bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship of free nortriptyline levels to therapeutic response
Authors: Perry P.J. , Browne J.L. , Alexander B. , Pfohl B.M. , Dunner F.J. , Sherman A.D. , Tsuang M.T.
Published: August 2007

ABSTRACT– The relationship between the free plasma concentration of nortriptyline and therapeutic reponse was examined. Eighteen depressed inpatients were treated for 21 days with steady state total nortriptyline plasma concentrations between 50–150 ng/ml. Steady state free nortriptyline concentrations were measured. The therapeutic nortriptyline response was measured by administering the Hamilton and the Carroll Rating scales at day zero and day 21.

Statistical relationships between free levels of drug and clinical response were found to be insignificant. Qualitative assessment of the data suggest that free serum levels of nortriptyline in excess of 10 ng/ml may have an inhibitory effect on clinical response.
Relationships between brain density, cortical atrophy and ventriculomegaly in schizophrenia and mania
Authors: Coffman J. A. , Nasrallah H. A.
Published: August 2007

ABSTRACT– A number of parameters assessed by computed tomography have been shown to differentiate between populations of psychiatric patients and normal controls. Changes in these parameters have been felt to result from atrophic processes. We hypothesized that changes in one parameter ought to result in related changes in another if they result from the same process. We tested this hypothesis by comparing CT scan results of density measurement with area and linear measurements of ventricular size and radiological assessments of cortical and cerebellar atrophy. Our results indicate that few statistically significant relationships appear to be present, the only such relationship being found between increased third ventricular size and cerebellar atrophy. We conclude that regional changes in brain density are not necessarily correlated with local changes in CSF volume, which suggests the involvement of disparate processes in their causation.
An open multicentre study of the treatment of florid schizophrenia with remoxipride
Authors: McCreadie R. G. , Morrison D. , Eccleston D. , Gall R. G. , Loudon J. , Mitchell M. J.
Published: August 2007

ABSTRACT– Remoxipride. a novel substituted benzamide, was given for 4 weeks to 18 florid schizophrenics in an open study. The mental state of the majority improved as measured by the Brief Psychiatric Rating Scale. Remoxipride itself did not appear to cause troublesome extrapyramidal effects. There were no significant adverse effects on the cardiovascular system and no significant abnormalities in laboratory tests. These results suggest that remoxipride has antipsychotic effects, and that this should be tested in controlled clinical trials.
Relationship between suicide, homicide and accidental deaths among the aged in Finland in 1951–1979
Authors: Kivelä S.‐L.
Published: August 2007

ABSTRACT– Time trends for suicide, homicide and accident mortality among the Finnish population 65 years or over in 1951–1979 are presented. From 1951 to 1967 suicide, motor‐vehicle accident mortality and overall accident mortality among elderly males tended to follow more or less similar patterns. In 1951–1979 male suicide rates correlated positively and significantly over time with male motor‐vehicle accident mortality and with male total accident mortality. The results from this mortality analysis in the elderly population are compared with those obtained by Holinger et al. in the total population. There is also a brief discussion of the methodological problems of the study. The results suggest that self‐destructive tendencies are not a central variable in female accident mortality among the aged population. On the other hand, it is possible that they play some role in motor‐vehicle accident mortality in the aged male population. No suggestions about self‐destructive tendencies in homicides among the aged could be made.
Patient attitudes in short‐term psychiatric care
Authors: Hansson L. , Berglund M. , Liljencrantz C. , Andersson G. , Öhman R.
Published: August 2007

ABSTRACT– The attitudes of patients were measured after 4 days and at discharge during two 4‐month periods. The attitudes were related to ratings of symptoms, patient background, and type of treatment contract used (cooperation or staff‐directed). The patients were generally satisfied with their treatment. A mere 7% disapproved of the general ward structure. The attitude data were subjected to a factor analysis and a 7‐factor solution explaining 70% of the variance was found to be suitable. The factors were labelled Ward Structure, Key Worker, Nursing Care, Group Treatment, Psychopharmacological Treatment, Social Network, and Other Patients. A high level of satisfaction in the Ward Structure, Nursing Care, Psychopharmacological Treatment, and Other Patients factors was found to be related to a lower incidence of symptoms at discharge. The staff‐contract group showed more favourable attitudes in the Nursing Care factor (both initially and at discharge) and the Psychopharmacological Treatment factor (only initially), while the cooperation‐contract group did so in the Social Network factor. It is suggested that the two contract procedures resulted in the development of different kinds of interpersonal relationships during treatment, the cooperation group relying more on the social network, whereas the staff‐contract group was more apt to rely on psychopharmacological treatment and on the nursing staff.
Mortality variations among public mental health patients
Authors: Wood J. B. , Evenson R. C. , Cho D. W. , Hagan B. J.
Published: August 2007

ABSTRACT– Earlier studies of mortality of psychiatric patients are reviewed, and agreements and inconsistencies related to age, sex, diagnosis and cause of death are noted. The authors then analyze 5,268 deaths during a 5‐year period of current or former patients in Missouri public psychiatric hospitals and mental health clinics, calculating mortality ratios that are simultaneously age‐, sex‐, diagnostic‐, and causespecific. The results are used to construct a quantitative model. The ratios vary most with cause, then diagnosis, least with sex. Influenza and pneumonia contribute most to patient mortality; patient death rates for cancer are lower than population rates at all ages. There are substantial interactions of diagnosis with cause and sex. Among those diagnosed organic brain syndrome, who have the highest overall ratios, the ratios are extra high for females and for influenza and pneumonia, relatively low for external causes.
Suicidal behaviour in major depressive illness
Authors: Linkowski P. , de Maertelaer V. , Mendlewicz J.
Published: August 2007

ABSTRACT–We investigated past suicidal behaviour and family history of suicide in 713 inpatients with major depressive illness. A familial history of suicide (mainly violent) significantly increased the frequency of violent suicidal behaviour in depressive women; bipolar patients being more affected than unipolars. In depressed men, the presence of suicidal behaviour was not significantly affected by polarity. The occurrence of familial suicide significantly increased the risk of violent suicidal behaviour in male depressed attempters. The present study indicates that a familial history of violent suicide is associated with the presence of violent suicidal behaviour in major depressive patients.
Delusions and the psychopathology of the elderly with dementia
Authors: Berrios G. E. , Brook P.
Published: August 2007

ABSTRACT– Thirty‐seven, out of a sample of 100 elderly subjects, all suffering from dementia, were found to have delusions. The delusions were more common in women, in patients with a history of psychiatric illness, and amongst those with higher information subscores (Blessed Scale); and were less common in patients suffering from apraxia or severe psychosocial incompetence. Amongst the deluded patients the simultaneous presence of disorientation, hallucinations and hyperactivity often signified the diagnosis of delirium, but on follow up it was not correlated with death within 18 months. The same symptoms in the non‐deluded patients were correlated with severe social incompetence and death within 18 months. It is concluded that the presence of delusions in subjects over 75 years old suffering from dementia is related, to certain extent, to previous or concomitant psychiatric illness, and that it reflects a relative preservation of mental function amongst those without such history.
Epidemiology of affective disorders in Florence
Authors: Faravelli C. , Incerpi G.
Published: August 2007

ABSTRACT– A structured interview designed to detect affective disorders according to operational diagnostic criteria was administered to a representative sample of 639 people living in Florence. The 1 year prevalence percent was 1.7 for bipolar disorder, 0.31 for atypical bipolar disorder, 5.2 for major depression, 1.4 for cyclothymic disorder, 2.3 for dysthymic disorder (all diagnosed according to DSM III criteria) and 4.5 for minor depression (RDC criteria). The corresponding figures relative to the point prevalence were: 0.6, 0.16, 3.8, 0.47, 1.2, 0.31. The use of care services on the part of affective cases (none, GP, public psychiatric facilities, private psychiatrist, hospital) was also recorded.
Prevalence of DSM III schizophrenia among the first‐degree relatives of schizophrenic probands
Authors: Frangos E. , Athanassenas G. , Tsitourides S. , Katsanou N. , Alexandrakou P.
Published: August 2007

ABSTRACT– The extent of the genetic component, if any, in DSM III schizophrenia still remains unresolved. To further examine the issue, the first‐degree relatives of 116 DSM III schizophrenic probands in our department were compared with those of an equal number of normal subjects, randomly selected and matched for age and sex. More than three fourths of the surviving relatives of each group were interviewed and rated according to DSM III criteria. Information of varying degrees of completeness was obtained about the remainder (surviving and dead). The gathered data were sufficiently detailed to provide general evidence that schizophrenia, and schizophrenia‐related personality disorders were significantly more common in the first‐degree relatives of DSM III schizophrenic probands than in the relatives of the controls. These findings suggest that even narrowly defined schizophrenia, such as that obtained by using DSM III criteria, has also a genetic component.
Attempted suicide in Denmark
Authors: Wang A. G. , Nielsen B. , Bille‐Brahe U. , Hansen W. , Kolmos L.
Published: August 2007

ABSTRACT– Ninety‐nine patients, randomly chosen among hospital admitted suicide attempters, were initially interviewed at the Department of Psychiatry, Odense University Hospital, Denmark, and then followed up for a period of about 3 years. Half of the patients repeated the attempt in the follow‐up period, mostly in the first year. Ten patients committed suicide, half of them in the first 3 months after the interview, shortly after discharge from hospital. The majority of the repeaters were living alone, while those that committed suicide were mostly married women aged 50–60 years. Other characteristic features for the repeaters were previous suicidal behaviour and suicidal behaviour among relatives. Many had a psychiatric record and expressed chronic somatic complaints. Around the time of the attempt, many expressed hopelessness, isolation and suicidal ideation. Pierce's Suicide Intent Scale performed poorly due, in particular, to low specificity. Future work will focus on objective risk factors, those indicated here and others, in order to establish an up‐to‐date background for assessment and management.
Benzodiazepines, but not antidepressants or neuroleptics, induce dose‐dependent development of tolerance to lorazepam in psychiatric patients
Authors: Aranko K. , Mattila M. J. , Nuutila A. , Pellinen J.
Published: August 2007

ABSTRACT– Psychomotor effects of oral lorazepam 3 mg were studied in psychiatric patients stratified into four groups: 1) a group of six patients with no previous use of psychotrophic drugs (NoD), 2) a group of 12 patients treated with antidepressants and/or neuroleptics (PsyD), 3) a group of 10 patients treated with low doses of benzodiazepines (BZs) (lowBZ), and 4) a group of nine patients treated with high doses of BZs (highBZ). Similar objective psychomotor tests and subjective assessments were administered under single‐blind conditions to all treatment groups at baseline, after intake of placebo, and after intake of 3 mg lorazepam. Both lorazepam (CGC) and total BZs (bioassay) in serum were assayed. The results demonstrate that treatment with BZs induce dose‐dependent development of tolerance to psychomotor effects of lorazepam. Antidepressants and neuroleptics failed to induce cross‐tolerance to lorazepam. The rise in serum lorazepam concentrations after lorazepam intake was similar (about 28 μg/1) in all treatment groups, suggesting a functional, not dispositional, tolerance. However, the initial learning effect in psychomotor performance was poorer among BZ users than among others.
Bufotenine reconsidered
Authors: McLeod W. R. , Sitaram B. R.
Published: August 2007

ABSTRACT– Bufotenine given intravenously to a medically trained volunteer subject correlated with the appearance of profound perceptual and emotional changes which were of short duration. The compound rapidly disappeared from the blood and metabolites quickly appeared in the urine of the subject.
Kidney function in a selected lithium population
Authors: Bendz H.
Published: August 2007

ABSTRACT– Forty‐six lithium (Li) patients who had been on Li for about 1–11 years were studied while on Li and after about 3 months (7 weeks‐26 months) off Li. Kidney function was compared between patients on Li and the same patients off Li, and, in 32 matched pairs, between patients on and off Li and psychiatric controls. Urine osmolality (U‐osmol) was significantly lower, urine volume higher in patients on Li than in controls. Measures of both glomerular and tubular function improved when Li‐patients discontinued medication. U‐osmol remained somewhat lower than in controls and was negatively correlated with time‐on‐Li. Although serum creatinine was somewhat higher in Li‐patients off Li than in controls, clearance values were not different between the two groups. Long‐term lithium treatment causes a permanent reduction of tubular function. Time‐on‐Li is a risk factor. In this population the reduction was clinically insignificant. In addition, Li treatment causes a reversible reduction of both tubular and glomerular function. The results can probably be generalized to other outpatient Li populations with the same time‐on‐Li and with U‐osmol below 800 mOsm/kg during ongoing treatment.
The wish to have a child
Authors: Lalos A. , Jacobsson L. , Lalos O. , von Schoultz B.
Published: August 2007

ABSTRACT– All women (n= 30) who were to undergo microsurgical treatment for tubal infertility, and their partners (n= 29), were subject to individual interviews just before and 2 years after the tubal surgery. Initially, they answered an open question concerning their wish to have a child and then were asked to choose from a list of 36 alternatives, a maximum of five motives for having a child. The infertile couples’ motives were compared with those of three reference groups: one group of 30 who had decided to continue their pregnancy, another group of 101 women who also planned to continue pregnancy and a third group of 459 women applying for legal abortion. All motives on the list were categorized as “philosophical”, “social/cultural”, “interpersonal” and “intrapsychic” motives. The interpersonal and intrapsychic motives dominated both the infertile women and their partners. A central motive was that a child is an ultimate expression of love between a man and a woman. The motives of the infertile couples, generally, did not differ from those of the reference groups.
Identifying children at high somatic risk: possible long‐term effects on parental conceptualizations of the children's personality and behavior
Authors: McNeil T. F. , Thelin T. , Aspegren‐Jansson E. , Sveger T.
Published: August 2007

ABSTRACT– The identification of α1antitrypsin deficiency (ATD) in neonates was hypothesized to have negative long‐term consequences on the parents’ views of the children's personality characteristics. This hypothesis was tested by comparing 5–7‐year‐old children's personality and behavioral characteristics, as reported by parents of 61 children with ATD versus parents of 61 control children without ATD. Data were collected by both interviews in the home and temperament questionnaires. No evidence was found of the hypothesized negative effect on parental views.
Early treatment response in anxious outpatients treated with diazepam
Authors: Downing R. W. , Rickels K.
Published: August 2007

ABSTRACT– Two hundred and two moderately chronic psychiatric outpatients, all suffering from anxiety of at least moderate severity and all diagnosable as cases of Generalized Anxiety Disorder, participated in a single‐blind 6‐week trial of diazepam (15–40 mg/day). The trial was preceded by a 1 week placebo washout, and provided for evaluation visits after 1, 2, 4 and 6 weeks of diazepam treatment. Patients were divided into High, Medium and Low Initial Improvers using 1 week change in Hamilton Anxiety Scale total score to assign patients to three subgroups of equal size. These groups did not differ significantly on those demographic factors and attributes of illness history which were documented, nor on assessments of symptom and illness severity, and mode of intake. Examination of a number of patient and physician assessments of illness severity revealed that the High group had the greatest 6‐week improvement, the Low group the least. During the first week, the High group attained 86%, the Medium group, 65%, and the Low group, 29% of its full 6‐week drug response. Diazepam dose levels were lowest for the High group and highest for the Low group. Placebo response was least for the High group and greatest for the Low group. An attempt to find distinctive attributes of the three initial improvement groups was unsuccessful.
Tardive dystonia and severe tardive dyskinesia
Authors: Giménez‐Roldán S. , Mateo D. , Bartolomé P.
Published: August 2007

Abstract Nine tardive dystonia cases were compared with 13 tardive dyskinesia cases selected for the severity and persistence of their involuntary movements. Both groups were neurological referrals from an identical source. While advanced age and female preponderance were prominent features in tardive dyskinesia, onset in most tardive dystonia cases occurred in young adulthood, and the sex distribution showed a slight majority of males. Other differences in the dystonia group included gait abnormalities in four cases, lower tolerance of neuroleptic discontinuance, with the reappearance of psychoses, and a poorer prognosis for reversibility after follow‐up. In fact, none of the dystonia patients reversed as opposed to seven of the tardive dyskinesia patients. In order to identify the full spectrum of tardive dystonia and exclude any referral bias, systematic epidemiological studies on psychiatric populations should include young adults of both sexes.
Profiles of antidepressant activity with the Montgomery‐Asberg depression rating scale
Authors: Montgomery Stuart A. , Smeyatsky N. , de Ruiter M. , Montgomery D. B.
Published: August 2007

The Montgomery and Asberg Depression Rating Scale (MADRS) is a 10 item severity scale constructed to be sensitive to change with treatment. It was designed to be sensitive for individual items and is therefore useful for measuring differential profiles of action. The MADRS profiles of activity were examined in a six‐week double‐blind comparative group study of depressed patients treated with mianserin or zimeldine. Three of the ten items on the MADRS showed individual significant advantages for mianserin, reduced sleep (weeks 1 and 3), concentration difficulties (week 1), and reduced appetite (week 3). These findings are in agreement with earlier reports of poor sleep and gastrointestinal upset associated with the 5‐HT uptake inhibitor zimeldine. The selective improvement in concentration difficulties and in the other items support the view that mianserin is particularly useful in alleviating the anxiety associated with depression. The sedative effect of mianserin did not appear to interfere with concentration. There were significant improvements in the mianserin‐treated group at 1, 2, 3, and 4 weeks for the MADRS, Hamilton Depression Rating Scale and Clinicians Global Impression scale. There was no significant advantage for mianserin at 5 and 6 weeks. The differential clinical effects were apparent early in the study but any selectivity of action appeared to be overwhelmed by the general antidepressant effect later in treatment.
REGISTER STUDIES: DATA FROM FOUR AREAS IN NORTHERN ITALY
Authors: Torre Eugenio , Marinoni Alessandra
Published: August 2007

Descriptive statistics derived from four psychiatric case‐register areas are presented. Attrition numbers of long‐stay inpatients and the accumulation of high‐user patients in non‐residential facilities are discussed, with the aim of providing tentative suggestions for a more rational planning of services. Similarities and differences among various areas of Northern Italy are also described.
Psychotherapeutically Oriented Treatment of Schizophrenia: Results of 5‐year‐follow‐up
Authors: ALANEN YRJÖ O , RÄKKÖLÄINEN VILJO , RASIMUS RIITTA , LAAKSO JUHANI , KALJONEN ANNE
Published: August 2007

The authors have developed a psychotherapeutic approach to schizophrenia within the community psychiatric health care system. The orientation is psychodynamic but global in the meaning that the therapeutic plans are made on the basis of case‐specific need of the patients and of their families and include both individual psychotherapy, family therapy and therapeutic communities.

The material is composed of 100 successive patients of the schizophrenia group aged 16 ‐ 44 years and for the first time admitted for treatment into the different units of the Turku Mental Health District in 1976‐77. A multiprofessional staff was acting as therapists, supported by a continuous and intensive on‐the‐job ‐training and supervision.

The results preliminary reported in this paper are based on a follow‐up study 5 years after admission to treatment. 56 patients could be included in the psychotherapy group given at least some mode of psycho‐therapy in an adequate amount. The background variables of patients selected for various modes of therapy as well as the prognositc results are studied with the aid of logistic regression analyses.

The findings indicate that the development of a global psychother‐apeutic orientation is possible in the field of community psychiatry and yields results that demonstrate its meaningfulness. The implementation of psychotherapy had clearly positive explanatory connections with a favourable prognosis, and although these connections were not equally strong as the connections of some central clinical and psycho‐social variables, they were obvious and manifold.
Aging and Schizophrenic Psychosis
Authors: CIOMPI LUC
Published: August 2007

The author discusses the question of the interference of schizophrenia and aging, and specially of the impact of biologic and organic versus social and situational factors. The presentation is based on long‐term follow‐up‐studies by the author himself and others, showing favorable outcomes in about half of the cases. Contrary to general beliefs, old age has quite often a favorable influence, eg. by dampening acute productive symptoms and drives and by improving interpersonal relations. Psycho‐organic deterioration is hardly more frequent, in schizophrenics, than in the general population. In conclusion, in old age, too, schizophrenia does no longer appear as a fatally progressive organic disease, but as a multi‐conditional open life process in vulnerable individuals with persisting potential for improvement even in old age.
Depression Research: A Review with Special Emphasis Etiology
Authors: KRINGLEN EINAR
Published: August 2007

In this review of depression research the author has focused the attention on twin and adoption studies, although problems of classification, epidemiology, and biological and environmental factors related to depression are also touched upon.

It is being noted that the available studies in the area are few, the number of twins in the various samples is small and the diagnostic classificationsvary. Of particular interest are the results presented by Bertelsen et al. (l), because of the large systematic sample. A summary of the studies that are based upon sampling through twin registers, i.e. the Scandinavian investigations, employing a relatively strict concept of manic depressive psychosis (bipolar disorder), gives a mean concordance of 50% in MZ twins and 15% in DZ twins. (1, 2, 3) Whereas genetical factors seem to play a significant role in the etiology of severely depressed subjects, there is no evidence that hereditary factors are of importance in the neurotic or reactive depressions, since concordance is low in both MZ and DZ (4).

The available adoption studies are also few and replications are definitely necessary before one can arrive at firm conclusions. Mendlewicz & Rainer (5) reported more psychopathology of an affective nature in the biological parents of the adoptees with bipolar illnes than in the social parents. In contrast, von Knorring et al. (6) did not observe an increase in affective psychopathology in the biological parents of adoptees with affective disorder. Noteworthy is the excess of affective psychoses in the social parents.

The author holds the view that any speculation with regard to genetic transmission is premature.

Although the findings from the various investigations are not unambiguous, twin and adoption studies support the notion that genetic factors play a considerable role in bipolar disorder, whereas non‐bipolar depression is basically environmentally determined.
Changing Patterns of Mentall Health Care
Authors: HÄFNER HEINZ
Published: August 2007

The evaluation of intra‐ and extramural psychiatric care nowadays calls for new models and methods of services research as the transition from custodial to community mental health care results in patterns of utilization of high complexity. Not only the capacity and the components of the care system has changed considerable but also the composition of the cared patient groups.

In Mannheim 3/4 of the schizophrenic patients requiring institutioned care for one year or more are admitted to sheltered homes and appartments due to the establishment of complementary sevices in the last 15 years. Data of a representation cohort of 148 schizophrenics observed over a period of 18 months show that corresponding to the multiple needs of the patients multiple needs of the patients multiple utilization prevails. The efectiveness of extramural care can be demonstrated by a reduced probability of readmission to inpatient treatment.

The economic efficiency of the provision of complementary care was evaluated by analyzing coostts of service use by the cohort. The diect costs per case of all the servies utilized over on year averaged 43% compared with an uninterrupted stay in a mental state hospital. Also in community mental health care almost 80% of the total costs accrue rom hospital readmission due to relapses.
Perphenazine Decanoate vs. Perphenazine Enanthate
Authors: Knudsen Peder , Hansen Lars Bolvig , Auken Grete , Wæhrens Jens , Højholdt Karsten , Larsen Niels‐Erik
Published: August 2007

In a six‐week randomized, double‐blind study the efficacy and side effects of perphenazine decanoate (PD) and perphenazine enanthate (PE) were evaluated and compared in 26 and 24 acute psychotic patients respectively. Of either formulation 100 mg were administered intramuscularly every two weeks. Maximum and minimum plasma concentrations of perphenazine were measured for each injection period using gas liquid chromatography. There was no statistically significant difference between PD and PE in terms of overall antipsychotic efficacy, assessed by means of the Brief Psychiatric Rating Scale (BPRS). However, when an ‘Amelioration Score’ (AMS) of at least 50% of the totally obtainable scores was defined as individual response criterion it was revealed that in the PD group only one patient (4%) did not meet this criterion, compared with six patients (25%) in the PE group. Extrapyramidal side effects were significantly more pronounced in the PE‐treated patients, who also required significantly higher amounts of antiparkinson medication. The mean maximum concentration of perphenazine in plasma was 5.0 nmol/l in the PD, and 10.6 nmol/l in the PE‐treated patients. The ratio of the mean maximum to the mean minimum concentraion was 1.41 and 4.02 in the decanoate and enanthate groups respectively.

In the patients treated with PD there were signs of accumulation indicating the possibility of prolonging dosage intervals. The present study yielded further support to previous findings demonstrating that intramuscular administration of PD dissolved in sesame oil, in contrast to PE, results in even and flat plasma perphenazine concentration curves, which not only provides a stable antipsychotic effect but also most likely carry the responsibility for the low incidence of extrapyramidal side effects observed.
A nosological study of patients presenting with somatic complaints
Authors: Srinivasan K. , Murthy R. Srinivasa , Janakiramaiah N.
Published: August 2007

ABSTRACT The nosological status of patients presenting with multiple somatic complaints with reference to ICD‐9 was examined in the present study. In 22% of the cases it was not possible to arrive at a single ICD‐9 diagnosis. The majority of these cases had combinations of somatic, anxiety and depressive symptoms. Nine percent of the cases could not be given any psychiatric diagnosis using ICD‐9. These cases had very few psychological symptoms and were not identified as pscyhiatric cases by the present state examination. The various possible factors responsible for this diagnostic uncertainty have been highlighted.
Diagnostic reliability among French psychiatrists using DSM‐III criteria
Authors: Fuhrer R. , Rouillon F. , Lellouch J.
Published: August 2007

ABSTRACT The reliability of French psychiatrists using DSM‐III axis I disorders was studied using videotaped semi‐structured diagnostic interviews. 136 psychiatrists with different levels of clinical experience classified 11 cases into six preselected diagnostic categories: Schizophrenia, Major Depressive Episode, Dysthymic Disorder, Cyclothymic Disorder, Other Psychiatric Diagnosis, No Present Psychiatric Diagnosis. A modified Kappa coefficient for multiple observers was used to calculate agreement and thereby estimate reliability. We obtained an overall Kappa of 0.55 for six categories, and when the Dysthymic and Cyclothymic Disorders were combined into one class, i.e. other specific affective disorders, the Kappa value increased to 0.64. The Kappa value for individual categories was best for Schizophrenia and Major Depressive Episode, and poor for Dysthymic and Cyclothymic Disorders. Clinical experience or prior knowledge of DSM‐III criteria did not have a significant effect on reliability.
Is lithium justified after one manic episode?
Authors: Mander A. J.
Published: August 2007

ABSTRACT Fifty‐seven per cent of patients with a DSM III diagnosis of mania were discharged on lithium after the first admission. This group differed from those not prescribed lithium in terms of length of admission, severity of symptoms, sex and social class. Outcome was not influenced by prescription of this drug even though it was shown to be an effective prophylactic. The reasons for this are discussed and recommendiations for future clinical practice are made.
A brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication
Authors: Min S. K.
Published: August 2007

ABSTRACT A summary of clinical data is presented on 34 men and 52 women patients with brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication. Their ages ranged from 34 to 82 years, with peak incidence in the sixth and seventh decade. Possible etiological factors were age, duration of unconsciousness on acute intoxication, and previous physical illness. The onset was relatively sudden after the apparent clear period which ranged from 2 to 40 days (mean 22.5 days). The most frequent symptoms were apathy, dull facial expressions, dementia, such as amnesia and disorientation, hypokinesia, mutism, irritable distractibility, urinary and/or fecal incontinence, gait disturbance and abnormal neurological signs and reflexes. EEG was abnormal in 33 of the 57 cases (58%). Of 27 patients who were given a computed tomographic brain scan, 15 patients were abnormal. The prognosis was relatively good in the follow‐up study of 56 patients. Only age was related to a better prognosis.
Personality and psychosis: use of the Standardized Assessment of Personality
Authors: Cutting J. , Cowen P. J. , Mann A. H. , Jenkins R.
Published: August 2007

ABSTRACT The Standardized Assessment of Personality, a semistructured interview for use with an informant, was used with a relative or a close friend to determine the premorbid personality of 100 consecutive patients admitted with major psychiatric disorders – major affective disorders (18 manics, 35 depressives), schizophrenia (28) and other functional psychoses (19). Forty‐four per cent of the entire sample had an abnormal personality as defined by the presence of one of 10 prominent traits to a marked degree. A further 6% had the same traits to a lesser degree. The proportion of patients with an abnormal personality (all types) was comparable across the four diagnostic groups (manics 39%, depressives 54%, schizophrenics 39%, other functional psychotics 37%). However, if one included all traits (marked and mild), patients with an affective disorder had more between them than did the non‐affective groups. This difference was largely accounted for by cyclothymic, anxious and obsessional traits. The schizophrenics and other functional psychotics had surprisingly few prominent traits and, in particular, a schizoid personality rarely preceded a schizophrenic illness.
Dexamethasone suppression and energy balance in eating disorders
Authors: Abou‐Saleh M. T. , Oleesky D. , Crisp A. H. , Lacey J. H.
Published: August 2007

ABSTRACT The dexamethasone suppression test (DST) was investigated in 45 female anorectic out‐patients (cross sectional study) nine of whom were followed serially as in‐patients (longitudinal study). DST non‐suppression was strongly associated with negative energy balance (low body weight and low Ponderal Index) but there was no significant association with the presence of affective or neurotic disturbance in these patients. These findings cast doubt on the value of the DST in the management of depressive illness.
Acute schizophrenic episode: is it a culture‐related syndrome?
Authors: El‐Rufaie O. E. F. A.
Published: August 2007

ABSTRACT The patients in this study, from Abu Dhabi, United Arab Emirates, presented with an acute psychotic syndrome preceded by stressful life events. The patients represented only three nationalities, although many people from other nationalities labour under similar stressful conditions. It is suggested that cultural factors play a role in the aetiology of this particular syndrome.
Serum dopamine‐β‐hydroxylase activity in patients with major depressive disorders
Authors: Kjellman B. F. , Beck‐Friis J. , Ljunggren J. G. , Ross S. B. , Unden F. , Wetterberg L.
Published: August 2007

ABSTRACT The dopamine‐β‐hydroxylase (DBH) activity in serum was assayed in 32 acutely ill inpatients with major disorder and in 33 healthy control subjects. Twenty‐six of these patients were also studied in a state of remission. The DBH activity was compared to the serum levels (studied during a 24 h period) of T4, T3, TSH, prolactin and melatonin as well as to the outcome of the dexamethasone suppression and TRH test and to various clinical symptoms, as estimated by different rating procedures. No significant differences in DBH activity were found between the acutely ill patients, patients in remission, or normal subjects. Thus, the determination of the activity does not seem to be of practical importance as a laboratory diagnostic tool for major depressive disorder. A significant positive correlation was found between the DBH activity and the TSH levels, estimated by several parameters during the 24 h period, in the acutely ill patients, whereas no significant correlation was found in patients in remission or in the normal subjects. No significant correlation was found between the DBH activity in any group and the other laboratory or clinical parameters. The mechanism behind the significant correlation between the DBH activity and TSH levels remains to be clarified.
Psychiatric hospital treatment of young people
Authors: Almqvist F.
Published: August 2007

ABSTRACT To develop and extend psychiatric work among the young, information is required on, e.g., the manner and extent to which young people have so far made use of psychiatric hospital services. In this study report, psychiatric hospital treatment from age 15–21 years is described epidemiologically. The percentage of young people treated in psychiatric institutions during the 7‐year follow‐up period was 2.7. Of all the young psychiatric patients in this cohort, only some 20% required institutional care. A small group of about 0.7% of the total young population accounted for some 70% of the total number of psychiatric hospital days involving young people.
Duration of survival in senile dementia
Authors: Diesfeldt H. F. A. , van Houte L. R. , Moerkens R. M.
Published: August 2007

ABSTRACT In this study 297 institutionalized patients with primary degenerative dementia were investigated. Age at onset of dementia was determined and individual longevity quotients (i.e. actual duration of survival divided by expected survival) were calculated. Expected survival was derived from the Dutch life tables for the general population. Age at onset of dementia was 75.6 ± 7.8 years (mean ± SD). Duration of dementia until death was 7.2 ± 4.1 years. Dementia of early onset (before age 76) was associated with a significantly reduced life expectancy (LQ = 0.70 ± 0.30), but this was not found for onset after age 75 (LQ = 0.91 ± 0.58). Duration of symptoms at the time of admission into a nursing home was not associated with severity of behavioural and cognitive impairments as measured with behaviour rating scales. However, the severity of behavioural impairments predicted 1‐year survival after admission, as could be shown by multivariate analysis which corrected for the effects of age and sex.
A comparative study on the antipsychotic properties of desenkephalin‐γ‐endorphin and ceruletide in schizophrenic patients
Authors: Verhoeven W. M. A. , Westenberg H. G. M. , van Ree J. M.
Published: August 2007

ABSTRACT The neuropeptides desenkephalin‐γ‐endorphin (DEγE) and ceruletide were administered intramuscularly to patients with schizophrenic psychoses following a double‐blind placebo‐controlled design, including a total of 44 subjects. Neuroleptic medication was continued during the experimental period, which was started with one placebo injection for all patients. One week later subjects received a single intramuscular injection with 3 mg DEγE, 40 ug ceruletide or placebo. After an interval of 10 days, the patients received six similar injections over a period of 2 weeks. Treatment with either peptides resulted in a decrease of psychotic symptomatology as compared to placebo treatment. The beneficial effect of the peptides lasted at least 2 weeks after the experimental treatment period. Of the 14 patients treated with placebo only, three showed a slight response. Of the 30 patients treated with the neuropeptides, eight did not respond (DEγE: 3; ceruletide: 5), eight had a slight response (DEγE: 6; ceruletide: 2) and 14 responded moderately or markedly (DEγE: 6; ceruletide: 8). No obvious difference between the effects of the two neuropeptides was found, besides a somewhat earlier onset of the effect of ceruletide. Patients presenting relatively less negative psychotic symptoms were particularly susceptible to treatment with either peptide. Apart from slight and shortlasting gastrointestinal complaints after the first injections with ceruletide in some patients, no side effects were observed.
Factors influencing the ward atmosphere
Authors: Friis S.
Published: August 2007

ABSTRACT— On 35 short‐term wards the connection between ward atmosphere as perceived by patients and various setting and treatment characteristics was explored by the use of a hierarchical multiple regression analysis. The most important variables proved to be: mean age of patients, percentage of psychotic patients, number of patients, staff turnover rate, and interaction score. A higher mean age of patients was associated with changes in the ward atmosphere preferred by older patients. An increased percentage of psychotic patients and an increased number of patients were associated with changes which were probably anti‐therapeutic for psychotic patients. Increased staff turnover was paralleled by changes which were probably unfavourable for both psychotic and nonpsychotic patients. An increased emphasis on interaction was paralleled by changes which were probably beneficial for nonpsychotic patients, but partly unfavourable for psychotic patients.
Current outcome in schizophrenia: women vs men
Authors: Seeman M. V.
Published: August 2007

ABSTRACT: This article reviews the 1980's literature on gender differences in schizophrenia outcome. Neuroleptic response, long‐term course, and housing, appear to be superior in women. Mortality ratios are advantageous to schizophrenic men. After menopause, women may require higher neuroleptic doses than men and are more at risk for severe tardive dyskinesia. The antidopaminergic effects of estrogens appear to be responsible for some of the outcome differences.
Relative activity of metabolic pathways for norepinephrine in endogenous depression
Authors: Roy A. , Linnoila M. , Karoum F. , Pickar D.
Published: August 2007

ABSTRACT: Thirteen patients with endogenous depression, compared to 25 normal controls, had a significantly greater ratio of the urinary excretion of norepinephrine plus its metabolitie normetanephrine to either the sum of the two urinary norepinephrine metabolites 3‐methoxy‐4‐hydroxyphenylglycol plus vanillylmandelic acid or to the sum of urinary norepinephrine and all of its metabolites. As urinary levels of norepinephrine and normetanephrine are derived from an extraneuronal metabolic pathway, while levels of 3‐methoxy‐4‐hydroxyphenylglycol and vanillylmandelic acid are more representative of total norepinephrine metabolism, these results suggest that there is a shift in endogenous depression to extraneuronal metabolic pathways for norepinephrine and its metabolites.
Influence of pregnancy and child‐rearing on amphetamine‐addicted women Five‐year follow‐up after delivery
Authors: Eriksson M. , Steneroth G. , Zetterström R.
Published: August 2007

ABSTRACT: A group of 69 amphetamine‐addicted women who all abused during part of or the whole pregnancy have been followed since the birth of the index child born in 1976 or 1977. Seventeen of the mothers gave up drug abuse in early pregnancy. Ten of these succeeded to stay off drugs and excessive alcohol, while six relapsed into drug abuse. In addition, three women have been off drugs since delivery and 12 for at least 1–3 years. Twelve of the 25 mothers who were drug‐free at the end of the period had retained the custody of their children, while 11 mothers who were drug‐free at the end of the period had their children placed in foster homes. In contrast to this, 16 drug‐using mothers were still caring for their children. A criminal record and a story of psychiatric in‐patient care was common, especially among the mothers who had lost custody of their children. On the other hand, mothers who had retained custody more often lived with a drug‐free man and had regular employment.
Studies of cellular immunity, serum interferon titers, and natural killer cell activity in schizophrenic patients1
Authors: Schindler L. , Leroux M. , Beck J. , Moises H. W. , Kirchner H.
Published: August 2007

ABSTRACT: In one of the hypotheses on the causes of schizophrenia it is proposed that viruses may play a role in the etiology and pathogenesis of at least some forms of schizophrenia. In our study, 30 healthy adults and 30 schizophrenic patients were investigated for humoral and cellular immunity against herpes simplex virus (HSV) and cytomegalovirus (CMV). A whole blood test system with several advantages over commonly used procedures was used to study cell‐mediated immunity to CMV and HSV. Our data showed no difference between serum antibody levels or cellular immunity of the schizophrenic patients and control individuals as far as HSV and CMV were tested. Serum interferon may be indicative for the presence of a yet unidentified virus. Therefore, we tested interferon levels in the serum of patients. No interferon was detected in any of the samples tested. Further, we tested the activity of natural killer (NK) cells in the blood of schizophrenic patients and controls. NK‐activity of the patients' blood cells was not different from that of normal donors.
Growth hormone and somatomedin serum levels in patients with major depressive illness undergoing electroconvulsive therapy
Authors: Apéria B. , Thorén M. , Undén F. , Wetterberg L.
Published: August 2007

ABSTRACT: Thirty‐three patients with major depressive illness received electroconvulsive therapy (ECT), and serum growth hormone (GH) levels were measured 30, min before and 1, 5, 15, 30 and 60 min after treatment. Six of the patients were studied 2 days before the first ECT (ECT‐1) while receiving anaesthesia only. The anaesthesia given appeared to depress GH levels, which were significantly lower at 1 and 5 min after ECT than before treatment. When ECT was given there was a recovery of the GH level at 60 min, indicating a stimulatory effect of ECT on GH secretion. In 26 of the patients also investigated during the sixth and last ECT (ECT‐6) in a series, no such recovery was observed. This may be due to changes in the sensitivity of intracerebral monoaminergic receptors in neurons controlling GH secretion from the pituitary gland. Since inhibition of GH secretion is mediated via beta‐adrenergic pathways, the depression of GH secretion may be due to ECT‐induced supersensitivity of postsynaptic beta‐adrenergic receptors. In 27 of the patients serum somatomedin A, measured by radioreceptorassay (SMA‐RRA), was analysed before ECT‐1 and in 19 patients before ECT‐6. In seven subjects the SMA‐RRA was measured 30 min before and 1, 5, 15, 30, and 60 min after ECT‐1. SMA‐RRA levels were mainly within the normal range for age and did not change during ECT. No difference in SMA‐RRA levels was observed before ECT‐1 and ECT‐6. This indicates that, although abnormalities in the GH‐response to challenge stimuli have been reported in adults with major depressive disorder, their GH production is normal.
Paranoid disorder ‐ environmental, cultural or constitutional phenomenon?
Authors: Ndetei D. M.
Published: August 2007

ABSTRACT At a London hospital the prevalence and types of recorded paranoid disorders, and their characteristics were extracted from the files of in‐patients of various cultural groups. It was found that West Indians and Africans had more paranoid colouring in their psychiatric illness than any other group. Other immigrant groups had less paranoid features than the English group. The self or a family member was the commonest focus of intended harm in all the cultural groups. Supernatural modes of injury were common in the West Indians and Africans. It is argued that in immigrants paranoid disorder is not merely due to discrimination consequent on their migrant status, but that cultural factors inherent in the immigrants are also of etiological importance.