these needs was very similar in Mannheim, Salford, Samsø and Camberwell, whereas the rates for long-term beds still show clear national differences.
Psychosocial factors and blood pressure
Authors: Goldberg Evelyn L. , Comstock George W. , Graves Carol G.
Published: July 2009

SYNOPSIS

Blood pressure levels as recorded in a community-wide screening programme were compared with findings in an earlier mental health study for persons who participated in both programmes. Blood pressure was not related to previously ascertained psychosocial characteristics among persons who were not under treatment for hypertension, suggesting that depression, hostility, psychosomatic reactions to stress, or the felt need for help with emotional problems were not important in the pathogenesis of hypertension. Treatment for hypertension, however, was associated with an excess of psychosomatic symptoms, a factor which needs to be taken into account in assessing the benefits of treatment.
Biochemical changes in the cholinergic system of the ageing brain and in senile dementia
Authors: Bowen D. M. , Davison A. N.
Published: July 2009

SYNOPSIS

Loss of neurons from the ageing human brain is accompanied by reduction in biochemical markers. Compared with age-matched controls about one third of nerve cell components are lost from the temporal lobe of patients with senile dementia of Alzheimer's type. There is marked loss of choline acetyltransferase activity, especially in the hippocampus. This alteration parallels the intensity of neuropathological damage and relates to prior mental impairment. Smaller changes in other neurotransmitter synthesizing enzymes are generally found.
A statistical error in Wood & Cook's (1979) ‘Attentional deficit in the siblings of schizophrenics’
Authors: Millar Keith , Walder Cristine
Published: July 2009

SYNOPSIS

Re-analysis is made of the data from a recent study purporting toshow an attentional deficit in the siblings of schizophrenics when compared with a matched control group. The re-analysis fails to support the previously reported levels of statistical reliability and may question the inferences to be drawn from the study.
Salivary secretion and depressive illness: a physiological and psychometric study
Authors: Noble Peter , Lader Malcolm
Published: July 2009

SYNOPSIS

Salivary secretion was measured in 34 depressed inpatients who were also assessed clinically and psychometrically. Thirty-one of the patients were reassessed two weeks after a course of ECT. Before ECT, diminished salivation was associated with retardation and gastrointestinal somatic symptoms. Overall, the patients' salivary secretion did not change after ECT. More detailed analysis showed that the salivary secretion of the more retarded patients was low before ECT and increased subsequently, whereas that of the least retarded patients was high before ECT and diminished subsequently. It is suggested that the relationship between retardation and salivation may explain some of the divergent results of previous studies.
Conceptual distance indices as measures of alienation in obsessional neurosis
Authors: Makhlouf-Norris F. , Gwynne Jones H.
Published: July 2009

SYNOPSIS

A new method for the measurement of alienation is proposed. It is based upon the conceptual distance between people. For each subject, the observed distances between all possible pairs of elements were calculated and compared with the expected distance between two elements drawn at random. The ratios derived in this way were used to examine intra-self alienation and actual self isolation. The obsessional patient is self alienated and isolated. The normal control subject is self and socially integrated.
Danger periods for suicide in patients under treatment
Authors: Copas J. B. , Freeman-Browne D. L. , Robin A. A.
Published: July 2009

SYNOPSIS

Using statistical methods, the hypothesis that suicide occurs either at the beginning or at the end of a spell of treatment is shown to fit the available data.
Relationship between physical and psychiatric disorder
Authors: Eastwood M. R. , Trevelyan M. H.
Published: July 2009

Synopsis

The purpose of this study was to test the hypothesis that there is a positive association between physical and psychiatric disorder. The study was designed to reduce potential sources of bias and the approach included random sampling of a general practice population; independent assessments of the physical and psychiatric states using objective methods and strict criteria for diagnosis; and the use of a control group. The results suggest that the hypothesis is confirmed and furthermore that ‘clustering’ of both types of disorder occurred in some individuals.
Active muscular relaxation in desensitization of phobic patients
Authors: Benjamin S. , Marks I. M. , Huson J.
Published: July 2009

Synopsis

Eight phobic outpatients were treated by six sessions of desensitization followed by exposure or vice versa. Treatment was by visualization of phobic images up a hierarchy for 20 minutes at a time. During desensitization patients were relaxed before and after each image, while during exposure they looked at a neutral slide instead. Skin conductance activity was significantly lower during relaxation than during observation of the neutral slide. The patients, therapist, and a ‘blind’ assessor rated the main phobia as significantly improved for both treatments together. Each of the two treatments contributed similarly to improvement during and after treatment sessions, on measures of main phobia, subjective anxiety, and heart rate. Relaxation training appears to be redundant to the desensitization procedure.
Methysergide in mania: a double-blind comparison with thioridazine
Authors: McNamee H. B. , Poidevin D. Le , Naylor G. J.
Published: July 2009

SYNOPSIS

During 20 separate illnesses 17 severely disturbed manic patients were given either methysergide or thioridazine in a 21 day double-blind controlled trial. For most of the trial patients received either 9 mg methysergide or 450 mg thioridazine daily; during one 24-hour period 12 mg methysergide or 600 mg thioridazine was administered. Daily clinical assessments were made. Methysergide proved significantly less effective than the phenothiazine.
Part 2. Improvement criteria in drug trials with neurotic patients
Authors: Kellner Robert
Published: July 2009

SYNOPSIS

Based on the available research evidence, several rating and self-rating methods are recommended which appear to be suitable for the measurement of changes in distress in drug trials with neurotic patients.
Clinical and biochemical comparison of clorazepate and diazepam
Authors: Robin Ashley , Curry Stephen H. , Whelpton Robin
Published: July 2009

SYSNOPSIS

Clorazepate and diazepam were compared with respect to clinical effectiveness and concentrations of benzodiazepine compounds in plasma in 15 severely anxious outpatients. Each patient was studied in a double blind trial incorporating two-week periods of the two drugs and of placebo. The doses were almost equimolar—5 mg diazepam or 7·5 mg clorazepate three times daily. Clinical progress was assessed by visual analogue scales and by the Symptom Rating Test. Psychopathology scores were highest at the end of the placebo periods, and lowest at the end of the clorazepate periods, regardless of the order of treatments. After diazepam, both diazepam and N-desmethyldiazepam (nordiazepam) were detected in blood, and after clorazepate, only N-desmethyldiazepam was detected. N-Desmethyldiazepam concentrations were higher after clorazepate. Clinical progress was apparently related to the concentration of N-desmethyldiazepam in plasma.
High first admission rates for schizophrenia in the west of Ireland
Authors: Kelleher M. J. , Copeland J. R. M. , Smith A. J.
Published: July 2009

SYSNOPSIS

Standardized clinical instruments were used to examine a consecutive series of 89 mental hospital admissions in the west of Ireland and 174 admissions representative of mental hospital admissions in London. The diagnoses given to these patients by the U.S./U.K. Project psychiatrists were compared with diagnoses given the same patients by the hospital psychiatrists in the two countries. Similar levels of agreement were obtained between hospital and Project psychiatrists in the two countries and, where the alcoholic patients were removed, the proportion diagnosed as schizophrenic by the Project in the two samples was identical.
Psychological testing in depressive illness: 2. Perceptual functioning
Authors: Horne D. J. De L. , Gill J.
Published: July 2009

SYSNOPSIS

On the Aubert illusion, involving judgement of visual vertical in the absence of visual field cues, depressed patients were shown to display regressive tendencies compared with controls. In fact, their performance was very similar to that of children. However, their performance at judging postural vertical without the use of visual field cues was normal. The impaired performance of the depressed patients was compared with the deficits observed on the same experimental tasks for various other groups of patients with psychiatric or neurological disorders.
Barbiturate tolerance and psychological functioning in elderly depressed patients
Authors: Cawley Robert H. , Post Felix , Whitehead Antonia
Published: July 2009

Synopsis

Increases in barbiturate tolerance and in scores on certain cognitive tests were found to have occurred after the treatment of elderly depressives. These changes were related to original severity of illness and to the extent of improvement, as well as to a number of other clinical features including age at first attack. The reported findings lent support to theories linking depressive illness with reduction in cortical arousability.
HLA in manic-depressive psychosis
Authors: Wentzel J. , Roberts D. F. , Whalley L. J.
Published: July 2009

Synopsis

HLA types studied in 113 patients with manic-depressive psychosis did not confirm the previously suggested association with HLA Bw16. No difference was found between unipolar and bipolar manifestations. A possible excess of A10 in patients is of interest, since this antigen binds with psychotropic drugs.
Smoking, personality and reasons for smoking
Authors: McManus I. C. , Weeks S. Jane
Published: July 2009

Synopsis

The relationships between smoking, reasons for smoking and personality were investigated in 98 cigarette smokers. Contrary to the usual findings, smoking did not relate to extraversion (E) but related instead to psychoticism (P). It is suggested that this relation is the true one, and previous findings have been due to a contaminated measure of E. Neuroticism (N) was related to the amount smoked, and particularly to a willingness to give reasons for smoking. There was no relation between the Reasons for Smoking Questionnaire, and attempts or success at giving up smoking. Smokers who rolled their own cigarettes were more introverted than others. No measures showed significant relations with the nicotine content of cigarettes
Statistical tests in experimental psychiatric research
Authors: Hand D. J.
Published: July 2009

Synopsis

It is pointed out that the subjects used in psychiatric research experiments are usually drawn in such a way as to invalidate many of the commonly applied statistical tests. The necessarily non-statistical component of any inference is noted, and the area where one might hope for an exact statistical inference is identified. A class of tests permitting such inferences is described. Their theoretical and practical advantages are outlined.
Legal and administrative influences on the English suicide rate since 1900
Authors: Jennings C. , Barraclough B
Published: July 2009

SYNOPSIS

We examined the hypothesis that changes in the suicide rate of England and Wales since 1900 are an artefact of changes in the process of classifying violent deaths. Four potential sources of artefact were considered: (1) the reliability of the procedure for investigating suspected suicides; (2) coding by the Office of Population Censuses and Surveys; (3) changes in the law; (4) High Court decisions on suicide. None of these can explain the large observed fluctuations in the suicide rate.
The concepts of disease
Authors: Taylor F. Kräupl
Published: July 2009

SYNOPSIS

Concepts of disease have often been influenced by mediaeval scholasticdoctrines. Today these are best replaced by the premises of modern class logic. One of the basic problems then concerns the universal class of patients. Its solution depends on the answer to the question: What are the distinguishing attributes of this class? Scadding stipulated that these attributes must differ from the norm of a species and be associated with biological disadvantage. This paper argues that these attributes must be abnormal by the standards of a population and/or the norms of an individual, and must be associated with at least one of three criteria: (a) therapeutic concern for himself experienced by a person, (b) such concern for him experienced by his social environment, and (c) medical concern for him. This solution, though based on subjective criteria, seems to tally with the actual practice in diagnosing disease.
Traditionalism and mental health in the South Pacific: a re-examination of an old hypothesis
Authors: Murphy H. B. M. , Taumoepeau B. M.
Published: July 2009

SYNOPSIS

Nineteenth-century theory held that mental disorder was rare in stable, traditional rural societies. Today most societies are rapidly changing, but Tonga still fits that model and the evidence suggests that the psychoses are genuinely infrequent there. It is proposed that both the theory and the evidence deserve further examination.
Sub-syndromes of tardive dyskinesia
Authors: Kidger T. , Barnes T. R. E. , Trauer T. , Taylor P. J.
Published: July 2009

SYNOPSIS

A reliable method for recording the site and duration of purposeless movements was devised. With this method 267 subjects were studied, 182 of whom had been exposed to neuroleptics. The results were submitted to a principal components analysis and 3 movement dimensions emerged. One group of movements resembled a parkinsonian syndrome. The other 2 groups of movements both conformed to the generally accepted criteria for tardive dyskinesia. These groups were: (1) head and neck movements and (2) trunk and limb movements. The possibility of the second and third groups representing clinically relevant sub-syndromes of tardive dyskinesia is discussed.
The possible relationship of herpes simplex virus infection to cause of retardation in severe mental handicap
Authors: Reid A. H. , Martin K. W. , Ballinger B. R. , Heather B. B.
Published: July 2009

SYNOPSIS

The relationship between herpes simplex virus type 1 and mental retardation is explored by studying the antibody levels to this virus in a group of 86 severely and profoundly retarded adults. A tendency towards higher antibody levels is found in patients whose retardation is of unknown aetiology. The relationship of these observations to previous research findings and the possible significance of herpes simplex virus in the aetiology of mental retardation are discussed
Experience with the Bortner questionnaire as a measure of Type A behaviour in a sample of UK families
Authors: Robinson N. , Heller R. F.
Published: July 2009

SYNOPSIS

The self-administered, 14-item Bortner questionnaire was used to characterize the Type A behaviour of the members of a group of families selected from 3 general practice registers. The questionnaire was found to be easy to complete and showed no systematic variation on repeat administration. The rank order of the 14 items was similar in the men, women and children of the study (and in a sample of Belgian men where the Bortner questionnaire had been validated against other measures of Type A behaviour). There was a social class gradient among the men but not among the women or children, and there was no correlation of this behaviour characteristic between parents and their children. This simple questionnaire may thus be an acceptable way of characterizing Type A behaviour which, it is suggested, might develop during adult life in response to occupational experiences.
The metamorphosis of schizophrenia: from chronicity to vulnerability
Authors: Zubin Joseph , Magaziner Jay , Steinhauer Stuart R.
Published: July 2009

Synopsis

On the evidence of long-term follow-up studies of cohorts of patients in Europe the outcome of schizophrenia appears to be changing from chronicity to an episodic course with a more favourable outlook. While the reasons for this change are unclear it is suggested that schizophrenia is characterized essentially by a state of vulnerability to the disorder. This vulnerability may or may not give rise to an episode of illness, depending on the incidence of triggering life event stressors and on the moderating influences of social networks, ecological factors, and premorbid personality. The traditional view of schizophrenia as an essentially chronic condition reflects not so much the natural history of the disorder as iatrogenic influences, lack of satisfactory extra-mural care, the accumulation of a relatively small proportion of truly chronic illnesses and the failure to recognize the termination of an episode of illness in patients with poor premorbid personalities. Evidence for the episodic nature of schizophrenia is presented.
Evaluating a household survey measure of psychic distress
Authors: Mellinder Glen D. , Balter Mitchell B. , Uhlenhuth Eberhard H. , Cisin Ira H. , Manheimer Dean I. , Rickels Karl
Published: July 2009

Synopsis

This paper describes a study to assess the validity of a brief household survey measure of psychic distress (PSYDIS). The measure classifies persons according to their pattern of scores on four dimensions, including anxiety and depression. Study subjects were interviewed first respondents from the general population in a cross-sectional household survey. Then, according their ratings on PSYDIS, subsamples were selected for psychiatric evaluation in a clinic a few weeks later. The survey ratings of 287 persons were compared with evaluations of the same persons experienced psychiatrists. Overall levels of concordance ranged from 76% to 80%, depending the psychiatric criterion used. Concordance was very high for women; it was lower for men for persons classified as High on PSYDIS

We then applied two analytic strategies for increasing agreement between the clinical judgements and the clinical ratings. Strategy number I augmented the symptom checklist data with additional survey data on the subject's history of episodes of distress. Strategy II revised procedures for constructing the PSYDIS typology by (1) using more rigorous cutting point scores on the component scales, and (2) using a non-typological method of classification. The first strategy improved agreement between the clinic and survey measures; the second did not. The paper also compares PSYDIS with other brief symptom checklist measures.
Medical students' attitudes to psychiatry at the end of the clinical curriculum
Authors: Wilkinson D. G. , Toone B. K. , Greer S.
Published: July 2009

Synopsis

The significantly favourable changes in medical students' general attitude to psychiatry and intention to specialize in the subject, which we found after an 8-week psychiatric clerkship, were maintained one year later, at the time of the students' M.B., B.S. examinations. However, of 18 specific attitudes to psychiatry, only one changed significantly overall – fewer students agreed that ‘psychiatrists are held in poor regard by most other doctors’. Contrary to other reports, these preliminary findings suggest that a psychiatric clerkship may be followed by stable attitudes and intent towards the specialty.
An evaluation of the proposal for a multi-axial classification of child psychiatric disorders
Authors: Rutter M. , Shaffer D. , Shepherd Michael
Published: July 2009

Synopsis

As part of its programme on the standardization of psychiatric diagnosis, classification, and statistics, the World Health Organization has sponsored studies in different parts of the world to evaluate systematically a multi-axial approach to classification with particular reference to the field of child psychiatry. Preliminary findings from the United Kingdom study with 22 child psychiatrists are reported. The study included two parts: (1) a reliability study using the case histories of 17 patients; and (2) the testing of the classification in routine clinical practice. The ways in which these methods may be used to evaluate a new system of classification are described. It is concluded that a multi-axial system has such important advantages that it should be tried out further both in the field of child psychiatry and in other branches of psychiatry.
Medical Research Council Unit for Epidemiological Studies in Psychiatry
Authors: Kreitman N.
Published: July 2009

The unit was originally established in 1961 under the directorship of Professor G. M. Carstairs. Within a year of its formation it moved from London to Edinburgh where it has continued since, functioning in close collaboration with the Edinburgh University Department of Psychiatry. In April 1971 it was reconstituted under the same name and under the direction of the former assistant director, Dr. N. Kreitman. Its activities have been directed throughout primarily to the neuroses, personality disorders, and forms of abnormal behaviour such as ‘attempted suicide’ rather than to the psychoses or mental defect. The scientific staff currently number nine whole-time and two part-time workers.
Creativity, divergent and allusive thinking in students and visual artists
Authors: Tucker Peter K. , Rothwell Sharon J. , Armstrong Michael S. , McConaghy Neil
Published: July 2009

Synopsis

Visual artists of acknowledged creativity but not students with divergent thinking showed allusive (loose) thinking on an Object Sorting Test. It was concluded that high but not low level creativity in some fields may be associated with a predisposition to schizophrenia.
The relationship of exercise response to personality
Authors: Stanaway R. G. , Hullin R. P.
Published: July 2009

SYNOPSIS

In an experiment to investigate the relationship of exercise response to the personality dimensions of introversion-extraversion and neuroticism, 30 subjects filled in an Eysenck Personality Inventory and were later given a standard amount of exercise on a bicycle ergometer, with blood samples being taken before and afterwards to be analysed for lactate and glucose. A highly significant positive correlation was found between neuroticism and the change in blood glucose and a highly significant curvilinear relationship between neuroticism and the increase in blood lactate, with the largest increases in lactate occurring at the extremes of the neuroticism scale. No significant relationship was found between introversion-extraversion and either of the biochemical variables. Hypotheses are put forward to account for the relationship between neuroticism and the change in blood glucose in terms of the action of adrenaline in releasing glucose from the liver, and to account for the relationship between neuroticism and the increase in blood lactate in terms of differing rates of pulmonary ventilation during and after exercise.
Cortical atrophy and air encephalography: a clinical and radiological study
Authors: Mann A. H.
Published: July 2009

SYNOPSIS

Forty-nine patients with radiological evidence of cortical atrophy were followed up five to 10 years after their radiographic examination. The survivors were examined personally. The original radiographs were then reassessed to establish features indicating a good and poor prognosis. Dimensions of the body of the lateral ventricle distinguished good and poor prognosis, whereas the appearance of the cortical surface did not.
Manfred Bleuler's The Schizophrenic Mental Disorders: an exposition and a review
Authors: Lewis Aubrey
Published: July 2009

Eugen Bleuler's Dementia Praecox oder die Gruppe der Schizophrenien was published in 1912. Thirty years later an erudite historian of psychiatry referred to it as an epoch-making monograph, a product of many years of careful research—‘the most important contribution to psychiatry made in the 20th century’. It was a bold prediction, and he could hardly have foreseen that in another 30 years there would be another product of many years of careful research into schizophrenia, again providing a classic of psychiatry, the work of yet another Bleuler. There have been many instances of son following father in the psychiatric career but in none of them have father and son tilled the same wide field with the same assiduity and unremitting mastery as these.
Changing images of the brain
Authors: Lantos P. L.
Published: July 2009

SYNOPSIS

Our concept of the structure and function of the normal and diseased brain has developed throughout the centuries. The first stage in the discovery of the brain stretched over three millennia, from the earliest descriptions by the Egyptians in the sixteenth century B.C. to the comprehensive anatomical treatise of Vesalius. The invention of the light microscope brought to the eye a previously invisible world, and heralded the beginnings of the systematic histological investigation of the immensely complex cellular networks of the brain. With the advent of electron microscopy, the organelles and connections of brain cells have been revealed, and the new era of molecular biology has begun. Neuropathology, which concerns itself with diseases of the brain, spinal cord, nerve and muscle, has enormously benefited from these developments to establish the morphological basis of diseases of the nervous system.
Multiple measures of hemispheric dysfunction in schizophrenia and depression
Authors: Schneider Sid J.
Published: July 2009

SYNOPSIS

Electrodermal, electroencephalographic and perceptual measures of lateral hemispheric function were obtained from groups of chronic schizophrenics, depressives and normals on 2 occasions, separated by 4 weeks. The measures of hemispheric function were derived from previous research. About half of the schizophrenics were medicated on both occasions; the other schizophrenics underwent drug ‘washout’ before the first session. Results revealed that the measures of laterality were not strongly intercorrelated. In the perceptual task, the schizophrenics and normals displayed different laterality effects. Unlike the normals, the schizophrenics' left hemisphere function appeared to be inferior to the right hemisphere function in the perceptual task. The laterality effects of the depressives and normals differed on two electrodermal measures: skin conductance level and skin conductance response amplitude. The depressives' electrodermal activity from the right hand was diminished as compared with the left hand; the normals did not show this effect. Medication decreased electrodermal activity in the schizophrenics, but had no significant effect on laterality. These results suggest that the various measures of laterality used singly in previous research in psychopathology may not all assess the same phenomenon.
Validation of the General Health Questionnaire in a young community sample
Authors: Banks Michael H.
Published: July 2009

SYNOPSIS

Validity coefficients of the 30-item, 28-item and 12-item versions of the General Health Questionnaire (GHQ) were determined by comparison with the Present State Examination (PSE) in a sample of 200 17-year-olds. The PSE classified 7 people (3·5%) as cases, although only 47% were identified as free of symptoms. Misclassification rates, sensitivity and specificity values are presented for different cutting scores for the three versions of the GHQ. The GHQ-28 had superior values, especially with a cutting score of 5/6; the GHQ-12 with a 2/3 cutting score also had acceptable values. All versions of the GHQ correlated highly with the PSE Index of Definition and total scores, providing support for the treatment of GHQ scores as a continuous variable in this kind of population. Correlations between sub-scales of the GHQ-28 give further evidence for a general factor and the relative independence of the social dysfunction sub-scale.
Do positive symptom and negative symptom subtypes of schizophrenia show qualitative differences in language production?
Authors: Allen Heidelinde A.
Published: July 2009

Synopsis

The present study examined a prominent symptom subtype conception of the psychopathology of schizophrenia. It analysed the presumed dichotomy between hallucinations, delusions and formal thought disorder as positive symptoms and flattening of affect and poverty of speech as negative symptoms, and tested predictions concerning the nature of the mediating processes of positive and negative symptoms. Four different analyses were applied to the transcripts of speech produced by 9 normals, 10 chronic schizophrenics with only positive symptoms of whom 7 had incoherence of speech, and 9 chronic schizophrenics with only negative symptoms of whom 4 had poverty of speech. The conception of the nature of the mediating processes of positive and negative symptoms was not supported by the results. Further, a clear dichotomy between positive and negative symptom groups was not shown to exist, because positive speech disorder and negative speech disorder did not follow the presupposed dichotomy. Thus, contrary to existing conceptions of speech disorder in schizophrenia, both positive and negative speech disorder are marked by poverty of thought, as measured by the production of fewer and shorter ideas and lower speech variability.
The long-term psychological adjustment of children treated for congenital dislocation of the hip
Authors: Standen P. J.
Published: July 2009

Synopsis

Eighty–one children previously treated for congenital dislocation of the hip (CDH) before the age of 5 were followed up several years after their treatment, and their psychological adjustment was compared with that of 3 other groups; (i) 44 children who had experienced a single hospital admission of less than a week before the age of 5; (ii) 26 children who had experienced 2 or more hospital admissions, the first being before the age of 5; and (iii) 51 children who had no experience of hospital admission. All 4 groups were similar in composition in terms of sex ratio, age at follow-up, family size, birth order, parental age and social situation. Psychological adjustment was measured by means of Rutter's questionnaires for parents and teachers. In addition, the children completed a Schonell reading test. Both the parental and the teacher's questionnaires selected more disordered children in the CDH group. The CDH group also had a higher total score and more health and behaviour problems than did the single admission group on the parental questionnaire. On the teacher's questionnaire they were more antisocial than the single and no admission groups combined. No significant differences were found on the reading test. While the overall impression is that the CDH group are poorly adjusted, there is some suggestion that it is the younger children who are contributing to this effect.
Clinical trial design: the neglected problem of asymmetrical transfer in cross-over trials
Authors: Millar Keith
Published: July 2009

Synopsis

The paper illustrates drawbacks of the popular cross-over design in clinical trials in psychiatry where treatment effects become distorted by, and confounded with, the effects of their order of administration. It is argued that research workers should analyse data from cross-over trials for asymmetries due to order of treatment and seriously doubt the reliability of data if such effects are found. The problem is avoided by the use of separate-groups designs.
A study of long-attending psychiatric day-patients and the services provided for them
Authors: Pryce I. G. , Baughan C. A. , Jenkins T. D. O. , Venkatesan B.
Published: July 2009

Synopsis

A year's follow-up study of day-hospital long-attenders underlined doubts as to the adequacy of service provision in urban areas of England and Wales for the increasing numbers of chronic psychiatric patients living in the community. Very few of the 82 men and 53 women were married or capable of employment, and both psychiatric and physical morbidity were high; 2 young men committed suicide and 3 elderly men died within a year of discharge. Over the age of 45 men tended to be socially isolated and over the age of 60 they were also physically ill; a number probably required better residential care. Few women under 45 attended, possibly because the services offered were unacceptable.
Persistent auditory hallucinations: coping mechanisms and implications for management
Authors: Falloon Ian R. H. , Talbot Ralph E.
Published: July 2009

Synopsis

The strategies used by 40 chronic schizophrenic out-patients with persistent auditory hallucinations to cope with the intrusive phenomena were explored. Frequent coping mechanisms included changes in activity, interpersonal contact, manipulations of physiological arousal, and attentional control. A high risk of suicide was noted.

Coping behaviour appeared somewhat independent of clinical and sociodemographic variables. Successful coping appeared to result from systematic application of widely used coping strategies. The implications for the clinical management of patients with persistent auditory hallucinations are discussed.
Suicide in England and Wales: an analysis of 100 years, 1876–1975
Authors: Low A. A. , Farmer R. D. T. , Jones D. R. , Rohde J. R.
Published: July 2009

Synopsis

The variations in suicide mortality in England and Wales over a 100-year period (1876–1975) are explained by the development of a descriptive model. The model used is a stepwise linear regression using 5 variables including toxic gas production. The variables give a good description of the observed changes in suicide mortality. The limitations of the method and the data are discussed. Despite the limitations of the method, it can be concluded that toxic gas production affected total suicide mortality.
(Des-Tyr1)-γ-endorphin in the treatment of schizophrenia
Authors: Manchanda Rahul , Hirsch Steven R.
Published: July 2009

Synopsis

Inj. (Des-Tyr1)-γ-endorphin was used in a pilot study over a period of 12 days for the treatment of 11 schizophrenics and the assessments were carried out using standardized rating scales. Only 2 patients showed an improvement. Euphoria and excitement were observed in 3 patients. The findings are discussed in contrast to the earlier reports of a dramatic improvement with the compound.
Continuous infusion of luteinizing hormone releasing hormone (LHRH) in patients with anorexia nervosa
Authors: Beumont P. J. V. , Abraham Suzanne F.
Published: July 2009

SYNOPSIS

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or midfollicular phase of the menstrual cycle served as controls.

The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in a patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.
Electrodermal activity in the affective disorders and schizophrenia
Authors: Toone B. K. , Cooke E. , Lader M. H.
Published: July 2009

SYNOPSIS

Electrodermal activity was measured bilaterally at rest and during stimulation in 22 schizophrenic, 11 depressed and 12 anxiety state patients, and in 32 normal volunteers. No group showed a distinctive pattern of lateral asymmetry. The frequency of spontaneous fluctuations in electrodermal activity was greater in the anxiety state and schizophrenic groups and in those patients who reported auditory hallucinations during recording. Few schizophrenic subjects failed to respond to visual stimulation but a substantial minority failed to habituate. The implications of these findings are discussed.
Compulsory admissions in a London borough: I. Social and clinical features and a follow-up
Authors: Szmukler G. I. , Bird A. S. , Button E. J.
Published: July 2009

SYNOPSIS

This study examines the role that clinical and social factors play in compulsory admissions to hospital in a London borough. 150 patients compulsorily admitted under a Section of the Mental Health Act 1959 were compared with 100 informally admitted patients. Significant differences in social-demographic and clinical characteristics are described as well as differences in outcome on follow-up. A long-term unwillingness on the part of the compulsory patients to engage in follow-up services was evident. These differences still held when the compulsory patients were compared with a group of informal patients matched for age, sex and diagnosis. Patients referred by the police and admitted under Section 136 of the Mental Health Act showed those features associated with compulsory admission in general to the most severe degree.
The future of psychiatry in science and society
Authors: Blakemore Colin
Published: July 2009

SYNOPSIS

Psychiatry is, in a number of ways, a unique area within medicine. It is a subject of intense public interest, with a wide-ranging influence on non-medical culture; its practitioners have a perplexing variety of strategies of diagnosis and treatment, the diversity of which can be attributed to the lack of understanding of the physical basis of mental disease. It is argued here (using schizophrenia as a particular example) that the special nature of the signs and symptoms of psychiatric disorders, involving mainly behavioural disturbances, and alterations of thought and mood, have led to particular social, even political, attitudes towards the mentally ill, to the segregation of psychiatry as a medical discipline and to a view of the disease process different from that operating in other areas of medicine. The future progress of psychiatry, both in science and in society, might depend on changes of attitude among psychiatrists themselves.
Lithium therapy and thyroid function: a long-term study
Authors: Lazarus J. H. , John R. , Bennie E. H. , Chalmers R. J. , Crockett G.
Published: July 2009

SYNOPSIS

Seventy-three patients who had been continuously receiving lithium carbonate for 6 months or more had their thyroid function evaluated clinically and biochemically. Goitre was found in 37 %, exophthalmos in 23 %, positive thyroid auto-antibodies in 24 % and abnormal TRH tests in 49 %. It would appear that thyroid failure due to lithium is usually dependent on antibody mediated damage. It is unlikely that lithium has a direct effect on the hypothalamic–pituitary axis.
Asperger's syndrome: a clinical account
Authors: Wing Lorna
Published: July 2009

SYNOPSIS

The clinical features, course, aetiology, epidemiology, differential diagnosis and management of Asperger's syndrome are described. Classification is discussed and reasons are given for including the syndrome, together with early childhood autism, in a wider group of conditions which have, in common, impairment of development of social interaction, communication and imagination.
The psychosexual histories of adolescent girls and young women with anorexia nervosa
Authors: Beumont P. J. V. , Abraham Suzanne F. , Simson Kathleen G.
Published: July 2009

SYNOPSIS

Comprehensive psychosexual histories were elicited from 31 female patients with anorexia nervosa. The subjects showed a wide spectrum of sexual knowledge, attitudes and behaviour. Some appeared to be markedly inhibited, while others were experienced and assertive in regard to sexual matters. Age at interview appeared to be the major factor determining whether individual patients were sexually experienced or not.

A majority of patients felt that a sexual challenge had precipitated their illness, and most reported a decrease in sexual interest and enjoyment following weight loss, particularly when this was severe. The effect of the illness on actual sexual behaviour, however, was variable, some patients decreasing and others increasing their sexual activity.