bluuebunny/crossref_metadata_2025 huggingface dataset:
Cortisol response to dexamethasone and noradrenergic function in depression
Authors: Maes M. , Ruyter M. de , Suy E.
Published: August 2007

ABSTRACT— Positive correlations between measures of hypothalamic‐pituitary‐adrenal (HPA)‐axis activity and noradrenergic turnover have been reported in depression. To investigate this relationship the authors measured peak postdexamethasone cortisol levels (8 a.m., 4 p.m. and 11 p.m.) and the 24‐hour urinary 3‐methoxy‐4‐hydroxy‐phenylglycol (MHPG) flow in 84 depressed patients. The results show that there is no positive association between those measures of HPA‐axis and noradrenergic activity. On the contrary, patients with severe non‐suppression (≥10 μg/dl or 277 nmol/l) tended to have a lower MHPG‐excretion.
Sex reassignment surgery in Europe: A survey
Authors: Cohen‐Kettenis P. T. , Wålinder J.
Published: August 2007

ABSTRACT— Since the first publications on a sex reassignment operation in Denmark in the early fifties, the European environment in which sex reassignment surgery (SRS) takes place has changed drastically. However the possibilities differ considerably between one country and another. To get a picture of the European situation a questionnaire was sent out to gender clinics and private practitioners treating transsexuals in 15 European countries. Questions were asked about evaluation of candidates for a treatment program, details of such programs, the legal and financial situation in the different countries and attitudes and place of psychotherapy in the SRS procedure. By and large there seems to be fairly good consensus within those European SRS treatment programs we had the opportunity to evaluate.
Nonspecific psychological distress, psychosocial stressors and delusional psychosis
Authors: Jørgensen P. , Aagaard J. , Jespersen J. Hjermind , Mortensen L.
Published: August 2007

ABSTRACT— The purpose of the study was to examine patients with delusional psychosis regarding characteristic personality traits as illustrated by nonspecific psychological distress, and psychosocial stress prior to onset of the psychosis. The design of the study was a comparison of first‐admitted psychiatric patients with delusional psychosis and psychiatrically symptom free surgical controls.

Patients with delusional psychosis reported significantly more psychosocial stress than controls during the 3 months prior to admission. They also reported significantly higher mean values than controls on the subscales named poor self‐esteem, helplessness‐hopelessness, dread, sadness, anxiety and approval of rule breaking on the schedule of nonspecific psychological distress.

In discriminating patients with delusional psychosis and surgical controls, approval of rule breaking, helplessness‐hopelessness, and severity of psychosocial stressors were the most informative variables.

Patients with delusional psychosis will be followed up in order to analyze if nonspecific psychological distress and psychosocial stressors are of importance for the prediction of the course and the outcome.
Mental health in the population approaching retirement age
Authors: Mattila V. , Joukamaa M. , Salokangas R.K.R.
Published: August 2007

ABSTRACT— The present paper deals with a Finnish long‐term prospective study, the objective of which is to shed light on adjustment to retirement and old age. In this phase, only the preliminary findings of the initial survey carried out in 1982 are available. For the purposes of the study, a random sample of 200 individuals was drawn from among Turku inhabitants born in 1920. Another sample, consisting of 189 persons of the same age, was drawn from rural municipalities in the neighborhood of Turku. An extensive structured psychosocial interview could be conducted with a total of 339 subjects. The research methods used included e.g. the 36‐item version of Goldberg's General Health Questionnaire (GHQ).

Relatively little mental disturbance was revealed in the interview, and no major differences occurred between the urban and the rural sample. Somewhat over one‐third of both samples were probable psychiatric cases as defined according to the GHQ.
Changes in serum thyroxine (T4) and serum thyroid stimulating hormone (TSH) during prolonged lithium treatment
Authors: Maarbjerg K. , Vestergaard P. , Schou M.
Published: August 2007

ABSTRACT— We determined serum T4 and serum TSH serially in a cohort of patients given lithium treatment for up to 6 years; the total lithium exposure time was 409 years and the average serum lithium concentration 0.69 mmol/l. T4 showed a small and not significant fall at 6 months and returned to the pre‐lithium level at 12 months. Hereafter, T4 rose gradually and after 6 years of lithium treatment T4 was 53% higher than the pre‐lithium value. TSH was significantly increased at 6 and 12 months and then returned to the pre‐lithium level. Eight patients required thyroxine treatment for lithium‐induced hypothyroidism, i.e. 2 per 100 years of lithium exposure time. Single deviant values of T4 and TSH could be seen, followed by normal values. We suggest that TSH is determined at intervals during lithium treatment. It may be prudent to subject lithium‐treated patients with abnormal thyroid values to re‐examination and to abstain from starting thyroxine treatment on the basis of a single deviant value.
Causable mania (reactive, puerperal, secondary, life event related). The development of an idea
Authors: Ambelas A.
Published: August 2007

ABSTRACT— This paper reviews the development of the concept of non‐endogenous mania from myth to psychiatry and on to today. The varieties of causable mania are examined and an attempt is made to bring together the evidence which has been growing in the last few years from research in various different areas. As a result, a bridge appears between organic and psychoanalytical conceptualizations of mania, which may have important consequences for the management of manic patients in the future. Mania emerges as part of the depressive process rather than as its opposite.
“Ode Ori”: A culture‐bound disorder with prominent somatic features in Yoruba Nigerian patients
Authors: Makanjuola R. O. A.
Published: August 2007

ABSTRACT— Thirty patients diagnosed by Nigerian Yoruba traditional healers as suffering from a condition termed “Ode Ori” are described. The chief complaints were of a crawling sensation in the head and body, noises in the ears, palpitations and various other somatic complaints. Anxiety and depressive symptoms were prominent in all the patients and indeed the most common DSM‐III diagnoses were of depressive and anxiety disorders. The significance of the disorder and its features is discussed in the context of the socio‐cultural background of the patients.
Psychological sequelae of kidney donation. A 5–10 year follow up study
Authors: Sharma V.K. , Enoch M.D.
Published: August 2007

ABSTRACT— Twenty three out of 30 potential kidney donors were followed up after a period of 5–10 years. Fourteen were donors, and the other nine subjects who were refused from kidney donation on medical grounds constituted the control group (non‐donors). Psychiatric morbidity was assessed by using the Present State Examination (PSE) Interview Schedule. CATEGO‐ID Program identified one case in the donor group and one case in the non‐donor group. The psychiatric problems of both the cases were unlikely to be related to the kidney transplantation. The majority of the donors, irrespective of the outcome of the transplant procedure, expressed positive feelings towards kidney donation. This study suggests that the kidney donation does not cause long term adverse psychological sequlae.
Skin conductance nonresponding and nonhabituation in schizophrenic patients
Authors: Bartfai A. , Levander S. E. , Nybäck H. , Schalling D.
Published: August 2007

ABSTRACT— Bilateral skin conductance (SC) and heart rate (HR) were measured for 18 RDC diagnosed schizophrenic patients during rest and during presentation of identical tones. Computed tomography scans were evaluated. All but two patients were on neuroleptic medication. Six patients were nonresponders, seven habituated to the tones and five were nonhabituators. Nonresponders had lower SC level, fewer SC spontaneous fluctuations and higher HR level than the other subgroups. On neuropsychological tests the performance of the habituator group was closest to that of healthy subjects. Nonresponders did not differ in clinical symptoms, anamnestic data or in the prevalence of psychiatric morbidity in their families. Seventeen percent of the nonresponders had poor premorbidity adjustment vs 80% of the nonhabituators. Nonhabituators had higher ranks in the following symptoms: Presence of commenting voices, and Inability to feel. They also tended to have wider third ventricles than the other two subgroups. The results support earlier findings in our laboratory suggesting nonhabituators as an important subgroup among schizophrenic patients.
Schizophrenia:
Authors: Bland R. C. , Newman S. C. , Orn H.
Published: August 2007

ABSTRACT— Twenty persons with schizophrenia were identified in a community sample of 2144 adult household residents interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The hierarchy‐free lifetime prevalence for a variety of psychiatric disorders is compared in those with and without schizophrenia. Those with schizophrenia were found to have increased chances of having other disorders, all except one having had at least one other disorder. Major depressive episodes, obsessive compulsive disorder, phobia, alcohol abuse/dependence and drug abuse/dependence, each occurred in over half of the schizophrenics, and panic disorder, antisocial personality, and mania were each found in one sixth to one quarter of the schizophrenics.

Although current diagnostic systems generally lack an empirical basis for hierarchies, the practical significance of co‐morbidity must be determined from outcome studies, familial morbid risk data and possible differential effects of treatments.
Female alcoholics
Authors: Haver B.
Published: August 2007

ABSTRACT— In a long‐term follow‐up study of 44 female alcoholics, the women's childhood history of family violence was found to be related to violence in partner relationship as an adult and to outcome of treatment. The number of violent relations experienced during childhood was significantly related to a repetitive pattern of violent partnerships after treatment, which added to a poor outcome. The small number of selected women studied limits the generalization of data. However, treatment intervention in violent partner relationships of female alcoholics probably would benefit long‐term outcome.
Psychiatric morbidity among relatives of different subgroups of neurotic depression
Authors: Failde M. , Eisemann M. , Perris C.
Published: August 2007

ABSTRACT— The morbidity risk for affective disorders was calculatated among the relatives of subgroups of reactive‐neurotic depressive patients. The patients were divided into reactive and neurotic depressives. The parents of the neurotic subgroup had a significantly lower morbidity risk of affective disorders in comparison with the parents of the reactive subgroup. The role of genetic and environmental factors in the etiology of reactive‐neurotic depression was discussed.
Dexamethasone suppression test (DST) in relation to depressive somatic and suicidal manifestations
Authors: Modestin J. , Ruef C.
Published: August 2007

ABSTRACT— An investigation of 51 depressed inpatients showed a significant positive correlation between non‐suppression in dexamethasone suppression test (DST) and the extent of depressive somatic symptoms. The DST did not differentiate between depressive suicidal and non‐suicidal patients.
The inventory to diagnose depression, lifetime version
Authors: Zimmerman M. , Coryell W.
Published: August 2007

ABSTRACT— The lifetime version of the Inventory to Diagnose Depression (IDDL) is a 22‐item self‐report scale designed to diagnose a lifetime history of DSM‐III major depressive disorder (MDD). One hundred and sixty‐four first‐degree relatives of healthy control probands completed the IDDL and were interviewed with the Diagnostic Interview Schedule (DIS). The IDDL had good internal consistency (Cronbach's alpha = 0.92), split‐half reliability (Spearman‐Brown coefficient = 0.90), and all of the item total correlations were significant. The lifetime prevalence of MDD was nonsignificantly higher in the IDDL than the DIS (14.8% vs. 11.7%). Using the DIS as the criterion measure, the sensitivity of the IDDL was 74% and its specificity was 93% and the chance corrected agreement between the two measures was kappa = 0.60.
CSF‐adrenaline ‐ low in “somatizing depression”
Authors: Gjerris A. , Rafaelsen O. J. , Christensen N. J.
Published: August 2007

ABSTRACT— Cerebrospinal fluid (CSF) adrenaline and noradrenaline were measured in 14 depressed patients and in seven controls. CSF‐adrenaline, but not noradrenaline, was significantly reduced in the depressed patients. Moreover, a significantly negative correlation between “anxiety, somatic”, “hypochondriasis”, evaluated as single items on the Hamilton Depression Scale, and CSF‐adrenaline concentrations, was found.
Monoamines and their metabolites in cerebrospinal fluid of patients with senile dementia of Alzheimer type using high performance liquid chromatography and gas chromatography‐mass spectrometry
Authors: Parnetti L. , Gottfries J. , Karlsson I. , Långström G. , Gottfries C.‐G. , Svennerholm L.
Published: August 2007

ABSTRACT— Monoamines and their main metabolites were measured using HPLC‐EC in the cerebrospinal fluid from age‐matched elderly in‐patients affected with senile dementia of Alzheimer type and chronic schizophrenia. Determination of the monoamine metabolites MHPG, HVA and 5‐HIAA was also performed by means of gas chromatography‐mass spectrometry. Significant differences were obtained with the two methods, the largest deviation being found for HVA, which was 15% higher in the HPLC method than in the GC‐MS method, despite the correlation between the results of two measuresments being consistent for all the three metabolites. The degrees of motor, intellectual and emotional deterioration were assessed using GBS rating scale. The results show a clear psychobehavioral and neurochemical differentiation of the two patient groups. HVA and 5‐HIAA levels were significantly lower in SDAT patients, and showed a trend toward negative correlation with the degree of dementia.
Continuation ECT in the management of relapses of major affective episodes
Authors: Decina P. , Guthrie E. B. , Sackeim H. A. , Kahn D. , Malitz S.
Published: August 2007

ABSTRACT— Three cases are reported describing the use of continuation ECT. Continuation ECT consisted of six to twelve treatments for about 3 to 6 months after recovery from the index affective episode. Continuation ECT may be indicated in patients with a severe episode of illness, optimal acute response to ECT, and negative response to continuation drug therapy. In such patients, the mostly theoretical risks associated with the procedure may be outweighed by the dangers associated with early relapse.
Effect of interrupted sleep patterns and partial sleep deprivation on DST and mood in psychiatric house officers
Authors: Altshuler L. L. , Kagan B. L. , Baxter L. R. , Smith G. , Wilkins J. N.
Published: August 2007

ABSTRACT— To gain further insight into clinical associations seen in depression, the authors investigated the effect of interrupted night‐time sleep on the HPA axis and mood in 20 psychiatric house officers taking overnight call. Specific interest was in whether multiple awakenings could induce a positive DST. No statistically significant association emerged between number of nocturnal awakenings, number of hours of sleep deprivation or temporal occurrence of sleep deprivation and cortisol, DST or mood. The results suggest that cortisol and DST changes are not likely to be causally linked to, or epiphenomenon of disrupted sleep. The implications of these findings for major depression are discussed.
Social course and outcome of delusional psychosis
Authors: Jørgensen P.
Published: August 2007

ABSTRACT— The purpose of the study was to examine first‐admitted patients with delusional psychosis regarding social background, course and outcome. The study was handicapped by the lack of data of social variables as regards population in the catchment area, so comparisons were made with the population in the County and in the Nation. The index population comprised 88 patients. Social variables such as civil state and cohabitation are presented. At admission one‐third had been employed continuously during the past year, while one‐fourth had had no useful work at all. Significantly more patients were recruited from the lowest social group. Significantly more patients had inadequate social support, and two‐thirds met friends less than once a week on an average. Only one‐fourth of the patients seemed socially well adjusted and economically self‐supporting. At follow‐up 2 years later the distribution of the patients as regards useful work, social support, social contacts and social adjustment has significantly changed with more patients now with less useful work and social support, fewer social contacts and increased social maladjustment. The difficulty of interpretation of the findings is stressed but it is concluded that the present psychiatric treatment including social intervention is insufficient to prevent this social downlift mobility during a 2‐year observation period as regards patients with delusional psychosis. Further study will search for social predictors of course and outcome.
Marital status and depression: A study of English national admission statistics
Authors: Bebbington P.
Published: August 2007

ABSTRACT— Data are presented from the English national statistics for first admissions with affective disorders during the years 1982–1985. Overall rates per 105 of the population aged over 15 years were 36.1 for men and 59.1 for women. The peak incidence for depressive neurosis was middle adulthood, that for affective psychosis much later. The widowed and divorced showed much higher rates than the single and married for all types of disorder. Marriage appeared less protective for women than for men. The age‐incidence relationship among the divorced and widowed was exaggerated for depressive neurosis and reversed for psychosis. The results are interpreted in terms of a (possibly biological) releasing effect of age upon affective psychosis that could be overwhelmed by severely adverse social circumstances. The findings support the validity of the distinction between affective psychoses and depressive neurosis.
Female alcoholics V: The relationship between family history of alcoholism and outcome 3–10 years after treatment
Authors: Haver B.
Published: August 2007

ABSTRACT— In a long‐term follow‐up study of 44 female alcoholics, a family history of alcoholism was related to younger age of onset of problem drinking, but did not necessarily imply a poorer outcome within this highly selected group of individuals. Alcoholism in father and his family was not related to either antisocial or borderline personality disorder nor outcome. However, alcoholism in mother and her family correlated with both borderline personality disorder and a significantly poorer outcome. The findings are discussed within different frames of reference, considering genetic mechanisms, psychodynamic factors and family systems theory.
Urban environment, marital status and mental disorders
Authors: Andersen J. E.
Published: August 2007

ABSTRACT— This study examines the distribution of sex, marital status and mental disorders among new referrals to outpatient clinics from two different urban evironments. Differences in the distribution of marital status among patients and inhabitants in the two urban environments were tested with the “chi‐square” method for each sex separately. In proportion to the population, significantly more married, separated and divorced women were referred from satellite communities than from traditional urban areas. When DSM‐III diagnoses were taken into account, there were significantly more married women with “affective and anxiety disorders” in satellite communities. Similar differences were not observed among men in satellite and traditional urban communities. Social environment seems to be a major contributor to mental disorders in women. In addition, sex role plays an important part in the development of “affective and anxiety disorders” in married women. Sex role alone does not explain the findings of this study.
Phases on the way to alcoholism in female psychiatric patients
Authors: Vaglum S. , Vaglum P.
Published: August 2007

ABSTRACT: Sixty‐four female alcoholic psychiatric patients were interviewed with a semistructured clinical interview and the standardized interviews: SADS and SSP. The drinking histories were classified into two pre‐alcoholic phases: the sporadic and the regular drinking phases: and two alcoholic phases: the escalating and the established phases. Age of abuse, the presence of major depression, schizophrenic psychosis, borderline and schizotypal personality disorder, primary or secondary abuse, number of alcoholic partners, attribution of causes of abuse, and marital state were related to one or several phases. Age of first drink, social class, alcoholism in parents and drug abuse were not. The study demonstrates the diversity of pathways to alcoholism in women, and shows the importance of studying different phases separately. A subgroup with “rapid changes” to a high, stable abuse was characterized by a high frequency of major depression and relationship problems.
Psychotic homicides in Copenhagen from 1959 to 1983
Authors: Gottlieb P. , Gabrielsen G. , Kramp P.
Published: August 2007

ABSTRACT: During the years from 1959 to 1983, 263 Copenhagen defendants of homicide underwent a psychiatric examination for the court. Twenty‐three percent of the defendants were held to be psychotic at the time of the crime. The psychotic defendants differed from the non‐psychotic by being older, less often substance abusing and by choosing victims inside their families. It is discussed whether a reduction in the available number of psychiatric beds could be a contributional reason for the increase in especially the number of schizophrenic defendants. About one third of all defendants were by the examining psychiatrists found in need of a sanction different from ordinary punishment; furthermore, a tendency towards sanctions of treatment instead of just placement in a psychiatric hospital was documented and is discussed. The increasing demand of capacity for forensic, psychiatric patients is mentioned.
Management of depressive illness in a Nigerian neuro‐psychiatric hospital
Authors: Makanjuola J. D. A. , Oyerogba K. O.
Published: August 2007

ABSTRACT— The management of 430 patients treated for depressive illness, at the Neuro‐Psychiatric Hospital Aro, Abeokuta, Nigeria, has been reviewed. Psychotherapy particularly with tricyclic antidepressants and electroconvulsive therapy were the main methods of treatment, but neuroleptics and anxiolytics were frequently prescribed to combat psycho‐neurotic symptoms. Psychological management amounted to rudimentary psychotherapy and individual counselling provided by doctors and nurses with no particular training in these areas. The need to improve on material and personnel resources at the hospital was emphasized.
Tardive dyskinesia in schizophrenics
Authors: Gureje O.
Published: August 2007

ABSTRACT— The prevalence of tardive dyskinesia (TD) in 70 Nigerian schizophrenics was 37%. Age was related to the presence of TD in males but not in females. Significantly more females had TD in the lower extremeties. Comparison of patients with TD and those without revealed no significant differences with regard to the presence of neurological “soft” signs.
A prospective study of panic disorder in a Nigerian psychiatric out‐patient population
Authors: Otakpor A. N.
Published: August 2007

ABSTRACT— Fifteen corresponding to 3% of the 500 patients seen at the Outpatient Psychiatric Clinic of the University of Benin Teaching Hospital Nigeria between December 1985 and September 1986 met the DSM ‐ III criteria for panic disorder. The female to male ratio was 3:1; the mean age of onset was 23.7 years and married patients dominated the group. Predisposing life events were present in four patients and in three of these the factors were multiple. Ten of the patients improved markedly on imipramine in an open drug trial design which lasted 3 months; the two non‐responders had both situational and spontaneous panic attacks. The effect of social stressors as precipitants of panic attacks was highlighted.
Comparison of the cortisol suppression index and the DST within major depressive disorder
Authors: Whiteford H. A. , Peabody C. A. , Berger P. A.
Published: August 2007

ABSTRACT— The authors compared the Cortisol Suppression Index (CSI) and raw postdexamethasone cortisol values for their usefulness in detecting endogeneity and severity in major depressive disorder (MDD). The 8 AM postdexamethasone cortisol provided the best correlation with both endogeneity and severity. The CSI does not appear to be a satisfactory alternative to the current DST for this purpose.
REM sleep and cortisol response to the cholinergic challenge with RS 86 in normals and depressives
Authors: Krieg J.‐C. , Berger M.
Published: August 2007

ABSTRACT— The influence of the muscarinic agonist RS 86 on rapid‐eye‐movement (REM) sleep and on hypothalamic‐pituitary‐adrenocortical (HPA) axis was studied in healthy subjects and in patients with a major depression. In both groups, RS 86 induced a shortening of REM latency and an increase in REM sleep; these effects were more pronounced in the depressives than in the controls. This finding supports the assumption that in depression the REM sleep regulating neurons are hypersensitive to cholinergic stimuli. However, neither in the healthy subjects nor in the depressed patients was an RS 86 induced increase in plasma cortisol seen. This observation does not agree with the assumption that, in humans, the HPA axis is stimulated by muscarinic neurons and that hypercortisolemia in depression is due to an overactivity of muscarinic neurons activating the HPA axis.
Schizoaffective disorder: A dimensional approach
Authors: Yasamy M. T.
Published: August 2007

The current categorical approach has not proved successful in resolving the problem of classifying patients with both affective and schizophrenic features. A dimensional approach is suggested; postulating two interacting factors; “dissociotaxia”, a neurointegrative abnormality; and “hyperactivation”, an abnormality in activation regulation. The latter factor can convert dissociotaxia to associative dyscontrol and produce mixed schizoaffective features. Clinical‐phenomenological, prognostic, genetic‐familial, treatment response and biological evidence is reconsidered from this standpoint; and the preferability of the dimensional approach is suggested, both for understanding the underlying psychopathology, and for constructing a different classification system, extensible to other areas of psychiatry.
Regional brain glucose metabolism in drug free schizophrenic patients and clinical correlates
Authors: Wiesel F. A. , Wik G. , Sjögren I. , Blomqvist G. , Greitz T. , Stone‐Elander S.
Published: August 2007

Regional brain glucose metabolism was investigated in healthy volunteers (n= 10) and in drug free schizophrenic patients (n= 20). The metabolism was determined by positron emission tomography (PET) with 11C‐glucose as the tracer. Diagnosis of schizophrenia was made according to RDC and DSM III. Eight patients had their first psychotic episode, four patients had a subchronic course and eight patients had a chronic course with an exacerberation of their illness. Computed tomography (CT) of the brain were made in all the subjects. Regions of interest (n= 35) were drawn on displayed CT images and the marked regions were transferred to the corresponding slice of the PET examination. The PET investigation was made in a dimly lit, quiet room with the eyes of the subject covered. The time course of the 11C‐glucose uptake was measured by a four ring PET scanner (PC‐384‐7B).

Metabolic rates of glucose varied greatly among the schizophrenic patients investigated. The variance was significantly greater than that of the controls in most regions. Decreases in mean levels of metabolic rates were related to patients with subchronic or chronic courses. Changes in metabolism were not related to previous duration of neuroleptic treatment of the patients. Left‐right asymmetries were found in the temporal lobe (area 22) and the basal frontal cortex (area 11), the metabolic rates of the patients being lower on the left side compared to the controls. Asymmetry of the metabolic rate of the amygdala in hebephrenic patients was the opposite of that found in paranoid patients and controls. Negative correlations between regional metabolic rates and autistic or negative symptoms were found. Thus, the lower the metabolic rate was, the more autistic the patient. Metabolic rates were not correlated to atrophic changes of the brain.

No basis for a specific alteration in frontal cortical metabolism of schizophrenics was obtained. Changes in regional metabolic rates in schizophrenia are suggested to reflect disturbances in more general mechanisms which are of importance in neuronal function.
Staff observation aggression scale, SOAS: Presentation and evaluation
Authors: Palmstierna T. , Wistedt B.
Published: August 2007

A new psychiatric report and rating scale assessing severity and frequency of aggressive behaviour is presented and evaluated. It is based on the staff's standardized reports of aggressive incidents. By using a special aggression report form, comprehensive and standardized information is obtained, thereby permitting scoring and further analysis of different aspects of aggressive incidents. The reliability of scoring is tested and found to be good as is the scale's capacity to discriminate between different patterns of aggressive behaviour in different groups of patients. As a result of this and because of the simplicity of the scale, it is thought to be a potentially useful tool in scientific research on aggressive behaviour from psychiatric inpatients.
Social networks, social support and the type of depressive illness
Authors: Brugha T. , Bebbington P. E. , MacCarthy B. , Potter J. , Sturt E. , Wykes T.
Published: August 2007

We hypothesised that there would be greater deficiencies in the quality and quantity of close personal relationship and social support in “neurotic” than in “endogenous” depressives, and that the relation between support and recovery would be stronger in the former. One hundred and thirty men and women who contacted hospital psychiatric services with depression were interviewed, and 119 (92%) reinterviewed after approximately 4 months. The association between the type of depression and deficiencies in social relationship was not impressive. However, differences were apparent in the prognostic implications of social relationship. For “neurotic” depressives, about half the social support variables assessed were significantly related to outcome, whereas the only significant predictor for “endogenous” cases was the presence of a close confidant. The results argue for further research on social support in clinical samples of acute depression.
The thyrotropin response to thyrotropin‐releasing hormone as a biological marker of suicidal risk in depressive patients
Authors: Kørner A. , Kirkegaard C. , Larsen J. K.
Published: August 2007

ABSTRACT: In order to evaluate a possible predictive value for committing suicide of a reduced thyrotropin‐stimulating hormone (TSH) response to thyrotropin‐releasing hormone (TRH) stimulation we studied 306 depressed patients. The patients were followed for a mean of 5.8 (SD 2.9) years. During this period, 18 patients committed suicide. The TSH response to TRH stimulation in these 18 patients who committed suicide was lower than in the patients who did not commit suicide. The difference is not statistically significant. It is concluded that the TSH response to TRH cannot be said to identify the patients who later commit suicide.
Perinatal origin of adult self‐destructive behavior
Authors: Jacobson B. , Eklund G. , Hamberger L. , Linnarsson D. , Sedvall G. , Valverius M.
Published: August 2007

ABSTRACT: The study was undertaken to test whether obstetric procedures are of importance for eventual adult behavior of the newborn, as ecological data from the United States seem to indicate. Birth record data were gathered for 412 forensic victims comprising suicides, alcoholics and drug addicts born in Stockholm after 1940, and who died there in 1978–1984. The births of the victims were unevenly distributed among six hospitals. Comparison with 2,901 controls, and mutual comparison of categories, showed that suicides involving asphyxiation were closely associated with asphyxia at birth, suicides by violent mechanical means were associated with mechanical birth trauma and drug addiction was associated with opiate and/or barbiturate administration to mothers during labor. Irrespective of the mechanism transferring the birth trauma to adulthood—which might be analogous to imprinting—the results show that obstetric procedures should be carefully evaluated and possibly modified to prevent eventual self‐destructive behavior.
Mortality in severe depression
Authors: Berglund M. , Nilsson K.
Published: August 2007

ABSTRACT: Twelve hundred and six psychiatric in‐patients, 506 men and 700 women, with severe depression/melancholia were rated at discharge with a multidimensional diagnostic schedule during 1956–1969. The sample was followed up until December 31, 1983. A total of 476 deaths were recorded including 103 suicides. Suicides and to a small proportion diseases of the nervous system constituted the total excess mortality in unipolar disorders. In bipolar disorders there was also an increased mortality from physical disorders, while the suicide frequency was lower (9% versus 4%). Male suicides had higher initial ratings for the items brittle, sensitive, maritial problems, acute onset and lower ratings for psychomotor retardation than other men. Female suicides had a higher frequency of attempted suicides than other women. Acute onset and attempted suicide were associated with suicides early in the course contrary to the other differentiating items. The suicide frequency was similar in admissions during 1956–1962 compared with those during 1963–1969.
Risk factors for suicide among patients with schizophrenia
Authors: Allebeck P. , Varla A. , Kristjansson E. , Wistedt B.
Published: August 2007

ABSTRACT: In order to assess risk factors for suicide among patients with schizophrenia, we compared 32 patients with schizophrenia who committed suicide during an 11 year follow‐up with a control group of 64 schizophrenics who did not commit suicide. A history of previous suicide attempts was the factor most strongly related to suicide. In females we found an increased risk for suicide among unmarried, divorced or widowed and among those living alone. In males we found an increased risk among those with a history of alcohol abuse. In contrast to findings in other studies, distribution of age and sex and a history of depressive episodes were factors not associated with an increased risk for suicide. We conclude that suicidal acts among schizophrenics are often impulsive and difficult to predict. Traditional risk scales are of limited value in the clinical assessment of suicidal risk.
Suicide in psychiatric patients
Authors: Berglund M. , Krantz P. , Lundqvist G. , Therup L.
Published: August 2007

ABSTRACT:All cases from the county, who were subjected to post‐mortem examination at the Department of Forensic Medicine, University of Lund with a diagnosis of suicide during 1949–1984, were compared with the inpatient register at the Department of Psychiatry, University Hospital, Lund during 1949–1969. During these years all patients were rated at discharge with a multidimensional schedule. All patients with initial ratings of severe depression/melancholia and alcoholism were analyzed separately and excluded from the present sample. The ratings of the suicide cases were compared with those of 8,046 other inpatients. There were 67 suicide cases, 36 men and 31 women. The suicide cases had higher frequencies of the item easily led/dependent/immature personality (34% versus 18%) and of attempted suicides (19% versus 8%). There were no differences in ratings of symptoms as slight depression and anxiety or of situational factors. Attempted suicide was related to suicides early in the course, while easily led/dependent/immature was not so related. At the time of the suicide there was a higher frequency of never married and a lower frequency of married subjects in the present series compared with suicides in severe depression/melancholia and alcoholism.
Pharmacology of the benzodiazepines; with special emphasis on alprazolam
Authors: Söderpalm Bo
Published: August 2007

Different aspects on the structure‐activity relationships, the pharmacokinetic and the pharmacodynamic properties of the benzodiazepines (BDZs) are briefly outlined, followed by a more thorough description of the current hypothesis on the mode of action of these drugs, focusing on the supramolecular GABA‐BDZ‐chloride‐ionophore receptor complex. The existence of different synthetic ligands for the receptor exerting opposite effects is discussed together with the recent finding in mammals of an endogenous ligand with anxiogenic‐like effects. The possibility of the anxiolytic effects of the BDZs being related to actions on monoaminergic systems is also briefly mentioned. A new group of BDZs, the triazolo‐BDZs, is described. One of these compounds, alprazolam (APZ), exhibits a different clinical profile as compared to traditional BDZs. Apart from being effective in the treatment of generalized anxiety, it has been proven effective also in the treatment of panic disorder. Some studies also indicate anti‐depressant effects of the compound. The reason for these apparent unique effects of APZ is not clear.

A brief description of a commonly applied animal model (the Vogel conflict model) for the study of anxiety‐related mechanisms is given and original animal data from experiments aiming at elucidating the mechanism behind the anti‐panic effect of APZ are presented. The results indicate that tolerance to different pharmacodynamic effects of APZ and the traditional BDZ diazepam (DIZ) develop to different extents. Thus, tolerance development to the ataxic/sedative effects of APZ was pronounced, whereas no significant tolerance developed to the anxiolytic‐like effects. For DIZ, however, tolerance development was pronounced to both the anxiolytic‐like and the ataxic/sedative effects. Hence, in the rat, the “therapeutic range” with regard to anxiolytic‐like effects is more favourable for APZ than for DIZ after long‐term treatment. Evidence for the possibility of a similar mechanism also in man has been reported. It is suggested that the efficacy of APZ, in contrast to DIZ, on panic disorder seems due to the former drug possessing more anxiolytic potency in relation to its side‐effects at long‐term treatment, hence enabling a sufficient increment of the dosage applied.
A model of panic and agoraphobic development
Authors: Klein Donald F. , Gorman Jack M.
Published: August 2007

‐A model for the development of agoraphobia with panic attacks is proposed. The initiating clinical manifestation is the sudden appearance of spontaneous panic. The inter‐panic chronic anxiety may have several components: i.e. conditioning, increasing autonomic distress, and sensitization to the panic leading to avoidance. The illness course is quite variable but usually chronic. The spontaneous panic is blocked by imipramine with primary pharmacological anti‐panic effects. However, no direct effect of imipramine upon either anticipatory anxiety or avoidance behaviour is hypothesized. Among the psychotherapies, direct in vivo exposure mobilizes the patient more rapidly than office based therapy. Our data are consonant with the theory that the avoidances of agoraphobia are secondary to spontaneous panic attacks, and that the primary benefits of imipramine and exposure therapy are in their respective effects on panic and avoidance. Moreover, laboratory challenge studies, brain imaging studies, and genetic studies all point to a biological diathesis for panic disorder.
Community development and preventive work
Authors: Rytter Kirsten
Published: August 2007

Abstract The theoretical frame of reference in connection with prevention, some theoretical approaches, and the practical consequences of giving priority to prevention are discussed. The following points are stressed: that one must expand the theoretical frame of reference of prevention to include theory on local community, social networks and concepts of mutuality and selfsupporting processes that preventive work is most efficient when it is developed in the form of fruitful interaction between primary intervention and selective intervention that giving priority to preventive work rather than implementing continuous expansion of institutions and fields of administration involves changes in the ones that already exist.
Searching for prevention
Authors: Esser Richard
Published: August 2007

Abstract The pitfalls of prevention are how we commonly think of high‐risk groups, multideterminate causation, social change, community psychiatry and mental health. All of these pitfalls stem from a common trap in our thinking about living in terms of a cleavage between normality and abnormality. An alternative view of effective living is presented called The Vital Process. Vitality is seen as the key to prevention. Vitality emerges out of the challenge of facing our inner desperation. Living is making vitality out of desperation. We turn craziness into creativity, rage into courage, panic into initiative, violence into dynamism, hopelessness into achievement and self waste into self fulfillment. When we refuse to face our inner desperation we are at risk for its overwhelming us. Psychiatric diagnoses make this werse. They describe static pictures assumed to be abnormalities foreign to normal people. They make us more fearful and more blocked. The key to effecting prevention is making this idea of vitality central to our work roles. Doing this should replace the bureaucratic in our social institutions with a vital energy. The place for a vital psychiatry should be working directly in such social institutions and sharing responsibility for them. The path for changing these institutions is through leadership imbued with vitality. This in the end resolves into an issue of political leadership. The gain to be derived from such a rethinking of society is a greatly more effective mobilization of our human creativity resources. This is identical with preventing the psychiatric.
Cognitive impairment among the elderly in a Korean rural community
Authors: Park J.‐H. , Ha J. C.
Published: August 2007

ABSTRACT— Cognitive function among the elderly aged 65 or older was studied in a rural community of Korea. The prevalence rates of cognitive impairment were significantly higher in females (64%) than in males (33%). Sex differences of prevalence of both mild impairment (25% in males vs 45% in females) and severe (8% in males vs 19% in females) reached statistically significant levels. The prevalence of severe impairment increased with age, and the age‐related increase was steeper after 80 in males and after 75 in females. The prevalence of mild impairment, on the other hand, did not increase so prominently with aging. From this point of view, it could be assumed that severe cognitive impairment may be highly related to real dementia, and that the elderly with mild impairment may consist of heterogenous groups associated with cognitive dysfunction of mild degree.
Clinical symptomatology and drug compliance in schizophrenic patients
Authors: Bartkó G. , Herczeg I. , Zádor G.
Published: August 2007

ABSTRACT— The differences in the psychopathologic status of 26 compliant and 32 noncompliant schizophrenic patients were evaluated on the basis of rating scales used at discharge. Noncompliant patients had significatly higher scores for grandiosity, lack of feeling of illness and insight into it. Their score for global psychopathological state and disturbance in social adjustment was also significantly higher. The compliant patients had significantly higher score for self‐rated depression.
Self‐poisoning among four immigrant groups
Authors: Merrill J. , Owens J.
Published: August 2007

ABSTRACT— Rates of deliberate self‐poisoning in four immigrant groups, Asian, West Indian, Irish and Scottish were compared with those of English‐born residents in an inner‐city area of Birmingham. For both Asian and West Indian groups males and older females were underrepresented but young females had rates similar to the English group. Irish females and Scottish of both sexes were overrepresented. The rates of self‐poisoning for all four immigrant groups considerably exceeded those of their country of origin, the difference being most marked among young Asian females. Explanations for these findings are examined.
A comparative study on schizophrenia diagnosed by ICD‐9 and DSM‐III: Course, family history and stability of diagnosis
Authors: Hwu H. G. , Chen C. C. , Strauss J. S. , Tan K. L. , Tsuang M. T. , Tseng W. S.
Published: August 2007

ABSTRACT— Data from the Taipei Center of the International Pilot Study of Schizophrenia were reanalyzed using the ICD‐9 and DSM‐III diagnoses at 7‐year follow‐up. Patients diagnosed as schizophrenic according to DSM‐III were shown to be a more homogeneous group in terms of their clinical manifestations, social functions and family psychiatric history than those defined as schizophrenic by ICD‐9. The discordant cases of ICD‐9 schizophrenia and DSM‐III affective disorders were found to be different from the concordant schizophrenic group, but similar to the concordant group of affective disorders diagnosed by ICD‐9 and DSM‐III. Thirty‐five per cent of mood‐incongruent psychotic major depressive disorders defined by DSM‐III at initial evaluation were diagnosed as schizophrenia at 7‐year follow‐up.
Anorexia nervosa and motherhood: Reproductional pattern and mothering behavior of 50 women
Authors: Brinch M. , Isager T. , Tolstrup K.
Published: August 2007

ABSTRACT— A follow‐up carried out on an average 12.5 years after hospital contact of 151 patients with a former diagnosis of Anorexia nervosa (AN), aimed at reproductional outcome. None of the 11 males had children. Fifty of the 140 women had born a total of 86 children, which is approximately 1:3 of the expected fertility. Involuntary childlessnes was of the same size as found in the background population. The rate of prematurity among the offspring was twice the expected and perinatal lethality six times the expected. Mentally the mothers did well, both during pregnancy and the post‐partum period. They breastfed their children for the same mean time as did other women, and the development of the children did not differ from that found in a background population. More women in the group of mothers than in the group of non‐mothers had better scores of all‐round functioning at follow‐up.