bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population
Authors: Reiss David
Published: July 2009

Synopsis

African-Caribbean (N= 136) and White British (N= 192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self-consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups.
Growth hormone response to growth hormone releasing hormone in non-delusional and delusional depression and healthy controls
Authors: Contreras F. , Navarro M. A. , Menchon J. M. , Rosel P. , Serrallonga J. , Perez-Arnau F. , Urretavizcaya M. , Vallejo J.
Published: July 2009

Synopsis

Growth hormone (GH) responses to growth hormone releasing hormone (GHRH) of 53 in-patients meeting DSM-III-R criteria for major depressive episode with melancholia (24 non-delusional and 23 delusional depression) were compared with those of 19 healthy controls. No significant differences in basal GH were found between the control and either the non-delusional or the delusional groups. The whole group of depressed patients showed a significantly lower response than the control patients at all points of the GH response to GHRH curve as well as a lower area under curve. When the three groups (control, delusional and non-delusional depressed) were compared, it was found that only the non-delusional depressed patients had a significantly lower area under curve and lower values at +60, +90 and +120 min than the controls. The only significant difference between the two groups of depressed patients was that the delusional group showed a delayed appearance of the maximum response peak and a more prolonged response.
Cognitive features of psychotic states arising in late life (late paraphrenia)
Authors: Almeida O. P. , Howard R. J. , Levy R. , David A. S. , Morris R. G. , Sahakian B. J.
Published: July 2009

SYNOPSIS

The cognitive performance of 47 elderly psychotic patients with onset of symptoms in late life (late paraphrenia) was compared to that of 33 controls matched for age, sex, ethnic origin, number of years of education, and pre-morbid IQ as measured by the NART. Neuropsychological indices of general cognitive functioning (MMSE, CAMCOG, WAIS-R verbal and performance scores) showed that patients were performing the tasks at a significantly lower level than controls. Patients also showed a trend to have a lower span capacity than controls, particularly at the spatial span subtest. There was no obvious impairment of learning as measured by the digit and spatial recurring span tasks nor of simultaneous matching-to-sample ability. However, patients' performance on a delayed-matching-to-sample procedure was significantly worse than that of controls. In addition, patients performed worse than controls on the Recognition Memory Test for Faces, but not for Words. Finally, the performance of patients on tests assessing executive functioning (Verbal Fluency Test, Computerized Extra and Intra-Dimensional Shift Task, Computerized Spatial Working Memory Task, and Computerized Tower of London Task) was consistently worse than that of controls. These results suggest that psychotic states arising in late life are predominantly associated with a decline on measures of general cognitive ability and executive functioning. The neuropsychological meaning of these findings is discussed in the light of cognitive models of psychotic symptoms, as well as of schizophrenia and dementia research. We concluded that the lack of a clear pattern of impairment among these patients may be the result of their clinical and cognitive diversity.
Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia
Authors: Waddington J. L. , Youssef H. A. , Kinsella A.
Published: July 2009

SYNOPSIS

Current clinical correlates of duration of initially untreated psychotic symptoms were investigated in a cross-sectional analysis followed by a 10-year prospective study among 88 inpatients with a long-standing schizophrenic illness, many of whom had experienced prolonged periods of untreated psychosis due to illness onset and hospital admission in the pre-neuroleptic era. After controlling for the effects of age, and duration and continuity of subsequent neuroleptic treatment, the primary clinical correlate of duration of initially untreated psychosis was muteness. Over the subsequent 10-year-period, no new cases of muteness emerged and some existing cases of muteness partially resolved, though the speech that emerged remained very sparse and revealed generally gross cognitive debility. The pathophysiology underlying active, unchecked psychosis may also constitute an active morbid process that is associated with the further progression of severe negative symptoms and cognitive dysfunction in the long-term.
Acute stress response: a comparison of head injured and non-head injured patients
Authors: Bryant Richard A. , Harvey Allison G.
Published: July 2009

SYNOPSIS

Acute stress responses were investigated in head injured (N = 38) and non-head injured (N = 38) motor vehicle accident victims immediately following their trauma. Results indicated that amnesia of the traumatic event was associated with less acute post-traumatic stress, intrusive symptoms, perceived injury, and fear of future risk. A proportion of head injured patients reported intrusive and avoidance symptoms despite being amnesic of their trauma. Findings are discussed in terms of the differential post-traumatic adjustment of head injured and non-head injured traumatized patients.
Age–period–cohort analysis of the incidence of schizophrenia in Scotland
Authors: Takei Noriyoshi , Lewis Glyn , Sham Pak C. , Murray Robin M.
Published: July 2009

Synopsis

Studies examining a possible decline in the incidence of schizophrenia over the last two to three decades have paid little attention to the possible role of birth cohort effects. We collected data on a Scottish national sample of all schizophrenic patients, admitted for the first time between 1966 and 1990 (N = 11348; male = 6301). In an Age–Period–Cohort analysis, a full model, incorporating three factors, had a substantially better fit to the data than other models (especially, an Age–Period model), providing clear evidence of the presence of a cohort effect. After adjustment for the effects of age and period, there was a 55% reduction in the rate of schizophrenia in men and a 39% fall in the number of women over the 50-year birth period from 1923 to 1973. The marked decline in the first admission rates observed in Scotland cannot, however, be attributed entirely to this cohort effect. Rather, a greater proportion of the declining first admission rates (88%) is ascribed to the period effect (i.e. artefactual or causally related cross-sectional effects). Nevertheless, the fact that a birth-cohort effect accounts for part of the declining incidence, suggests that causal environmental factors operating early in life have been diminishing in intensity.
Prevalence of psychiatric morbidity in the adult population of a rural South African village
Authors: Rumble S. , Swartz L. , Parry C. , Zwarenstein M.
Published: July 2009

Synopsis

We report on the first South African two-stage community prevalence study of psychiatric morbidity, conducted in Mamre, a rural ‘coloured’2 village, 50 km from Cape Town. Randomly selected adults (N = 481) were assessed using the Self-Reporting Questionnaire (SRQ) as a first-stage screen and the Present State Examination (PSE-9) was administered to a proportion of the sample (N = 121) as the second-stage criterion. Demographic, health care utilization, and substance abuse data were also collected. Using the PSE-9 CATEGO Index of Definition of 5, the weighted prevalence of psychiatric morbidity was 27·1 % (confidence interval of 19·5−34·7 %), the majority of cases being given a tentative diagnosis of depressive or anxiety disorder. The CATEGO algorithm may not be fully appropriate in this cultural context as there was an apparent overdiagnosis of paranoid states. The SRQ's weighted sensitivity and specificity were 0·49 and 0·82 respectively. Overall, the SRQ correctly identified 67% of cases and non-cases. No demographic variables predicted psychiatric morbidity, but there was an indirect link between morbidity and primary care utilization. Further South African studies of the validity of both the SRQ and of criterion instruments are needed. These may contribute to knowledge regarding cultural factors affecting psychiatric diagnosis.
Pre-morbid asociality in neuroleptic-resistant and neuroleptic-responsive schizophrenia
Authors: Findling R. L. , Jayathilake K. , Meltzer H. Y.
Published: July 2009

Synopsis

The purpose of this study was to evaluate whether childhood and adolescent premorbid asociality differed in neuroleptic-responsive and neuroleptic-resistant schizophrenia. Premorbid asociality was assessed with the Pre-morbid Asociality Adjustment Scale in 411 patients meeting DSM-III-R criteria for chronic schizophrenia or schizoaffective disorder categorized as being either neuroleptic-responsive or neuroleptic-resistant. Patterns of childhood and adolescent asociality were found to be different in neuroleptic-resistant and neuroleptic-responsive patients. Pre-morbid asociality during the pre-adult years was not consistently worse in patients with poor response to neuroleptic treatment. Greater impairment in late adolescent psychosexual functioning was predictive of poor outcome with regard to neuroleptic treatment.
Patterns of DSM-III-R alcohol dependence symptom progression in a general population survey
Authors: Nelson C. B. , Little R. J. A. , Heath A. C. , Kessler R. C.
Published: July 2009

Synopsis

Age of onset reports obtained retrospectively for each symptom of DSM-III-R alcohol dependence (AD) are used to study patterns of lifetime symptom progression in a large general-population survey of people in the United States. It is shown that symptom progression among a substantial majority of respondents can be summarized as movement across three clusters. Cluster A is defined by symptoms of role impairment/hazardous use (A4), use despite social, psychological or physical problems (A6), and drinking larger amounts or over a longer period of time than intended (A1). Cluster B is defined by tolerance (A7) and impaired control (A2, A3). Cluster C is defined by withdrawal (A8, A9) and giving up activities in order to drink (A5). Clusters are shown to follow a time sequence, with at least one symptom in Cluster A usually occurring first, followed by symptoms in Clusters B and C. In all, 83·4% of the symptom cluster transitions estimated from retrospective age of onset reports are consistent with this progression. Progression to AD is differentially predicted by symptom profiles reported at the age of first symptom onset, with persons reporting Cluster C symptoms most likely to progress subsequently to AD. Furthermore, profiles of AD defined by the highest symptom cluster present at AD onset are differentially predicted by prior personal and parental histories of psychopathology and, among men, are predictive of diagnosis persistence.
A longitudinal study of factors predicting change in cognitive test scores over time, in an older hypertensive population
Authors: Prince M. , Lewis G. , Bird A. , Blizard R. , Mann A.
Published: July 2009

Synopsis

This study aims to describe factors associated with cognitive decline among 2584 subjects, aged 65–74, who were followed up for 54 months in the Medical Research Council Elderly Hypertension Trial (1982–1989). The subjects completed a cognitive test, the Paired Associate Learning Test (PALT), five times over this period. Decline on the PALT was associated with advanced age, male sex, rural residence, depression and low intelligence. These effects were modified by gender and level of pre-morbid intelligence. Advanced age, rural residence and number of cigarettes smoked daily were only associated with PALT decline among women of below median intelligence. The association between depression and PALT decline was only apparent in women of below median intelligence and men of above median intelligence. While these findings are consistent with other research into cognitive decline, they differ in some ways from reported risk factors for dementia, suggesting aetiological separateness. That women were more vulnerable than men to the effects of age and smoking raises the question of the impact on cognition of accelerated atherosclerosis after the menopause.
Infant growth in the context of maternal eating disorders and maternal depression: a comparative study
Authors: Stein A. , Murray L. , Cooper P. , Fairburn C. G.
Published: July 2009

Synopsis

There is evidence of growth faltering in infants of mothers with eating disorders. The aim of the current study was to examine whether this is a specific relationship. Thus, the infants of mothers with eating disorders were compared with infants of mothers with post-natal depression and a large comparison group. This study also aimed to explore possible mechanisms whereby growth disturbance comes about.

It was found that the infants of mothers with eating disorders were smaller, both in terms of weight for length and weight for age, than either comparison group infants or infants of mothers with post-natal depression. There was little evidence, however, that mothers with eating disorders preferred smaller children or were dissatisfied with their children's shape or that they misperceived their children's size. On the contrary these mothers seemed highly sensitive to their children's shape and, compared with the other two groups, were more likely to judge their children's size accurately. None of these maternal measures significantly predicted the child's growth.

The mechanism whereby growth disturbance arises in the context of eating disorders does not appear to be by means of a direct extension of the maternal psychopathology to the infant.
Relationships between age and symptom severity among women seeking medical treatment for premenstrual symptoms
Authors: Freeman E. W. , Rickels K. , Schweizer E. , Ting T.
Published: July 2009

Synopsis

Age at the time of seeking treatment for premenstrual symptoms (PMS) was examined in a sample of 332 women who reported severe distress and met criteria for Late Luteal Phase Dysphoric Disorder (LLPDD). The mean age of the sample was 33·1 (±5·3) years. Severity of symptoms decreased with age and was not associated with the duration of symptoms. Depression-related factors were associated with the severity of PMS, and together with the duration of symptoms, were the best discriminators between the younger (ages 20–35) and older (ages 36–44) women in this sample. These data suggest that the years of the late twenties through mid-thirties are the most vulnerable time for distressing PMS and fail to support the clinical premise that PMS worsens with age until menopause. Further longitudinal study should be conducted to confirm and extend these findings.
Cerebral hemispheric asymmetry revisited: effects of handedness, gender and schizophrenia measured by radius of gyration in magnetic resonance images
Authors: Bullmore E. , Brammer M. , Harvey I. , Murray R. , Ron M.
Published: July 2009

Synopsis

Abnormal patterns of cerebral hemispheric asymmetry have been inconsistently reported in association with schizophrenia. Radius of gyration (Rg) is a measure of the mean dispersion of points in a radially organized structure about that structure's centre of gravity. We developed computerized methods for estimating Rg of the magnetic resonance image (MRI) boundary between cortex and subcortex, and applied these methods to measurement of cerebral hemispheric asymmetry in 37 schizophrenics (SZs) and 30 controls (CONs). In right-handed CONs, Rg of right brain boundaries was significantly greater than Rg of left brain boundaries; in left-handed CONs, Rg of left brain boundaries was significantly greater than Rg of right brain boundaries. In right-handed males (both SZ and CON), there were significant differences in Rg between hemispheres; whereas in females (both SZ and CON) there were no such differences. Right-handed male SZs (N = 26) were distinguished by reversal of the right-handed male CON pattern of interhemispheric difference in Rg, and by global reduction in Rg of right brain boundaries. There was no evidence for significant abnormality of Rg in right-handed female SZs (N = 7). These findings suggest an important interactive effect of gender and schizophrenia on lateralized cerebral structure.
Life events and senile dementia. I. Admission, deterioration and social environment change
Authors: Orrell Martin , Bebbington Paul
Published: July 2009

Synopsis

This study examines the frequency of life events before admission and before deterioration in 70 dementia patients, in comparison with 50 dementia controls living in the community and 50 fit elderly people matched for age and sex. We hypothesized that there would be an excess of events connoting changes in routine and the social environment. Specific scales were developed to measure these aspects of events. Our results supported the initial hypothesis, confirming that it is the social disruptiveness of change rather than the threat implied by life events that is associated with deterioration. The findings are discussed in the light of current models of the dementia process.
Is early separation anxiety a specific precursor of panic disorder–agoraphobia? a community study
Authors: Silove D. , Harris M. , Morgan A. , Boyce P. , Manicavasagar V. , Hadzi-Pavlovic D. , Wilhelm K.
Published: July 2009

Synopsis

The present study aimed to examine memories of early separation anxiety symptoms in a community sample of women at heightened risk to neurotic disorder. The chief finding was that subjects with a lifetime history of panic disorder–agoraphobia (PD–Ag) returned statistically higher scores on a retrospective measure of early separation anxiety compared to subjects with either generalized anxiety or other phobic disorders, a result which was not accounted for by differences in neuroticism or General Health Questionnaire scores. Although limited by its retrospective design and the problem of co-morbidity in subclassifying the anxiety disorders, the present study does provide added support for the hypothesis – endorsed by DSM-III-R – that there is a developmental link between early separation anxiety and panic disorder.
Cognitive dysfunction in schizophrenia followed up over 5 years, and its longitudinal relationship to the emergence of tardive dyskinesia
Authors: Waddington John L. , Youssef Hanafy A. , Kinsella Anthony
Published: July 2009

Synopsis

In this study, 51 chronic schizophrenic in-patients were evaluated for a range of demographic, clinical and medication variables, and followed up over five years. There was no significant overall change in cognitive function in this patient group as a whole, suggesting the absence of active disease at this stage of the illness. The only correlate of individual instances of cognitive deterioration over the study period was the emergence of new cases of tardive buccal-lingual-masticatory but not of limb-trunkal dyskinesia, and the greater severity of such movement disorder. A positive family history was also identified prospectively as a predictor of the emergence of tardive dyskinesia in chronic schizophrenia.
Families coping with schizophrenia: coping styles, their origins and correlates
Authors: Birchwood Max , Cochrane Raymond
Published: July 2009

Synopsis

An analysis of the coping styles adopted by relatives of schizophrenic patients has been identified by many reviewers as essential to an understanding of the complex interactions between patient and caregiver and to the origins of relatives' expressed emotion (EE). This study reports a taxonomy of coping behaviour derived from interviews with relatives of schizophrenic patients. It was found that relatives adopted broad styles of coping across all areas of patients' behaviour change. Relationships were uncovered between the styles and (a) relatives perceived control, burden and stress, (b) patients' social functioning, severity of behavioural disturbance and progress of the illness. It is suggested that advising relatives of changes in their coping styles in the course of family intervention must be tempered by an understanding of their origins in patients' behaviour. Further research is recommended to identify the coping styles associated with the high EE/low EE research classification.
Childhood sexual experiences reported by male psychiatric patients
Authors: Metcalfe Michael , Oppenheimer Rhoda , Dignon Andree , Palmer R. L.
Published: July 2009

Synopsis

One hundred adult male psychiatric patients were investigated concerning their recollections of defined sexual activities occurring with adults before the age of sixteen.

Twenty-three subjects reported such events. The events were remembered as having been mostly distressing at the time but their later significance is unclear.
An electrophysiological correlate of Eating Attitudes Test scores in female college students
Authors: Wilson Josephine F. , Mercer Joy C.
Published: July 2009

Synopsis

Eating Attitudes Test (EAT) scores of forty female college students were compared to their electrodermal activity (EDA) responses when offered a plate of chocolate chip cookies. A significant positive correlation was detected between the EAT scores and the skin conductivity measures associated with the presentation of food. Women with the highest EAT scores also exhibited the greatest sympathetic nervous system responses to a plate of cookies. This finding supports the conclusion that the EAT is capable of identifying individuals who are preoccupied with food or anxious about eating.
Coping with chronic fatigue syndrome: illness responses and their relationship with fatigue, functional impairment and emotional status
Authors: Ray C. , Jefferies S. , Weir W. R. C.
Published: July 2009

SYNOPSIS

The implications of patients' approaches to managing chronic fatigue syndrome were examined in a cross-sectional study. With severity of fatigue controlled, attempting to maintain activity was associated with less functional impairment, while accommodating to the illness was positively related to impairment; behavioural disengagement was related not only to higher levels of impairment but also to greater emotional disturbance. Fatigue itself was positively associated with focusing on symptoms and with behavioural disengagement; it was associated also with illness accommodation, but only for illness of longer duration. The causal direction of relationships between coping and fatigue severity is ambiguous, and a follow-up study will address the effects of coping on changes in the illness over time.
Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dyskinesia
Authors: Waddington John L. , Youssef Hanafy A.
Published: July 2009

Synopsis

Basic cognitive function was assessed at initial and at 5- and 10-year follow-up assessments among 41 primarily middle-aged in-patients manifesting the severest form of schizophrenia; additionally, the presence and severity of tardive dyskinesia was evaluated on each occasion. Overall, there was a modest but significant deterioration in cognitive function over the decade, particularly among older men. Longitudinally, patients with persistent tardive (orofacial) dyskinesia continued to show poorer cognitive function than those consistently without such movement disorder, though within neither group did cognitive function change over the decade. Those patients demonstrating prospectively the emergence of orofacial dyskinesia showed a marked deterioration in their cognitive function over the same time-frame within which their movement disorder emerged, but this decline did not progress further thereafter. There appears to exist some modest, progressive deterioration in cognitive function even late in the chronic phase of severe schizophrenic illness which appears to derive primarily from patients showing de novo emergence of tardive orofacial dyskinesia.
Maladaptive coping and affective disorders among cancer patients
Authors: Parle M. , Jones B. , Maguire P.
Published: July 2009

Synopsis

Coping has attracted much attention in research as a possible mediator of the psychological impact of cancer. Yet, conceptual ambiguity and methodological limitations have resulted in weak and contradictory findings. A major shortcoming has been the use of designs which do not represent adequately the complexity or the diversity of demands which arise from the diagnosis and treatment of cancer. The neglect of appraisal in the assessment of the relationship between coping and mental health is of particular concern, given the role it has been found to play in the onset and maintenance of affective disorders.

In a prospective study 673 newly diagnosed cancer patients were interviewed 4 to 8 weeks and 1 year later to assess the effects of their appraisals, coping responses and resolution of any concerns on subsequent mental health. Logistic regression analyses, adjusted for possible confounding variables, were used to investigate the relationships between coping variables and affective disorders. When examined separately the degree of threat appraised, the reporting of a helpless response and perceived success of primary responses in resolving concerns all predicted subsequent affective disorder. However, in a multivariate model only appraisal and success of the response in resolving the concern were significant. No response was found to prevent affective disorders, however certain types of responses were associated with the resolution of specific concerns. The results highlight the importance of assessing the whole coping process and the need to address the complex and multifaceted characteristics of cancer demands. On the basis of our findings we describe a maladaptive cycle of coping, which we believe contributes to the later onset of affective disorders in cancer patients.
Unexplained physical symptoms: outcome, utilization of medical care and associated factors
Authors: Speckens A. E. M. , Van Hemert A. M. , Bolk J. H. , Rooijmans H. G. M. , Hengeveld M. W.
Published: July 2009

Synopsis

The aim of the study was to investigate the recovery and frequency of physician contact in patients with unexplained physical symptoms and to identify factors associated with persistent disorder. Of 100 consecutive patients who presented with medically unexplained symptoms to a general medical out-patient clinic, 81 participated in a follow-up study. The mean follow-up time was 15·2 months (S.D. 4·0). At follow-up, many of the patients with unexplained physical symptoms reported that they had recovered (30%) or improved (46%) with regard to their presenting symptoms. Female sex and a high number of symptoms predicted a bad outcome in terms of recovery. Persistence of symptoms was not related to the duration of the symptoms, type of presenting complaint or the presence of psychiatric disorder. Forty per cent of patients with unexplained symptoms did not visit their general practitioner on their own initiative in the year following the initial visit to the clinic. Medical care utilization appeared to be associated with female sex, age, number and duration of symptoms, fatigue and psychiatric disorder, especially somatoform disorders. However, the association of a high frequency of physican contact with female sex and psychiatric disorder was not sustained after controlling for possible confounding factors.
The relationship between depression and anxiety: construction of a prototypical anxiety and depression scale
Authors: Koeter Maarten W. J. , Van Den Brink Wim
Published: July 2009

Synopsis

The question of the relationship between anxiety and depression remains to be solved. The fact that clinical pictures show substantial overlap makes it difficult, using conventional instruments, to distinguish between the co-occurrence of anxiety and depression and overlap in definitions and measurement of the two syndromes. This calls for the construction of scales which exclude symptoms common to both syndromes and incorporate symptoms specific only to anxiety or only to depression; i.e. scales with maximum discriminant validity. This article describes the construction of two such scales based on PSE symptoms; a prototypical anxiety scale and a prototypical depression scale. In a sample of 134 non-psychotic psychiatric out-patients these scales show good reliability and validity, both as a measure of severity and as a screening device. Compared to the Hamilton anxiety and depression scales (HARS and HRSD), the correlation between the prototypical anxiety and depression scales is low.
From the jumping Frenchmen of Maine to posttraumatic stress disorder: the startle response in neuropsychiatry
Authors: Howard Robert , Ford Rodney
Published: July 2009

Synopsis

The startle response is a universal and phylogenetically ancient reflex. Pathological exaggerations and modifications of startle underlie the symptomatology of a surprisingly diverse range of neuropsychiatric disorders, a fact that seems to have gone largely unappreciated. We review the available literature on the physiology of the normal human startle response and examine the neuropsychiatric conditions characterized by pathological startle. Startle epilepsy and primary hyperekplexia are considered as neurological disorders involving abnormal startle. Patients with hyperstartle and exotic culture-bound syndromes characterized by excessive startle are considered by the authors to represent extreme variants of the normal startle response. Post-traumatic stress disorder, drug and alcohol withdrawal states and schizophrenia all have abnormal startle as a clinical feature secondary to increased arousal and presumed disturbance of central neurotransmitter systems. The neurophysiological mechanisms by which abnormalities of the startle response may occur are discussed and a system of classification of neuropsychiatric hyperstartles is suggested.
A longitudinal study of general practitioner consultations for psychiatric disorders in adolescence
Authors: Smeeton Nigel , Wilkinson Greg , Skuse David , Fry John
Published: July 2009

Synopsis

Patterns of psychiatric diagnoses given during adolescence to a group of individuals continuously registered with a single general practitioner in South London over 20 years were analysed first during ‘early adolescence’ and secondly during ‘early adulthood’. Psychiatric diagnoses were found to be relatively common. Of the young adolescents who received a psychiatric diagnosis (almost one in ten of the group), 38% received a psychiatric diagnosis as young adults compared with only 16% of the remainder. Comorbidity was found to be very common – over 50% of young adults with a diagnosis of depression also had a diagnosis of anxiety and phobic neuroses. Young people with problems of a psychological nature therefore deserve more attention, particularly from the primary care team.
The use of the Ways of Coping (Revised) questionnaire with parents of children with Down's syndrome
Authors: Knussen Christina , Sloper Patricia , Cunningham Cliff C. , Turner Stephen
Published: July 2009

Synopsis

The principal aim of this study was to assess the validity and usefulness of the Ways of Coping (Revised) questionnaire (Folkman & Lazarus, 1985) with a British sample of parents of children with Down's syndrome. Factor analysis yielded five subscales which were compared with those reported elsewhere. Other properties of the instrument were investigated. It was concluded that the instrument was potentially valuable to those investigating coping in families with special problems.
A bulimic ruminator? The case of Dr Samuel Johnson
Authors: Parry-Jones Brenda
Published: July 2009

Synopsis

Utilizing a wide range of eighteenth- and nineteenth-century biographical sources, the eating pathology of Dr Samuel Johnson is illustrated and examined. His presenting symptoms are considered in the light of modern criteria for eating disorders and current research on bulimia nervosa and rumination disorder.
Posed facial expressions of emotion in schizophrenia and depression
Authors: Berenbaum Howard
Published: July 2009

Synopsis

The goals of the present study were to explore: (1) whether schizophrenics, depressives, and normals differ in their likelihood of expressing different emotions; and (2) whether the types of expressions subjects exhibit are associated with their level of reported depressive symptomatology. Subjects were asked to imagine: seeing, smelling, or tasting something disgusting; and having something wonderful happen to them. Subjects were asked to show the experimenter what their face would look like if these things happened. The groups differed in how frequently they exhibited anger or contempt in the first condition and happiness in the second condition. The depressives were most likely to exhibit anger/contempt and least likely to exhibit happiness. Using Beck Depression Inventory scores as dependent variables, there were significant interactions between diagnostic group and the type of facial expressions exhibited. The associations between facial expressions and BDI scores were in the opposite directions for depressives and schizophrenics.
Bulimia nervosa: a 5-year follow-up study
Authors: Johnson-Sabine E. , Reiss D. , Dayson D.
Published: July 2009

Synopsis

Fifty patients with bulimia nervosa were followed up for a minimum length of 5 years. Standardized interviews, observer-rated instruments and self-rated questionnaires were employed both at entry and at completion of the follow-up period. After tracing, the positive response rate was 72%; one patient had died. At the time of follow-up 31% of those traced had made a complete recovery and 25% still fulfilled diagnostic criteria for bulimia nervosa. Judged on behavioural symptoms 47·2% of responders had a ‘good’ outcome. Good outcome was associated with fewer social problems, higher social class, and a significant improvement in eating attitudes at follow-up. All outcome groups reported a reduction of interference by symptoms in other areas of life, and an improvement in mood state. No factors, including those described in previous studies, were identified which predicted outcome.
A quantitative study of body-related attitudes in patients with anorexia and bulimia nervosa
Authors: Ben-Tovim David I. , Walker M. Kay
Published: July 2009

Synopsis

The Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) is a psychometrically sound self-report instrument for assessing women's attitudes towards their own bodies. The BAQ responses of a large sample of patients with eating disorders (ED) diagnosed in accordance with DSM-III-R criteria were compared with those from a normative population and from diverse groups of psychiatrically and physically ill patients. The ED group was distinct, and showed extreme responses in the area of weight and shape concerns. But a better discrimination between the ED and other populations was achieved using subscales that related to ‘body disparagement’ (an intense loathing of the body) and ‘attractiveness’, rather than to weight and shape concerns. ED patients may have a more pervasive disturbance in body-related attitudes than is currently widely accepted. Patients with anorexia and bulimia nervosa showed very similar attitudes despite the symptomatic differences between the groups.
Social networks and support in long-term psychiatric patients
Authors: Cresswell C. Maxine , Kuipers Liz , Power M. J.
Published: July 2009

Synopsis

This paper describes quantitative and qualitative aspects of social support in a sample of 40 long-term schizophrenic day patients attending a rehabilitation unit. The influence of symptomatology and experience of life stressors on network and support characteristics was also investigated. The primary networks of these patients were found to be small, comprising on average 7 members, of whom only 3 were seen regularly. Despite this, subjects rated their perceived support as adequate. The secondary networks were of the order of 32. It emerged that greater prevalence of negative symptoms was significantly associated with lower ideal levels of support and this group of patients was significantly less likely to seek support in the event of a life stressor. This may be a protective mechanism to insulate the person from the effects of stressful relationships but at the same time means that they are isolated from potential supports. The clinical implications are discussed in terms of offering optimum support for this marginalized group.
Growth hormone and physiological responses to clonidine in depression
Authors: Katona Cornelius L. E. , Healy David , Paykel Eugene S. , Theodorou Andreas E. , Lawrence Kevin M. , Whitehouse Andrew , White Bill , Horton Roger W.
Published: July 2009

Synopsis

Clonidine (1·3 μg/kg) was administered to 62 control and 55 depressed patients free of psychoactive drugs for at least 7 days and fasted overnight. Growth hormone (GH), pulse, blood pressure and sedation were measured every 15 min for 1 h before and 2 h after clonidine infusion.

GH response did not differ significantly between control and depressed subjects overall or when divided by sex. The systolic hypotensive and sedative responses were blunted in depressed subjects compared with controls; these effects appeared to be secondary to residual antidepressant drugs since the differences were only significant for those depressed subjects with short drug-free intervals.

No differences between depressed subjects and controls were seen in diastolic hypotensive or bradycardic responses and no differences in GH, cardiovascular or sedative responses were found between endogenous and non-endogenous depressed subjects.
Emotional distress and fatigue in coronary heart disease: the Global Mood Scale (GMS)
Authors: Denollet Johan
Published: July 2009

Synopsis

Evidence indicates that emotional distress has a long-term impact on morbidity and mortality in patients with coronary heart disease (CHD), and that symptoms of depression, fatigue, and reduced energy may identify high-risk patients. This study was designed to: (1) devise a sound and practical measure of emotional distress in CHD patients; (2) examine the relationship between emotional distress and fatigue following CHD; and (3) examine changes in emotional distress as a function of cardiac rehabilitation. A sample of 478 men with CHD (mean age = 57·8±8·7 y) filled out questionnaires 3–6 weeks following a myocardial infarction (N = 110), bypass surgery (N = 302), or coronary angioplasty (N = 66). Statistical analyses of 56 Dutch mood terms were used to produce the 20-item Global Mood Scale (GMS) which measures negative affect (characterized by fatigue and malaise), as well as positive affect (characterized by energy and sociability), in patients with CHD. The GMS was found to be a reliable scale (α > 0·90; r > 0·55 over a 3-month period), and correlations with existing measures of emotional functioning and self-deception indicated its convergent and discriminant validity. Most importantly, fatigue was not related to cardiorespiratory fitness in a subset of 140 patients, but clearly was associated with negative affect. Consistent with the self-efficacy model, scores on the GMS mood scales improved significantly as a function of rehabilitation (P < 0·0001). Although symptoms of emotional distress are easily explained away by situational factors, previous research suggests that failure to recognize the clinical significance of these symptoms in CHD patients may result in the delay of much needed intervention. The current findings suggest that the GMS is a theoretically and psychometrically sound measure of emotional distress in CHD patients, and that this scale is sufficiently sensitive to assess change.
The role of the practice nurse in the management of depression in general practice: treatment adherence to antidepressant medication
Authors: Wilkinson Greg , Allen Pam , Marshall Eileen , Walker Jan , Browne Wendy , Mann Anthony H.
Published: July 2009

Synopsis

This pilot study demonstrated the feasibility of providing practice nurse support as an adjunct to standard general practitioner treatment to patients with depressive disorders prescribed antidepressant medication. With respect to the measures used and pilot study objectives identified, there were no statistically significant differences between the study groups in treatment adherence to the prescription of antidepressant medication or in the incidence and severity of adverse events to medication. Large-scale randomized controlled trials are in progress to assess the effectiveness of practice nurse interventions in the management of depressive illness in general practice.
Scientific thought and the boundary of insanity and criminal responsibility
Authors: Smith Roger
Published: July 2009

SYNOPSIS

The insanity defence is considered in terms of the operation of incommensurable scientific and legal discourses, a dualism which in turn is held to reflect individualist values. This analysis is used to explain both the recurring nature of medico-legal controversy and the historical results of the defence in Victorian England.
Psychotropic drugs and taxonomic systems
Authors: Shepherd Michael
Published: July 2009

SYNOPSIS

Attempts to underpin the classification of psychiatric drugs in biological and clinical terms are discussed with reference to their value and limitations. The current need for a multiplative, heuristic taxonomy is suggested.
Neuroendocrine tests of monoamine function in man: a review of basic theory and its application to the study of depressive illness
Authors: Checkley S. A.
Published: July 2009

SYNOPSIS

Neuroendocrine tests are now available for studying monoamine function in the brains of patients with mental illness. Great care is required in the selection of drugs which act upon specific monoamine receptors to produce specific hormonal responses. Equal care is required in the control of biological variables which may influence hormonal release.

Recently reported neuroendocrine studies of depressive illness are assessed in these terms. The results of these studies support the hypothesis that there is defective noradrenergic function in the brains of some patients with depressive illness.
Anxiety in surgical patients
Authors: Johnston Marie
Published: July 2009

SYNOPSIS

The natural course of anxiety before and after surgery was examined using the State– Trait Anxiety Inventory in 4 studies involving 136 surgical patients. The results suggested that high levels of anxiety were experienced before admission to hospital, between admission and surgery and following surgery, and were not restricted to the immediate pre-operative period. Only a small percentage of patients reached their maximum level of anxiety on the morning of surgery.

These results have implications for those planning interventions to alleviate anxiety associated with surgery and for those studying surgical stress as a model for other naturally occurring stresses.
Neurophysiological correlates of senile dementia: I. Motor and sensory nerve conduction velocity
Authors: Levy Raymond , Isaacs Anthony , Hawks Gail
Published: July 2009

This paper describes an investigation into the relationship between senile dementia and slowing of peripheral nerve conduction velocity. Twenty-eight demented patients and 19 controls were studied. Each patient was rated clinically and given a battery of simple psychological tests in addition to the physiological recordings. The results were as follows: (1) Motor nerve conduction was slower in the demented group than in the control group but this difference was not significant. (2) When subjects were divided according to their dementia score, those with scores above 7 were found to have motor nerve conductions which were significantly slower than those with scores of 7 or less. (3) There was a significant correlation between the severity of the dementia as measured by the rating scale and the psychological tests and the degree of slowing of motor nerve conduction. (4) In those patients who were retested after one year, increase in dementia was significantly correlated with a further slowing of conduction in motor nerves. (5) The possible role of vitamin deficiency was investigated in a small sub-group of demented patients. Deficiencies of thiamine, nicotinic acid, and vitamin B12were not thought to be important but some patients had low folate levels. The significance of these results is discussed.
Obsessional symptoms and obsessional personality traits in patients with depressive illnesses
Authors: Kendell R. E. , Discipio W. J.
Published: July 2009

An inventory of obsessional symptoms and traits was administered to patients with depressive illnesses while they were ill and again after recovery. They obtained higher scores than normals even when well and their scores increased considerably during episodes of depression in proportion to the depth of the depression. In mania, on the other hand, obsessional symptoms are rare.
Observations on the Psychiatric Section of the International Classification of Diseases and the British Glossary of Mental Disorders
Authors: Wing Lorna
Published: July 2009

Problems arising from the categories used in the Eighth Revision of the International Classification of Diseases, and from some of the definitions included in the British Glossary, are discussed. Suggestions are made for changes which would facilitate the use of the I.C.D., firstly for furnishing quantitative data to answer questions about groups of cases, and secondly for retrieval of information about patients with particular syndromes for purposes of research studies. Finally, a multi-axial system for diagnostic coding is described.
The institutes of psychiatry: growth, development, and future
Authors: Kolb Lawrence C.
Published: July 2009

This paper, an abbreviation of the first Aubrey Lewis Lecture, concerns itself initially with the evolution of the institute concept as a part of western institutional development. The growth of the concept of the institutes of psychiatry as organizations in medicine, initially bringing together the biological, psychosocial, and clinical sciences as they relate to the field, is documented briefly in the history of the beginnings of the New York State Psychiatric Institute, the earliest established institute in the specialty. Later sections of the paper concern themselves with the conflicts between the goals of these institutes, those of related universities, the supporting governmental agencies, and private supportres. The author discusses the problems inherent in bridging the gap between the formation of a multidisciplinary institution and one which may come to function effectively in an interdisciplinary fashion. Consideration is given to the theoretical and administrative measures potentially valuable in bridging this gap. This abbreviated version of the lecture deletes the evaluation of those factors which have led to the widespread development of the institutes of psychiatry.