bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpersonal dependency, self‐esteem and depression in primary alcoholism
Authors: Vrasti R. , Enasescu N. , Poelinca C. , Apostol V.
Published: August 2007

This study was undertaken to clarify the relationship between alcoholism and depression by means of the personality traits interpersonal dependency and self‐esteem. In a sample of 52 alcoholics that met Feighner's criteria for primary alcoholism, the subjects were assessed by means of the Zung Depression Self‐rating Scale, the Hirschfeld Interpersonal Dependency Scale and the 23‐item version of the Janis & Field Self‐esteem Scale by Rimée & Leyens. By means of the score on the Zung scale the subjects were divided into depressive vs. non‐depressive alcoholics. There were no intergroup differences in interpersonal dependency. However, the depressive alcoholics scored significantly lower on the self‐esteem scale. The authors suggest that the level of self‐esteem in alcoholics is a function of secondary depression, whereas the interpersonal dependency might be influenced by the pathological drinking pattern.
Low B12 levels related to high activity of platelet MAO in patients with dementia disorders
Authors: Regland B. , Gottfries C.‐G. , Oreland L. , Svennerholm L.
Published: August 2007

In 35 patients with Alzheimer's presenile disease (AD), 56 patients with senile dementia of the Alzheimer type (SDAT), 54 patients with vascular dementia (VD) and 10 patients with confusional states, age, vitamin B12 in serum, P‐folate, B‐folate and B‐Hb were investigated. Platelet monoamine oxidase (MAO) and cerebrospinal fluid (CSF) levels of homovanillic acid (HVA), 5‐hydroxyin‐doleacetic acid and 3‐methoxy‐4‐hydroxyphenylglycol were measured. Group differences showed that vitamin B12 levels were reduced in the group of patients with confusional states and SDAT. Five out of ten and 13 out of 56 (respectively) had vitamin B12 concentrations below the lower limit of the reference value (130 pmol/1). A negative correlation was found between B12 levels and platelet MAO activity. The findings indicate that there is a subgroup of patients with late‐onset dementia that has low vitamin B12 blood concentrations. HVA levels in CSF, usually found to be reduced in AD patients, were normal in this subgroup.
The prevalence of transsexualism in Singapore
Authors: Tsoi W. F.
Published: August 2007

The prevalence of transsexualism in Singapore was estimated by counting all the patients who sought sex‐reassignment surgery and were subsequently diagnosed as transsexuals by psychiatrists. Up to 1986, there were a total of 458 Singapore‐born transsexuals, of which 343 were males and 115 were females. This was a prevalence of 35.2 per 100,000 population age 15 and above (or 1/2900) for male transsexualism, and 12.0 per 100,000 (or 1/8300) for female transsexualism. The sex ratio was about 3 males to 1 female. The main reason for the high prevalence was the availability of sex‐reassignment surgery.
Lithium, polyuria and abnormal diurnal weight gain in psychosis
Authors: Vieweg W. V. R. , Godleski L. S. , Hundley P. L. , Yank G. R.
Published: August 2007

We evaluated diurnal weight gain and polyuria among 31 institutionalized chronically psychotic patients receiving lithium and 42 controls not receiving this drug. The patients were weighed weekly for three weeks at 7 a.m. and 4 p.m. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the difference by 100, and then dividing the result by the 7 a.m. weight. Polyuria was assessed using mean urine creatinine concentration (MUCR). NDWG was abnormal among study patients (1.9 ± 1.2%) and controls (1.6 ± 1.5%) independent of lithium treatment. The variation in MUCR explained about 20% of the variation in NDWG in both groups.
Different types of partial hospitalization programs: results of a nationwide survey in the Netherlands
Authors: Schene A. H. , van Lieshout P. A. H. , Mastboom J. C. M.
Published: August 2007

An outline is presented of four characteristically different types of partial hospitalization programs currently operating in the Netherlands. The findings are based on empirical data gathered from a study of 85 institutions active in this particular field. The institutions are distinguished according to the function they perform within the total mental health care system, the assumption being that these programs are capable of fulfilling four main functions: 1) an alternative to full‐time hospitalization; 2) a continuation of full‐time hospitalization; 3) an extension of ambulatory treatment; 4) a day care or rehabilitation service for the chronically mental ill. A study was made of the differences and similarities between four types of institution specializing in one of the four functions mentioned above. In this connection, the authors have particularly concentrated on staffing, number of places, accommodation, organization, referral, patient population (age, education, diagnoses), treatment (type, duration, drug use) and contraindications.
Calcium metabolism and abnormal involuntary movements (tardive dyskinesia) in psychosis
Authors: Youssef H. A. , Waddington J. L.
Published: August 2007

Serum calcium levels were measured in 25 chronically ill psychotic inpatients with involuntary movements, in comparison with 25 otherwise indistinguishable patients without such a syndrome. Those with involuntary movements were significantly more likely to have a serum calcium level below the normal range. These results are discussed in terms of the role of calcium in neuronal dysfunction, and in broader aspects of the general biological disadvantage that appears to characterize older patients with this movement disorder.
Anorexia nervosa in two Nigerians
Authors: Famuyiwa O. O.
Published: August 2007

The general belief that anorexia nervosa is rare among non‐whites should be cautiously accepted based on some very recent reports of the occurrence of the disorder in individuals of African descent. Two young Nigerians who presented classical features of anorexia nervosa are reported. In Case I, anorexia now regarded to be of low diagnostic value was absent, but in both cases identified antecedent psychosexual conflicts are explainable by well‐known psychodynamic hypotheses. The relatively low prevalence of the disorder that has been observed might be due to: the protective influence of the Nigerian extended kinship system, the customary passion for plumpness as an attribute of physical attractiveness, carbohydrate diet “resistance” and the non‐inclusion of cases in hospital records because of consultation with unorthodox healers. The general trend of increasing prevalence calls for more diagnostic vigilance, particularly among doctors serving populations with Third World background.
Brain density in depression: methodological and psychopathological aspects
Authors: Schlegel S.
Published: August 2007

The relationship between brain density, measured by computerized tomography (CT), and severity of depression was investigated in 44 patients with a major depressive episode according to DSM‐III. In order to limit methodological problems, correlations between both the Brief Psychiatric Rating Scale (BPRS) and the Bech‐Rafaelsen Melancholia Scale (BRMS) with density values were controlled for age, different ventricle measurements, brain size, and density and size of the skull. The BRMS score correlated inversely with density of the right thalamus, the right head of the caudate, and with parietal grey matter and occipital regions of both hemispheres. Similar, but nonsignificant results, were obtained for the BPRS score.
Brain morphology in schizophrenia: a 2‐ to 5‐year CT scan follow‐up study
Authors: Vita A. , Sacchetti E. , Valvassori G. , Cazzullo C. L.
Published: August 2007

In order to investigate whether structural brain changes in schizophrenia are static or progress in time, 17 schizophrenic patients were examined by computed tomography (CT) between 2 and 5 years after the initial scan. There was no change in cerebral ventricular size or degree of cortical atrophy over this period. The stability of CT scan measures of cerebral atrophy in individual schizophrenic patients confirms the hypothesis of the early appearance of structural brain abnormalities in schizophrenia as formulated in previous cross‐sectional studies. Furthermore, the pathological process responsible for the CT finding of cortical or central atrophy does not seem to progress nor to reverse itself in young schizophrenic patients.
Behavioral assessment of patients treated with alpha‐interferon
Authors: Niiranen A. , Laaksonen R. , Livanainen M. , Mattson K. , Färkkilä M. , Cantell K.
Published: August 2007

To document behavioral effects of interferon (IFN) with daily consecutive assessments we developed an easily administered procedure for bedside testing. It included assessment of mental control and affective behavior, and a self‐assessment questionnaire. The method was evaluated in 9 lung cancer patients before and during the treatment with alpha‐IFN and the results were supplemented with those obtained by a neuropsychological test battery of one of the patients. The latter tests covered memory, visuoperceptual, visuoconstructional, speech, language, intellectual and psychomotor functions, reading, writing, and calculation. The bedside method was capable of revealing the essential effects of IFN on human behavior, i.e. irritability, slowing of behavior, dyscoordination, and motor perseveration. Consequently, the bedside testing method is recommended for frequently repeated clinical assessments of aberrant behavior of patients treated with IFN, while neuropsychological test batteries serve better for testing situations requiring more detailed and quantified data of localization value.
INVESTIGATIONS OF THE PREVALENCE OF PSYCHIATRIC DISORDERS
Authors: Bland R. C.
Published: August 2007

More than thirty studies of the prevalence of psychiatric disorders have been reported from Western countries in the last thirty years. Significant methodological advances have occurred, including sophistication of sampling techniques, improvements in caseness definitions and identification of cases, and clear definitions and specification of rules for diagnosis. The introduction of standardized diagnostic instruments for use by trained lay interviewers is expected to facilitate studies of psychiatric epidemiology. The methods used in each of the studies are briefly described.
DESIGN AND FIELD METHODS OF THE EDMONTON SURVEY OF PSYCHIATRIC DISORDERS
Authors: Orn H. , Newman S. C. , Bland R. C.
Published: August 2007

ABSTRACT‐

This paper describes aspects of the study design and field methods used in a survey of psychiatric disorders carried out in Edmonton, Alberta, Canada. Between January 1983 and May 1986, information was gathered on 3,258 community residents using the Diagnostic Interview Schedule and the General Health Questionnaire ‐ 30 item version. The survey had a response rate of 71.6%. The nature of the sampling stragegy used, features of the study instruments chosen, the selection and training of interviewers, and the approach to data analysis are briefly described.
PERIOD PREVALENCE OF PSYCHIATRIC DISORDERS IN EDMONTON
Authors: Bland R. C. , Newman S. C. , Orn H.
Published: August 2007

ABSTRACT‐

3,258 randomly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). Six‐month prevalence figures for DIS/DSM III diagnoses are given, and selected figures for the one‐month and one‐year prevalence, and the one‐year symptom‐free rates. The six‐month prevalence for any diagnosis is 17.1%, comparable to findings from other population studies using DSM III derived diagnoses, but lower than studies using the PSE. The prevalence rates for most disorders tended to be lowest in the elderly, but this was not as marked as the drop in lifetime prevalence. Men had higher prevalence for substance use disorders than women, but women had higher rates for affective disorders and anxiety/somatoform disorders. Prevalences for all disorders were either similar or lower in those who were married or living as though married, than in those who were not cohabiting. One‐year symptom‐free rates were highest for those with substance use disorders and lowest for those with anxiety/somatoform disorders ‐ largely due to the persistence of phobias.
AGE OF ONSET OF PSYCHIATRIC DISORDERS
Authors: Bland R. C. , Newman S. C. , Orn H.
Published: August 2007

Age of onset of psychiatric disorders was determined from a random sample of 3, 258 household residents who were administered the DIS by trained lay interviewers. Onset was determined by the subject's recall of the age of the first symptom in those who met lifetime criteria for a diagnosis (DSM III without exclusions). The peak age of risk for most disorders was from the teens to 30 years, however a number of schizophrenics showed first symptoms before age 10. Few cases of any disorder had an onset in old age. The ages of onset are generally lower than those usually given from series of treated or hospitalized cases.
PREVALENCE OF PSYCHIATRIC DISORDERS IN THE ELDERLY IN EDMONTON
Authors: Bland R. C. , Newman S. C. , Orn H.
Published: August 2007

Prevalence rates (six month and lifetime) for a random sample (N=358) of the eldery living at home, are compared to the rates for a sample (N=3,258) of the whole adult popultion of Edmonton and found to be generally lower in the elderly, except for cognitive impairment. These household resident results are similar to those reported from the United States using similar methods. A sample (N = 199) of the elderly living in institutions was found to have a very high overall prevalence of illness, mostly consisting of cognitive impairment (69%). It is estimated that over half of all cases of cognitive impairment live in institutions. This has considerable implications for the programs in institutions for the elderly, and also the need for institutions in the future, unless alternate means of care can be developed.
Prediction of clinical change by ethological methods
Authors: Bouhuys A. L. , Beersma D. G. M. , Van den Hoofdakker R. H.
Published: August 2007

The aim of this paper is to show that ethology may contribute to the search for early indicators of clinical changes in depression. Three studies are presented. One study deals with the prediction of treatment outcome over 10 weeks and the other two with the prediction of the acute clinical response to total sleep deprivation (TSD). In each study a number of behaviours were observed, as displayed during a baseline psychiatric interview by the patients as well as the psychiatrist. In this report, the predictive potency of directly observed behaviours is compared to the predictive value of global clinical measures of psychomotor activation. The behaviours of the patients were interpreted as “relational” and “nonrelational” behaviours. The relational behaviours (i.e., variation in looking, yes‐nodding, gesturing) occurred less, the nonrelational behaviours (i.e., intensive body touching, head movements) occurred more in responders than in nonresponders to 10 weeks of treatment. Also in the TSD studies body touching was positively related to improvement. Global clinical assessment of psychomotor activation could not be related to outcome. The advantages of the observational methods are discussed.
Childbirth as a life event: Sociocultural aspects of postnatal depression
Authors: Cox John L.
Published: August 2007

This paper illustrates some important socio‐cultural aspects of postnatal depression with particular reference to my research in East Africa. Evidence is reviewed that in many non Western countries post‐partum rituals are still carried out and the hypothesis that the absence of such routine behaviours increases the likelihood of postnatal depression is examined. The lack of obstetric and family rituals may for example lower a mothers self esteem, stress the marital relationship, and can represent an ambivalent social status. The need to investigate this socio‐cultural dimension of postnatal illness in collaboration with Medical Anthropologists is outlined.
On cross‐cultural comparative studies with the EMBU*: A note on specific methodological issues
Authors: Arrindell W A , van der Ende J.
Published: August 2007

ABSTRACT This article focusses on specific methodological problems of equivalence in cross‐cultural comparative research with the EMBU, a measure for assessing memories on upbringing.
The Overseas Student: Expatriate, Sojourner or Settler?
Authors: Cox John L.
Published: August 2007

ABSTRACT The Overseas Student can be regarded as a sojourner who lives temporarily in a foreign country and must achieve satisfactory academic objectives within a limited period of time. The “push” and “pull” factors which determine why students study overseas are described. Suggestions are made about the optimum training of mental health professionals and university welfare personnel to enable them to assist overseas students who are distressed. The similarities and differences between a student soourner and an expatriate are described. There is a need for studies to establish the reasons why expatriates return before the completion of their work contract.
Differences in adjustment among university‐educated men and women: (Mental health of the Finnish student. Follow‐up, report IV)
Authors: Holmström Reijo , Koivisto Riitta‐Liisa , Niemi Päivi
Published: August 2007

The present study forms a part of a thirteen‐year longitudinal study of mental health and examines how university‐educated men and women have adapted to an average environment. In basic cross‐tabulations, 63 out of the total 356 psychological and sociological characteristics proved to be differently distributed for men and women. On the other hand, there were no quantitative differences in global mental healthillness indicators between the sexes. Fifteen central personality characteristics indicating good adaptation were kept constant. Different scales for men and women were needed for adjustment measures such as: »social position», »level of university degree», »ego strength», »control of anger», »general ability», »norm‐dependence». On the contrary, »satisfaction with occupation», »self‐actualization in love», »having children», »quality of social background» were distributed identically. Consequently, keeping these indicators constant did not decrease sex‐differences.

Hartmann's concept of adaptation to average environment proved to be rather difficult to apply in practice. Differences in how men and women adapted in Finnish society were examined in detail. The general adjustment was rather successful but there were signs indicating that the women's adaptation was less successful.
Attitudes towards mental illness
Authors: Bhugra D.
Published: August 2007

With the advent of community psychiatry, the pressure of care of the mentally ill will increasingly fall on the family and the community. In order for this transition to succeed, it is important to bear in mind the attitudes of the community and the caregivers. This article reviews the literature on public attitudes and suggestions are made for future research and lessons to be learnt from the experience in Northe America.
Paranoid symptoms and disorders among 100 among refugees: a longitudinal study
Authors: Westermeyer J.
Published: August 2007

Paranoid disorder has been recognized as a special problem among migrants in general, and refugees in particular. Controversy exists about whether vulnerability to paranoia is a pre‐emigration or post migration phenomenon, and whether paranoia is caused by genetic or organic factors, victimization, or the stress of acculturation, information is limited on the distribution of paranoid symptoms among refugees. The course of paranoid symptoms in refugees is unknown. Findings reveal that: most refugees have no or mild paranoid symptoms (suspiciousness or mistrust); a small number have severe symptoms (ideas of reference, paranoid delusions or paranoid hallucinations); paranoid symptoms (unlike depressive symptoms) tend to remain at about the same level over several years; and the prevalence and incidence of paranoid disorders among refugees are high compared with other groups.
Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test
Authors: Sundbom E. , Kullgren G. , Armelius B.‐Å.
Published: August 2007

Twenty seven psychiatric inpatients, diagnosed according to DSM‐III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminaily in a tachistoscope and the patient's perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.
Successful treatment with clonazepam for neuroleptic‐induced akathisia
Authors: Horiguchi J. , Nishimatsu O. , Inami Y.
Published: August 2007

Twenty‐one patients with severe neuroleptic‐induced akathisia resistant to antiparkinsonian medications were treated with oral clonazepam in an open trial. All the patients reported subjective improvement. We suggest that elonazepam is effective in managing neuroleptic‐induced akathisia.
Assessment of suicide risk by computer‐delivered self‐rating questionnaire: preliminary findings
Authors: Levine S. , Ancill R.J. , Roberts A.P.
Published: August 2007

A prospective study of 167 consecutive patients admitted to a general hospital following an episode of deliberate self‐harm was carried out; 102 patients were interviewed by computer and then by a psychiatrist who was blind to the results of the computer interview. The computer interview consisted of a self‐rating modification of the Hamilton Rating Scale for Depression and a novel questionnaire developed lo assess suicidal ideation. This article explores the preliminary findings in these patients and suggests that not only is the computer interview acceptable to the majority of patients but the data suggest, in line with previous studies, that the patients are prepared to confide information to the computer that they may be unwilling to tell the clinician. Further the data also suggest a significant pathoplastic effect of the personality of the patient on the perception of the psychopathology by the clinician. The computer appeared to be a better predictor of suicidality than the interview by the clinician.
Factors associated with discontinuation of long‐term lithium treatment
Authors: Nilsson A. , Axelsson R.
Published: August 2007

Sixty‐four outpatients with major affective disorder according to DSM‐IH and on continuous lithium treatment for an average duration of 7.8 years were first investigated in 1980 and then followed for 7 years. The predictive value of patients’ attitudes to their lithium, the prognostic influence of psychiatric status, side effects, and anamnestic and laboratory data including lithium parameters were studied. At the end of the 7‐year follow‐up, 61% of the patients were still on lithium maintenance treatment, 25% had discontinued lithium for clinical reasons, and 14% of the patients had died. Side effects of lithium were the major clinical reason for discontinuing treatment, while attitudes towards medication were of minor importance. Approximately one fourth of the patients who discontinued lithium were differentiated from those who continued treatment by showing a high frequency of the neurologic side effects incoordination, paresthesia, and disturbed sensibility in addition to having more severe tremor. In yet another fourth of those who discontinued for clinical reasons, lithium was stopped by the treating psychiatrist as maximal urine osmolality values were considered to be too low. These patients did not show any signs of clinically significant impairment of renal functions. Their psychiatric status was excellent in terms of extremely low CPRS scores. The patients who died during the follow‐up period were differentiated from those who continued treatment by a much higher frequency of alcohol and drug abuse prior to the initiation of lithium therapy. The total number of side effects and the number of severe side effects were significantly larger than in continuers on lithium. The most common causes of death were cardiovascular disease and suicide. In no case was the cause of death attributed to lithium therapy.
Diazepam‐binding inhibitor and corticotropin‐releasing hormone in cerebrospinal fluid
Authors: Roy A. , Pickar D. , Gold P. , Barbaccia M. , Guidotti A. , Costa E. , Linnoila M.
Published: August 2007

Diazepam‐binding inhibitor (DBI) is a neuromodulatory peptide for gamma‐aminobutyric acid (GABA) neurotransmission. Cerebrospinal fluid (CSF) levels of DBI have been found to be elevated in depression. CSF levels of the peptide corticotropin‐releasing hormone (CRH) have also been found to be elevated in depression. Therefore, we examined for a relationship between DBI and CRH in human CSF. We found significant positive correlations between CSF levels of DBI and CRH in depressed patients, pathological gamblers, and normal controls. These data, along with the elevated CSF levels of DBI in depression, suggest the possibility that DBI may have a role in coordinating responses to stress in humans in addition to its possible role in the pathophysiology of depression.
Ego functioning predicts first‐year status in adults with anorexia nervosa and bulimia nervosa
Authors: Sohlberg S. , Norring C.
Published: August 2007

ABSTRACT— Severe personality disturbance is a feature that possibly explains chronicity in eating disorders, a largely inexplicable development in terms of previously investigated factors. We tested this hypothesis in a group of 41 anorectics and bulimics with ratings of 13 ego functions and of status at 1‐year follow‐up. Patients who stiil were preoccupied with weight or shape and had a DSM‐111‐R eating disorder at follow‐up had more severe ego disturbance at initial presentation than those who were free from sympioms. The relevance of demographics, syndromal diagnosis and clinical factors other than ego functioning was limited. The importance of ego functioning for prognosis in eating disorders thus appears to overshadow that of several factors that have been extensively cited in the literature.
The truth about suicide in Portugal
Authors: de Castro E. Ferreira , Pimenta F. , Martins I.
Published: August 2007

ABSTRACT— It seems odd that male suicide rates have decreased in Portugal over the last few years, whereas the opposite has happened in most other countries. In order to investigate the reasons for such a decrease, suicide rates were compared with controversial cases (ICD‐9 category E 980–989) and with homicide rates. The results show that, since 1980 and coinciding with the use of ICD‐9, controversial cases have increased 12 and 21 times among males and females respectively. The profile of controversial cases is similar lo that of suicide according to sex, age, marital status and season. Rates for homicide have remained steady and have a distinct profile. It is concluded that since 1980 there has been a significant underreporting of suicides in Portugal, which have been registered as controversial cases. The difficulty of investigating and preventing suicide with such statistical data is stressed; an improvement in suicide reporting and registering is urgently required.
An ethological approach to autism: an analysis of visual behaviour and interpersonal contact in a child versus adult interaction
Authors: Pedersen J. , Livoir‐Petersen M. F. , Schelde J. T. M.
Published: August 2007

ABSTRACT— Eighteen children classified into 4 diagnostic categories were compared based on their behaviour in a child‐adult interaction. The categories consist of autistic children with full syndrome, autistic children in a residual Kate, hyperactive children, and mentally retarded children. An ethological analysis of the interpersonal distance, the amount of physical contact, and the direction of the look/gaze was carried out to describe some behavioural aspects of infantile autism. The autistic children with full syndrome were found to be different from the other categories by a relatively close interpersonal distance, a high frequency of physical contact, and a low frequency of “look at face”.
Dimensional approach to infantile autism in mentally retarded adults
Authors: Lund J. , Jensen J.
Published: August 2007

ABSTRACT— By use of latent trait models, a 7‐item autism rating scale was established, based on the Medical Research Council's Schedule of Handicaps, Behaviours and Skills. Data from a community‐based sample of 302 mentally retarded adults were analysed, assigning good internal validity to the autism scale, and revealing a distribution of symptoms consistent with dimensional, rather than categorical, distribution of infantile autism. A total of 23 (7.6%) of the sample were earlier diagnosed as suffering from infantile autism. Using this clinical diagnosis as a reference, the autism rating scale, with a cut‐off point at ≥2, established diagnoses with a sensitivity of 0.83 and specificity of 0.89.
Platelet monoamine oxidase, plasma dopamine β‐hydroxylase activity, dementia and family history of alcoholism in chronic alcoholics
Authors: Lykouras E. , Markianos M. , Moussas G.
Published: August 2007

ABSTRACT— The authors measured platelet monoamine oxidase (MAO) activity and plasma dopamine β‐hydroxylase activity in 36 male chronic alcoholics during a period of non‐abstinence, and in 29 normal controls. The influence of family history, dementia, chronicity of drinking and liver injury on the enzyme activities was also examined by multiple regression analysis. Platelet MAO was significantly lower in the alcoholic group. Both enzyme activities were negatively related to the presence of dementia, while low MAO activity was associated with positive family history (parents, sibs) of alcoholism.
The heterogeneity of 3‐methoxy‐4‐hydroxy‐phenylglycol levels among depressed patients
Authors: Karege F. , Bovier P. , Gaillard J.‐M. , Tissot R.
Published: August 2007

ABSTRACT— A previous report by our group and results published by other research groups have indicated a dichotomy in MHPG levels in depressed patients. This study attempted to characterize phenomena associated with this dichotomy in plasma MHPG levels. First, we have noted, at least in female patients, that homogeneity of MHPG levels, as tested by fitting with a normal curve, can be ruled out. In contrast, in the total population, a dichotomy was less evident in this study; the 2 subgroups, high and low levels of MHPG, partially overlap, and this results in a gaussian distribution. However, based on the hypothesis of a bimodal distribution, as shown by others and not excluded here, it was possible to find some factors associated with heterogeneity. Thus, polarity of depression, sex and age of the patients, age of disease onset and depression score affect MHPG levels. On the other hand, other elements suspected to modify MHPG values, such as the different lengths of the washout period (minimum 10 days), or some medication (chloral‐hydrate or levomepromazine) required during the washout period, did not show any effect. The aim of this study was to better characterize this peripheral index for its possible use in clinical application.
Effect of clonazepam on neuroleptic‐induced oculogyric crisis
Authors: Horiguchi J. , Inami Y.
Published: August 2007

ABSTRACT— Fourteen patients with neuroleptic‐induced oculogyric crisis resistant to antiparkinsonian drugs were treated with oral clonazepam. The neuroleptic‐induced oculogyric crisis was completely inhibited by clonazepam in 10 patients, moderately inhibited in 2, slightly inhibited in 1, and not changed in 1. We suggest that clonazepam is useful in managing neuroleptic‐induced oculogyric crisis.
Differentiation and prediction in schizophrenia using the metacontrast technique
Authors: Cesarec Z. , Nyman A. K. , Nyman G. E.
Published: August 2007

ABSTRACT— A perceptgenetic, projective test procedure, the metacontrast technique, was performed in a series of 66 young schizophrenics at admission in a psychiatric institution. The test responses to tachistoscopic expositions of stimulus pairs with incongruent or threatening contents are classified in terms of defense strategies representative of neurotic and psychotic states. The sample tested was followed up clinically after 14–17 years. At inception the series of subjects was dichotomized into one nonregressive (latent, pseudoneurotic, n= 42) group and one regressive, with full‐blown psychotic symptoms (n= 24). The distribution of response types did not differentiate between the groups; neurotic and psychotic patterns were represented in both. At follow‐up, the initial presence of signs of repression was significantly more common in such initially nonregressive patients as had escaped a later psychotic breakdown. A compound expression of test signs, hypothesized to be a predictor of future development, was shown to differentiate also between categories of outcome in terms of clinical picture and working capacity.
Suicide and the attempted suicide: An interntional perspective
Authors: Diekstra R. F. W.
Published: August 2007

This article reviews the scope of suicide and attempted suicide as public health problems from an interntional perspective. Socio‐demographic trends are analyzed and explanatory theories for interntional differences proposed.

Suicide and attempted suicide can be prevented, but the development and evaluation of effective large‐scale prevention programs is still in its infancy. Inadequacies in current programs across the world has promoted the establishment of national Task Forces on Suicide Prevention in the United States, Canada and The Netherlands, as well as a WHO strategy on suicide prevention. These groups have formulated comprehensive strategies for the prevention of suicide. The main components of these strategies are:

‐ Design and implementation of national research programs;

‐ The improvement of services;

‐ The provision of information and training on suicide prevention to relevant professional groups, organizations and the general public; and

‐ Formulation of strategies and techniques to deal with special risk groups.

The added recommendations are seen as important steps in translating a comprehensive national plan to prevent suicide into clinical and research programs that can be effectively implemented to prevent these tragedies around the world.
Why do amitriptyline and dothiepin appear to be so dangerous in overdose?
Authors: Montgomery S. A. , Baldwin D. , Green M.
Published: August 2007

Data from different analyses of reported deaths from overdose with antidepressants in the U. K. reveal that amitriptyline and dothiepin are the antidepressants most likely to be associated with death from overdose. All widely used tricylic antidepressants (TCAs) except clomipramine and lofepramine appear to be dangerous in overdose, whereas the newer antidepressants such as mianserin, trazodone, viloxazine and the TCA lofepramine appear to be relatively safe. The toxicity of amitriptyline and dothiepin appears to be greater than all antidepressants including other TCAs and it is important to try to understand why. A number of explanations will be considered:

1. Dothiepin and amitriptyline may be inherently more toxic than other TCAs.

2. Dothiepin and amitriptyline may induce suicide more than other antidepressants. It is assumed that antidepressants are neutral with regard to inducing suicide but this may not be true. There is, for example, evidence that alprazolam and other benzodiazepines induce suicidal behaviour.

3. Amitriptyline and dothiepin are often presented in subtherapeutic and ineffective doses and it is possible that increased suicides may result from inadequately treated depression.

4. There may be a selective overreporting of deaths with amitriptyline and dothiepin.

5. Amitriptyline and prothiaden may be selectively given to the suicide prone on the mistaken assumption that they are safe.
Disaster psychiatry and traumatic stress studies in Norway
Authors: Malt U. F. , Weisæth L.
Published: August 2007

ABSTRACT The breakthrough of Norwegian disaster psychiatry and traumatic stress studies came when the “Board of Norwegian Doctors of 1957” carried out exceptionally thorough and comprehensive studies of former concentration camp prisoners. These studies convincingly demonstrated that chronic mental illnesses could develop in persons who had a harmonious childhood but who had been subject to extreme physical and psychological stress.

During the seventies Norway became the first country in the world to have a University chair of disaster psychiatry. The scope of the field was broadened by the initiation of several studies on traumatic neurosis, industrial disaster and injuries. The support from the Joint Norwegian Armed Forces Medical Services, the University of Oslo, the Norwegian Research Council for Science and the Humanities, and later the Royal Norwegian Council for Scientific and Technical Research, was crucial for this development.

Currently stress and disaster psychiatry has become an integrated part of the care of victims who have suffered individual or collective disaster. Disaster psychiatry is taught in medical schools and is part of the obligatory training for residents in psychiatry.
Fire fighters: A study of stress and coping
Authors: Hytten Karsten , Hasle Anders
Published: August 2007

ABSTRACT Fifty‐eight non‐professional fire fighters, 91% of all firefighters from different industries who participated in a hotel fire rescue operation, were investigated by means of a structured self‐report questionnaire about their stress experience during and after the rescue action. Together with 57 professional fire fighters, they participated in rescuing hotel guests confined for as much as three hours in a 12 storeyed hotel building on fire. Fourteen persons (11%) died, 114 guests survived. Forty‐seven percent of the non‐professional fire fighters reported that the disaster experience was the worst they had ever experienced. Even so, 80% thought that they had coped with the job well to fairly well and for as many as 66% the rescue action represented something positive to them in retrospect. Ten percent claimed that stress reactions disturbed them in executing effective rescue work. Fifty‐eight percent maintained that more preparation and training could have improved their effort. Fire fighters with previous practical experience seemed to “digest” the disaster experience more easily than inexperienced fire fighters as measured by the Impact of Event Scale. High level of competence and opportunity for debriefing as well as disaster characteristics are discussed as factors explaining the favourable coping with extreme stress.
Pharmacological data of the atypical neuroleptic compound melperone (Buronilr̀)
Authors: Christensson E. G.
Published: August 2007

Based on the non‐cataleptic properties, the weak affinity for D2 receptors and the inability to induce DA receptor supersensitivity after both acute and repeated administration, melperone may be characterized as an atypical neuroleptic drug. This indicates a weak effect of melperone on striatal DA neurotransmission. On the other hand melperone is potent in blocking amphetamine induced locomotion, exploratory behaviour, L‐Dopa induced jumping and aggression suggesting a limbic mode of action.

The effect on limbic Da neurotransmission together with an antiadrenergic and 5‐HT modulating action may explain the antipsychotic effect and the low incidence of extrapyramidal side effects observed during treatment with melperone.
Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule
Authors: Hwu H.‐G. , Yeh E.‐K. , Chang L.‐Y.
Published: August 2007

ABSTRACT The Taiwan Psychiatric Epidemiological Project, conducted from 1982 to 1986, used the multistage random sampling method with 5005, 3004 and 2995 subjects selected respectively from metropolitan Taipei (MT), 2 small towns (ST) and 6 rural villages (RV). The case identification tool was the Chinese modified Diagnostic Interview Schedule (DIS‐CM). This study presents the lifetime and one‐year prevalence of 27 and of 17 specific psychiatric disorders respectively. The lifetime prevalence of any disorder defined by the DIS‐CM—excluding tobacco dependence—was 16.3%, 28.0% and 21.5% in the MT, ST and RV samples respectively. The differences in lifetime prevalence between the sexes and between the 3 sampling areas were significant for 15 and 8 disorders respectively. The ST sample seemed to have the most disorders, with the highest prevalence among 3 sampling areas. The mean ratio of one‐year to lifetime prevalence was 0.67. The differences in prevalence rates between the 3 sampling areas and between the international studies are discussed from methodological, social and cultural points of view.
Depression among general hospital patients in Greece
Authors: Lykouras E. , Ioannidis C. , Voulgari A. , Jemos J. , Tzonou A.
Published: August 2007

ABSTRACT We estimated the prevalence of depression in 150 medical and surgical inpatients. Forty‐three patients (29%) scoring at 14 or above on the Beck Depression Inventory (BDI) were classified as depressed. An excess of women and white‐collar workers and more stressful life events during the last 12 months were found among the depressed patients. Of the 21 BDI items, 6 differentiated the 43 medical‐surgical depressed patients from a group of 43 psychiatric inpatients with a diagnosis of primary or secondary depression (Feighner's criteria). Medically ill depressed patients scored higher in social withdrawal, work inhibition and irritability but lower in loss of libido, sleep disturbance, and lack of satisfaction. Our results show rates of depression in a medical inpatient population in Greece comparable with those in other studies. The use of BDI may help assessment of depression in general hospital patients.
Some characteristics of the psychiatric population attending a primary care centre in Kuwait
Authors: Suleiman M. A. , Malasi T. H. , Mirza I. A. , El‐Islam M. F.
Published: August 2007

ABSTRACT This study examined the sociodemographic correlates of pyschiatric illness in a primary care centre in Kuwait. A total of 164 psychiatric patients seen over a 3‐year period formed the experimental group while 165 nonpsychiatric patients attending the same centre formed the control group. Results showed significant differences in basic demographic variables of the 2 groups. The psychiatric patients were significantly more likely to be single, unskilled, young, less educated and living alone or in an overcrowded household and to report more recent life events than controls. The absence of family and social support, lacking a meaningful job and chronicity of illness were significantly correlated with poor treatment response. Possible interpretations of the results were discussed in the cultural context of our patients. The fact that 57% of the psychiatric patients had been ill for more than 6 months prior to consultation highlights the importance of orientation of primary care practitioners to the psychiatric aetiology of somatic presentation of many of their patients.
Patterns of care in the field of mental health
Authors: Sytema S. , Giel R. , ten Horn G.H.M.M.
Published: August 2007

ABSTRACT The concept “patterns of care” plays a central role in research focusing on the evaluation of mental health care. It is a concept encompassing a number of dimensions. The primary ingredients are the type, the setting, the intensity and the duration of care. In this paper, a critical survey is provided of a total of 7 classifications or scales of patterns of care. An argument is advanced for developing a more systematic working method within this research area, in which new scales of patterns of care are developed, building on the methodology already in existence. Standardization is urgently needed if comparative research is to yield better results than it has in the past.
Disaster severity and emotional disturbance: implications for primary mental health care in developing countries
Authors: Lima B. R. , Chavez H. , Samaniego N. , Pompei M. S. , Pai S. , Santacruz H. , Lozano J.
Published: August 2007

ABSTRACT Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill‐defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.
Clonidine in the treatment of mixed bipolar disorder
Authors: Kontaxakis V. , Markianos M. , Markidis M. , Stefanis C.
Published: August 2007

ABSTRACT In a mixed bipolar disorder patient, DST‐positive, treated with neuroleptics and antidepressants, the addition of clonidine (up to 0.6 mg/day) caused a rapid improvement in his psychopathology, without any significant side effects. The concentrations of the metabolites of noradrenaline, dopamine, and serotonin (MHPG, HVA, and 5‐HIAA), the hormone prolactin and the activity of dopamine‐beta‐hydroxylase estimated in plasma during the clonidine trial are also reported.
The use of motor vehicle exhaust for suicide and the availability of cars
Authors: Lester D. , Frank M.L.
Published: August 2007

ABSTRACT– A study of the states of the United States showed that suicide rates using car exhaust were lower in states that had lower rates of car ownership, a greater proportion of the population living in non‐urban areas and that were further north. The implications of these results for a public health approach to suicide prevention are discussed.
The dexamethasone suppression test and suicide attempts
Authors: Schmidtke A. , Fleckenstein P. , Beckmann H.
Published: August 2007

ABSTRACT– We examined covariations between results of the dexamethasone suppression test (DST) and suicidal behaviour for 44 patients who had attempted suicide at least once; the suicide methods, diagnoses and time factors were controlled for. The control groups comprised 82 psychiatric patients and a sample of 69 patients with endogenous depression. In spite of hypotheses suggesting the contrary, there was no significant relationship between DST results and acute suicide attempts. Although patients who had used “soft” methods were often suppressors, chi‐square tests using the suicide classification of the ICD‐9 as well as tests employing more precise subcategories failed to reveal any significant covariation. In groups of patients with an identical diagnosis of endogenous depression, the sensitivity of the DST with regard to suicide attempts was 52%. The difference between suppressors and nonsuppressors in previous suicide attempts was insignificant. Further, the Hamilton Rating Scale for Depression profiles of DST suppressors and nonsuppressors showed no significant differences with regard to either different symptoms or the evaluation of acute suicide risk.