bluuebunny/crossref_metadata_2025 huggingface dataset:
On the contribution of sleep wake physiology to the explanation and the treatment of depression
Authors: Van den Hoofdakker R. H. , Beersma D. G. M.
Published: August 2007

Physiological exploration has disclosed profound disturbances in the regulation of sleep in depression. The finding that depression can be relieved or intensified by manipulation of sleep has inspired the investigation of the possible pathogenetic significance of these dysregulations. Three hypotheses play a leading role in this context: the “phase‐advance”, the “S‐deficiency” and the “acetylcholine‐monoamine imbalance” hypothesis. They explain the therapeutic effects of a variety of sleep wake manipulations as consequenses of the normalization of depressogenic sleep regulation disturbances.

The issue discussed in this paper is whether these claims are valid. To what extent can the hypotheses explain the existing sleep physiological disturbance in depression as well as the results of therapeutic interventions in sleep? The empirical data provide firm evidence for the importance of particularly the timing of sleep in relation to the course of depression, both in respect to the spontaneaous and the experimentally induced fluctuations of the clinical state. Without considerable extensions none of the hypotheses provide an adequate explanation of these facts.
Cybernetics, activation, and drug effects
Authors: Klein Danold F.
Published: August 2007

Patients present unique combinations of familial relationships, developmental idiosyncrasies, social aberrations, affective states, cognitive abilities, symptoms, defects, and maladaptations.

Psychopharmacological treatments form a useful approach to cutting through this complexity to the core pathophysiology. Focusing on disorders that can be brought to complete remission by medication suggests that retarded and agitated depressions, manic and angry hyperactive paranoid states, panic disorder, emotionally unstable character disorders and schizophrenias are governed by the degree of derangement of an affective‐activation control system.

Defects in this control system are best conceptualized in cybernetic terms rather than in terms of the current rheostat models. Conceptualization of cybernetic defects allows for understanding of psychopathological developments as well as give a framework for pharmacological benefits.

One aspect of the activation‐affective disorders, are disorders of two types of pleasure regulatory mechanism, here referred to as appetitive and consummatory. The relationship of disorders of these hedonic control mechanisms to affective states and those of drug abuse are considered. This schema also affirms a close relationship between the bipolar affective disorders and the schizophrenias.
Noradrenergic and serotonergic receptor system function in panic disorder and depression
Authors: Heninger G.R. , Charney D.S. , Price L.H.
Published: August 2007

Recent studies which have utilized the administration of neurotransmitter agonists and antagonists to study presynaptic and postsynaptic receptor system function in panic disorder and major depression are reviewed. In panic disorder, patients have been found to be overly sensitive to the alpha‐2 adrenergic agonist clonidine, and the alpha‐2 adrenergic antagonist yohimbine, but they have relatively normal responses to tryptophan, the precursor of serotonin, and MCPP, a directly acting serotonin agonist. In depression, patients appear to have relatively normal responses to clonidine and yohimbine except for some supersensitivity to yohimbine effects on blood pressure and subjective symptoms. In contrast to the panic disorder patients, depressed patients demonstrate a neuroendocrine subsensitivity to tryptophan. Taken together, these studies suggest a relative abnormality in the alpha‐2 adrenergic regulation of the noradrenergic system in panic disorder and a subsensitivity of the serotonergic system in depression. The pharmacologic treatment response in panic disorder and depression is similar in that both conditions respond to tricyclic antidepressants and monoamine oxidase inhibitors, but different in that panic disorder does not respond to atypical antidepressants such as trazodone and bupropion, but does respond to benzodiazepines, in contrast to depression. The possible mechanisms involved in producing these findings and the methods to more fully study possible receptor system abnormalities in these illnesses are discussed.
Influence of child‐rearing on aggressive behavior in a transcultural perspective
Authors: Ekblad Solvig
Published: August 2007

ABSTRACT The aim of this paper is to summarize the literature and exemplify the author's research findings concerning the influence of different systems of child‐rearing across cultures on aggressive behavior by using an individual‐environment interaction approach. The question is whether a restrictive environment (e.g., China), foster children with lower levels of and less variation in aggression than children in a more permissive environment (e.g., Sweden). The main results involve 290 primary school children, mean age 10.3, their mothers and teachers in Beijing. The children showed distinct individual differences in aggression, though at a lower level and with less variation than Scandinavian children. Aggression was meaningfully related to other selfreport dimensions, such as positive attitude to school and negative relations with parents, findings similar to those in the Western literature. In line with the literature, sex differences in terms of aggression was also found among the Chinese children, namely, that girls seem better able to control aggression than boys. Chinese mothers in comparison to Swedish mothers, seemed to be more in control of their children. Children preferred their mothers, shame was the most frequent disciplinary method used, followed by reasoning. Both parents made decisions concerning the child. Finally, theoretical and practical implications are concluded in the paper.
Parental rearing patterns and drug abuse: Preliminary report
Authors: Kokkevi Anna , Stefanis Costas
Published: August 2007

SUMMARY Results from a controlled study on a sample of 91 imprisoned drug dependents on perceived parental rearing practices using the EMBU and on parental family characteristics are presented. While few differences were observed between drug dependents and imprisoned controls‐father less warm and mother more permissive in drug dependent group‐comparisons of drug dependents with a general population sample revealed more differences be‐tween the two populations: drug dependents perceive both parents compared to the general population group as less rejective, very permissive, their mother as warmer and more overprotective and their father more inconsistent and less favouring them than siblings. supportive evidence on the dependents’ family psychopathology is provided by studying family characteristics. While our findings seem to support the prevailing view in the literature on the role of the mother of the drug dependent characterised by strong emotional bonds and overprotection as well as of the rather emotionally distant father, the question is raised on the contribution of other factors, such as psychopathic personality on the above findings.
Identity ‐ lost and found: Patterns of migration and psychological and psychosocial adjustment of migrants
Authors: Dan Hertz G.
Published: August 2007

ABSTRACT This paper focuses on patterns of integration in migrant individuals and families. The level of adjustment in traditional and Westernized families has been examined. Different factors affecting adjustment are pointed out. Migration process is interpreted as a transient and necessary crisis situation. Risk factors in the acculturation crisis are reported and predictive and preventive measures are suggested. Characteristics of migrant and remigrant groups are compared. The role of “homesickness” in clinical symptom formation is discussed.
Experiences from a psychiatric service to immigrant groups using native therapists
Authors: Jansson Bengt
Published: August 2007

ABSTRACT Experiences from an out‐patient department giving psychiatric service in their own language to three immigrant groups to Sweden, namely Finnish, Yugoslavian and Greek patients are described. Compared to Swedish patients, depressive disorders and alcohol abuse were much less common among the patients from southern Europe, who instead showed much more of psychosomatic distress. Treatment results were not too encouraging, a negative social situation of the patient was often difficult to change. In the future, the author considers it advantageous to have one psychiatric immigrant department for one nationality at one place and to connect it to an already existing department for Swedish patients.
Obsessive‐compulsive symptoms in childhood and adolescence
Authors: Honjo S. , Hirano C. , Murase S. , Kaneko T. , Sugiyama T. , Ohtaka K. , Aoyama T. , Takei Y. , Inoko K. , Wakabayashi S.
Published: August 2007

We investigated 61 patients (38 boys and 23 girls) under 18 years of age with obsessive‐compulsive symptoms seen in the Department of Psychiatry, Nagoya University Hospital, from 1982 until 1986. In this period, a total of 1293 patients under 18 years of age visited the clinic. The percentage of patients with obsessive‐compulsive symptoms was 5%. The earliest onset of symptoms was at age 3 years, and the average age of onset was 11.6 years. We found no particular tendency in terms of the number of siblings and the birth order of the patients. Obsessive traits were the fundamental personality traits of patients. Moreover, according to the other characteristics of personality, the patients were subdivided into schizothymic, viscous temperament, and cyclothymic. Parents of the patients were more apt than usual to have obsessive‐compulsive personalities. Psychiatric disturbances and occupations were also investigated. Incidents related to school situations commonly triggered obsessive‐compulsive symptoms. The most frequently noted obsessive thought was dirt phobia, and the most common compulsive behavior was washing. School refusal and violence at home were especially common as associated symptoms of obsessive‐compulsive symptoms. We also describe the treatment regimen and the outcomes of the patients.
The prevalence of cognitive impairment in an elderly Canadian population
Authors: Robertson D. , Rockwood K. , Stolee P.
Published: August 2007

ABSTRACT— We investigated cognitive impairment in a study of the health of the elderly population of Saskatchewan. Surveys of elderly persons living at home (n=1267) and living in long‐term care facilities (n‐990) were conducted in 1981. Cognitive impairment was assessed by a short 10‐item mental status questionnaire previously validated against a clinical diagnosis of dementia in an elderly Canadian population. The prevalence of clinically significant cognitive impairment was found to increase with age and with dependence level in long‐term care facilities. We estimate that 7.8% of the elderly population have cognitive impairment consistent with a clinical diagnosis of dementia. Our estimates are compared with those derived from other studies. These findings affirm the importance of dementia as a cause of dependence in the elderly and the need for long‐term care facilities to deal with dementia and its consequences. Also, since at least as many persons with cognitive impairment live at home as in long‐term care facilities, health care planners must direct attention to the elderly with dementia at home.
Further evidence supporting the role of the serotonin system in suicidal behavior: a preliminary study of suicide attempters
Authors: Marazziti D. , De Leo D. , Conti L.
Published: August 2007

ABSTRACT— The 3H‐imipramine binding parameters (Bmax and Kd) were studied in platelets from female suicide attempters and from healthy volunteers. The Bmax was significantly lower among suicide attempters, with no modification of the Kd. These results provide support of the hypothesis that decreased serotonin function may play a role in suicidal behavior.
Retirement, aging, psychosocial adaptation and mental health
Authors: Manila V. J. , Joukamaa M. I. , Salokangas R. K. R.
Published: August 2007

ABSTRACT— This article deals with certain preliminary findings obtained in a long‐term prospective study begun in 1982 using the interview method; the first follow‐up was carried out in 1986, the method consisting of a postal inquiry and the collection of recorded data. The sample consists of 200 randomly selected inhabitants of Turku born in 1920 and 189 individuals of the same age living in rural municipalities in the vicinity of Turku. During the 4‐year Follow‐up period the subjects’ biopsychosocial situation remained almost unchanged, showing that, for most people, retirement is not a scressor of crucial importance or a life crisis. Of the variables relating 10 the initial survey, poor subjective physical health, self‐assessed work disability, poor financial situation, change into a taciturn and timid individual in adolescence, the spouse's poor mental equilibrium, an excess of leisure time and general dissatisfaction with life were associated with subsequent mental disturbance as measured by use of the General Health Questionnaire.
Perception of early parenting by patients diagnosed avoidant personality disorder: a test of the overprotection hypothesis
Authors: Stravynski A. , Elie R. , Franche R.‐L.
Published: August 2007

ABSTRACT— The perceptions of their parents by patients diagnosed avoidant personality disorder (DSM‐III) and matched normal subjects were compared. The overprotection hypothesis proposed by Parker was not found to predict the perceptions of patients diagnosed avoidant personality disorder. Social introversion in patients was found to be related to perceptions of their parents as shaming, guilt‐engendering and intolerant.
Acute effect of electroconvulsive therapy on brain perfusion assessed by Tc99m‐hexamethylpropyl‐eneamineoxim and single photon emission computed tomography
Authors: Bajc M. , Medved V. , Basic M. , Topuzovic N. , Babic D. , Ivancevic D.
Published: August 2007

ABSTRACT— Regional cerebral blood flow (rCBF) was measured in relative terms with Tc99m‐hexamethylpropylerieamineoxim and single photon emission computed tomography in 11 patients undergoing electroconvulsive therapy (ECT). The patients suffered from major depressive disorder (n= 8) or schizoaffective disorders (n= 3). rCBF was measured under general anesthesia 3 days prior to the ECT treatment and coinciding with the ECT stimulation. ECT caused a redistribution of the tracers uptake. The uptake became more pronounced in frontal parts of the brain and in the basal ganglia than in posterior parts of the cortex, and the thalamus. This selective effect of ECT on rCBF may be related to catecholaminergic projections to anterior parts of the brain.
Diagnosis change, lithium use and admissions for mania in Edinburgh
Authors: Mander A. J.
Published: August 2007

ABSTRACT— Admissions for mania have risen significantly in Edinburgh since 1970. Differencing was used to remove time trends; this showed that the rise was not accounted for by diagnosis change (from schizophrenia or personality disorder) or by lithium prescription. The contribution of non‐specific factors such as admission policy and the experience of trainee psychiatrists deserves evaluation. If this rise continues there will be significant resource implications for the future.
Depression among elderly people
Authors: Carpiniello B. , Carta M. G. , Rudas N.
Published: August 2007

ABSTRACT— A total of 317 elderly subjects randomly selected among people living in the community in 1 urban and 2 rural areas were studied by means of a semistructured clinical interview, the Social Adjustment Scale, and the Beck Depression Inventory. An emerging trend was demonstrated towards a higher rate of prevalence of depression among females and urban residents. Widowhood, absence of a confidant, poor education and financial difficulties (only among urban elderly people) were significantly correlated with rates of depression. Physical impairments and diseases were also associated with depression, independently of whether subjects lived alone. The findings are discussed using a psychosocial frame of reference.
Magnetic resonance imaging in Alzheimer's disease, multi‐infarct dementia, alcoholic dementia and Korsakoff's psychosis
Authors: Besson J. A. O. , Crawford J. R. , Parker D. M. , Smith F. W.
Published: August 2007

ABSTRACT— Regional spin lattice relaxation times (T1) measured during nuclear magnetic resonance imagine of the brain were compared in patients with Alzheimer's disease, multi‐infarct dementia, alcoholic dementia, Korsakoff's psychosis and control subjects. Regional differences were found between all patient groups compared with controls and within patient groups, with the exception of the comparison between Korsakoff's psychosis and alcoholic dementia. Correlations between regional T1 change and cognitive lest scores were also found, with particular emphasis between visuospatial deficits and parietal T1. The possible role of T1 measures in the pathophysiology of these disorders is discussed.
Alcohol withdrawal and mood
Authors: Bokström K. , Balldin J , Långström G.
Published: August 2007

ABSTRACT— The usefulness of a self‐report technique for description of mood was tested at various stages of alcohol withdrawal. The Mood Adjective Check List (MACL), consisting of 71 mood‐associated adjectives and measuring 6 bipolar aspects of mood, was used. Three groups of alcohol‐dependent patients (DSM‐III‐R) reported on their momentary mood states twice a day, respectively, during early withdrawal (n= 78), during late withdrawal (n= 13), and after full remission (n= 12). Significant improvement; was found in all 6 mood dimensions during early withdrawal. Improvement in 3 basic mood dimensions was also found during late withdrawal, thus indicating a prolonged lime of recovery. The reports given by patients in full remission showed no changes in mood over time. Relative to norm group values, significant differences were found in 4 of the 6 mood dimensions for patients in very early withdrawal. The present study shows that mood changes attributable to after‐effects of alcohol intake can be assessed and described during various stages of withdrawal.
Dysmorphic penis image perception: the root of Koro vulnerability
Authors: Chowdhury A. N.
Published: August 2007

ABSTRACT— Koro is an acute anxiety reaction in which the perception of decreased penis length because of hyperinvolution from intra‐abdominal traction is the main feature. In an earlier study the author reported that, despite having an average length penis, Koro patients perceived smaller penis length, in both the flaccid and extended state, than did normal subjects. To examine the influence of response bias on the dysmorphic penis length perception, a longitudinal study was undertaken, in which the Draw‐a‐penis Test, a graphomotor projective test, was administered on the same Koro patients 3 times over 2 years. The patients showed a remarkable constancy in their perception of penis length. The dysmorphic quality of own‐penis perception is discussed in relation to Koro vulnerability.
Lithium‐induced changes in the body mass index
Authors: Mathew B. , Rao J. Murti , Sundari U.
Published: August 2007

ABSTRACT— A total of 117 manic‐depressives who had been on lithium for a mean duration of 4.7 years were examined before lithium therapy and subsequently at intervals. Information relating to pre‐lithium height and weight and current weight were determined and used to calculate the body mass index (BM1) for each individual. Other relevant variables such as age, sex, cumulative lithium dose, duration of therapy, thyroid profile and serum lithium levels were recorded. The results indicated that, although there was a nonsignificant increase in BMI for the whole population, lithium and sex were not significant predictors of any increase in BMI. In nearly 27% of patients BMI actually slightly decreased during lithium therapy. The overall conclusions from this study are that, in the population studied, lithium may not have exerted any pharmacological effects to increase BMI.
Predictors of postpartum adjustment
Authors: Robinson G. E. , Olmsted M. P. , Garner D. M.
Published: August 2007

ABSTRACT— Identification of uomen at risk for problems in postpartum adaptatin could allow interventions that might prevent difficulties. Eighty‐five women were followed from the second trimester of pregnancy to 12 months postpartum. One year postnatally, 27 women were found to have low global severity index scores on the Symptom Check List (SCL‐90) (≤ 0.16), while 17 women had high global severity index scores (≥ 0.46). The high scoring group were also significantly more dissatisfied with their marriages and their partners. The high scorers also had significantly higher global severity index scores and lower intimacy with spouse scores when measured at 12–16 weeks gestation. The SCL‐90 and the Miller Social Intimacy Scale, when used in the second trimester of pregnancy, appear to predict the women who may have adjustment problems in the postpartum period.
Delusional disorders
Authors: Opjordsmoen S.
Published: August 2007

ABSTRACT— Of 301 first‐admitted patients with delusional psychoses, 94 met DSM‐III criteria of schizophrenia (S), 53 paranoid disorder (PD), 47 schizophreniform disorder (SFD), 35 schizoaffective disorder (SAD), 54 major affective disorder (AD), and 18 other disorders (OD). Retterstol selected the patients and personally interviewed them after 5–18 years, and later the author interviewed them after 22–39 (mean 30) years. At last follow‐up good functioning was noticed in 42%, moderate symptoms in 22%, severe defect in 20%, and very severe defect in 16%; 40% were still delusional. On average S patients did poorest, and OD patients slightly better. AD patients had superior outcome, while PD, SFD and SAD patients showed an intermediate position, but a little closer to AD than to S. However, heterogeneous course and outcome was noticed in all diagnostic groups.
Delusional disorders
Authors: Opjordsmoen S.
Published: August 2007

ABSTRACT— A sample of 301 patients with delusional psychoses was personally followed up an average of 10 years after first admission (by Retterstöl), and 30 years after admission (by the author). Using a multivariate technique the following significant predictors of outcome emerged; discharge diagnosis according to DSM‐III (accounted for most of the total variance), marital status, and Axis V at 10‐year outcome, and diagnosis, martial status, and gender at 30‐year outcome. No significant difference of outcome was found between patients living in urban and rural areas in bivariate or multivariate analyses. Women did slightly better than men at 10‐year follow‐up, but at 50‐year follow‐up men did significantly better. These results may be consistent with the hypothesis that other factors than those occurring during the premorbid period are manifest in the later course of the disorder. However, Axes IV and V proved useful, stressing the necessity of working with social as well as psychopathological issues when patients are treated.
A RESEARCH METHOD FOR THE STUDY OF PSYCHOLOGICAL AND PSYCHIATRIC ASPECTS OF DISASTER
Authors: Raphael Beverley , Lundin Tom , McFarlane C
Published: August 2007

This paper attempts to draw together some of the current questions related to the methodology of exploring the psychological and psychiatric aspects of human response to disaster. It sets out soem of the key areas in which research questions might be mounted. A range of relevant instruments are suggested. The value of a structured inteview which can explore issues of relevance to disaster victims is demonstrated. Early screening measures and proposals regarding these, as well as the particular instruments for longer term follow‐up and assessment of outcome, are discussed in considerable detail. The article concludes with an overview of the principal issues to be addressed in methodology research, and emphasises the need for a collaborative approach using core items so that studies embracing different disasters and different countries can have some comparative basis.
Substances involved in fatal drug overdoses in Brisbane, 1979–1987
Authors: Cantor C. H.
Published: August 2007

Suicide rates may be reduced by decreasing the availability, cultural acceptance or lethality of certain methods of suicide. With these principles in mind fatal overdoses in Brisbane 1979‐ 1987 were surveyed for substances involved. Psychotropic agents, especially barbiturates predominated. Chloral hydrate was far the most commonly implicated single compound. A case is put for curtailing the availabilty of barbiturates and chloral hydrate. This combined with increasing detection of depressed persons may lead to a further rise in overdoses involving antidepressants which as a group require reduction in their lethality.
The three‐year biopsychosocial outcome of 551 hospitalized accidentally injured adults
Authors: Malt U. F. , Blikra G. , Høivik B.
Published: August 2007

ABSTRACT The negative biological, psychological and social outcomes following accidental injuries were assessed after three years in 551 adults by questionnaires, medical records and information from the National Insurance Offices. Fifty‐four percent reported at least one negative outcome. Some reduction of physical function was reported by 31.8% and worsened bodily health by 26.0%. In about half of these cases reduced life quality was the main problem. Of the persons 18.9% claimed worsened psychological health and 18.2% decreased capacity for work as an effect of the injury. It is concluded that accidental injuries are an important source of morbidity and reduced life quality in society and that the long‐term outcomes are best conceived within a biopsychosocial frame of reference.
The Late Effect of Accidental Injury Questionnaire (LEAIQ)
Authors: Malt U. F. , Blikra G. , Høivik B.
Published: August 2007

ABSTRACT ‐The Late Effect of Accidental Injury Questionnaire (LEAIQ) is a self‐report questionnaire constructed to assess the biological, psychological and social effects of traumatic injuries. The LEAI covers current civil and employment status (4 questions); possible negative or positive consequences of the injury (20 questions) symptoms of post‐traumatic distress (24 questions); aspects of the accident situation and the emotional impact of the trauma considered to be of relevance for the development of post‐traumatic stress disorder and litigation behaviour (3 questions). The last part of the LEAIQ deals with the patient's opinion about the hospital treatment and follow‐up control and self‐perceived current medical or social needs (4 questions).

Preliminary data on reliability and validity are reported from two studies investigating a total of 640 accidentally injured adults. The data indicate that the LEAIQ is easy to fill in for the patients and provides fairly good estimates of the frequency of the long‐term biological, psychological and social effects in a sample of accidentally injured adults. The data on sensitivity and negative predictive power further suggest that the LEAIQ should be suitable in clinical practice as a first‐step instrument for screening late effects of trauma.
Chronic melperone administration does not enhance oral movements in rats
Authors: Gunne L. M. , Johansson P.
Published: August 2007

Melperone and haloperidol were compared in a rat model for tardive dyskinesia. Drugs were given chronically for 12 months with the drinking water and the frequency of oral movements was measured at monthly intervals. Haloperidol (0.2 and 0.4 mg/kg/d) produced an increase in vacuous chewing movements, whereas melperone (2.4, 5.1 and 11.0 mg/kg/d) did not differ from untreated controls.
Serotonin function in affective disorders
Authors: Grahame‐Smith D.G.
Published: August 2007

The evidence indicating a specific abnormality of brain 5‐HT function in depressed patients is reviewed. Biochemical studies have indicated that low plasma levels of tryptophan are unlikely to be the primary ‘cause’ of depression or of abnormal brain 5‐HT function in depression. However, there may be a reduction of 5‐HT synthesis or function in the brains of depressed patients and the uptake of 5‐HT into platelets from depressed patients is consistently reduced. Neuroendocrine studies have suggested that various groups of depressed patients may exhibit different types of abnormal 5‐HT‐mediated responses. It is important to distinguish between the acute and chronic pharmacological effects of antidepressant treatment, which may account for the latency seen between onset of therapy and full clinical effect. Clinical studies have provided further evidence that 5‐HT is implicated in the causation and treatment of depression, as both 5‐HT precursors and selective inhibitors of 5‐HT uptake are effective in the treatment of depression. Furthermore, inhibition of 5‐HT synthesis can block the effect of antidepressant compounds. It is concluded that 5‐HT function is decreased during depression, and that this carries important implications for the pharmacology of antidepressant drugs.
A review of the metabolism and pharmacokinetics of paroxetine in man
Authors: Kaye C.M. , Haddock R.E. , Langley P.F. , Mellows G. , Tasker T.C.G. , Zussman B.D. , Greb W.H.
Published: August 2007

Paroxetine is well absorbed from the gastrointestinal tract, and appears to undergo first‐pass metabolism which is partially saturable. Consistent with its lipophilic amine character, paroxetine is extensively distributed into tissues. Its plasma protein binding at therapeutically relevant concentrations is about 95%. Paroxetine is eliminated by metabolism involving oxidation, methylation, and conjugation. All of these factors lead to wide interindividual variation in the pharmacokinetics of paroxetine. Renal clearance of the compound is negligible. The major metabolites of paroxetine are conjugates which do not compromise its selectivity nor contribute to the clinical response. Ascending single‐dose studies reveal that the pharmacokinetics of paroxetine are non‐linear to a limited extent in most subjects and to a marked degree in only a few. Also, steady‐state pharmacokinetic parameters are not predictable from single‐dose data. In many subjects, daily administration of 20–50mg of paroxetine leads to little or no disproportionality in plasma levels with dose, although in a few subjects this phenomenon is evident. Steady‐state plasma concentrations are generally achieved within 7 to 14 days. The terminal half‐life is about one day, although there is a wide intersubject variability (e.g. with 30mg, a range of 7–65 hours was observed in a group of 28 healthy young subjects). In elderly subjects there is wide interindividual variation in steady‐state pharmacokinetic parameters, with statistically significantly higher plasma concentrations and slower elimination than in younger subjects, although there is a large degree of overlap in the ranges of corresponding parameters. In severe renal impairment higher plasma levels of paroxetine are achieved than in healthy individuals after single doses. In moderate hepatic impairment the pharmacokinetics after single doses are similar to those of normal subjects. Paroxetine is not a general inducer or inhibitor of hepatic oxidation processes, and has little or no effect on the pharmacokinetics of other drugs examined. Its metabolism and pharmacokinetics are to some degree affected by the induction or inhibition of drug metabolizing enzyme(s). From a pharmacokinetic standpoint, drug interactions involving paroxetine are considered unlikely to be a frequent occurrence. Data available have failed to reveal any correlation between plasma concentrations of paroxetine and its clinical effects (either efficacy or adverse events).
A placebo‐controlled, double‐blind, clinical trial of paroxetine in depressed outpatients
Authors: Rickels K. , Amsterdam J. , Clary C. , Fox I. , Schweizer E. , Weise C.
Published: August 2007

A placebo‐controlled, randomized, double‐blind study was carried out in outpatients suffering from major unipolar depressive disorder to assess the efficacy and tolerability of paroxetine in the treatment of depression. The study lasted for six weeks. After a placebo washout period of 4 to 14 days patients took 20mg of paroxetine or matched placebo as a morning dose for one week; thereafter the dose of paroxetine could be titrated between 10 and SOmg/day. Patients were evaluated at baseline, weekly during the first four weeks of the study, and at the end of sixweeks; patients who entered a six‐week extensionphasewere evaluated at 9 and 12 weeks. Evaluations were carried out using HAMD (including ECDEU factors), MADRS, HSCL, Covi anxiety and Raskin depression scales, CGI, and a seven‐point rating of global improvement. Adverse events and laboratory values were also recorded at each assessment. One hundred and eleven patients entered the study, and efficacy data were available for 102 of these (49 on paroxetine and 53 on placebo). Efficacy measurements demonstrated significantly greater clinical improvement with paroxetine than placebo after two weeks of treatment, and this became even more marked after six weeks. Patients who continued treatment for a further six weeks maintained their clinical improvement. When adverse events were examined, statistically significant differences between paroxetine and placebo were seen only for sweating, diarrhoea, nausea, and somnolence. No significant changes were seen in any of the laboratory parameters measured. If these results are confirmed in future studies, paroxetine will represent an important addition to the treatments available for depression.
Meta‐analysis of early phase I1 studies with paroxetine in hospitalized depressed patients
Authors: Byrne M.M.
Published: August 2007

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Antidepressant withdrawal syndromes: phenomenology and pathophysiology
Authors: Dilsaver S. C.
Published: August 2007

ABSTRACT The literature reporting signs and symptoms produced by the abrupt or gradual withdrawal of antidepressants is reviewed. Patients with antidepressant withdrawal syndromes are presented and principles governing their care are highlighted. Finally, the author summarizes evidence that antidepressant‐induced supersensitiviry of central and peripheral muscarinic cholinergic mechanisms may account for commonly observed antidepressant withdrawal phenomena.
Use of mental health services in south Verona and Groningen
Authors: Sytema S. , Balestrieri M. , Giel R. , ten Horn G.H.M.M. , Tansella M.
Published: August 2007

ABSTRACT A comparison was made of the utilization of mental health services in a psychiatric case register area in Italy (south Verona) and one in the Netherlands (Groningen). All residents living in these areas who contacted a mental health service in 1982 were traced and followed for a period of one year. The year prevalence rates differed considerably (110/10,000 in south Verona and 329/10,000 in Groningen). Rates of single consulters were similar in both areas, while those of chronic inpatients were more than 11 times higher in Groningen than in south Verona. After excluding both single consulters and chronic inpatients, when comparing service consumption according to fixed classes of scores, the category of highest service use accounted for 60% of care provided in Groningen as compared with less than 30% in south Verona. The proportion of total service consumption due to inpatient care was about the same in both areas, but brief admissions were more common in south Verona. Moreover, when service use was considered as a relative construct, about 10% of patients in both areas could be called high users. Finally, long‐term patients were more prevalent in Groningen (26%) than in south Verona (13%).
The use of psychiatric facilities by depressives: results of the Upper Bavarian study
Authors: Meller I. , Fichter M. , Weyerer S. , Witzke W.
Published: August 2007

ABSTRACT Utilization of psychiatric facilities by noninstitutionalized persons aged 20 years and older, identified as “depressive cases”, was examined. Data were based on the representative community sample of the Upper Bavarian follow‐up field study with an original sample size of 1668 people. In the 5‐year follow‐up 1384 (83%) subjects were interviewed, while 80 subjects (4.8%) had died. The 5‐year prevalence of depressive disorders, according to the definition used, was 10.3%. We analyzed which people with depressive disorders sought help from mental health professionals according to type of depressive disorder, sociodemographic data, psychosocial factors and course of disorder. The psychiatric treatment rate (in‐ or outpatient) was 23.9% of the depressive cases. The majority of treated persons were outpatients. Patients with the diagnosis of endogenous depression were most likely to have received psychiatric treatment. Limitation in the ability to work due to depression was the most important psychosocial factor influencing help‐seeking behavior. The highest consultation rate in psychiatric facilities was obtained from the depressives who had grown up without their parents.
A combination of hypothalamic phospholipid liposomes with trazodone for treatment of depression
Authors: Giannelli A. , Rabboni M. , Zarattini F. , Malgeri C. , Magnolfi G.
Published: August 2007

ABSTRACT In an open controlled trial of 48 patients with major depression illness (according to DSM‐III), the patients were randomly assigned to 2 groups. One group of 25 patients was treated with 200–300 mg/day of trazodone and a second group of 23 patients was treated with 200–300 mg/day trazodone plus 1 ampoule (corresponding to 1000 gamma of lipidic phosphorous) twice daily of hypothalamic phospholipids (HPL). The effectiveness of treatment was evaluated by the Hamilton Rating Scale for Depression (HRSD). Side effects of treatment with trazodone were looked for by measuring systolic and diastolic blood pressure and heart rate and from EEG made before and on the 7th and 30th days of treatment. Combination with HPL shortened the typical latency of action of the antidepressant trazodone, definitely improved the subjective symptoms, especially the psychosomatic symptoms, on the HRDS and decreased the incidence of such side effects of trazodone as hypertension, reflex tachycardia and asthenia.
Psychalgic depressive disorder: a descriptive and comparative study
Authors: Chaturvedi S. K.
Published: August 2007

ABSTRACT In this study 35 consecutive patients diagnosed as having psychalgic depressive disorder (PDD) who lacked sadness but presented with chronic pain have been described. The patients were mainly female, middle‐aged and from an urban background. Pain, usually at multiple sites, was reported to be severe by most patients. Predominant depressive symptoms were lack of interest in surroundings (97%), although this was not directly reported, early morning awakening (91%), loss of appetite (100%), and suicidal ideas (66%). None had marked sadness or weeping spells. Lack of reactivity of mood was present in only 2 cases. These psychalgic depression cases were compared with a group of 30 patients diagnosed as having psychogenic pain disorder. PDD cases were significantly more often female, married, less educated, and from an urban background. Pain was significantly more intense and at multiple sites, as compared with the psychogenic pain disorder cases. Clinical outcome was better for PDD cases.
Minor physical anomalies and recidivistic adult violent criminal behavior
Authors: Kandel E. , Brennan P. A. , Mednick S. A. , Michelson N. M.
Published: August 2007

ABSTRACT Minor physical anomalies (MPA) result from disruptions of gestation, and may be used as signs of central nervous system defects in development. Utilizing a Danish birth cohort, we tested the hypothesis that MPA predict adolescent and adult recidivistic violent criminal behavior. The number of MPA was measured at 11 to 13 years of age and police records of criminal behavior were ascertained at 20 to 22 years of age. Recidivistic violent offenders evidenced an elevated level of MPA compared with subjects with one violent offense or subjects with no violent offenses.
Suicide among soldiers and young men in the Nordic countries 1977–1984
Authors: Hytten K. , Weisæth L.
Published: August 2007

ABSTRACT– A comparison af suicide rates among soldiers and civilians in the Nordic countries during the 8‐year period 1977–1984 revealed that suicides among soldiers were more frequent in Norway than in Sweden and Finland. An in‐depth study of the suicides of Norwegian soldiers during the same time period points to selection procedures and distance from home to the soldier's duty camp as possible causal factors. The suicides were frequently precipitated by an acute crisis. Preventive measures are discussed.
Suicide in Jordan 1980–1985
Authors: Daradkeh T.K.
Published: August 2007

ABSTRACT– In a study of suicide from 1980 through 1985 in Jordan, there were 219 suicides with an annual suicide rate of 2.1 per 100,000. The peak suicide rate was found to be among the age group 15–34 years. Nearly two‐thirds of males that committed suicide were single, which was not the case with suicides among females. Over half of males that committed suicide were either unemployed and/or unskilled manual workers and over two‐thirds of females that committed suicide were either housewives and/or students. Nearly two‐thirds of the total population that committed suicide had previous psychiatric treatment. Violent methods of suicide were most frequently used. Some of the results were observed for the first time and the role of sociocultural factors is discussed. Suggestions are made to explore the role of religion in combatting suicide.
Mortality in psychiatric inpatients
Authors: Casadebaig F. , Quemada N.
Published: August 2007

ABSTRACT– The number of persons taken into psychiatric hospital care during 1982 in France was estimated using data on length of stay and analysing these by the person‐year method. The number of observed deaths was compared by sex and age group with the number of deaths expected if the mortality in the general French population in 1982 were applied to the numbers of inpatients of the same sex and age group. The result of this comparison was that the mortality in mentally ill inpatients was found to be 3 times higher than that in the general population. This higher rate is further accentuated in younger age groups, especially women. This excess mortality has been observed with respect to natural causes of death as well as to unnatural causes, i.e. injury and suicide. Deaths from diseases of the circulatory system are overrepresented. As is true in the general population, these diseases account for the greatest number of deaths. Excess mortality is also high from diseases of the respiratory system. There is a high excess mortality due to signs, symptoms and ill‐defined conditions, especially among women. Only in the case of neoplasms is there no excess mortality. Finally, excess mortality is found for deaths by injury and poisoning, especially for women, and suicides, particularly among men. Nevertheless, up to the age of 34, the female suicide rate is higher than that of men.
Repeat self‐harm: an 18‐month follow‐up
Authors: Hassanyeh F. , O'Brien G. , Holton A.R. , Hurren K. , Watt L.
Published: August 2007

ABSTRACT– An 18‐month follow‐up of cases of deliberate self‐harm (DSH) revealed that 30% had repeated the act. Of a large number of items recorded at index DSH only one, a past history of self‐harm, was associated with repetition. It is suggested that some factors not predictive of longer term repeat DSH may be important in the assessment of risk for immediate further self‐harm.
Suicide and attempted suicide in general practice, 1979–1986
Authors: Diekstra R. F. W. , van Egmond M.
Published: August 2007

ABSTRACT– Using data from the Continuous Morbidity Registration Sentinel Stations over the period 1979–1986, the authors tried to determine the incidence and the characteristics of patients in general practice who attempted or committed suicide. Almost half of the suicide attempts and suicides had contacted their general practitioner (GP) shortly before the suicidal act. A minority of these cases were recognized by the GP as having a high suicide risk. In almost 70% of the suicides and 58% of the suicide attempters the GPs reported the existence, currently or previously, of a depressive episode. About half of both the suicides and the suicide attempters had been treated or seen by mental health professionals or social workers. Given the fact that suicide and suicide attempt are relatively rare events in general practice, and given the fact that for the patients who contact their GP shortly before the suicidal act, it is not at all certain whether they present clearly recognizable signs of suicide risk at that time, the authors conclude that GPs cannot play an important role in the prevention of suicidal behaviour.
Personality disorder and suicide intent
Authors: Casey P. R.
Published: August 2007

ABSTRACT– Studies of suicide intent have found a link between seriousness of the attempt and personality. Following a parasuicide, 60 patients were assessed using measures of depression, suicide intent and personality. Personality disorder was found to be present in over 65% of these and was mainly of explosive type. It was significantly more common in men than women and the dimension measuring sociopathy was equivocally linked to male gender. There were no other associations between gender and the other dimensions measured. Using a categorical approach to personality, suicide intent was not significantly different between the categories of personality; there was no correlation between dimensional or categorical measures of personality and suicide intent, when the severity of depression was controlled. By itself personality did not contribute significantly in determining variance in intent but it did interact significantly with age.
Clinical differentiation between major depression only, major depression with panic disorder and panic disorder only
Authors: Alnœs R. , Torgersen S.
Published: August 2007

ABSTRACT– A consecutive sample of 298 nonpsychotic psychiatric outpatients was classified according to DSM‐III and divided into 4 diagnostic groups: pure major depression, mixed major depression/panic disorder, pure panic disorder and a remaining group of other disorders. The patients' reports of childhood relationship to parents and sibilings, family atmosphere, their own personality characteristics as children and precipitating events were compared in the various groups. In addition, differences in personality and frequencies of personality disorders were investigated by means of various instruments. Our results show that the type of relationship to parents in childhood differed in the various groups. The mother seems to be the most crucial person for the development of depression, the father for the development of panic disorder. Patients with major depression are more obsessive and patients with panic disorder more infantile and avoidant with less control of their personality. Finally, patients with mixed conditions are more in accordance with the DSM‐III anxious personality disorder cluster.
Methylphenidate in Amytal‐resistant mutism
Authors: Frost L. H.
Published: August 2007

ABSTRACT– Methylphenidate eliminated mutism in a catatonic schizophrenic after Amytal® had failed. Response permitted an adequate clinical evaluation and temporary resumption of eating, self‐care and sociability. This suggests that methylpheni‐date has a useful role in the clinical evaluation of the mute patient who fails to respond to Amytal and that 2 psychopharmacological varieties of catatonic mutism may exist.