bluuebunny/crossref_metadata_2025 huggingface dataset:
The Scottish First Episode Schizophrenia Study
Authors: McCreadie Robin G. , Wiles David H. , Moore John W. , Grant Stewart M. , Crocket George T. , Mahmood Zahid , Martin G. Livingston , Watt James A. G. , Greene J. G. , Kershaw Peter W. , Todd Norman A. , Scott Angus M. , Loudon John , Dyer James A. T. , Philip Alistair E. , Batchelor David , Menzies Catherine W.
Published: August 2008

An assessment of 31 main care-giving relatives living with schizophrenics was carried out using the General Health Questionnaire and the Social Adjustment Scale by Self Report. More than 75% of relatives had a high probability of themselves being a psychiatric case. Relatives also showed social role dysfunction and impairment especially marked in social and leisure activities. Relatives' distress was related to the level of symptoms in patients, as assessed by the Present State Examination.
The Memory Clinic: A New Approach to the Detection of Dementia
Authors: Van der Cammen T. J. M. , Simpson J. M. , Fraser R. M. , Preker A. S. , Exton-Smith A. N.
Published: August 2008

Memory impairment is a salient and early feature of developing dementia, but in practice is often not recognised until it has reached an advanced stage. The operation described is of a Memory Clinic opened on an experimental basis at the Geriatric Research Unit, University College London, in 1983, with the aim of identifying the causes of memory impairment in the elderly, with particular reference to the early detection of dementia. It proved possible to identify a group of people with early dementia who had previously been undiagnosed, and also to reveal deficiencies in the utilisation of existing services. Memory clinics would be a valuable addition to geriatric and psychogeriatric services.
The Concepts of Mild Depression
Authors: Snaith R. P.
Published: August 2008

The term ‘depression’ is now used to cover a wider range of emotional disturbances than was the case when psychiatrists confined their attention to patients referred to psychiatric hospitals. There is considerable confusion about the variety of meanings and the loose terminology leads to claims and counter-claims about aetiology and treatment. The current classificatory systems and the variety of rating scales do not clarify issues concerning appropriate management. The guidelines for a clearer definition of a biogenic form of the concept of depression, which is likely to respond to antidepressant drug therapy, would be of considerable value to psychiatrists, non-psychiatric physicians and others who try to treat or help people in states of disordered emotion. Such guidelines are proposed.
Amnesia
Authors: Kopelman M. D.
Published: August 2008

This paper describes the clinical features of selected examples of organic and psychogenic amnesia, and it discusses the nature of the dysfunction that these amnesias entail. The anterograde component of organic amnesia involves a severe impairment in acquiring (or learning) new information, rather than accelerated forgetting, and this may reflect an underlying limbic or neurochemical dysfunction. Retrograde amnesia has a basis which is (at least partially) independent of anterograde amnesia - in some patients, it appears to involve a failure to reconstruct past experience from contextual cues, and this may reflect a superimposed frontal dysfunction. Two types of confabulation are discussed, one of which (‘provoked’) is a normal response to poor memory, and the other ('spontaneous’) appears to reflect incoherent, context-free retrieval, associated with more severe frontal pathology. It is argued that many cases of psychogenic amnesia may resemble organic amnesia, in that they result from an impaired acquisition of information at the time of initial input, perhaps thereby predisposing the subject to subsequent retrieval difficulties.
The Dexamethasone Suppression Test in Depression
Authors: Coppen Alec , Metcalfe Maryse
Published: August 2008

The response to the dexamethasone suppression test (DST) was examined in 543 patients suffering from major depressive illness and 246 healthy controls, from 13 research centres, representing 12 different countries, in a World Health Organization Collaborative Study. In almost all the centres, the post-dexamethasone plasma Cortisol concentration was significantly higher in the patients than in the controls. Although there is variation between centres, this abnormal response to the DST was shown to be frequent in patients from widely different geographical areas.
The Structure of Depressive Symptoms in the Elderly
Authors: Good W. R. , Vlachonikolis I. , Griffiths P. , Griffiths R. A.
Published: August 2008

In a structured sample of 100 male and 100 female minimally impaired patients, aged 60 years and over, females were more depressed. Varimax factor analysis demonstrated four factor groupings which have clinical relevance - Depression, Anxiety, Cognitive impairment, and Psychosomatic disorder; their relative importance is different in males and females. Analysis of variance of the scores of clusters generated by cluster analysis demonstrated four groups of subjects - normal, mildly depressed, moderately depressed with borderline dementia and disability, and severely depressed with moderate dementia and frank disability. In the mildly and moderately depressed, symptoms of anxiety predominated.
DSM-III Personality Disorder Clusters in Three Populations
Authors: Reich J. , Thompson W. Douglas
Published: August 2008

DSM-III personality disorder clusters had not previously been tested for their ability to distinguish between different population groups. A major obstacle - different demographic characteristics of different populations - was overcome by using logistic regression. Three out-patient psychiatric referral groups (chronic pain, disability applicants and competency to stand trial) provided subjects; adjustments were made for age, race, sex and education. The groups were significantly different in the adjusted prevalence of DSM-III personality disorder clusters. Clinical association between personality disorder and drug or alcohol abuse was again confirmed.
Depression, Dementia and Disability in the Elderly
Authors: Griffiths R. A. , Good W. R. , Watson N. P. , O'Donnell H. F. , Fell P. J. , Shakespeare J. M.
Published: August 2008

A structured sample of mobile elderly patients in a rural community practice was assessed on validated rating scales for depression, dementia and disability. A total of 62% of the sample was abnormal on at least one variable. The overall prevalence of depression was 13%; the overall prevalence of dementia was either 10 or 18% depending on the criterion of Mental Test Score (MTS). Depression and dementia were related, depression being more common in females. In depressed and demented patients, MTS was age-related in those over 60 years; in depression alone, MTS was not age-related. Dementia was age-related, particularly over the age of 75. Disability increased with age and was more common in females. Disability was associated with both depression and dementia.
Communicability and Thought Disorder in Schizophrenics and Other Diagnostic Groups
Authors: Ragin A. Barnett , Oltmanns T. F.
Published: August 2008

To evaluate qualitative differences in the nature of thought disorder, the ‘cloze’ procedure and the Scale for the Assessment of Thought, Language and Communication were used to compare speech samples from schizophrenic, depressive, manic, schizo-affective and normal subjects at two different times. At the acute phase, thought-disordered subjects (schizophrenics, manics and schizo-affectives) were less communicable than non-thought-disordered subjects (depressives and normals). Communicability increased with remission of the more flagrant features of disturbance. Comparison of the thought-disordered diagnostic groups in the rate and pattern of remission of specific features of thought disorder indicated that factors reflecting goal-disrupted cognition distinguished the groups.
A Comparative Hospital Survey of Psychotropic Drug Prescribing
Authors: Muijen M. , Silverstone T.
Published: August 2008

In a survey of psychotropic drug prescribing for in-patients in three different types of psychiatric hospitals, the prevalence of combinations of more than one psychotropic drug varied from 45% in one hospital to 94% in another, with significant consistent differences between the use of drug combinations in the various hospitals. Combinations of two antipsychotic drugs were particularly frequent; the hospital with the lowest prevalence of polypharmacy was the only one with an associated psychopharmacology unit. Access to clinical pharmacology teaching may be an important factor in determining appropriate drug-prescribing habits.
Behavioural Treatment of Life-threatening Masochistic Asphyxiation: A Case Study
Authors: Haydn-Smith P. , Marks I. , Buchaya H. , Repper D.
Published: August 2008

Asphyxia as a means of heightening sexual pleasure unfortunately comes to notice more often in the coroner's court than in the psychiatrist's consulting room. The victims are usually adolescent men who strangle or hang themselves while masturbating; transvestism is frequently associated with this behaviour (Simpson, 1979; Friedmann & Faguet, 1982; Mason, 1983). Few such people ask for help, and behavioural treatment in such a case has not been previously described.
An Evaluation of the Performing and Recording of Physical Examinations by Psychiatric Trainees
Authors: Rigby J. C. , Oswald A. G.
Published: August 2008

The physical examination on admission, as recorded in the psychiatric case notes, was assessed for 100 consecutive admissions under the age of 65. Assessment was made on the presence or absence of reference to 43 items of examination and the recording of the examinations was found to be uniformly poor. One of the authors re-examined 50 patients within 48 h of admission and the findings were then compared with the initial recorded examination. Significant unrecorded positive findings were most frequent in the neurological and locomotor systems.
Is There Really A Split in Schizophrenia?
Authors: McGuffin P. , Farmer A. , Gottesman I. I.
Published: August 2008

Although the clinical presentation and course of schizophrenia is highly variable, it is unclear whether this reflects heterogeneity at an aetiological level. The genetic evidence is reviewed concerning ‘traditional’ clinical subtypes as well as more novel categories derived from multivariate statistical methods and Crow's type I-type II classification. Recent data based on a twin series and reanalysis of older published family material suggest that attempts to divide up schizophrenia have resulted in splits between two or more categories of disorder which occupy different positions on the same continuum of liability. Thus, apparent heterogeneity is more likely to be due to quantitative difference in familial-genetic loading rather than qualitative differences. Similarly, the hypothesis that schizophrenia can be broadly divided into two groups, one genetic and the other non-genetic has little to support it. It seems improbable that any further useful and genetically relevant subdivision of schizophrenia can be effected on purely clinical grounds. Further progress awaits developments in the discovery of endophenotypes and the application of molecular genetic marker strategies.
Behavioural Psychotherapy in General Psychiatry
Authors: Marks I.
Published: August 2008

It is widely believed by psychiatrists that patients who require behavioural psychotherapy need to be referred for such treatment to a specialist in the subject. Two assumptions underlie this idea. One is that behavioural treatment requires a detailed knowledge of learning theory which is possessed by few psychiatrists. The other assumption is that behavioural methods are too time-consuming for a busy psychiatrist in a routine outpatient or primary care clinic.
Hostility and Deliberate Self-Poisoning: The Role of Depression
Authors: Farmer R.
Published: August 2008

The evidence for an association between hostility and deliberate self-poisoning is reviewed. Although the concept of hostility is poorly defined and different measuring instruments may not measure the same entity, self-poisoning subjects as a group appear to have very high levels of hostility. However, depression is also associated with hostility and when studies have taken into account the psychiatric diagnosis of overdose patients it is outwardly-directed hostility which distinguishes these individuals from other psychiatric patients or normals. A model is proposed to show the inter-relationships of hostility, depression and self-poisoning.
No Fixed Abode
Authors: Herzberg J. L.
Published: August 2008

There is little information available on psychiatric disorder in homeless women. This study compares clinical casenote information of all homeless women admitted to an East London psychiatric hospital from 1971–1980 inclusive, with information on a cohort of homeless men admitted during the same period. The results show that the women appear to have been socially more stable than the men prior to admission and yet they have less satisfactory admissions to hospital. Possible reasons for these apparent inconsistencies are discussed.
Late Paraphrenia or the Paraphrenias?
Authors: Holden N. L.
Published: August 2008

This study describes 47 cases of paranoid psychosis occurring for the first time after the age of 60. Cases were drawn from the Camberwell catchment area and were followed up for 10 years or until death. The clinical picture of patients showed few differences from those described in earlier studies. Subgroups are described with contrasting clinical features and differing outcome. The findings suggest that late paraphrenia is a heterogenous syndrome giving the appearance of a spectrum of overlapping conditions with paranoid delusions.
A Comparative Trial of a New Antidepressant, Fluoxetine
Authors: Levine S. , Deo R. , Mahadevan K.
Published: August 2008

This clinical trial of a new antidepressant, fluoxetine, shows it to be as effective as a standard tricyclic drug, imipramine. It is effective as a single daily dose and is free of any significant side-effects. It is less sedative and appears to cause fewer problems of weight increase. The three scales used to assess efficacy showed a very positive correlation.
Characteristic Plasma Hormone Changes in Alzheimer's Disease
Authors: Christie J. E. , Whalley L. J. , Bennie J. , Dick H. , Blackburn I. M. , Blackwood D. H. R. , Fink G.
Published: August 2008

A systematic endocrine investigation in dementia, depression and control subjects showed that plasma growth hormone (GH) was higher in the morning and plasma TSH concentrations were higher throughout the day in Alzheimer-type dementia (ATD) than in age-matched depressed patients (MDD), and plasma TSH concentrations were also higher throughout the day in female ATD compared with age-matched female control subjects. The increased plasma TSH concentrations could not be due to reduced negative feedback because plasma T3, T4 and rT3 were in the normal range. Plasma concentrations of oestrogen-stimulated neurophysin (ESN) were lower throughout the day in ATD compared with MDD and controls and lower in the morning compared with other dementias. The high plasma GH and TSH concentrations in ATD may reflect the reduced hypothalamic content of somatostatin in ATD, and the reduced concentrations of ESN may reflect reduced cholinergic activity in ATD prain. These selective hormonal changes provide a useful diagnostic test for Alzheimer's disease.
Increased Plasma LH in Manic-Depressive Illness: Evidence of a State-Independent Abnormality
Authors: Whalley L. J. , Kutcher S. , Blackwood D. H. R. , Bennie J. , Dick H. , Fink G.
Published: August 2008

Basal plasma luteinising hormone concentrations and the LH responses to LH-releasing hormone injection were higher in 11 young men after recovery from mania than in 15 control subjects. Since plasma concentrations of testosterone and sex hormone binding globulin were similar in the recovered manic compared with the control subjects, the increased LH response to LHRH is likely to have been due to the priming effect of LHRH consequent on an increased release of LHRH into hypophysial portal vessel blood. Abnormal control of LHRH, and thereby LH release, is a state-independent feature in male patients with mania and may be a useful trait marker for this disorder.
Lithium in the Treatment of Aggression in Mentally Handicapped Patients
Authors: Craft M. , Ismail I. A. , Krishnamurti D. , Mathews J. , Regan A. , Seth R. V. , North P. M.
Published: August 2008

In a double-blind trial lasting 4 months in 42 mentally handicapped patients, the effect of lithium on aggression was assessed in comparison with placebo. In the lithium-treated group, 73% of patients showed a reduction in aggression during treatment. There were significant differences in mean weekly aggression scores and in the frequency of aggressive episodes between the lithium and placebo groups. Side-effects were noted in 36% of the lithium group (and 20% of the placebo group), but were mainly transitory. There were no episodes of toxicity, and no patients had to be withdrawn from the trial. Lithium appears to be worth a 2-month trial in such patients, where repeated aggression has not been relieved by more appropriate placement, occupation or company.
Oxygen Saturation during Electroconvulsive Therapy
Authors: Swindells Steven R. , Simpson Karen H.
Published: August 2008

Oxygen saturation was measured during anaesthesia and electroconvulsive therapy (ECT) using ear oximetry. Significant hypoxia occurred during some treatments; desaturation related to the number of ventilations performed after muscle relaxation and prior to the shock. Desaturation did not correlate significantly with seizure duration. These findings highlight the need for adequate oxygenation during ECT.
Anorexia Nervosa and Gastric Rugal Hyperplasia
Authors: Cockett A. D.
Published: August 2008

A case of anorexia nervosa associated with gastric rugal hyperplasia in a 36-year-old male is reported and some speculations are made about the relationship between these two conditions.
Epilepsy and Psychosis - Ask the Family
Authors: Clarke David J. , Buckley Mary E. , Burns Bruce H.
Published: August 2008

Psychotic episodes and epilepsy can occur without mental retardation in tuberous sclerosis. The diagnosis may depend on elucidating the family history since physical signs may not be obvious. Establishing the diagnosis makes genetic counselling possible.
An Epidemic of Suicide Attempts by Burning in a Psychiatric Hospital
Authors: Zemishlany Z. , Weinberger A. , Ben-Bassat M. , Mell H.
Published: August 2008

Three patients attempted suicide by burning in one ward of a psychiatric hospital in a period of less than 1 month. No such attempts had occurred there in the previous 9 years. The three patients were schizophrenics with depressive features who occupied the same room in the ward. It seems reasonable to suggest that at least the choice of method and the timing of these suicide attempts were influenced by imitation. Hospital staff should be especially aware of the influence of imitation in suicide in order to avert such undesired epidemics.
Bulimia Nervosa
Authors: Lacey J. Hubert , Smith G.
Published: August 2008

This study examines the impact of pregnancy on the reported eating behaviour of 20 untreated normal body weight bulimia nervosa women; it also reports foetal and obstetric abnormalities and indicates the initial eating habits of the infants. The prevalence of binge-eating and self-induced vomiting reduced sequentially during each trimester of pregnancy. By the third trimester 15 women (75%) had stopped all bulimic behaviour and in the remainder the disturbed eating was less severe. Symptoms tended to return in the Puerperium and in nearly half the sample abnormal eating was more disturbed after delivery than before conception. However, the improvement associated with the pregnancy described by seven patients was maintained and for five it appears to have been curative. The common fear among pregnant bulimics that their abnormal eating behaviour may damage their unborn child cannot be dispelled by this study; the incidence of foetal abnormality (including cleft palate and cleft lip), multiple pregnancies and obstetric complications (including breech presentation and surgical intervention) was high. The nutrition and development of the infants was good although three mothers (15%) reported slimming their babies down within the first year.
Detection of Postnatal Depression
Authors: Cox J. L. , Holden J. M. , Sagovsky R.
Published: August 2008

The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specficity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
Detention in Broadmoor
Authors: Dell S. , Robertson G. , Parker E.
Published: August 2008

When the length of stay of restricted patients admitted to Broadmoor under the legal category of psychopathic disorder was examined, the factor found to be of primary importance was the gravity of the admission offence. If the men's offences did not cause personal injury, they had a good chance of early release. Patients convicted of violent or sexual offences, and particularly those who attacked strangers, made up the great majority of the long-term group. For the mentally ill there was no relationship between length of stay and admission offence: instead the data suggested that severity and chronicity of illness were the main relevant factors.
Ethanol Retards Desensitisation of Simple Phobias in Non-alcoholics
Authors: Cameron O. G. , Liepman M. R. , Curtis G. C. , Thyer B. A.
Published: August 2008

Twenty non-alcoholic patients with DSM-III defined simple phobias for small animals received behavioural approach tests and exposure therapy while under the influence of a moderately intoxicating dose of ethanol or after placebo administration. Ethanol did not demonstrate any acute anti-anxiety effect, but retarded the rate of behaviouralin vivodesensitisation, without changing the final treatment outcome. State-dependent effects of ethanol on anxiety were not demonstrated. This study supports prior research indicating no anti-anxiety or ‘tension-reducing’ effects of ethanol for simple phobias.
Clonidine
Authors: Maguire J. , Singh A. N.
Published: August 2008

Three patients suffering from bipolar affective disorder, manic phase, and who were resistant to conservative treatment were successfully treated with clonidine. This would support the nor-adrenergic hyperactivity theory of mania. The rapidity of action of clonidine and its lack of relatively serious side-effects renders it a potential alternative to conventional anti-manic agents.
The Role of Food Substitutes in a Token Economy System
Authors: Scott Derek W. , Wood Rodger Ll.
Published: August 2008

Data from five behaviour management (token economy) units were analysed for periods of 10–20 weeks before and after the use of a food substitute (Complan®), provided when insufficient tokens had been earned to buy a full- or part-meal. The efficacy of this form of negative punishment to control disturbed and aggressive behaviour was examined. No evidence was found to suggest that the contingent use of a food substitute made any contribution to the therapeutic process.
Response of Depressive Symptoms to Nortriptyline, Phenelzine and Placebo
Authors: Georgotas Anastasios , Mccue Robert E. , Friedman Eitan , Cooper Thomas B.
Published: August 2008

The effects of nortriptyline, phenelzine, and placebo on 13 symptoms of depression were compared in 75 patients, aged 55 or over, who were suffering from major depression. Nortriptyline and phenelzine were more effective than placebo in treating depression mood, guilt feelings, suicidal ideation, agitation, anxiety, loss of energy, and a.m. diurnal variation of mood. Nortriptyline was better than phenelzine or placebo in improving middle/late insomnia. Most of the symptoms did not show significant improvement until the fourth week of treatment.
Recurrent Pseudocyesis and Hypomania
Authors: Taylor J. , Kreeger A.
Published: August 2008

The case of a young woman presenting with three distinct episodes of pseudocyesis occurring concurrently with annual hypomanic illness is described, and the association between pseudocyesis and affective disorder discussed, with regard both to possible underlying psychopathology and to previously proposed psychoneuroendocrine mechanisms.
Suicide and Social Response in Fiji: a Historical Survey
Authors: Haynes Ruth H.
Published: August 2008

A historical review of suicide in Fiji shows that rates for people of Indian descent have always been higher than those of other groups, yet until now this phenomenon has attracted little official or public attention. Recent changes in the incidence and methods of suicide have led to the introduction of some preventive measures, but the emphasis has been on eliminating some of the methods rather than the reasons for suicide. The continuing high incidence of suicide by hanging involving some sectors of society appears to have been overlooked. Possible causes of this apparent lack of interest are examined, such as the low status historically of Indian immigrants and concepts held about them by other groups in Fiji, and the ‘invisibility’ of groups of people such as rural women and the aged.
Psychiatric Morbidity in Primary Health Care a Two-stage Screening Procedure in Developing Countries: Choice of Instruments and Cost-effectiveness
Authors: Sen B. , Wilkinson G. , Mari J. J.
Published: August 2008

The use in two developing countries of a two-stage psychiatric screening procedure with an emphasis on minor morbidity is described. This was the first use of the Self-Reporting Questionnaire and Clinical Interview Schedule in conjunction. Health auxiliaries with limited training administered the first-stage screening instrument. In comparison with other psychiatric screening techniques used in developing countries, the procedure described may prove to be more cost-effective in primary care and community surveys, and more appropriate for assessing the wide range of minor psychiatric morbidity commonly encountered in such settings.
Affective Illness After Stroke
Authors: Ebrahim S. , Barer D. , Nouri F.
Published: August 2008

Mood assessments were made after six months of 149 survivors taken from a register of all patients admitted to hospital with acute stroke. Using a General Health Questionnaire score of 12 or more as a criterion of important affective illness, its prevalence was 23%. There was no difference in risk of affective illness between left and right hemisphere strokes. Affective illness was strongly associated with functional ability, with limb weakness and with longer hospital stay in those with good functional recovery. Only 15% of those with high scores were receiving antidepressant drugs. The general practitioner is in the best position to detect psychiatric illness in stroke survivors; the use of mood rating scales such as the GHQ, in conjunction with clinical assessment may improve detection.
Relationship between Interictal Psychopathology and the Type of Epilepsy
Authors: Edeh J. , Toone B.
Published: August 2008

Psychiatric morbidity was assessed in a sample of 88 adult epileptic patients drawn from general practices in South London. Using the Clinical Interview Schedule, 48% emerged as psychiatric cases. When either total CIS score or caseness status was used for comparison, group differences were evident; patients with temporal lobe epilepsy and focal non-TLE did not differ, but each was significantly more impaired than those with primary generalised epilepsy. The groups also differed in their psychiatric symptom profiles. The results suggest that the increased prevalence of interictal psychopathology commonly associated with TLE may also be a feature of other forms of focal epilepsy.
The Impact of Recent Undesirable Life Events on Psychiatric Disorders in Childhood and Adolescence
Authors: Goodyer I. M. , Kolvin I. , Gatzanis Sonia
Published: August 2008

The timing and number of recent stressful life events occurring in the year before onset of emotional or behavioural disorder was examined in a consecutive sample of children. Overall, events increase the relative risk of psychiatric disorder by 3–6 times. Events occur throughout the 12 months, but tend to cluster in the 16 weeks nearest onset of symptoms. The number of events influences the onset of disorder: cases with multiple events are more likely to have an event within 16 weeks of onset; cases with single events are more likely to have the event 36–52 weeks before onset. Cases whose onset occurs within 4 weeks of an event may have experienced single or multiple events. The results support the concept of additivity of recent stressful events in some cases of emotional and behavioural disorders in childhood.
Depressed Mood After Stroke
Authors: Wade D. T. , Legh-Smith J. , Hewer R. A.
Published: August 2008

A community study on stroke registered 976 patients. Over 60% of survivors at three weeks, six months and 12 months after the stroke were assessed for depressed mood, using the Wakefield self-assessment depression inventory, and on other functional and social activities. At each point, 25–30% of those assessed were depressed; over 50% of patients depressed at three weeks remained so at one year. Factors associated with depression included loss of functional independence, a low level of other activities, a low reasoning ability, and being female and living with someone; path analysis showed that most depression was not explained by these factors. Few depressed patients at six months were on antidepressant medication.
Suicide in Scottish Prisons
Authors: Backett S. A.
Published: August 2008

A consecutive series of prison suicides in Scotland between 1970 and 1982 was examined. The initial phase of imprisonment was found to be the most vulnerable stage of confinement, with almost two-thirds of the deaths having taken place within the first month. A disproportionately high number were found to be on remand. A history of some form of psychiatric involvement was common, and a third of the group had received previous psychiatric inpatient treatment. In contrast to results from general population studies, there was little evidence to link suicide with a history of depressive illness. A record of problems with either alcohol or drug dependence was found in almost half the cases. The importance of general measures designed to reduce stress and promote coping mechanisms is emphasised.
Reality Orientation and Reminiscence Therapy
Authors: Baines Sheila , Saxby Peter , Ehlert Karen
Published: August 2008

We compared reality orientation with reminiscence therapy for elderly people in a large residential home, using a controlled cross-over design. Both kinds of therapy group were enjoyed by both staff and residents, and enabled staff to get to know moderately and severely confused residents. The group that received reality orientation followed by reminiscence therapy showed improvement in cognitive and behavioural measures which was not found in the other two groups. It may be important to use reality orientation techniques with confused residents before involving them in a reminiscence group.
Referrals to a Scottish Drug Dependence Unit
Authors: O'Rourke M. M. , Taylor J. A.
Published: August 2008

The social and demographic characteristics, drug history and current levels of drug taking, drug-related illnesses, and criminal records of a one year cohort of attenders at the Southern General Hospital are described. The findings are compared with those of previous studies at the same clinic; made when methadone was prescribed for a limited period in reducing dosage and when this policy was being replaced by one of the use opiate-free drugs to cover withdrawal.
Comparison of Electrical Measurements on Constant Voltage and Constant Current ECT Machines
Authors: Railton R. , Fisher J. , Sinclair A. , Shrigmankar J. M.
Published: August 2008

Electrical measurements were made during treatment of two groups of patients, one group receiving treatment from a constant current ECT machine and the other from a constant voltage machine. The electrical impedance and energy were calculated and compared for the two groups. More energy was delivered by the constant voltage than by the constant current machine, but the spread of energy delivered was comparable. With a consistent technique for applying the electrodes there is little to choose between these machines, but the constant current machine may be preferred where consistency cannot be achieved.
Varieties of Combat Stress Reaction
Authors: Garb R. , Kutz I. , Bleich A. , Solomon Z.
Published: August 2008

The use of an immunological metaphor allows the incorporation of established theoretical ideas about trauma and stress in an integrative way which enables delineation and illustration of several varieties of combat stress reaction, including subtle forms of that condition which do not often appear in post-traumatic stress disorder literature.
Heroin Abusers in Psychiatric Beds
Authors: Fraser Alan A. , Greer Anne , Jauhar Pramod
Published: August 2008

A retrospective study was carried out of all heroin abusers admitted to an acute psychiatric unit to examine their use of the facility of in-patient care. The compliance with treatment was low. Most patients discharged themselves or were discharged prematurely for using drugs while in the ward; only 21% were discharged as planned. The value of hospital admission in the management of opiate abusers may have to be reconsidered in view of the increasing prevalence of heroin abuse and the limited number of psychiatric beds.
Ganser Syndrome
Authors: Dabholkar P. D.
Published: August 2008

A case of Ganser syndrome occurring in an 11 year-old Indian boy is described, and the psychodynamics and nosological status of the syndrome discussed. Ganser syndrome should be regarded as a hysterical state, and should not be confused with the similar picture observed in organic brain syndromes and psychoses.
Pathology, Phenomenology and the Dopamine Hypothesis of Schizophrenia
Authors: McKenna P. J.
Published: August 2008

The dopamine hypothesis of schizophrenia implies that positive schizophrenic symptoms should be understandable by reference to brain structures receiving a dopamine innervation, or in terms of the functional role of dopamine itself. The basal ganglia, ventral striatum, septo-hippocampal system, and prefrontal cortex, sites of mesotelencephalic dopamine innervation, are examined and it is argued that their dysfunction could form the basis of particular schizophrenic symptom classes. The postulated involvement of dopamine in reinforcement processes might further assist such interpretations. This type of analysis can be extended to other categories of schizophrenic psychopathology.
Expressed Emotion and Relapse in First Episodes of Schizophrenia
Authors: Mintz Jim , Mintz Lois , Goldstein Michael J.
Published: August 2008

Re-analyses of data presented by Macmillan et al (1986b) challenge their conclusions that high expressed emotion is not prognosticate significant for the course of schizophrenia or unrelated to the level of behavioural disturbance prior to admission. Several equally plausible models of causal relationships between EE and duration of untreated illness are presented. We conclude that our re-analyses of the Macmillan data do not warrant premature closure regarding the significance of the EE variable.
Haloperidol Decanoate v. Fluphenazine Decanoate as Maintenance Therapy in Chronic Schizophrenic In-patients
Authors: McKane J. P. , Robinson A. D. T. , Wiles D. H. , McCreadie R. G. , Stirling G. S.
Published: August 2008

In a double-blind study of 38 chronic schizophrenic in-patients, haloperidol decanoate was compared with fluphenazine decanoate as maintenance therapy over 60 weeks. Both drugs were given by injection at 4-week intervals. Haloperidol and fluphenazine were assumed to be equipotent; the mean starting dose of the former was 127 mg and of the latter 106 mg. The number of withdrawals over 60 weeks was similar in both groups but relapses, strictly defined, were significantly more frequent in the haloperidol group. When patients were switched to haloperidol, Parkinsonism diminished more quickly than in the fluphenazine group, but after 60 weeks there was no difference in severity in the two drug groups. The higher relapse rate and the quicker reduction in Parkinsonism in the haloperidol group might be due to a misjudgement in equivalent doses of the two drugs. Plasma haloperidol steady state levels were reached in most patients by 8–12 weeks. Plasma neuroleptic and prolactin levels, week-by-week systemic drug availability and Parkinsonism showed less variation between injections with haloperidol than with fluphenazine.
A Controlled Comparison of Fluoxetine and Amitriptyline in Depressed Out-patients
Authors: Young J. P. R. , Coleman A. , Lader M. H.
Published: August 2008

Fluoxetine, a selective serotonin uptake inhibitor (mean dose 73 mg each morning) was compared with amitriptyline (mean dose 122 mg at night) in a double-blind study of 64 depressed out-patients. Fifty patients completed the 6-week trial. The drugs did not differ with respect to psychiatrists' ratings, but amitriptyline was slightly superior with respect to patients' ratings. The amitriptyline-treated group had complaints of dry mouth and dizziness on standing; the fluoxetine-treated group of sleep disturbances, nausea, and headaches.
Life Events and Psychiatric Disorder: the Role of a Natural Disaster
Authors: McFarlane Alexander C.
Published: August 2008

Examining the impact of natural disasters on psychological health provides an opportunity to study the role played by extreme adversity in the onset of psychiatric disorder. Four hundred and sixty-nine fire-fighters who had been intensely exposed to an Australian bushfire disaster completed a detailed inventory of their experiences four months later. They also completed a brief life events schedule and the 12-item General Health Questionnaire. Only 9% of the GHQ score variance could be accounted for by the disaster and other life events; the effects of the disaster appeared to be separate and additive. This is similar to the relationship between life events and psychiatric illness found in other settings. It is suggested that vulnerability is a more important factor in breakdown than the degree of stress experienced.
Mental Health in Africa: I. the Extent of Mental Health Problems in Africa Today
Authors: German G. Allen
Published: August 2008

This paper is concerned with steadily developing knowledge of the epidemiology of some psychiatric disorders in sub-Saharan Africa. The diversity of ‘Black Africa’ is noted, and preconceptions about African psychiatry briefly discussed. Problems of sociological versus clinical philosophies are also mentioned. Early estimates of prevalence of psychiatric disorder in black Africa were universally low, being based on hospital data. More recent studies, sampling diverse populations, suggest a burden of psychiatric morbidity in black Africa which is not dissimilar to that found in more developed countries, and some studies suggest that rates in Africa may even be higher than in developed countries.
Calcium-Activated Potassium Conductance
Authors: Dinan Timothy G.
Published: August 2008

Neuroleptics are structurally a heterogenous group of compounds which possess antipsychotic activity. They increase dopamine metabolites by blocking dopamine receptors and enhancing presynaptic turnover. This forms the cornerstone of the dopamine hypothesis of neuroleptic action, which is supported by wide-ranging behavioural, physiological and biochemical studies. It is, however, clear that neuroleptics are far less specific for the dopamine receptor than was previously considered. They influence a range of neuronal activities, including calcium-activated potassium conductance, which governs the rate of action potential generation by many neurones. Recent physiological studies indicate that all commonly used neuroleptics alter calcium-activated potassium conductance in central neurones, in concentrations similar to those achieved clinically. An adaptive increase in calcium-activated potassium conductance mechanisms in key sensory processing neurones would render the psychotic patient less susceptible to bombardment by environmental stimuli. This action may explain in part the therapeutic effect of neuroleptics.
Commentary on Dinan's Hypothesis
Authors: Iversen Leslie L.
Published: August 2008

Dinan's paper seeks to question the validity of the now widely accepted hypothesis that neuroleptic drugs of various different chemical categories all act by a common mechanism, namely by blockade of dopamine receptors of the D2 type in brain (for review see Creese et al, 1978, 1983; Iversen, 1985). While it is always refreshing to re-examine existing scientific dogma, his criticisms did not appear to me to be very substantial. Having quite fairly reviewed the evidence in favour of the “dopamine hypothesis” for neuroleptic drug action, Dinan summarises his reasons for questioning it. He points out that many neuroleptic drugs have potent actions on a number of other targets, apart from the dopamine receptors in brain. This is indeed so, and the archetypal compound, chlorpromazine, has a particularly rich spectrum of pharmacological activity, being a potent antagonist of serotonin (5-HT2) receptors, ?-adrenoceptors, and histamine (HI) receptors in brain and other tissues. Other neuroleptics also have potent actions on a number of other systems. Indeed, if one were to have studied only chlorpromazine, it is doubtful whether the “dopamine hypothesis” could ever have been developed. The strength of this hypothesis lies in the fact that of all the diverse pharmacological actions which different neuroleptic drugs exhibit, this is the only action that is common to all neuroleptic compounds. Furthermore, in a large group of neuroleptics, which differ widely in potency (doses in man ranging from 1 mg/day to almost 1000 mg/day), the potencies of these drugs as dopamine (D2) antagonists correlate significantly with their clinical potencies. Attempts to make such correlations with any other known pharmacological properties of these drugs fail to show significance (Creese et al, 1978, 1983).
Psychological Intervention in Civilian Flying Phobia
Authors: Walder C. P. , McCracken J. S. , Herbert M. , James P. T. , Brewitt N.
Published: August 2008

Thirty-eight people with a moderate to severe degree of aerophobia self-referred themselves to a course designed to help them travel by air. The course involved three long sessions based on giving information, graded exposure without avoidance, and group support with natural coping models. Measures of self-reported anxiety levels were taken at regular intervals. The results showed that being given information or undergoing a simulated flight had little effect on perceived anxiety. Prolonged exposure to flying had a marked effect on reducing anxiety and anticipated apprehension about future flying. At one-year and three-year follow-up, 40% and 60% of participants had flown commercially, although there was some minor restoration of anticipated anxiety associated with flying; 84% showed less anxiety about flying. Psychological intervention, in collaboration with airlines, may have marked benefits in reducing fear of flying.
Anxiety Management for Persistent Generalised Anxiety
Authors: Butler G. , Cullington A. , Hibbert G. , Klimes I. , Gelder M.
Published: August 2008

A preliminary controlled investigation of the effectiveness of Anxiety Management as a treatment for generalised anxiety disorder (GAD) is described. Patients with a primary diagnosis of GAD, in which the current episode had lasted for at least 6 months but not more than 2 years, were included. Anxiety Management, a self-help treatment including procedures for managing somatic and cognitive symptoms, and for dealing with avoidance and low self-confidence, was given either immediately or after a 12-week waiting period. The average length of treatment was 8.7 sessions. Highly significant changes in anxiety, depression, and problem ratings were shown after treatment. These changes were replicated when the waiting list group had also received treatment, and gains were maintained by both groups for 6 months. Similar degrees of improvement and maintenance of change were shown in subgroups with and without minor depressive disorder or recurrent panic attacks.
Paranoid Psychoses after Abuse of Proprietary Cold Remedies
Authors: Lambert M. T.
Published: August 2008

It is well established that psychosis may arise in the context of the abuse of certain prescribed or illicit drugs. Two cases of paranoid psychosis are described in which proprietary preparations containing amphetamine-like drugs were abused. The role of these drugs is discussed with reference to previous case reports, and it is emphasised that initial clinical assessment and urinary screening for drugs may fail to reveal the relevant history with respect to proprietary medicines.
Encephalitis Lethargica, a Contemporary Cause of Catatonic Stupor
Authors: Johnson John , Lucey P. A.
Published: August 2008

Two cases of catatonic stupor are described due to presumed encephalitis lethargica. Catatonic and obsessional phenomena in the setting of a depressive psychosis associated with a movement disorder may constitute a post-encephalitic syndrome.
The Grammar of Psychotherapy
Authors: Cobb John P. , Lieberman Stuart
Published: August 2008

The Grammar of Psychotherapy is a method of teaching both communication skills and the elements of psychotherapy. Supervised training is supplemented by self-monitored tasks. The course is economical in terms of tutors' time, and is particularly suitable for trainees in general psychiatry.
The DSM-III Concepts of Schizophrenic Disorder and Schizophreniform Disorder
Authors: Makanjuola Roger O. A. , Adedapo Sunday A.
Published: August 2008

Consecutive new patients presenting at a Nigerian psychiatric unit over a 14-month period and fulfilling the DSM-III criteria for schizophreniform disorder, (active) schizophrenia and residual schizophrenia were studied. There were no differences between the three groups with respect to background social data. The schizophreniform patients had a lower incidence of previous psychotic episodes. There were no differences between the first two groups with respect to the distribution of PSE symptoms and signs, Schneider's First Rank Symptoms, or severity of psychopathology. Initial clinical outcome, and longer-term clinical and social outcome, assessed 25–38 months after index presentation, was best in the schizophreniform patients and worst in the patients with residual schizophrenia. The findings are consistent with schizophreniform disorder lying on a spectrum of schizophrenic disorders. They also highlight inadequacies in mental health services in Nigeria and other developing countries.
Double-Blind Study of Imipramine versus Phenelzine in Melancholias and Dysthymic Disorders
Authors: Vallejo J. , Gasto C. , Catalan R. , Salamero M.
Published: August 2008

In a 6-week double-blind trial, the efficacy of imipramine and high dose phenelzine were compared in the treatment of Major Depression with Melancholia, and Dysthymic Disorder (DSM-III). Both drugs were found to be equally efficacious in the treatment of 32 patients suffering from Major Depression. In 32 Dysthymic patients, phenelzine in high doses was found to be superior to imipramine. The clinical implications of these findings are discussed.