bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosis in Mental Handicap
Authors: Heaton-Ward Alan
Published: August 2008

The literature on the purely psychiatric aspects of mental handicap is remarkably limited. In the third edition of Mayer-Gross, Slater and Roth's Clinical Psychiatry, apart from one or two brief incidental mentions elsewhere in the text, the main references consist of just one paragraph on psychoses and two short paragraphs on neuroses included in the section on ‘The Association of Mental Subnormality with Other Syndromes’! Similarly the only reference to mental illness in mental handicap in the eighth edition of Henderson and Gillespie's Text-Book of Psychiatry was a mere four lines on psychosis; by the ninth edition, this had grown to seven lines covering both neuroses and psychoses, but with two of those lines devoted to an admission by the authors of their own lack of knowledge.
The First Year at the New Esrath Nashim Hospital, Jerusalem 1968–69
Authors: Cohen Samuel I.
Published: August 2008

Esrath Nashim was the name of the women's forecourt of the Second Temple in Jerusalem. The words can also be interpreted as ‘women's aid’ and were adopted as its title by a ladies' benevolent organization. This body, in 1895, established in the Old City of Jerusalem a one-room asylum where two patients were cared for. In 1905 the Esrath Nashim Hospital was opened in the Jaffa Road in the New City, and after the founding of the State of Israel in 1948 it remained as the only psychiatric hospital in the new State, though others were soon established. The old hospital was a Turkish-style stone building which was impressive of its kind, but the difficulties under which it operated may be illustrated by recalling that when the present chairman of the Hospital Board took office in 1948 and obtained the first grant from the newly-established Ministry of Health it was decided that the most pressing need was to install a hot-water system. In the late 1950s the chairman persuaded the Board that they should build a new hospital, and in August 1968 this was finally opened, the first purpose-built psychiatric hospital in the country. At that time three pavilions, each with 50 beds, were complete.
A Comparison of Piribedil, Procyclidine and Placebo in the Control of Phenothiazine-induced Parkinsonism
Authors: Mindham R. H. S. , Lamb Pauline , Bradley Rachel
Published: August 2008

A double-blind, cross-over trial of the effectiveness of piribedil, procyclidine and placebo in the control of parkinsonism induced by fluphenazine decanoate was conducted in sixteen cases of chronic schizophrenia. Procyclidine was shown to be more effective and piribedil less effective than the placebo. Piribedil produced a number of unpleasant effects, including headache, vomiting and malaise.
A New Technique for the Treatment of Guilt
Authors: Friedman Dennis , Grossman Ashley
Published: August 2008

A behavioural technique is described suitable for the treatment of patients with high levels of guilt who attempt to relieve their depression by risk-taking activities which reflect their individual wishes and fears, or who suffer anxiety due to unacceptable past behaviour. It is recommended as an alternative brief method of treatment to psychoanalysis and is based on the application of behaviour therapy to a patient's psychopathology. Three case histories are described to illustrate the principles of the technique.
Treatment of Obsessive-Compulsive Neurosis with History of Childhood Autism
Authors: Lindley Peter , Marks Isaac , Philpott Robin , Snowden John
Published: August 2008

A young man was followed-up over three years who had severe obsessive-compulsive rituals and ruminations, interpersonal deficits, complicating depression and a history of childhood autism. Intensive behavioural treatment was given in an operant framework, with exposure in vivo, modelling, response prevention and social skills training. Compulsive rituals improved markedly and lastingly, but ruminations and social defects persisted. When intercurrent depression occurred dothiepin facilitated behavioural treatment. Adjustment remained fragile. Minimum maintenance treatment in the community could not be adequately arranged, so that gains made in hospital were partly lost at follow-up, despite continuing improvement in rituals.
The Stability of Mood and Social Perception Measures in a Sample of Depressive In-Patients
Authors: Lunghi Martin E.
Published: August 2008

Forty depressives and 40 matched controls were compared in terms of a number of self-report variables and in terms of their descriptions and evaluations of both real-life and hypothetical social relationships. Clear differences between the two groups reveal poorer self-ratings in the depressive sample, together with a tendency to describe and to evaluate both real and imaginary relationships more negatively. A retest of the depressed patients at the time of discharge from hospital showed improvement only in the two depression measures and not in any of the other self-rating and perceptual measures used. The possibility is discussed that the perceptual variables are predisposing to depression rather than concomitant with it.
Changes in Cognitive Functioning in Elderly Psychiatric Patients
Authors: Whitehead Antonia
Published: August 2008

Elderly psychiatric patients who were in contact with the hospital one year after in-patient admission were retested on a number of clinical and psychometric measures first done soon after admission. In general, changes were small; and for several measures very high correlations existed between the scores gained on the two occasions. When those patients with uncomplicated chronic brain syndromes were considered separately, increasing impairment was demonstrable.
Psychiatric Illness in Male Doctors and Controls: an Analysis of Scottish Hospitals In-patient Data
Authors: Murray Robin M.
Published: August 2008

An investigation was undertaken into the first admissions to (for the years 1963, 1965, 1968, 1972) and the total discharges from (for the years 1963–72) Scottish mental hospitals and psychiatric units of male doctors and other social class I males. The overall rates for both first admission and for all discharges were more than twice as high among male doctors as among other social class I males. First admission and total discharge rates for drug dependence, alcoholism, neurotic and ‘functional’ depression and for affective psychosis were all significantly higher among doctors than non-doctors. Doctors were more likely than non-doctors to have been referred by themselves or by medical sources other than general practitioners, and were as willing as non-doctors to enter hospital voluntarily. Greater access to psychiatrists may have contributed to their higher rates of in-patient care, but it is improbable that such factors accounted for all of the excess in rates of drug dependence, alcoholism and depression.
One Hundred Doctors at The Retreat
Authors: Franklin R. A.
Published: August 2008

A study of the cases of 100 doctors admitted to The Retreat, York, confirmed the findings of a'Brook et al (1967) in all important respects, addiction being the outstanding feature of the series.
Pathological Mourning after the Death of a Domestic Pet
Authors: Keddie Kenneth M. G.
Published: August 2008

Pathological bereavement reactions following the death of a close relative or friend have been well documented in the literature. Similar grief reactions have been described following other personal losses, such as the loss of a limb or the loss of one's home.

The cases of three women are described in whom pathological grief followed another category of loss, that represented by the death of a much loved domestic pet. The patients suffered disabling psychiatric symptoms following the death of their pet dogs. The dogs were all of the toy dog variety and had been at least 13 years of age at the time of their death. Institution of psychiatric treatment resulted in rapid recovery and at follow-up after a year there had been no recurrence of symptoms.
Multiple Personality—An Objective Case Study
Authors: Larmore Kim , Ludwig Arnold M. , Cain Rolene L.
Published: August 2008

A case of multiple personality is presented and described. Psychological and neurophysiological parameters obtained on the personalities are evaluated. Major differences between the personalities in the processing of sensory information (augmenting-reducing parameter) are discussed.
A Test of the Hierarchical Model of Personal Illness
Authors: Mcpherson F. M. , Antram Marian C. , Bagshaw V. E. , Carmichael Sheila K. , McPherson F. M.
Published: August 2008

To test the Foulds and Bedford hierarchical model of personal illness, the Delusions-Symptoms-States Inventory (DSSI) was administered to 100 psychiatric in-patients. Ninety-six had symptom patterns compatible with the hierarchy. This is significantly more than expected on the basis merely of the number of DSSI items affirmed, and overall the results support the model.
Psychiatric Morbidity and the Menopause: Survey of a Gynaecological Out-Patient Clinic
Authors: Ballinger C. Barbara
Published: August 2008

Two hundred and seventeen women between the ages of 40 and 55 years referred to a gynaecological out-patient clinic were screened for psychiatric illness by means of the General Health Questionnaire (GHQ) and a brief special questionnaire. Of the 114 women identified as possible psychiatric ‘cases' 104 were interviewed. A standardized psychiatric interview schedule was used. Compared with a general population sample from the same geographical area and in the same age range, women presenting at the gynaecological out-patient clinic were predominantly pre-menopausal and from the lower end of the 15-year age range, and were more likely to be separated or divorced, less likely to be single, and more likely to have had previous or to have subsequent contact with the local psychiatric services. A higher proportion of women were identified as psychiatric ‘cases' in the clinic population than in the general population, and their psychiatric disorder appeared to be more severe and more depressive in nature. The findings for this age group support the view that among women presenting for hysterectomy there is already an excess of psychiatric illness before the operation.

The association of gynaecological complaints and psychiatric morbidity in the pre-menopausal years is discussed.
The Stockton Geriatric Rating Scale: A Shortened Version with British Normative Data
Authors: Gilleard C. J. , Pattie Anne H.
Published: August 2008

This paper presents information on a shortened form of the Stockton Geriatric Rating Scale, which is shown to be as effective as the original version in discriminating among the elderly. The results for 400 people in the care of hospital or social services provide provisional normative data for the use of the scale, which should be of value in assessing the behavioural competence of the elderly on an individual and group basis.
Psychiatric Morbidity Among University Students in Egypt
Authors: Okasha Ahmed , Kamel M. , Sadek A. , Lotaif F. , Bishry Z.
Published: August 2008

During a nine-month period (1974–75), 1,050 students (846 male, 204 female) at Ain Shams University, Cairo, attended the Student Health Centre. Fifty-two per cent were referred there by their general practitioners, 5 per cent by their families and 3 per cent through their faculties; the remainder (41 per cent) were self-referred.

Male patients represented 2·8 per cent of the male students, but female patients only 0·9 per cent of the female students. In faculties dealing with practical subjects the male-female ratio was higher than in those dealing with more theoretical subjects. The diagnoses included anxiety neurosis (36 per cent of the cases), schizophrenia (18 per cent), depression (15 per cent) and neurotic depression (12 per cent).
Psychiatrists and a Computer as Interrogators of Patients with Alcohol-Related Illnesses: A Comparison
Authors: Lucas R. W. , Mullin P. J. , Luna C. B. X. , McInroy D. C.
Published: August 2008

A computer-administered ‘interview’ was developed for eliciting evidence relating to alcohol problems. Thirty-six volunteer male patients on their first visits to a specialist alcohol clinic were interviewed three times, by two psychiatrists and by the computer; information was sought about 72 predefined indicants concerning alcohol consumption, drinking behaviour, and symptoms. Each patient was asked to complete an attitude questionnaire anonymously.

The extent of agreement between the evidence elicited by the computer and by the psychiatrists was quite high, and their estimated error rates were very similar, all between 10 per cent and 12 per cent in total. With respects to amounts of alcohol consumed, patients reported significantly greater amounts to the computer than they reported to the psychiatrists. The median amounts of pure ethanol consumed ranged from 1 · 19 kg per week calculated from reports made to one of the psychiatrists, up to 1 · 58 kg per week calculated from reports made to the computer. The results from the attitude questionnaire indicated a high level of acceptability to patients of computer interrogation.
High Dosage Haloperidol in Chronic Schizophrenia
Authors: McCreadie Robin G. , MacDonald Ian M.
Published: August 2008

In a double blind chlorpromazine-controlled trial, high dosage haloperidol (100 mg daily) given for three months, appreciably improved the mental state of male chronic ‘drug resistant’ schizophrenic in-patients in the rehabilitation/long-stay unit of one psychiatric hospital. The results of a three-month follow-up suggested that the improvement could be maintained in some patients on lower doses of the drug.

Serious extrapyramidal side effects were not seen at high doses. However, the majority of patients on haloperidol showed a deterioration in ward behaviour, possibly related to drowsiness, and developed raised serum alkaline phosphatase levels. These side effects disappeared in the follow-up period when either the drug was discontinued or the dose of haloperidol reduced.
Seasonality of Mania: a Reappraisal
Authors: Walter S. D.
Published: August 2008

Some recently published data on the seasonal incidence of mania are re-examined. The reanalysis confirms a strong seasonal trend in females, but also demonstrates a similar trend in males; the latter result is at variance with an earlier finding which showed no seasonal pattern in males. A simple harmonic curve would describe the data extremely well in both sexes, and the parameters of these curves (the amplitude of variation and the time of maximum incidence) are very close for males and females.
Delusional Depressions: Natural History and Response to Treatment
Authors: Kantor Shepard J. , Glassman Alexander H.
Published: August 2008

A review of the abundant literature concerning the distinction between delusional and non-delusional depressions, especially of the work of Aubrey Lewis, reveals that before the introduction of specific therapies most in-patients with major depressive illness eventually recovered; the small percentage who did not almost all came from the delusional group. The dichotomy lost its clinical significance after the introduction of ECT, as both groups were equally responsive. However, accumulating evidence indicates that unipolar delusional depressives are significantly less responsive to tricyclic anti-depressant therapy than non-delusional depressives. The presence or absence of delusional thinking should be considered as a significant criterion in the classification of depressive disorders, and the presence or absence of delusional thinking should influence the choice of treatment for severely depressed patients.
A Clinical Trial of Phenelzine in Anxiety Depressive and Phobic Neuroses
Authors: Mountjoy C. Q. , Roth Martin , Garside R. F. , Leitch I. M.
Published: August 2008

A double-blind clinical trial of phenelzine and diazepam against placebo and diazepam in neurotic patients over a four-week period showed phenelzine to be superior to placebo on three rating scales in some groups of patients who completed the trial. The findings suggest that phenelzine may exert a beneficial effect on some as yet undefined features of anxiety and depression which were not revealed by a multiple regression analysis of clinical symptomatology or premorbid personality.
Schizophrenia in Hawaii: Analysis of Cohort Mortality Risk in a Multi-ethnic Population
Authors: Weiner Betsy Platt , Marvit Robert C.
Published: August 2008

Schizophrenic patients in treatment with the Hawaii state system have been followed from 1962 to 1972. This cohort includes 1,689 persons: out-patients as well as in-patients; of Japanese, Caucasian, part-Hawaiian, Filipino, Chinese and other ancestries. After ten years, 60 per cent remain registered with the Hawaii Mental Health Division; 14 per cent are found living in the state; 12 per cent are lost to follow-up; and 14 per cent have died. Mortality is analysed for all causes by comparison with similar ethnic and sex sub-groups of the general population.
Three Weeks in Isolation with Two Chronic Schizophrenic Patients
Authors: Morgan Roger
Published: August 2008

An account is given of impressions and observations collected during three weeks in November 1975 which the writer spent with two of his chronic schizophrenic patients in a purpose-built isolation unit inside which it was impossible to have any idea of the real time.

This experience gave the observer an unusually close view of schizophrenic and institutional behaviour and some insight into the natural outcome of staff-patient interaction.
Do Newspaper Reports of Coroners' Inquests Incite People to Commit Suicide?
Authors: Barraclough B. , Shepherd D. , Jennings C.
Published: August 2008

A statistical association has been found between reports of suicide inquests in a local paper and the subsequent suicide of men under 45 years.
Renin and Aldosterone Relationships in Manic Depressive Psychosis
Authors: Hullin R. P. , Jerram T. C. , Lee M. R. , Levell M. J. , Tyrer S. P.
Published: August 2008

SUMMARY The paper describes a two-month period of study in four bipolar manic-depressive patients in a metabolic ward. Plasma renin activity, packed cell volume, plasma sodium and potassium were determined at intervals. Twenty-four-hour urinary sodium, potassium and creatinine were also estimated daily. Aldosterone production rate was measured on two occasions for each patient. Three of the patients showed at least one episode each of mania and depression during the study, while the fourth patient, who was receiving prophylactic lithium throughout, had one ten-day depressive episode but was otherwise normal.

No obvious relationship between mood and plasma renin activity was observed, but the group showed a high resting renin activity, a blunted renin response to posture, and inappropriate aldosterone production rates for the renin activity found.

It is postulated that a primary defect in the aldosterone-renin system may be present in bipolar manic-depressive psychosis.
Hormone Responses to Methylamphetamine in Depression: a New Approach to the Noradrenaline Depletion Hypothesis
Authors: Checkley S. A. , Crammer J. L.
Published: August 2008

SUMMARY The corticosteroid response to methylamphetamine was lower in ten patients when they were depressed than when they were recovered (P < ·026). The growth hormone responses to the same injection in the depressed and recovered states were not significantly different. This pattern of responses is seen in normal subjects after blockade of alpha adrenergic receptors. These findings may indicate a functional deficiency of noradrenaline at alpha adrenergic receptors in these patients during the time they are depressed.
The Role of Social Anxiety in Social Interaction Difficulties
Authors: Hall Roisin , Goldberg David
Published: August 2008

Social anxiety was found to be the most common complaint in a sample of psychiatric patients reporting social interaction difficulties. High social anxiety was shown to be associated with impairments to social behaviour in socially anxious psychiatric patients and non-psychiatric volunteers. A comparison was made of systematic desensitization and a form of social skills training in the treatment of social interaction difficulties associated with high social anxiety. This indicated that while both therapies were effective in the reduction of social anxiety, the training programme was the more effective in reducing problem behaviour, but desensitization appeared to lead to a wider generalization of improvement as indicated by increases in social participation.
Decreased Urinary Output of Tyramine and its Metabolites in Depression
Authors: Carter Susan Bonham , Sandler M. , Goodwin B. L. , Sepping P. , Bridges P. K.
Published: August 2008

Despite dramatic clinical improvement in about one-third of a group of severely depressed, medication-resistant patients one year after modified leucotomy, their relative decrease in conjugated and free tyramine output after an oral tyramine load remained unchanged and abnormal. Whilst a direct deficit in intestinal tyramine-conjugating ability still needs to be finally ruled out, this appears most compatible with a deficit due to bodily metabolic failure, perhaps a deficit in membrane transport which could be an essential aspect of the depressive illness syndrome. Attention is drawn to a similar defect in migraine. The two illnesses may represent a common predisposition which an appropriate triggering mechanism may transform to the florid disease. Biochemical detection of such vulnerability may have important diagnostic and predictive significance.
Catechol-O-Methyl Transferase Activity in Patients with Depressive Illness and Anxiety States
Authors: Shulman Ralph , Griffiths John , Diewold Patricia
Published: August 2008

Erythrocyte catechol-O-methyl transferase (COMT) activity was studied in 65 patients with depressive illness and anxiety states. A hypothesis that measurement of this enzyme might have some value as an aid to diagnosis and as an index of clinical recovery has not been confirmed. In patients with endogenous depression, agitated subjects had COMT levels significantly higher than normal (P < ·01) and retarded subjects had levels significantly lower than normal (P < ·02). These observations are congruent with some reports of high and low urinary MHPG excretion in patients with depression. Further data correlating COMT assays with catecholamine metabolites in depressed patients may reveal homogeneous biochemical subgroups which could serve as a guide to rational therapy.
Histocompatability Antigens and Schizophrenia
Authors: McGuffin Peter , Farmer Anne E. , Rajah S. M.
Published: August 2008

The HLA (Human Leucocyte Antigen) types A and B were studied in 80 patients diagnosed as schizophrenic. There was an increased incidence of HLA-BW5 and a decrease in HLA-AW29 and HLA-BW17 as compared with healthy controls. In the sub-group of patients exhibiting Schneider's first-rank symptoms there was an increased incidence of HLA-A1 with a decrease in HLA-A2 and HLA-BW17.
Variations in the Seasonal Distribution of Births of Psychotic Patients in England and Wales
Authors: Hare E. H.
Published: August 2008

The quarterly distribution of births of patients born in England and Wales 1921–60 and first admitted in 1970–75 was examined by decade of birth and by age at year of admission. For patients with schizophrenia and affective psychosis, the distribution varied: in the early decade (1921–30), and for older patients (45–54 years) the proportion of births in the fourth quarter of the year was high, compared with expectation from live births in the general population; but it became lower in succeeding decades and for younger age groups. No comparable change occurred for births of patients with neurosis or personality disorder.
A Clinical Scale for the Self-assessment of Irritability
Authors: Snaith R. P. , Constantopoulos A. A. , Jardine M. Y. , McGuffin P.
Published: August 2008

To date there has been no suitable scale for the self-assessment of irritability in the clinical situation. Existing scales have either included aspects of personality trait together with present state or they have been constructed on non-clinical populations. A self-assessment scale has been constructed which seeks to overcome such faults. Measures of depression and of anxiety are included, together with measures of outwardly directed irritability and inwardly directed irritability. This scale should be known as the Irritability, Depression, Anxiety—or IDA—Scale.
Emotional Disturbance in Newly Registered General Practice Patients
Authors: Corser Charles M. , Philip Alistair E.
Published: August 2008

The General Health Questionnaire has had some popularity as an index of minor psychiatric morbidity and was used in the present study to ascertain the emotional state of newcomers to a practice in a new town. High scorers on the GHQ had more episodes of illness, had more severe ratings of psychological problems, and were more likely to receive a formal psychiatric diagnosis than were low scorers. A second survey one year later confirmed the variability of response to the GHQ, inherent in a ‘present state’ inventory. Doubts are expressed as to the psychiatric nature of the emotional upset measured by the GHQ.
Suicide Past and Present—The Temporal Constancy of Under-Reporting
Authors: Brugha Traolac , Walsh Dermot
Published: August 2008

It is known that official suicide statistics underestimate the incidence of suicide, but it is not clear whether the extent of under-reporting remains constant. An examination of coroners' records in Dublin from 1900 to 1904 and comparison with a similar series in 1964–68 suggests that the underestimation was of similar proportions in both series. It is suggested, therefore, that official suicide statistics are likely to reflect valid temporal changes in suicide and are therefore of value for the study of socio-economic influences on trends in suicide frequency.
The Chronicity of Schizophrenia in North West India
Authors: Kulhara P. , Wig N. N.
Published: August 2008

The results of a follow-up study of schizophrenics attending a centre in North West India are reported. The relevant literature is reviewed, The results were compared with two well-known studies, one from the United Kingdom and the other from Mauritius. The evidence presented suggests that the course taken by schizophrenia in a newly-developed city and its neighbourhood in this part of India is similar to the one seen in the Western world. This study does not support the view that chronicity of schizophrenia in non-European, non-white populations is different, at least in an urban setting.
Child Observation and Assessment Centres: Psychiatrist’ and Social Workers' Difficulties
Authors: Harris Jean Mary
Published: August 2008

Two child observation and assessment centres run by a Social Services Department have quickly filled up with older children who stay indefinitely. Many of these children have physical as well as emotional problems and have been admitted as family emergencies in an unplanned way. The paper discusses how, if at all, the psychiatrist called in for advice by social workers can help. This is thought to be a widespread problem.
The Contingent Negative Variation in Antisocial Behaviour: a Pilot Study of Broadmoor Patients
Authors: Fenton G. W. , Fenwick P. B. C. , Ferguson W. , Lam C. T.
Published: August 2008

Using a classical click/flash paradigm, the CNV was recorded from the following three groups of subjects at Broadmoor Hospital: (1) 14 ‘psychopathic’ patients selected by use of the 4/9 MMPI profile and confirmed by independent clinical diagnosis; (2) 15 ‘non psychopathic’ patients, all psychotic and mainly schizophrenic; (3) 14 healthy staff control subjects. All three groups were matched for age and sex; the two patients groups were also matched for length of stay. Two series of 32 paired stimuli were used, separated by an interval of 30 minutes. The mean CNV voltage was significantly lower in the ‘non-psychopathic’ patients. The amplitude of the ‘psychopath's' CNV response did not differ significantly from that of the staff controls, but the response variability between the first and second series of trials was much greater in the ‘psychopathic’ patients than in the other two subject groups. The ‘psychopathic’ subjects tended to show more rapid initial development of the CNV.
Glucose Metabolism in Unipolar Depression
Authors: Wright J. H. , Jacisin J. J. , Radin N. S. , Bell R. A.
Published: August 2008

Glucose utilization, serum insulin, human growth hormone, and free fatty acids were studied in 18 unipolar depressed patients and 14 normal controls, using the intravenous glucose tolerance test. Patients were kept drug-free for at least two weeks before testing, and physical activity and diet were carefully controlled. Previously described abnormalities in the balance between glucose and free fatty adds were not seen, but endogenous depression was associated with lowered glucose utilization rate with insulin resistance. Changes in kinetics of membrane transport in endogenous depression which could account for this finding are discussed.
An Unusual Case of the Capgras Syndrome
Authors: Fialkov M. J. , Robins Ashley H.
Published: August 2008

A variant of the Capgras syndrome is described in a 43-year-old woman who had vitiligo and multinodular goitre. The unusual feature of the case was that the patient not only misidentified members of her own family but also claimed that she herself had been replaced by a double.
Social Bonds in the Epidemiology of Neurosis: A Preliminary Communication
Authors: Henderson Scott , Byrne D. G. , Duncan-Jones P. , Adcock Sylvia , Scott Ruth , Steele G. P.
Published: August 2008

In a random sample of the general population (N = 142) a strong inverse relationship was found between social bonds and the presence of neurotic symptoms. This association was strongest in the case of close affectional ties. Together, measures of social bonds accounted for 47 per cent of the variance in neurotic symptoms. While there is likely to be contamination between the two sets of variables, and while the data do not indicate the direction of causality, these findings constitute an aetiological lead which should be pursued.
Distribution of Drug-Related Problems Among London Casualty Departments
Authors: Ghodse A. Hamid , Rawson Nigel S. B.
Published: August 2008

A survey of patients with drug-related problems seen in London casualty departments during the course of one month revealed 1,706 separate incidents. In 477 cases the patients were dependent on drugs, and more than 40 per cent were dealt with by only five hospitals, all in the West End of London. The remaining 1,229 incidents involved non-dependent patients who had taken a drug overdose, and these cases were distributed more evenly between hospitals all over the Greater London area. The implications of this study for service planning and for further monitoring of the patterns of drug misuse are discussed.
Depression and Hemispheric Functions: Changes Associated with Unilateral ECT
Authors: Kronfol Ziad , Hamsher K. Des , Digre Kathleen , Waziri Rafiq
Published: August 2008

Nine depressed patients received ECT to the dominant (left) side along with nine matched depressed patients who received ECT to the non-dominant (right) side. Neuropsychological tests showed that the right hemispheric functions were more frequently abnormal as compared to left hemispheric (dominant) functions in the pre-ECT tests. ECTs delivered to either the right or left side improved right hemispheric functions when the depression was ameliorated. This study indicates that in depression right hemispheric functions are initially disturbed and ECT, instead of being deleterious to these functions, tends to improve them.
The Usefulness of First-Rank Symptoms in the Diagnosis of Schizophrenia in a Saudi Arabian Population
Authors: Zarrouk El-Tayeb A.
Published: August 2008

Ninety-two schizophrenic patients of both sexes admitted to hospital at Taif, Saudi Arabia were examined to discover the incidence of Schneider's first-rank symptoms and their usefulness in diagnosing schizophrenia in this country. Fifty-two patients (56.5 per cent) were found to have these symptoms, most frequently ‘made’ phenomena and ‘somatic passivity’. The role of possible socio-cultural factors and the need for serious studies on transcultural psychiatry are discussed.
How Should We Measure Outcome in Psychotherapy?
Authors: Adams Malcolm
Published: August 2008

The problem of assessing outcome in psychotherapy is considered by examining the experiment conducted by Bloch et al (1977). The experimental design and statistical considerations in investigating psychotherapy outcome are briefly examined. It is argued that attention should be directed towards assessing the severity of patients problems rather than improvement after treatment.
Feigned Bereavement: Twelve Cases
Authors: Snowdon John , Solomons Richard , Druce Howard
Published: August 2008

Twelve patients who feigned bereavement are described. Most appeared depressed on admission, and in over half bereavement was erroneously believed by staff to be an important cause of their depression. This type of behaviour, leading to admission to hospital, may be regarded as abnormal illness behaviour, and reasons are given for considering most of the cases as variants of the Münchausen syndrome. Motivation for these deceptions is discussed, and reference is made to features which might arouse suspicion that bereavement is feigned.
Continuation Therapy with Amitriptyline in Depression
Authors: Coppen A. , Ghose K. , Montgomery S. , Rama Rao V. A. , Bailey J. , Jorgensen A.
Published: August 2008

Thirty-two patients who had responded to amitriptyline (150 mg daily) when suffering from a depressive illness were allocated either to receive placebo or to remain on the same medication for one year.

Plasma concentrations of the drug were regularly estimated. There was no correlation between plasma concentration and subsequent residual affective morbidity. In spite of considerable encouragement, three of the patients did not take the prescribed amitriptyline and they all relapsed. Five out of sixteen patients who received placebo relapsed. None of the patients who continued to take amitriptyline relapsed.

It is emphasized that the patients studied were selected, inasmuch as they were apparent responders to amitriptyline. It is concluded that this group of patients should continue to be treated with antidepressant medication for eight months after apparent recovery, and care should be taken to ensure the patients' compliance.
Suicide in Psychiatric Patients
Authors: Myers D. H. , Neal C. D.
Published: August 2008

The study relates to suicides occurring in Shropshire during 1965 to 1973 inclusive. Psychiatric patients who had committed suicide were compared with others, matched by sex and age who had not done so. The suicide group included a higher proportion of members who had behaved violently, experienced a broken marriage (through death, separation or divorce) or earlier had deliberately harmed themselves, often by dangerous means. Of the psychiatric patients who committed suicide 63 per cent had seen a doctor within a month beforehand, yet very few were receiving adequate physical treatment for depressive illness at the time of their death. Immigrants from eastern Europe were found to be particularly prone to suicide.
Ancestral Secondary Cases on Paternal and Maternal Sides in Bipolar Affective Illness
Authors: Johnson G. F. S. , Leeman M. M.
Published: August 2008

An analysis of the distribution of ancestral secondary cases of affective illness in families of patients with bipolar manic-depressive disorder was undertaken. Twenty probands with at least two affectively ill second degree relatives were available for study. Probands with both parents affected were excluded. The distribution of unilateral to bilateral pairs of all affected relatives, both excluding and including parents, of probands showed no significant differences from that expected in polygenic inheritance. However, separation into bipolar family history, positive or negative, showed significant differences from the expected ratio of unilateral to bilateral pairs in a bipolar family history positive group consistent with a single dominant gene inheritance.
Two Clinically Discrete Syndromes of Transsexualism
Authors: Buhrich N. , McConaghy N.
Published: August 2008

Transsexuals are defined as subjects who have a sustained feminine gender identity combined with a wish to alter their bodily appearance towards the feminine. The results of this study indicate that they can be differentiated into two clinically discrete groups.

In an investigation of 29 transsexuals who sought a change of sex operation it was found that those who had experienced fetishistic arousal were significantly more likely to be older, to have experienced heterosexual intercourse, to be married and to show penile responses to pictures of men and women indicative of a more heterosexual orientation. They had less experience of homosexual contact to orgasm as compared with transsexuals who had not experienced fetishistic arousal, but this difference was not statistically significant. Frequency of cross-dressing, strength of feminine gender identity and intensity of desire for a sex change operation did not discriminate the two groups. The fact that desire for a sex change operation may be associated with experience of fetishistic arousal could be one reason for the higher incidence of transsexualism in men than in women.
Two Transsexuals with 47–XYY Karyotype
Authors: Buhrich Neil , Barr Ron , Lam-Po-Tang P. R. L. C.
Published: August 2008

—Previous reports of sexual orientation and gender identity in subjects with XYY karyotype are reviewed. Two patients seeking a change of sex operation and found to have an XYY karyotype are described. It is argued that an XYY karyotype may predispose to a disturbed gender identity and possibly to the development of the transsexual syndrome.
Then and Now
Authors: Post Felix
Published: August 2008

Dr Post has been known to generations of students of psychiatry passing through The Maudsley Hospital, London, as a clinician and clinical teacher. He retired in July 1978.
Evaluation of a Social Work Service for Self-Poisoning Patients
Authors: Gibbons J. S. , Butler J. , Urwin P. , Gibbons J. L.
Published: August 2008

Four hundred patients aged at least 17 who came to Casualty in one year after deliberately poisoning themselves were randomly assigned between an Experimental social work service (task-centred casework) and a Control (Routine) follow-up service. 139 patients were excluded from the trial, most of whom were already in continuing psychiatric treatment. After one year there was no difference in the proportions of E and C patients who repeated self-poisoning (about 14 per cent), but significantly more of the excluded group had repeated (36 per cent). A random half of the trial patients were re-interviewed four months after admission. Both E and C groups had improved to a significant extent on measures of depressed mood and of social problems. E patients showed more change in social problems and were more satisfied with the service they had received.
Age Disorientation in Schizophrenia: A Constant Prevalence of 25 per cent in a Chronic Mental Hospital Population?
Authors: Stevens M. , Crow T. J. , Bowman M. J. , Coles E. C.
Published: August 2008

The prevalence of age disorientation was estimated in the population of patients with a diagnosis of schizophrenia in a large mental hospital. Of these 357 patients 25 per cent demonstrated age disorientation, defined as a five-year discrepancy between true and subjective age, and 11 per cent of the population believed themselves to be within five years of the age they were at admission, although they were a mean 28.9 years older. Age-disorientated patients differed from the age-orientated in being significantly older. However, when age-matched, they were younger at first admission and had a longer duration of stay than patients with a diagnosis of schizophrenia without age-disorientation. Age-disorientation may thus be a feature of a type of schizophrenic illness of early onset and poor prognosis.
Trials of Lithium, Chlorpromazine and Amitriptyline in Schizoaffective Patients
Authors: Brockington I. F. , Kendell R. E. , Kellett J. M. , Curry S. H. , Wainwright S.
Published: August 2008

Two drug trials in schizoaffective patients are reported. Nineteen ‘schizomanic’ patients were treated for one month, on a double blind basis, with chlorpromazine or lithium and 41 ‘schizodepressive’ patients with amitriptyline, chlorpromazine or both.

In the schizodepressive patients there was a trend to a better response to chlorpromazine, but drug response generally was poor, only 20 per cent of patients recovering within the month. In the schizomanic patients lithium seemed as effective as chlorpromazine, which supports the view that these patients were suffering from a variant of mania.
Symptom Patterns among Chronic Schizophrenic In-patients
Authors: Bedford A. , Presly A. S.
Published: August 2008

The Delusions-Symptoms-States Inventory (DSSI) was administered to 33 chronic non-paranoid schizophrenic patients resident on long-stay wards. It was found that the vast majority of cases (81 per cent) produced symptom patterns conforming to the hierarchy of classes of personal illness model, but with a radically different distribution among the classes from that in acutely ill patients. Within the model a half of the patients were allotted to the two lowest classes—Class 0 (Symptom-free) and Class 1 (Dysthymic States). When each set of items was considered separately and independently of the model, it was found that a half of the group professed to have recently experienced delusions. Affective states and depressive symptoms were reported by over a third of the patients.
The Benzodiazepine Receptor in Normal and Pathological Human Brain
Authors: Möhler H. , Okada T.
Published: August 2008

Benzodiazepines bind with high affinity to a specific benzodiazepine receptor, which occurs exclusively in the central nervous system. The affinity of various benzodiazepines to the receptor closely parallels their pharmacological and therapeutic potency. Binding to the receptor is stereospecific. The receptor is mainly localized in the synaptic membrane fraction and has its highest density in cortical areas of the brain. In Huntington's chorea a decrease in benzodiazepine receptor binding is found in caudate nucleus and putamen, which, at least in putamen, is due to a loss of benzodiazepine receptors apparently located on GABA neurones, which degenerate in Huntington's chorea. The loss of benzodiazepine receptors might explain why the ameliorative effects of benzodiazepines in the early stages of the disease are not sustained in the later stages.
Epidemiology and Clinical Psychiatry
Authors: Shepherd Michael
Published: August 2008

The Maudsley Bequest lectures have traditionally been intended for trainee psychiatrists. No previous lecture in the series has been concerned directly with epidemiology, and the trainee who seeks enlightenment in the British textbooks of psychiatry is likely to be disappointed or misled, for the standard view of the subject is epitomized in the statement which appears in their weightiest representative: ‘In this field the epidemiological approach concerns itself with investigation of the frequency with which definable forms of psychiatric disorder occur in carefully delineated populations' (Slater and Roth, 1969). While this aspect of the discipline is central to the interests of workers in the field of public health and administration, the notion of epidemiology as primarily an exercise in head-counting is unlikely to suggest the relevance of the discipline to clinical activities, especially if these are conceived as being focused primarily on the individual patient. In this lecture I propose to try and correct this impression and indicate the provenance and scope of epidemiology as a major branch of scientific inquiry which is indispensable to clinical psychiatry.
Psychiatrists' versus Patients' Concepts of Unpleasant Emotions
Authors: Leff J. P.
Published: August 2008

A semantic differential technique was used to elicit concepts of anxiety, depression and irritability from twenty patients suffering from neurosis and ten experienced psychiatrists. It was found that psychiatrists hold concepts of these unpleasant affects that are much more differentiated than those held by patients. In particular, the psychiatrists' concepts of anxiety and depression showed a correlation of zero, whereas the patients' concepts of these affects overlapped to a considerable degree.

Patients were unable to discriminate between anxiety and depression on the basis of 11 somatic symptoms, but were able to use these symptoms to distinguish anxiety and depression from irritability. The psychiatrists were in close accord with the patients over the somatic symptoms that distinguished anxiety from irritability.
Agoraphobia: a Critical Review of the Concept
Authors: Hallam R. S.
Published: August 2008

Phobic avoidance has been widely accepted as the central feature of the agoraphobic syndrome, and the presence of agoraphobia has been used to define groups of subjects for clinical research. A review of the evidence suggests that agoraphobia should not be classified with the phobias; several lines of inquiry point to the conclusion that it is a variable feature of patients suffering from anxiety neurosis. Implications for research and problems with the present classification of neurotic affective disorders are noted.
Men Remanded into Custody for Medical Reports: the Selection for Treatment
Authors: Bowden Paul
Published: August 2008

In a sample of men remanded into custody for medical reports during a three-month period, it was found that those who received recommendations for treatment had a diagnosis of acute mental illness, had in the past been admitted more frequently to mental hospitals and had spent a longer period as in-patients. They were also assessed as being difficult to manage, i.e. they were considered to be nuisances, were threatening and potentially violent. The men who were not recommended for treatment had a history of excessive drinking and drink-related offences; they also had more extensive criminal histories and a diagnosis of psychopathic disorder.
Men Remanded into Custody for Medical Reports: The Outcome of the Treatment Recommendation
Authors: Bowden Paul
Published: August 2008

Over a three-month period, 634 men were remanded into custody at Brixton Prison for medical reports; 87 received recommendations for psychiatric treatment and 82 individuals were actually referred to hospitals for treatment. Fourteen months later nearly three-quarters of the men who went to hospital had been discharged. They fell into three groups by outcome: men with acute psychoses for whom treatment was definitely beneficial; men who remained behaviourally disturbed after receiving treatment although their mental states improved; a group with chronic disorders for whom admission was not beneficial. The two groups with improved mental states represented only 5 per cent of the initial receptions to Brixton Prison.
Combination of Hormonal and Psychological Treatment for Female Sexual Unresponsiveness: a Comparative Study
Authors: Carney Anthony , Bancroft John , Mathews Andrew
Published: August 2008

Thirty-two couples with the presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. Treatment involved a combination of drug therapy and counselling. Half the subjects received testosterone and half diazepam, half received weekly and half monthly counselling. They were assessed before treatment, at the end of treatment and at six months follow-up.

Those receiving testosterone did significantly better on a number of behavioural and attitudinal measures than the diazepam group. There were no notable differences in outcome between the two counselling regimes. There were no undesirable side-effects with the testosterone.

Further work is needed to establish the indications for testosterone therapy for unresponsive women.