bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between major depressive disorder and physical illness
Authors: Moldin S. O. , Scheftner W. A. , Rice J. P. , Nelson E. , Knesevich M. A. , Akiskal H.
Published: July 2009

Synopsis

The association between major depressive disorder (MDD) and self-reported histories of specific physical illnesses was investigated in 320 controls and 1968 first-degree relatives and 254 spouses of probands in the NIMH Collaborative Depression study. The Schedule for Affective Disorders and Schizophrenia-Lifetime Version was used to assign Research Diagnostic Criteria (RDC) diagnoses and a structured self-report instrument was used to assess lifetime medical history. Lifetime MDD was diagnosed in 914 subjects, 402 of whom had been hospitalized or received somatic treatment (‘treated’ MDD). Strong associations were observed between MDD (either treated or untreated) and both frequent/severe headaches and migraine headaches. There was a marked gender effect such that the relative odds for a woman with treated MDD to report migraine were over 5:1. Other associations were found between MDD and skin infections, respiratory illness, ulcer, hypotension, and diabetes. This is the largest non-patient sample using standardized assessment of mental disorders by direct interview in which associations between specific physical illnesses and MDD have been demonstrated. Implications for clinical practice and neurobiological research in depression are discussed.
Expressed emotion and schizophrenia: the ontogeny of EE during an 18-month follow-up
Authors: Stirling J. , Tantam D. , Thomas P. , Newby D. , Montague L. , Ring N. , Rowe S.
Published: July 2009

Synopsis

Key relatives of 30 first or early admission psychotic patients (mainly with a diagnosis of schizophrenia) were interviewed (for a second time) 18 months after participating in an initial assessment of expressed emotion (EE). The patients were followed up throughout the interim period, during which time 17 experienced a psychotic relapse. Although there continued to be a negligible association between initial EE rating (established during the index admission) and relapse, a significant association between EE rating at 18 months and psychiatric status of the patient during the follow-up period emerged. Results are discussed in the context of recent interactional theories of the relationship between household EE and psychiatric morbidity.
A review of the biochemical and neuropharmacological actions of lithium
Authors: Wood Andrew J. , Goodwin Guy M.
Published: July 2009

Synopsis

The pharmacological actions central to the therapeutic effects of lithium have not yet been established, despite almost 40 years of clinical use and scientific investigation. We review the biochemical and neuropharmacological data relating to this problem and attempt to identify profitable areas for further research.
Remote memory in a patient with amnesia due to hypoxia
Authors: Beatty William W. , Salmon David P. , Bernstein Nancy , Butters Nelson
Published: July 2009

Synopsis

It has been suggested that amnesic patients suffer a selective loss of episodic memory while semantic memory remains well preserved. To assess the validity of this idea we studied remote memory in an amnesic patient, (M.R.L.), using several different measures that differ in the extent which they engage episodic or semantic memory. On two different versions of the Albert et al. (1979) remote memory battery M.R.L. displayed severe retrograde amnesia (RA) extending backwards in time for about 15 years with excellent preservation of older memories. With standard recall instructions his overall performance on the Crovitz test of autobiographical memory was impaired and all of M.R.L.'s specific, temporally dated memories were given from the first half of life. When asked to reconstruct his past residential history in detail, M.R.L. provided specific and generally accurate information for residences occupied from his boyhood until 1970, but thereafter his memory became quite unreliable. On a test of knowledge of terms commonly employed the surveying profession, in which he worked for the past 20 years, M.R.L.'s performance was also impaired. The consistent pattern of RA displayed by this patient on all of the tests of remote memory indicates that both episodic and semantic memory are impaired in amnesia.
Anhedonia and emotional responses to affect evoking stimuli
Authors: Berenbaum Howard , Snowhite Rebecca , Oltmanns Thomas F.
Published: July 2009

Synopsis

The purpose of the present study was to determine whether individuals with unusually high scores on the Scale for Physical Anhedonia (Chapmanet al.1976) would differ from average scorers in their emotional responses to affect-evoking stimuli. Ten male and ten female anhedonics, well as ten male and ten female control subjects, were each shown brief filmclips that were expected to elicit emotional responses. The subjects' facial expressions were videotaped while they watched the filmclips, and they also completed adjective checklists describing how they felt while watching them. The anhedonics and nonanhedonics did not differ in their self-reports of emotional experience, nor did they differ in their facial expressions of emotion while viewing the filmclips. Compared to men, women reported experiencing more emotion, and their facial expressions also indicated greater responsiveness.
Musical inventiveness of five idiots-savants
Authors: Hermelin B. , O'Connor N. , Lee S.
Published: July 2009

Synopsis

Accounts of musical ability in idiots-savants have up till now been confined to stressing the astounding musical memory which such persons may possess. The present study investigates compositional and improvisational skills in five idiots-savants. The findings are interpreted as indicating that a representational system of musical rules and structures is accessible to persons of low general intelligence, and that such a system may underlie reproductive as well as generative musical capacity.
Mood, pattern sensitivity and headache: a longitudinal study
Authors: Nulty Duncan D. , Wilkins Arnold J. , Williams J. Mark G.
Published: July 2009

Synopsis

Fifteen persons who admitted to chronic worry were asked to complete morning and evening diaries in which they reported the occurrence of headaches, assessed their mood, and observed a visually stressful pattern, noting the illusions it induced. Results showed an association between both trait and state measures of mood and headache occurrence, and between trait and state measures of headache occurrence and illusion susceptibility. However, mood and illusion susceptibility did not appear themselves to be associated either as trait or state variables. The implications of these results for remediation of headaches are discussed.
A longitudinal study of the psychological morbidity in children due to a natural disaster
Authors: McFarlane Alexander C. , Policansky Sandra K. , Irwin Claire
Published: July 2009

Synopsis

This longitudinal study examined the psychological impact of a bushfire disaster on a group of 808 children aged from 5 to 12. Contrary to prediction, the prevalence of behaviour and emotional problems 2 months after the fire was less than the prevalence in a carefully selected comparison group. Rather than decrease with time, the prevalence of psychological morbidity increased significantly, being as great 26 months after the disaster as at 8 months.
Kraepelin revisited: a reassessment and statistical analysis of dementia praecox and manic-depressive insanity in 1908
Authors: Jablensky A. , Hugler H. , Von Cranach M. , Kalinov K.
Published: July 2009

Synopsis

A meta-analysis was carried out on 53 cases of dementia praecox (DP) and 134 cases of manic-depressive insanity (MDI) originally diagnosed by Kraepelin or his collaborators in Munich in 1908. The original case material was coded in terms of Present State Examination syndromes and analysed statistically for internal consistency and discrimination between the two diagnostic entities. Kraepelin's DP and MDI were found to define homogeneous groups of disorders which could be clearly distinguished from one another. A CATEGO re-classification of the cases revealed an 80·2% concordance rate between Kraepelin's diagnoses and ICD-9. Cluster analysis of the original data reproduced closely Kraepelin's dichotomous classification of the psychoses but suggested that DP was a narrower concept than schizophrenia today, while MDI was a composite group including both ‘typical’ manic-depressive illnesses and schizoaffective disorders.
Generating and testing a causal explanation of the gender difference in age at first onset of schizophrenia
Authors: Häfner H. , Riecher-Rössler A. , An Der Heiden W. , Maurer K. , Fätkenheuer B. , Löffler W.
Published: July 2009

Synopsis

Motivated by the lack of knowledge of the pathophysiological processes underlying the manifestation of symptoms in schizophrenia, we have worked out a systematic search strategy. Since epidemiological distribution patterns consistently deviating from expected values provide valuable indications of causal relationships, we chose the higher age of females at first admission for schizophrenia, first reported by Kraepelin and since then confirmed in over 50 studies, as the basis for our study. This unexplained epidemiological finding was replicated on Danish and Mannheim case-register data by systematically controlling for selection and diagnostic artefacts and by testing alternative explanations at the individual stage of the study. To check whether the difference in age at first admission was determined by a difference in age at onset, a representative sample of 267 first-admitted patients with non-affective functional psychosis was examined by using an interview for the retrospective assessment of the onset of schizophrenia (IRAOS) designed for this purpose. Any of the definitions of first-ever onset applied – first sign of mental disorder, first psychotic symptom, first acute episode – led to a significant age difference of 3·2 to 4·1 years between the sexes. The distribution of onsets across the life cycle showed a later increase and a second, lower peak between the ages of 45 and 54 years among females compared with males. The lifetime risk for schizophrenia was equal for males and females. After testing the plausibility of psychosocial versus biological explanations we hypothesized that due to the effect of oestrogens the vulnerability threshold for schizophrenia is elevated in females until the menopause. Animal experiments and post mortem analyses showed that chronic oestrogen applications significantly shortened dopamine-induced behaviour and reduced D2 receptor sensitivity in the brain. The applicability of this pathophysiological mechanism to human schizophrenia was tested on acutely schizophrenic females with normal menstrual cycles. A significant negative correlation was found between measures of symptomatology and plasma oestrogen levels. The manifestation of symptoms in schizophrenia appears to be influenced by a sufficiently sensitive D2 receptor system in the brain, blocked by neuroleptics and modulated by oestrogens.
Anhedonia: a neglected symptom of psychopathology
Authors: Snaith Philip
Published: July 2009

Synopsis

In the last century psychopathologists attached importance to the concept of anhedonia, the loss of ability to experience pleasure. Its role in the diagnosis of melancholia was considered to be crucial. In the present century attention to anhedonia has faded, possibly because of the focus upon depressed mood as the pathognomonic feature of depressive disorders. Research on the symptomatology of endogenous depression did not include the concept; anhedonia was also lacking from the major instruments of psychiatric research, the depression rating scales,

Attention was drawn to anhedonia by two authors: by Meehl in the 1960s and by Klein in the 1970s. Meehl considered anhedonia from the point of view of a personality defect predisposing to mental illness; and Klein regarded anhedonia to be a symptom of depressive illness and probably the best clinical marker predicting response to antidepressant drugs.

In 1980 the revised DSM presented the concept of ‘loss of interest or pleasure’ as one of the two cardinal symptoms of major depression. Since then there has been a gradual recovery of emphasis although many systems confuse the two concepts of‘loss of interest’ and anhedonia. It is possible that anhedonia may provide the key to a more exact delineation of depressive disorders in biological research and in clinical practice. Further research will depend upon a more precise, cross-nationally agreed definition of the concept and the means of its assessment.
Chronic fatigue in primary care attenders
Authors: McDonald Elizabeth , David Anthony S. , Pelosi Anthony J. , Mann Anthony H.
Published: July 2009

Synopsis

From 686 patients attending primary care physicians, 77 were identified by a screening procedure as having chronic fatigue. Of these, 65 were given a comprehensive psychological, social and physical evaluation. Seventeen cases (26%) met criteria for the chronic fatigue syndrome. Forty-seven (72%) received an ICD-9 diagnosis of whom 23 had neurotic depression, with a further 5 meeting criteria for neurasthenia. Forty-nine were ‘cases’ as defined by the revised Clinical Interview Schedule (CIS-R), and 42 if the fatigue item was excluded. Psychiatric morbidity was more related to levels of social stresses than was severity of fatigue. The main difference between these subjects and those examined in hospital settings is that the former are less liable to attribute their symptoms to wholly physical causes, including viruses, as opposed to social or psychological factors. Identification and management of persistent fatigue in primary care may prevent the secondary disabilities seen in patients with chronic fatigue syndromes.
The course and outcome of depression in different cultures: 10-year follow-up of the WHO Collaborative Study on the Assessment of Depressive Disorders
Authors: Thornicroft Graham , Sartorius Norman
Published: July 2009

Synopsis

The World Health Organization's study on depressive disorders in different cultures began in 1972. Cohorts of depressed patients were identified in Basle, Montreal, Nagasaki, Teheran and Tokyo. The patients were assessed using standardized measures of social and clinical functioning. Ten-year follow-up data on clinical course, service contact, suicidal acts and social function outcomes were available for 439 (79%) patients. Over one-third (36%) were re-admitted at least once in the follow-up period, half of whom (18%) had very poor clinical outcome. Twenty-four per cent suffered severe social impairment for over half the follow-up period, and over one-fifth (21%) showed no full remissions. The best clinical course (one or two reasonably short episodes of depression with complete remission between episodes) was experienced twice as frequently in patients with a diagnosis of endogenous (65%) as in those diagnosed as suffering from psychogenic depression (29%). Among all patients, a fifth (22%) had at least one episode lasting for more than 1 year, and 10% had an episode lasting over 2 years during follow-up. Death by suicide occurred in 11% of patients, with a further 14% making unsuccessful suicide attempts.
The Prince Henry Hospital Mood Disorders Unit
Authors: Parker Gordon
Published: July 2009

In 1985 a Mood Disorders Unit (MDU) was established at Prince Henry Hospital in Sydney as a clinical research module, linked with the psychiatric department of the University of New South Wales. There were three general objectives: first, to provide a specialized state-wide clinical service for the assessment and management of those with affective disorders, particularly treatment-resistant depression; secondly, to make a research contribution; and thirdly, to serve as an academic centre for teaching and training of undergraduate and postgraduate students from a variety of disciplines.
Post-traumatic stress disorder: supportive evidence from an eighteenth century natural disaster
Authors: Parry-Jones Brenda , Parry-Jones William Ll.
Published: July 2009

Synopsis

Post-traumatic stress disorder was first recognized as a diagnostic category embracing reactions in response to overwhelming environmental stress ‘outside the range of usual human experience’ in DSM-III (APA, 1980). Such abnormal stressors are by no means a product of the twentieth century but have featured, sporadically, in all societies from the earliest civilizations. Longitudinal investigations of traumatic stress have rarely gone further back than the nineteenth century, and have been concerned, almost exclusively, with adverse effects following railway accidents and military combat. The present study, utilizing a mid-eighteenth century medical source, presents an analysis of the impact of a natural disaster on members of a peasant family trapped in an avalanche in the Italian Alps in 1755.
The subtyping of schizophrenia in men and women: a latent class analysis
Authors: Castle D. J. , Sham P. C. , Wessely S. , Murray R. M.
Published: July 2009

Synopsis

Latent class analysis on an epidemiologically based series of 447 first contact patients with a broad diagnosis of schizophrenia revealed evidence for two subtypes: a ‘neurodevelopmental’ type characterized by early onset, poor pre-morbid social adjustment, restricted affect and a male: female ratio of 7:3; and a ‘paranoid’ type characterized by later onset, persecutory delusions and an almost equal sex ratio. A third ‘schizoaffective’ subtype, whose existence was less clear cut, was almost entirely confined to females and characterized by dysphoria and persecutory delusions, and had negligible familial risk of schizophrenia. The aetiological, biological and clinical significance of this typology remains to be tested.
Clonidine infusion increases uptake of 99mTc-Exametazime in anterior cingulate cortex in Korsakoff's psychosis
Authors: Moffoot A. , O'Carroll R. E. , Murray C. , Dougall N. , Ebmeier K. , Goodwin G. M.
Published: July 2009

Synopsis

The effects upon regional brain function of infusing either saline or clonidine (1·5μg/kg) has been examined in 18 patients with alcoholic Korsakoff's psychosis using 99mTc-hexamethylpropyleneamineoxime (99mTc-HMPAO or 99mTc-Exametazime) and Single Photon Emission Tomography (SPET or SPECT). The hypothesis tested was that frontal lobe function would be increased by adrenoceptor stimulation. This was confirmed by an increase in the uptake of 99mTc-Exametazime into anterior cingulate regions of the frontal lobes. Patients were scanned before and after saline or clonidine infusion during performance of a verbal fluency task. There was a significantly increased performance of verbal fluency in patients given clonidine. This effect was variable and could not be unequivocably distinguished from increases in performance in the saline treated group. Nevertheless, the increase in neuropsychological performance was also correlated with increased function in left dorsolateral frontal cortex within the clonidine treated group. An exploratory examination of other brain areas suggested that relative increases in posterior cingulate cortex and changes in the symmetry of function within the thalamus may also be produced by acute infusion of clonidine in Korsakoff patients. The findings support the idea that adrenergic mechanisms may modulate cognitive performance by actions on attentional systems within the brain. These appear to be located primarily within limbic cortex. It is, of course, notable that this can occur in patients with profound and disabling amnesia.
The use of psychiatric services before imprisonment: a survey and case register linkage of sentenced prisoners in Melbourne
Authors: Herrman H. , Mills J. , Doidge G. , McGorry P. , Singh B.
Published: July 2009

Synopsis

Information about contact with psychiatric services before imprisonment was obtained for a stratified random sample of sentenced prisoners, who were not receiving prison psychiatric care, in Melbourne's three metropolitan prisons. The sample of 158 men and 31 women was matched with the longitudinal person-linked records of state psychiatric service use in the Victorian Psychiatric Case Register (VPCR). Records of contact with the state services were found for 54 men (34%) and 19 women (61%), including records of in-patient treatment for 25 men (16%) and 15 women (48%). For 64% of individuals with a positive match, the case-note diagnoses were substance use disorders only. Diagnoses of psychotic disorders were recorded for four prisoners, and mood disorders for another six.

In addition, clinicians conducted standardized diagnostic interviews and enquired about treatment and personal history. A further 24 prisoners reported specialist psychiatric treatment outside the state treatment sector.

This study links the findings from an interview survey of psychiatric morbidity in prisoners with the records available in the VPCR, and emphasizes a number of matters important to the public health. The high rates of previous treatment for substance abuse disorders, the apparent pool of prisoners with largely untreated major depression, and the service needs of those with chronic psychotic disorders are discussed.
University transition: major and minor life stressors, personality characteristics and mental health
Authors: Lu Luo
Published: July 2009

Synopsis

One hundred and two first-year students at an independent college in Taiwan participated in a questionnaire study. Measurements of stressors (major life events, minor daily hassles and perceived university stress), personality (locus of control, extraversion and neuroticism) and mental health (depression, anxiety and somatic symptoms) were taken. Using multivariate analyses, we found that: (1) life events predicted anxiety, while daily hassles predicted depression; (2) locus of control and extraversion correlated negatively, while neuroticism correlated positively with university stress; and (3) neuroticism had a main effect on symptom reportings across the board, while extraversion had a vulnerability effect on somatic symptoms. Relationships between life events and daily hassles, and the roles of personality in the stress process, are discussed.
Sex differences in lifetime depression rates: fact or artefact?
Authors: Wilhelm Kay , Parker Gordon
Published: July 2009

Synopsis

To isolate determinants of any female preponderance in depressive disorder, we earlier selected a sample of young adults, then similar in terms of several potential social determinants of depression and with equivalent rates of lifetime depression. We now report a 10-year review, which initially suggested a female preponderance in DIS-generated RDC and DSM-III lifetime depressive categories. The presence of sex differences in rates of lifetime depression was influenced by the definition of caseness used and the vantage point from which rates were determined. The longitudinal design and earlier corroborative witness reports established, however, clear evidence of instability in prevalence estimates, together with a sex effect on stability. Men were more likely to ‘forget’ episodes, while women were more likely to ‘remember’ episodes that had generally not previously reached ‘case’ criteria. When correction was made for such artefactual influences, a sex difference in lifetime depression rates was no longer evident. Such findings require review in general community samples, and suggest modifications to ‘case’ definition in epidemiological enquiries.
The Dubai Community Psychiatric Survey: acculturation and the prevalence of psychiatric disorder
Authors: Ghubash R. , Hamdi E. , Bebbington P.
Published: July 2009

Synopsis

Dubai, an Emirate in the Gulf region, has experienced spectacular social change as a result of the exploitation of its oil reserves. The Dubai Community Psychiatric Survey was designed to study the effects of this social change on the mental health of female nationals.

In this paper, we approach the problem by quantifying social change in two main ways: the first focused on social change at the individual level as measured by the Socio-cultural Change Questionnaire (Bebbingtonet al.1993). The second examined the effect of social change at the community level by identifying areas of residence at different levels of development. We hypothesized that attitudes and behaviours markedly at odds with traditional prescriptions would be associated with high rates of psychiatric morbidity.

On the individual level, the association between psychiatric morbidity and the amount of social change reflected in the behaviours and views of the subjects was not significant. However, there was a significant association between morbidity and between social attitudes and behaviours. At the community level, in contrast, the relationship between psychiatric morbidity and social change was significant: there was more psychiatric morbidity in areas at the extremes of the social change continuum. The hypothesis put forward in this study must be modified accordingly.
Symptom profiles of psychiatric disorders based on graded disease classes: an illustration using data from the WHO International Pilot Study of Schizophrenia
Authors: Manton K. G. , Korten A. , Woodbury M. A. , Anker M. , Jablensky A.
Published: July 2009

Synopsis

The Grade of Membership (GoM) model is a classification procedure which allows a person to be a member of more than one diagnostic class. It simultaneously quantifies the degrees of membership in classes while generating the discrete symptom profiles or ‘pure types’ describing classes. The model was applied to the symptomatology, history, and follow-up of 1065 cases in the WHO International Pilot Study of Schizophrenia. The model produced an eight diagnostic class or ‘pure type’ solution, of which five were related to the diagnostic concepts of schizophrenia and paranoid disorder, two types were affective disorders, and one asymptomatic type. A subtype of paranoid schizophreniform disorder found primarily in developing countries was identified. There was a strong association between pure types and the original clinical and computer generated (CATEGO) diagnoses. A GoM based psychiatric classification might more clearly identify core disease processes than conventional classification models by filtering the confounding effects of individual heterogeneity from pure type definitions.
A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation
Authors: Jorm A. F.
Published: July 2009

Synopsis

Data from four studies were used to assess the psychometric properties of the 26 IQCODE items. The items were assessed in terms of item–total correlations, test–retest reliabilities, correlations with indicators of current cognitive functioning and correlations with indicators of pre-morbid cognitive functioning. These data were used to develop a 16-item short form. The short form was cross-validated in a new sample using dementia/delirium diagnosis as the validity standard. It was found to perform as well as the long form.
Memory impairment in schizophrenia – a comparison with that observed in the Alcoholic Korsakoff Syndrome
Authors: Duffy Louise , O'Carroll Ronan
Published: July 2009

Synopsis

Until very recently, memory impairment was not considered to be a central feature of schizophrenia, except in chronic, deteriorated patients. In this study of a heterogeneous sample of 40 patients with DSM-III-R schizophrenia, episodic memory impairment was found to be prevalent, and in some cases, severe. The degree of memory impairment was not attributable to neuroleptic or anticholinergic medication, or to poor motivation or cooperation. These results, therefore, replicate those reported by McKenna et al. (1990) and Tamlyn et al. (1992), who suggested that the pattern of memory impairment in schizophrenia may conform in important respects to that of the classic amnesic syndrome. However, in a direct comparison of the schizophrenic sample with 18 patients suffering from the Alcoholic Korsakoff Syndrome (AKS), both quantitative and qualitative differences were found to exist between the two groups of patients. In particular, the level of long-term episodic memory impairment was found in the AKS sample to be far greater than that in the schizophrenic group. An interesting possible double-dissociation emerged between the two groups; although demonstrating superior episodic memory functioning, the schizophrenic sample were found to perform significantly more poorly than the AKS sample on a test of semantic memory.
Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study
Authors: Bickel Horst , Cooper Brian
Published: July 2009

Synopsis

To ascertain the frequency and distribution of new cases of dementing illness in the elderly population of Mannheim (population 308000), a survey sample of community residents of > 65 years of age was re-examined after an interval of 7–8 years, and a sample of elderly persons in long-stay care after 5–6 years. The estimated annual incidence rate for all forms of dementia, after correction for ageing of the samples, was 15·4 per 1000 persons aged > 65, made up of dementia of Alzheimer type (8·9 per 1000), vascular dementia (4·4 per 1000) and other forms (2·1 per 1000). Apart from the expected association with age > 65 years, the most powerful predictors of onset of a dementing illness were residence in long-stay care and the presence of minor cognitive deficits at the initial examination, each of which was associated with a highly significant increase in risk. In addition, a number of socio-demographic characteristics (marital status, occupational history and quality of present living accommodation) was found to be predictive, though analysis of larger samples or pooled research data would be necessary to establish their importance in this respect. The findings suggest that identification of mild cognitive impairment on screening could prove helpful in assessing risk for dementia from two to three years before the condition becomes clinically apparent.
Lack of cognitive recovery following withdrawal from long-term benzodiazepine use
Authors: Tata P. R. , Rollings J. , Collins M. , Pickering A. , Jacobson R. R.
Published: July 2009

Synopsis

Twenty-one patients with significant long-term therapeutic benzodiazepine (BZ) use, who remained abstinent at 6 months follow-up after successfully completing a standardized inpatient BZ withdrawal regime, and 21 normal controls matched for age and IQ but not for anxiety, were repeatedly tested on a simple battery of routine psychometric tests of cognitive function, pre- and post-withdrawal and at 6 months follow-up. The results demonstrated significant impairment in patients in verbal learning and memory, psychomotor, visuo-motor and visuo-conceptual abilities, compared with controls, at all three time points. Despite practice effects, no evidence of immediate recovery of cognitive function following BZ withdrawal was found. Modest recovery of certain deficits emerged at 6 months follow-up in the BZ group, but this remained significantly below the equivalent control performance. The implications of persisting cognitive deficits after withdrawal from long-term BZ use are discussed.
Do mental health surveys disturb? Further evidence
Authors: Jorm A. F. , Henderson A. S. , Scott R. , Mackinnon A. J. , Korten A. E. , Christensen H.
Published: July 2009

Synopsis

In a community survey of 873 persons aged 70 years or over, focusing on dementia, cognitive decline, depression, and current life circumstances, we included an enquiry into the emotional impact of the interview. A large majority reported at the end of the interview that it had no adverse effect on their emotional state. About 4% reported that it made them distressed, 1% that it depressed them, and 2% that it had intruded on their privacy. By contrast, 52% said it had made them feel good about themselves. Distress seemed to be largely related to performing poorly on cognitive tests. There is no information on the duration of these effects in the period following the interview. It is recommended that respondents in community surveys, including the elderly, be informed that they can decline to answer any question, and that interviewers be trained in how to respond to the few who will be distressed by the experience.
Antipsychotic drugs: is more worse? a meta-analysis of the published randomized control trials
Authors: Bollini P. , Pampallona S. , Orza M. J. , Adams M. E. , Chalmers T. C.
Published: July 2009

Synopsis

Effectiveness and side-effects of high- versus low-dose neuroleptic treatment of chronic psychosis have been assessed through a meta-analysis of 22 published randomized control trials comparing different neuroleptic doses. No incremental clinical improvement was found at doses above 375 mg equivalent of chlorpromazine, while a significant increase in adverse reactions was observed.
The impact of unemployment on the psychological well-being of British Asians
Authors: Shams Manfusa , Jackson Paul R.
Published: July 2009

Synopsis

This paper presents the results of a study of unemployment among British Asians living in the north of England. The sample comprises 139 employed and unemployed men. Using standardized psychological questionnaires with a semi-structured interview schedule, the psychological consequences of unemployment are examined in relation to other psychosocial variables. The results showed that the unemployed group had lower levels of psychological well-being, selfesteem, and employment commitment with high external beliefs, than the employed group. Length of unemployment was a significant determinant of psychological well-being and respondents with a longer period of unemployment had a lower level of psychological well-being than those who had been unemployed for a shorter period. The findings are examined in the context of existing empirical evidence, and the need to examine the psychological impact of unemployment among other British Asian groups is emphasized.
The criminal careers of incident cases of schizophrenia
Authors: Wessely S. C. , Castle D. , Douglas A. J. , Taylor P. J.
Published: July 2009

Synopsis

We present a population-based, longitudinal study of all incident cases (N = 538) of schizophrenia in the London Borough of Camberwell between 1964 and 1984. Cases were selected from the Camberwell Cumulative Psychiatric Case Register. Case-notes were obtained, and further classified using a computerized operational check list for rating psychotic illness. Cases are not restricted to hospital discharges, as in previous studies, and account is taken of time at liberty to offend. In order to test the hypothesis that schizophrenia makes an independent contribution to criminality over other mental disorders, controls were chosen to be representative of non-schizophrenic mental disorders matched for age, sex and period.

The rate of conviction is increased in women with schizophrenia compared to other mental disorders for most offence categories (rate ratio = 3·3). In men overall rates do not differ (rate ratio = 1·03), although there is an interaction between gender, schizophrenia and ethnicity, with young black men with schizophrenia being most at risk. The rate ratio for violent offences in men with schizophrenia is 3·8, confirming recent studies from Sweden. Subjects with schizophrenia were more likely to acquire any criminal record than those with other mental disorders. The rate of lifetime conviction was greater in those with schizophrenia than either a sample of working-class boys from the same area followed by Farrington & West, or National data.

The risk of first conviction is increased by schizophrenia, unemployment, ethnic group, substance abuse and low social class, and decreased by being employed, married, female and older age of onset. Adjustment using survival analysis showed that schizophrenia made a small independent contribution to the risk of acquiring a criminal record (hazard ratio = 1·4), but gender, substance abuse, ethnicity and age of onset were more substantial. Previous criminality was the strongest independent association of post-illness conviction, with schizophrenia only a trend. Although subjects with schizophrenia were more likely to acquire a criminal record, criminal careers began later and were shorter than those of the controls. The risk of criminality increased throughout the study period, but suggestions of a specific increase in those with schizophrenia as a result of changes in community care were not confirmed. These results confirm that women with schizophrenia are at increased risk of acquiring a criminal record, but the effect in men is for violent convictions only. The strongest associations of criminal conviction remain those recognized in non-schizophrenic subjects.
Neuroendocrine and clinical effects of electroconvulsive therapy and their relationship to treatment outcome
Authors: Smith J. , Williams K. , Birkett S. , Nicholson H. , Glue P. , Nutt D. J.
Published: July 2009

Synopsis

Two groups of variables, endocrine and clinical, have been reported to have predictive value in determining response to electroconvulsive therapy (ECT) in depressed patients. Baseline levels of oxytocin associated neurophysin (OAN) and peak OAN response to ECT may predict clinical outcome, while the presence of delusional symptoms may indicate favourable initial response to ECT. The purpose of this study was to examine the relationship between these variables on initial and longer term response over a course of ECT, using a direct measure of plasma oxytocin concentrations. A substantial and immediate increase in oxytocin was seen after the first ECT, with significantly attenuated responses after the third and fifth ECTs. Increased plasma vasopressin concentrations were seen after all ECT treatments, each response being of similar magnitude. No associations were found between either endocrine baseline levels or peak responses, and clinical outcome. Only clinical variables predicted outcome, as patients with psychotic symptoms had more rapid initial response to ECT, and patients who had relapsed 2 months after the end of ECT had significantly higher depression ratings at day 14 of treatment than treatment responders.
Central monitoring deficiency and schizophrenic symptoms
Authors: Mlakar J. , Jensterle J. , Frith C. D.
Published: July 2009

Synopsis

Twenty-five schizophrenic patients currently experiencing Schneiderian symptoms performed a series of tasks in which drawings had to be made in the absence of immediate visual feedback. In comparison to 10 normal controls and to 30 patients not experiencing Schneiderian symptoms, the target group had great difficulty in keeping track of their performance and remembering what actions they had made. These results are consistent with the hypothesis that Schneiderian symptoms (such as delusions of alien control) are associated with impairments in the central monitoring of action.
An overview of family interventions and relapse on schizophrenia: meta-analysis of research findings
Authors: Mari Jair De Jesus , Streiner David L.
Published: July 2009

Synopsis

The purpose of this overview is to appraise the studies on the efficacy and effectiveness of family interventions in decreasing relapse in schizophrenic patients. The studies were identified by means of a computerized MEDLINE search, and the scanning of review articles and the reference lists of the primary articles identified. More than 300 citations were reviewed, and the potentially relevant articles revealed six randomized controlled trials that were included in this meta-analysis. The criteria for selecting potential studies as well as for the meta-analysis were tested by means of an inter-rater reliability check that showed a good agreement between two independent raters (K= 0·83, andK= 0·82, respectively). There were independent assessments of the quality of the studies selected, and data extraction comprised a descriptive information of the study population, the types of interventions, and the relevant outcome measurements. The total number of patients included in the six trials was 350 (181 in the control group and 169 in the experimental group). Regarding the decrease of relapse in the experimental group, the pooled odds ratios and their 95% confidence intervals were: 0·30 (0·06, 0·71) for six months; 0·22 (0·09, 0·37) for nine months; and 0·17 (0·10, 0·35) for the 2-year follow-up. Two to five patients needed to be treated to avert one episode of relapse in a nine-month follow-up. The changes in Expressed Emotion status between experimental and control group combining nine months and one year follow-ups were shown to be marginally significant (P< 0·06), in favour of the experimental group. Emotional over-involvement was also marginally significant (P< 0·07), and there was no statistical difference in the distribution of criticism and hostility. In addition, the experimental group showed a significant increase with drug compliance and a reduction in hospitalization over time. These findings are discussed in light of the potential ingredients in the efficacy of family interventions by focusing on the limitations of using relapse as primary outcome in the assessment of efficacy trials with schizophrenic patients.
Parental treatment and the equal environment assumption in twin studies of psychiatric illness
Authors: Kendler K. S. , Neale M. C. , Kessler R. C. , Heath A. C. , Eaves L. J.
Published: July 2009

Synopsis

The validity of the twin method depends on the equal environment assumption (EEA) – that monozygotic (MZ) and dizygotic (DZ) twins are equally correlated in their exposure to environmental factors of aetiological importance for the trait under study. Parents may treat MZ twins more similarly than DZ twins thereby potentially violating the EEA. We tested this hypothesis for four common psychiatric disorders (major depression, generalized anxiety disorder, phobia, and alcoholism) in a population-based sample of female–female twin pairs where analyses indicate sufficient statistical power meaningfully to test the EEA. Mother's and father's beliefs about their twins' zygosity disagreed with assigned zygosity in approximately 20% of cases, often because of what they were told about their twins' zygosity at their birth. By structural equation model-fitting, we found no evidence that mother's or father's perceived zygosity influenced twin resemblance for any of the disorders. Compared to parents of DZ twins, parents of MZ twins were more likely to report that, in rearing their twins, they emphasized their similarities more than their differences. However, by model-fitting, mothers' and fathers' approach to raising twins had no significant influence on twin resemblance for the four examined psychiatric disorders. These results suggest that the differential treatment of MZ and DZ twins by their parents is unlikely to represent a significant bias in twin studies of these major psychiatric disorders.
Visual and motor functions in graphically gifted savants
Authors: Hermelin B. , Pring L. , Heavey L.
Published: July 2009

Synopsis

Savant artists represent a conundrum to our understanding of the nature of high level specific talents as well as to the concept of general intellectual impairment. In the present paper, we are particularly concerned with the relationship between general perceptual-motor functions in relation to drawing aptitude. Drawing is by definition a perceptual-motor operation, yet mental handicap tends to be associated with some degree of impairment in this area. The following study seeks to isolate such aspects of performance on general perceptual-motor skills that might be associated with drawing ability, and may thus be regarded as building blocks underlying the manifestation of graphic talent. The results are discussed in terms of the relationships between graphic talent, non-verbal intelligence and visual-motor functions.
Correlates of codisorders in homeless and never homeless indigent schizophrenic men
Authors: Caton C. L. M. , Shrout P. E. , Eagle P. F. , Opler L. A. , Felix A.
Published: July 2009

Synopsis

We recently completed a case–control study of 100 literally homeless and 100 never homeless indigent schizophrenic men in New York City, in which concurrent substance abuse and antisocial personality disorder were widespread. In this paper we probe the correlates of ‘pure’ schizophrenia (single disorder, N = 60), schizophrenia and substance abuse (double disorder, N = 89), and schizophrenia, substance abuse, and antisocial personality disorder (triple disorder, N = 50), across the homeless/never homeless distinction. Subjects were recruited from a homeless shelter and mental health service programmes in Upper Manhattan. Psychologist and social worker interviewers administered the Structured Clinical Interview for DSM-III-R, I, and II and other structured instruments to explore social, family and illness history, the current illness, and aspects of treatment and family support. Codisorder subjects emerged from more disadvantaged family backgrounds, experienced greater school difficulties, began drug use in early adolescence, were more prone to hyperactivity in childhood, and were more likely to have spent time in jail. While codisorder groups did not differ on key aspects of schizophrenia, the triple disorder group was found to suffer from a more severe form of substance abuse than double disorder subjects, associated with an earlier age of onset and abuse of a wider array of substances.

The widespread prevalence of codisorders among indigent schizophrenic men has major significance for clinical psychiatry. Study of the correlates of codisorders has revealed important differences in social, family, and illness history which may guide the development of more effective treatments and improved service delivery.
Volumetric MRI measurements in bipolars compared with schizophrenics and healthy controls
Authors: Harvey I. , Persaud R. , Ron M. A. , Baker G. , Murray R. M.
Published: July 2009

Synopsis

Twenty-six patients with RDC bipolar disorder were compared with a previously reported group of 48 RDC schizophrenics and 34 healthy controls, using volumetric MRI measurements of cerebral, cortical and sulcal volumes. The bipolar group appeared no different from the controls, and both of these groups had significantly larger cerebral and cortical volumes than the schizophrenics. Our previous report of a significantly reduced cortical volume in the schizophrenic group, with a corresponding increase in the volume of sulcal fluid is, therefore, not a generalized feature of psychotic illness but may be more specific to schizophrenia.
The predictive utility of expressed emotion in schizophrenia: an aggregate analysis
Authors: Bebbington Paul , Kuipers Liz
Published: July 2009

Synopsis

We analysed aggregate data from 25 studies linking Expressed Emotion (EE) and schizophrenia. We had access to original data sets from 17 studies, and used published data from the remainder. This provided us with 1346 cases from around the world. The association of EE with relapse was overwhelming, and was maintained whatever the geographical location. The predictive capacity of EE was virtually identical in men and women. While high contact with a high EE relative increased the risk of relapse, the opposite was true in low EE households. Medication and EE were independently related to relapse, and thus EE status has no bearing on the decision to prescribe. Our findings were confirmed using log–linear analysis.