bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal function in chronic lithium‐treated patients
Authors: Conte G. , Vazzola A. , Sacchetti E.
Published: August 2007

ABSTRACT– We investigated the renal function (urine volume, glomerular filtration rate, urinary osmolality and proteinuria) of 50 patients chronically treated with lithium carbonate for major affective disorder. No patient had any alteration in the parameters considered. No relationship was found between any of the parameters studied and duration of illness or lithium levels, both in serum and red blood cells. These results were confirmed by the administration of the DDAVP test to 10 patients of the original sample; no alteration of concentration ability was found. We suggest that the discrepancy between our findings and those of most authors was a result of the serum lithium level of our patient sample, which was lower than that usually used in other studies.
Behavioral and cerebrovascular effects of caffeine in patients with anxiety disorders
Authors: Mathew R. J. , Wilson W. H.
Published: August 2007

Caffeine is believed to induce anxiety in normal people and anxiety disorder patients and panic attacks in panic disorder patients. The drug is also known to reduce cerebral blood flow (CBF). Findings suggesting an anxiety‐related cerebral vasoconstrictive factor have been reported. We examined the relationship between changes in anxiety and CBF induced by intravenously injecting 250 mg of caffeine (comparable to 2 cups of coffee) in 8 patients with generalized anxiety disorder, 9 patients with panic disorder and 9 normal controls. CBF measurements were also obtained before and after an injection of normal saline in another group of 9 normal volunteers. The anxiety disorder patients did not show any evidence of increase in anxiety and panic after caffeine. Both patients and controls who received caffeine but not normal controls who received saline showed significant CBF decrease. The CBF changes were unrelated to changes in mood, autonomic activity and carbon dioxide levels.
Charles Bonnet Syndrome: a description of two cases
Authors: Hosty G.
Published: August 2007

Two cases of Charles Bonnet syndrome are presented, one of which responded to carbamazepine.
Schizophrenia: age at onset, gender and familial risk
Authors: Pulver A. E. , Brown C. H. , Wolyniec P. , McGrath J. , Tam D. , Adler L. , Carpenter W. T. , Childs B.
Published: August 2007

In a family history study of 366 schizophrenic probands and their 1851 first‐degree relatives, we found a relationship between age at onset of psychosis in the male probands and the risk for schizophrenia in their relatives. The relatives of male schizophrenic probands whose onset of psychosis occurred when they were younger than 17 years of age had an increased risk of schizophrenia when compared with the relatives of male probands with an age at onset greater than 17. We did not find an association between age at onset of psychosis in the female probands and familial risk. Cox proportional hazards models permitted us to examine the relationship between age at onset of psychosis in the probands and familial risk while controlling for possible confounding effects.
A statistical trial of subclassification for tardive dyskinesia
Authors: Inada T. , Yagi G. , Kamijima K. , Ohnishi K. , Kamisada M. , Takamiya M. , Nakajima S. , Rockhold R. W.
Published: August 2007

The authors applied a statistical method to subclassify tardive dyskinesia (TD) in 71 psychiatric patients. Based on two‐step statistical procedures and findings reported previously, TD is considered to consist of 2 subgroups: a classical dyskinesic group and a dystonic group. Symptoms manifested in the former group are seen most frequently in the oral region while the latter group, which is usually called tardive dystonia, is manifested by movement disorders in the trunk and extremities, predominantly. Abnormal movements occurring in the facial region characterize a population whose members may belong to either group.
A double blind comparative multicentre study of remoxipride and haloperidol in schizophrenia
Authors: Andersen J. , Kørner A. , Øsstergaard P. , Fensbo C. , Birket‐Smith M. , Thiesen S. , Hansen N. R. , Fogh M. , Kristensen M , Møller‐Nielsen E. M. , Jensen B. , Bjørum N.
Published: August 2007

Abstract Seventy‐two patients fulfilling the DSM‐III criteria for schizophrenia and schizophreniform psychosis were admitted to a multicentre, double‐blind controlled study to evaluate the efficacy and safety of remoxipride in comparison to haloperidol. The mean daily dose of remoxipride at the end of treatment was 353 mg and of haloperidol, 11 mg. Patients were assessed each week on the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression (CGI) and the symptoms checklist. No significant differences in efficacy were found between the two treatments. The median total BPRS score in the remoxipride group was 25 at start of active treatment and 17 at the last valid rating (n = 31). For the haloperidol group the corresponding figures were 24 and 15 (n = 29). According to the CGI, 40% of remoxipride patients and 50% of haloperidol patients were much or very much improved. Treatment‐emergent extrapyramidal symptoms, such as akathisia and rigidity, occurred significantly more frequently, and were more severe during treatment with haloperidol than with remoxipride (p = 0.012 and 0.024, respectively). Haloperidol‐treated patients reported significantly more drowsiness and increased sleep during treatment (p = 0.026 and 0.012, respectively). No statistically significant differences were seen in endocrine or autonomic symptoms. Remoxipride seemed to be as effective as haloperidol, had a lower frequency of side effects, and was used safely in the dose range 150–600 mg/day.
Moclobemide versus clomipramine in the treatment of depression: a multicentre trial in Spain
Authors: Civeira J. , Cervera S. , Giner J. , Allen S. R. , Hellstern K. , Malanowski H. , Wirz R. , Klär K.
Published: August 2007

The efficacy, tolerability and safety of moclobemide were compared with those of clomipramine in a double‐blind, randomized parallel group study over 4 weeks. Patients were suffering from various forms of depression: 33 received moclobemide and 31 clomipramine. The mean score on the Hamilton Rating Scale for Depression decreased gradually in both groups, with no significant differences between them; the final scores showed an improvement of 57% in the moclobemide group and 60% in the clomipramine group, compared with baseline. The investigators’ assessment of efficacy at the end of treatment was good or very good for 60% of moclobemide patients and 50% of clomipramine patients, and tolerance was good or very good for 31 patients on moclobemide and 26 on clomipramine. The drugs thus showed comparable antidepressant efficacy, and both were mostly well tolerated, although adverse events were more prevalent in patients treated with clomipramine.
Moclobemide versus tranylcypromine in the treatment of depression
Authors: Rossel L. , Mell E.
Published: August 2007

Moclobemide and tranylcypromine were compared in 2 randomized groups of 20 depressed patients each. Fifteen of the patients on moclobemide and 18 of those on tranylcypromine were diagnosed as suffering from endogenous depression. The dosage was 150–300 mg moclobemide and 15–30 mg tranylcypromine daily. At the end of treatment, improvement on the Hamilton Rating Scale for Depression was 59.3% in the moclobemide group and 65.5% in the tranylcypromine group. The final overall assessment of efficacy was good or very good for 68% of the patients on moclobemide and for 85% of those on tranylcypromine. The final assessment of tolerance was good or very good for 85% of the moclobemide patients and 100% of the tranylcypromine patients. None of the differences in scores between the groups were statistically significant. This study therefore yielded comparable results for efficacy and tolerance of the 2 drugs in the treatment of depression.
Moclobemide (Ro 11‐1163) in long‐term treatment
Authors: Stefanis C. N. , Merz‐Frei K.
Published: August 2007

Patients requiring long‐term treatment of depression (at least 60 days) were followed up at monthly intervals under treatment with moclobemide. A total of 102 patients completed 1 year of treatment; the mean dose at the start of treatment was 340 mg daily, decreasing to 300 mg after a year. Three quarters of these patients were suffering from endogenous depression. The investigator's overall assessment of efficacy was good or very good for 96% of patients; efficacy judged together with tolerance was good or very good for 85% of patients. There were no noteworthy changes in safety parameters throughout the study, and adverse events were mainly minor and of short duration. The result of this analysis suggests that moclobemide is effective, safe and well tolerated in long‐term administration.
Moclobemide (Ro 11‐1163) safety in depressed patients
Authors: Moll E. , Hetzel W.
Published: August 2007

Safety aspects were compared in 2203 patients given moclobemide and 1214 who received other antidepressants or placebo. A total of 2294 adverse events were reported by patients on moclobemide, mainly subjective symptoms (28.6%). Adverse events such as dry mouth, tremor, sweating, dizziness and constipation occurred much more frequently among 681 patients treated with various tricyclic antidepressants than in the 694 moclobemide patients with whom they were compared. Among 271 placebo‐treated patients there were 287 adverse events, compared with 386 events in the 285 moclobemide patients in the same studies. Hypertensive episodes or food‐drug interactions were reported by 19 patients on moclobemide and 5 on other antidepressants, but in only 2 of the former was ingestion of cheese a possible cause of headache. The assessment of tolerance on moclobemide was essentially the same as for placebo. Of the 1401 moclobemide patients in the electronic database, only 3.2% stopped treatment prematurely because of poor tolerance; the rates were higher for tranylcypromine, nomifensine, desipramine, clomipramine, amitriptyline and imipramine. During treatment, 6 patients attempted suicide with moclobemide alone (950–2000 mg) or together with imipramine (300 mg and 1200 mg). None of the intoxications was life‐threatening.
Prevalence of mental disorders among adults in Finland: basic results from the Mini Finland Health Survey
Authors: Lehtinen V. , Joukamaa M. , Lahtela K. , Raitasalo R. , Jyrkinen E. , Maatela J. , Aromaa A.
Published: August 2007

The Mini Finland Health Survey was an extensive epidemiological study of the Finnish population aged 30 or over; the prevalence of mental disorders was one aspect studied. Prevalence of symptoms in the General Health Questionnaire as well as the prevalence of self‐perceived and clinically assessed mental disorders was studied. The total prevalence of clinically assessed mental disorders was 17.4%, 14.8% in the men and 19.5% in the women. A definite disorder was observed for 11.7% of the subjects. About half of the subjects suffering from a mental disorder according to clinical assessment also reported a self‐perceived disorder. Of various diagnoses, the most common were phobic and anxiety neurosis (6.2%) and neurotic depression (4.6%). The prevalence of schizophrenia was 1.3%. The highest prevalence was found in the ages 50 to 64 years. The prevalence of psychoses was highest in northern and eastern Finland, and that of neuroses in southern Finland.
Slower theta activity over the midfrontal cortex in schizophrenic patients
Authors: Westphal K. P. , Grözinger B. , Diekmann V. , Scherb W. , Reeß J. , Leibing U. , Kornhuber H. H.
Published: August 2007

Disturbances of the topographical distribution of theta activity in the EEG spectra before and during voluntary movements were investigated in 31 neuroleptic‐treated and in 13 untreated schizophrenics and matched controls as well as in 15 normals medicated with haloperidol. All 4 groups demonstrated similar topographical distribution of theta mean power density, with highest values over the midfrontal region. In the center frequency of the theta band, however, treated and untreated schizophrenics had lower values over the midfrontal region than at parietal electrodes. In controls and normals medicated with haloperidol, this frontoparietal “gradient” demonstrated the inverse picture, with highest values at the frontal midline electrode. Patients and controls differed significantly in this gradient. The slower theta activity over the midfrontal cortex in the schizophrenic patients is related to the hypofrontality hypothesis.
Insulin sensitivity in patients with anorexia nervosa and bulimia
Authors: Kiriike N. , Nishiwaki S. , Nagata T. , Okuno Y. , Yamada J. , Tanaka S. , Fujii A. , Kawakita Y.
Published: August 2007

Insulin sensitivity was studied using the euglycemic insulin clamp technique in 5 female patients with anorexia nervosa and 4 females with bulimia. The results were compared with those of 15 male patients with non‐insulin‐dependent diabetes mellitus. Euglycemic insulin clamp was performed for 2 h using the Biostator, during which time insulin was infused at a rate of 0.77 mU kg−1 min−1. Fasting plasma glucose and immunoreactive insulin tended to be lower in patients with anorexia nervosa than in those with bulimia (69.8 ± 6.7 vs 75.9 ± 7.7 mg/dl, and 5.9 ± 2.0 vs 9.8 ± 3.4 U/ml). The mean metabolic clearance rate (MCR) was 9.2 ± 3.9 ml kg−1 min−1 for patients with anorexia nervosa, 5.1 ± 2.2 ml kg−1 min−1 for patients with bulimia, and 3.8 ± 0.3 ml kg−1 min−1 for patients with diabetes mellitus. However, one anorectic had a significantly high MCR. One anorectic and 3 bulimics had a significantly low MCR. These results suggest that insulin sensitivity varied in patients with anorexia nervosa, whereas it tended to decrease in some patients with bulimia but not to the same degree as in patients with diabetes mellitus.
A double‐blind comparison of mianserin and maprotiline in depressed medically ill elderly people
Authors: Schifano F. , Garbin A. , Renesto V. , De Dominicis M. G. , Trinciarelli G. , Silvestri A. , Magni G.
Published: August 2007

A double‐blind, randomized 4‐week mianserin vs maprotiline trial was conducted in 48 depressed geriatric medical inpatients. The drug dosages were up to 90 mg of mianserin and up to 150 mg of maprotiline per day. Efficacy was measured by the Geriatric Depression Scale, the Hopkins Symptom Check List depression subscale and the Clinical Global Impression Scale. The overall dropout figure was 27% of the sample. Side effects were relatively similar in the two treatment groups and suggested a safety profile somewhat better than that of the first‐generation antidepressants. Mianserin showed some advantages in efficacy over maprotiline, particularly by the 4th week of the trial, but the overall figures of treatment responders were rather small (Geriatric Depression Scale: mianserin 48%, maprotiline 30%). Clinical trials vs placebo are needed to clarify the role of antidepressant pharmacotherapy in depressed geriatric medical inpatients.
Zuclopenthixol decanoate and haloperidol decanoate in chronic schizophrenia: a double‐blind multicentre study
Authors: Wistedt B. , Koskinen T. , Thelander S. , Nerdrum T. , Pedersen V. , Mølbjerg C.
Published: August 2007

Zuclopenthixol decanoate (ZPT‐D) and haloperidol decanoate (HAL‐D) were compared in the maintenance treatment of chronic schizophrenic patients. All patients were treated with either ZPT‐D or HAL‐D for at least 3 months and were then randomly allocated to treatment with either ZPT‐D (100–600 mg every 4 weeks) or HAL‐D (38–200 mg every 4 weeks) for 9 months. Sixty‐four patients entered the study. Three patients were only assessed at baseline. Four patients in the HAL‐D group were withdrawn because of deterioration. One patient in the ZPT‐D group committed suicide. Fifty‐six patients completed the trial. The assessment programme comprised Clinical Global Impressions by psychiatrists and nurses, the Brief Psychiatric Rating Scale (BPRS), Montgomery‐Åsberg Depression Rating Scale (MADRS), UKU Side Effect Scale and Simpson‐Angus Scale. Ratings were made at baseline and after 12, 24 and 36 weeks of treatment. The severity of illness scores remained almost constant. The only between‐group difference was recorded at month 6 in favour of ZPT‐D. The BPRS total scores were reduced significantly in both groups with no between‐group differences. The depression scores on the MADRS were very low. Both treatments caused few and mild side effects according to the UKU Side Effect Scale and the Simpson‐Angus scale, and there were no significant differences between the groups. Both ZPT‐D and HAL‐D seem to be effective in the maintenance treatment of chronic schizophrenic patients and cause few side effects. The injections of ZPT‐D and HAL‐D can be given at 4‐week intervals.
Differences between schizophrenics born in winter and summer
Authors: Rodrigo G. , Lusiardo M. , Briggs G. , Ulmer A.
Published: August 2007

A total of 1814 patients were studied from the Mississippi State Hospital with a DSM‐III diagnosis of schizophrenia and aged 15–39 years at the time of admission. The 634 schizophrenics with a birth date between 1 December and 31 March were compared with the 1180 born between 1 April and 30 November for age of admission, race, sex, marital status, duration of initial admission and clinical subtype. The only significant difference between the variables was the duration of the first admission: winter‐born patients had a shorter psychiatric hospitalization than summer‐born schizophrenics. These findings are discussed in accord with similar studies.
Gender differences in depression: historical changes
Authors: Silverstein B. , Perlick D.
Published: August 2007

Depression has been widely reported to be more prevalent among females than among males. In this study we demonstrate that gender differences in depression occur only among individuals born during particular historical periods, and test the utility of a model focusing on changes in women's opportunities for academic and professional achievement in predicting periods of significant gender differences in depression. Based on reanalysis of data reported by Klerman et al., we find gender differences in depression among people 40 years of age and older to be high among cohorts that reach adolescence during periods of increasing opportunities for female achievement. Among cohorts that reach adolescence during periods of stable or decreasing opportunities for women, gender differences in depression are not significant at any age.
The criteria of Cloninger et al. and von Knorring et al. for subgrouping alcoholics: a comparison in a clinical population
Authors: Lamparski D. M. , Roy A. , Nutt D. J. , Linnoila M.
Published: August 2007

There is increasing evidence that meaningful subgroups of alcoholics may exist. Cloninger et al. and von Knorring et al. have developed criteria to delineate what both call type 1 and type 2 alcoholism. However, when we compared their criteria in a predominantly inpatient sample of male alcoholics, we found large differences between the approaches in identifying type 1 and type 2 alcoholism. Concordance was equally low in a subsample of 34 alcoholics exhibiting antisocial behavior and when subjects were divided by whether the first alcohol‐related problem began before or after 20 years of age. Similar findings emerged when we limited our analyses to primary alcoholics and alcoholics with no other mental disorders.
Is anhedonia a good measure of depression?
Authors: Silverstone P. H.
Published: August 2007

The symptom of anhedonia, or loss of pleasure, is widely recognized to occur in depression. More recently it has been suggested that this symptom alone might be the basis for a diagnosis of depression in medically ill patients, and the Hospital Anxiety and Depression Scale (HAD) has been designed with this in mind. To test the hypothesis that this symptom might discriminate well between major depressive disorder and other mental disorders, this study measured the degree and incidence of anhedonia in 147 consecutive psychiatric outpatients with a variety of DSM‐III‐R diagnoses. Anhedonia was assessed using items from the HAD. The results showed that, although depressed patients scored highly for anhedonia, this symptom was present in the majority of patients with diagnoses other than major depressive illness. Thus this symptom alone was unable to clearly distinguish between mental disorders, and it may therefore be inappropriate to use anhedonia as the basis for a diagnostic measure.
Clinical correlates of intent in attempted suicide
Authors: Hamdi E. , Amin Y. , Mattar T.
Published: August 2007

The seriousness of suicide attempts was evaluated in 62 consecutive referrals in 2 general hospitals. As measured by the Suicide Intent Scale (SIS) the majority of cases had a low to moderate intention to die. Increasing age, psychosis and deliberate self‐injury were associated with high suicidal intent. Hopelessness and a sense of isolation are significantly more frequent antecedent ideo‐affective states in cases with high intent and anger and frustration are more prevalent in cases with low intent. Two other measures of seriousness, the medical condition on admission and lethality of the method used, correlate significantly with the degree of intent. The SIS can distinguish between relatively homogeneous subgroups of suicide attempters for depth studies of aetiology and management.
Clomipramine effectively reduces premenstrual irritability and dysphoria: a placebo‐controlled trial
Authors: Sundblad C. , Modigh K. , Andersch B. , Eriksson E.
Published: August 2007

Forty nondepressed women displaying severe premenstrual irritability and/or dysphoria and fulfilling the DSM‐III‐R criteria of late luteal phase dysphoric disorder were treated daily for 3 menstrual cycles with either the potent serotonin reuptake inhibitor clomipramine (25–75 mg; flexible dosage) (n= 20) or placebo (n= 20). In both treatment groups premenstrual irritability and dysphoria (as rated daily by the patients using a visual analogue scale) were significantly reduced as compared with the rating during 2 pretreatment reference cycles; however, in the placebo group this reduction was only about 40% whereas, in the clomipramine group, the symptom decrease was >80%. At all 3 treatment cycles, patients on clomipramine displayed significantly lower symptom rating than controls. Also with respect to the rating of global improvement, the results obtained with clomipramine were considerably and significantly better than those obtained with placebo. It is concluded that low doses of clomipramine effectively reduce premenstrual irritability and dysphoria with a response rate close to 100%. The possible role of serotonin in the pathophysiology of the premenstrual syndrome is discussed.
Lithium treatment: a comparison of once‐and twice‐daily dosing
Authors: Abraham G. , Delva N. , Waldron J. , Lawson J. S. , Owen J.
Published: August 2007

The effects of once‐ and twice‐daily dosing with lithium carbonate were compared in a non‐blind, cross‐over study on 20 consecutive patients with mood disorders. Mental status, side effects and target organ function were examined after a minimum of a 1‐month treatment with each regimen. Eighteen patients completed the study and 2 withdrew because of side effects. There were no significant differences between the 2 groups on the Hamilton Rating Scale for Depression, the Bech‐Rafaelsen Mania Scale, the UKU Side Effects Scale or in serum lithium, electrocardiogram and urine volumes. Most blood tests showed no significant difference between the 2 treatment schedules except for white blood cells, ionized calcium and phosphate concentration. The once‐daily regimen was associated with a higher white cell count, increased serum phosphate and elevated serum ionized calcium. We conclude that patients are able to tolerate once‐daily dosing with lithium carbonate as well as twice‐daily dosing.
Effects of age and alcoholism on the prevalence of panic disorder
Authors: Krystal J. H. , Leaf P. J. , Bruce M. L. , Charney D. S.
Published: August 2007

Findings are reported evaluating the effects of aging and alcoholism histories on the 6‐month prevalence rates of panic disorder. The data were collected in 5 communities as part of the Epidemiologic Catchment Area (ECA) study: New Haven, CT; Baltimore, MD; St. Louis, MO; Durham, NC; and Los Angeles, CA. Reanalysis of ECA data provided additional support for a decline in the prevalence of panic disorder among elderly people. In addition, the presence of a history of alcohol abuse or dependence was associated with significantly elevated panic disorder rates in younger individuals, but an earlier decline in panic disorder prevalence with age, regardless of gender. These findings offer preliminary support for neurodevelopmental hypotheses for the onset and outgrowing of panic disorder. They also highlight the impact of alcoholism on the course of panic disorder.
Long‐term effects of intrafamilial sexual abuse in childhood
Authors: Bushnell J. A. , Wells J. E. , Oakley‐Browne M. A.
Published: August 2007

This study reports results from follow‐up interviews with 301 women aged 18–44 years who were first identified 2 years earlier in a cross‐sectional study of 1498 adults in the general population of the city of Christchurch, New Zealand. The prevalence of intrafamilial sexual abuse was 13%. This incestuous sexual abuse in childhood was associated with an increase in many adult mental symptoms, particularly symptoms of depression, bulimia and generalized anxiety. In this community study the consequences associated with sexual abuse within the family appear to be widespread and not very specific, and show as additional comorbidity rather than as increased severity within a disorder. These results do not support the strong direct causal effects postulated in some theories derived from clinical studies.
Risperidone versus haloperidol in the treatment of chronic schizophrenic inpatients: a multicentre double‐blind comparative study
Authors: Claus A. , Bollen J. , Cuyper H. De , Eneman M. , Malfroid M. , Peuskens J. , Heylen S.
Published: August 2007

Forty‐four chronic schizophrenic inpatients participated in this multicentre 12‐week parallel‐group double‐blind trial. After a run‐in period of 2 weeks and a single‐blind placebo wash‐out of 1 week, they were randomly assigned to treatment with either the serotonin2 and dopamine‐D2 antagonist risperidone or haloperidol. Two patients were excluded from the efficacy analysis. Five patients dropped out in the haloperidol group and 1 in the risperidone group. At the end of the trial, the mean daily dose was 12 mg for risperidone and 10 mg for haloperidol. The risperidone group showed greater improvement on the Positive and Negative Syndrome Scale for Schizophrenia, the Schedule for Affective Disorders and Schizophrenia – change version, and the Nurses’ Observation Scale for Inpatient Evaluation. The improvement of negative symptoms was more pronounced in the risperidone group until week 8 of double‐blind treatment. The consumption of antiparkinsonian medication was 10 times lower with risperidone. Both drugs were well tolerated and the laboratory, endocrinological and cardiovascular safety parameters were comparable. This study suggests that risperidone is comparable to haloperidol as an antipsychotic, but that it has a safer EPS profile.
A community‐based study of survival in dementia
Authors: Heeren T. J. , van Hemert A. M. , Rooymans H. G. M.
Published: August 2007

The objective of this study was to compare the mortality rate of demented and nondemented subjects in a single cohort. We followed up a cohort of subjects comprising all 1259 inhabitants of Leiden aged 85 years and over, evaluated earlier for the presence of dementia, and including institutionalized subjects. The main outcome measure was the mortality rate ratio of the demented and nondemented groups adjusted for age and sex. The mortality rate ratio of the dementedvsthe nondemented group was 1.9 (95% confidence interval: 1.7–2.2). No difference in mortality rate was found between those with mildvsmoderate to severe dementia. The mortality rate in dementia patients is higher than in nondemented subjects.
Bright dawn simulation compared with bright morning light in the treatment of winter depression
Authors: Avery D. , Bolte M. A. , Millet M.
Published: August 2007

In a randomized cross‐over design, 7 patients with winter depression were treated with a week of a bright (1700 lx) dawn simulation (0400 to 0600) and a week of standard bright (1700 lx) morning (0600 to 0800) light therapy. The Hamilton Rating Scale for Depression scores decreased significantly for the standard light therapy (18.9 to 6.6) but not for the bright dawn therapy (18.0 to 11.3). Early morning awakening was a frequent side effect with the bright dawn simulation. Although dawn simulation at a lower illuminance may be an effective treatment, the bright dawn used in this study showed only a nonsignificant trend to lower depression ratings. The illuminance of dawn simulation should be adjusted to minimize side effects.
Posterior fossa abnormalities in major depression: a controlled magnetic resonance imaging study
Authors: Shah S. A. , Doraiswamy P. M. , Husain M. M. , Escalona P. R. , Na C. , Figiel G. S. , Patterson L. J. , Ellinwood E. H. , McDonald W. M. , Boyko O. B. , Nemeroff C. B. , Krishnan K. R. R.
Published: August 2007

High‐field magnetic resonance (MR) images were used to study posterior fossa morphology in 27 patients with major depression and 36 normal control subjects. Depressed patients demonstrated smaller brain stem and cerebellar vermis than controls. These differences were highly significant for the anterior cerebellar vermis and medulla. There was also a striking age‐related decline in midbrain size in depressed patients as well as in controls. Our results are consistent with several lines of evidence implicating a role for the cerebellar vermis in affective disorders and, in addition, provide the first MR documentation of the differential effects of aging on posterior fossa morphology in normal subjects compared with patients with major depression.
Parasuicide during Ramadan in Jordan
Authors: Daradkeh T. K.
Published: August 2007

To investigate the impact of national and religious events on the rate of parasuicide, a comparison was made between the number of reported parasuicides during the month of Ramadan and the month before and after Ramadan in Jordan, for the years from 1986 to 1991. Significantly fewer parasuicides were reported during Ramadan than the month preceding it and the month that follows Ramadan. The findings confirm previous observations that national events reduce the rate of parasuicide, but the protective effect does not persist into the month that follows Ramadan.
Anorexia nervosa and bulimia: a prevalence study
Authors: Azevedo M. H. P. de , Ferreira C. P.
Published: August 2007

We determined the prevalence of anorexia nervosa and bulimia in a large sample of students attending a secondary school on the island of São Miguel (Azores) using the Diagnostic Interview for Children and Adolescents, which enabled us to collect the information necessary to make DSM‐III diagnoses. Although the prevalence of anorectic and bulimic behaviour was rather high, the partial syndrome of anorexia nervosa was found in only 0.48% of the students (0.76% for girls and 0.17% for boys) and the syndrome of bulimia in only 0.16% (0.30% of the girls; there were no boys with bulimia). The overall prevalence of eating disorders, including partial syndromes, was rather low (0.64%). These results stand in sharp contrast to reports that eating disorders are common and probably getting more common. The low prevalence found in the present survey is probably due to the absence of sociocultural pressures to control eating and weight.
Reliability of ICD‐10 research criteria: an Arab perspective
Authors: Okasha A. , Dawla A. Seif El
Published: August 2007

Within a broader World Health Organization (WHO) collaborative research around the ICD‐10 diagnostic criteria for research, the Regional Office for the Eastern Mediterranean (EMRO) ICD‐10 research coordinating center at the Ain Shams Institute of Psychiatry presented the data collected from 8 Arab centers, which investigated a total of 233 patients using the local psychiatric interview schedules and diagnosed according to ICD‐10 criteria. Interrater reliability was found to range between an almost perfect (0.81–1) to substantial agreement (0.61–0.80) (using the kappa coefficient) in diagnosing organic mental disorders, substance use disorders, schizophrenic, schizotypal and delusional disorders, affective disorders and neurotic and stress‐related disorders. The categories of psychological development and child and adolescent disorders were diagnosed less frequently and the agreement between raters was lower. Though no culture‐bound syndromes were encountered in any of the centers, difficulties in diagnosis using the research criteria were identified in the domain of simple schizophrenia and dissociative versus conversion disorders. These difficulties are discussed in consideration of the experience of our psychiatrists.
The St. Hans Rating Scale for extrapyramidal syndromes: reliability and validity
Authors: Gerlach J. , Korsgaard S. , Clemmesen P. , Lauersen A.‐M. Lund , Magelund G. , Noring U. , Povlsen U. J. , Bech P. , Casey D.E.
Published: August 2007

The St. Hans Rating Scale (SHRS) is a multidimensional rating scale for the evaluation of neuroleptic‐induced hyperkinesia, parkinsonism, akathisia and dystonia. This scale and the Abnormal Involuntary Movement Scale (AIMS) were tested by 7 raters (2 experienced, 2 less experienced and 3 totally inexperienced) in 30 psychiatric patients with tardive dyskinesia (TD). The test was performed 3 times in the same patients: 1) live evaluation during a video recording, 2) evaluation 2 weeks later from the videotape, and 3) evaluation after another 2 weeks from the same videotape. The intrarater reliability was high in the experienced group (0.91–0.96 for SHRS hyperkinesia scale, 0.80–0.84 for AIMS, and 0.82–0.97 for SHRS total parkinsonism). No significant changes occurred from live to video evaluation. The interrater reliability coefficient for the experienced group was also high: 0.89–0.95 for the SHRS hyperkinesia scale, 0.76–0.85 for the AIMS scale and 0.95–0.98 for the SHRS parkinsonism scale. The less experienced and the inexperienced raters had coefficients for intra‐ and interrater reliability that were 0.10 and 0.20 lower, respectively. The SHRS parkinsonism scale had a high construct validity, as determined by the homogeneity coefficients of Cronbach (0.82) and Loevinger (0.43). The corresponding coefficients for the hyperkinesia scales were low, in agreement with the individual distribution of TD (only about 50% present extremity dyskinesia and less than 25% facial, head and trunk dyskinesia, independent of the severity of the syndrome). Finally, convergent validity was found between the SHRS hyperkinesia scale and AIMS and divergent validity between all of the other scales. It is concluded that the SHRS represents an easily completed, reliable, valid and sensitive rating scale for extrapyramidal symptoms that can be used with and without videotapes.
A comparison of paroxetine and placebo in depressed outpatients
Authors: Dunbar G. C. , Claghorn J. L. , Kiev A. , Rickels K. , Smith W. T.
Published: August 2007

To compare the safety and efficacy of paroxetine (n= 167) and placebo (n= 169), data from 4 centres using the same protocol were pooled. A double‐blind parallel group design was used, with therapy lasting 6 weeks. Significant differences between paroxetine‐ and placebo‐treated patients were found on the major efficacy outcome variables by week 2 and on all efficacy variables by week 4 of the study. Improvement on the sleep factor of the Hamilton Rating Scale for Depression was found after 7 d. Observer and patient global efficacy ratings were in agreement by week 4. No serious adverse events occurred, and paroxetine had no clinically significant effects on vital signs or laboratory safety data. Side effects were more common on paroxetine and were similar to other serotonin reuptake inhibitors. In general, these were well tolerated and did not lead to dropout. Symptoms of increased arousal were not seen during early therapy.
Levomepromazine receptor binding profile in human brain—implications for treatment—resistant schizophrenia
Authors: Nair N. P. V. , Cecyre D. , Quirion R. , Lal S.
Published: August 2007

The receptor binding profile of levomepromazine (LMP) in human brain was compared with that of clozapine (CLOZ) and chlorpromazine (CPZ). LMP showed significantly greater binding affinity for both α‐1 and serotonin‐2 binding sites than either CLOZ or CPZ, and significantly greater binding to α‐2 sites than CPZ. A potent pharmacological effect at these receptor sites may explain the beneficial effect of LMP on psychotic symptoms and akathisia in treatment‐resistant schizophrenia recently described in 2 open studies. LMP requires further appraisal as a potentially useful neuroleptic in the management of treatment‐resistant schizophrenia.
Treatment of winter depression in Norway
Authors: Lingjærde O. , Reichborn‐Kjennerud T. , Haggag A. , Gärtner I. , Berg E. M. , Narud K.
Published: August 2007

Patients with seasonal affective disorder (winter depression) from the Oslo area (at about 60°N) recruited through mass media advertising were treated with 1500‐lx white full‐spectrum light for 2 h in the morning for 6 days. Their clinical state was assessed at baseline and 1, 3, 6, 10 and 14 weeks after commencement of treatment with an extended version of Montgomery‐Åsberg Depression Rating Scale (MADRS) and Clinical Global Impression. Forty patients (35 women, 5 men, age range 24 to 64 years) completed 1 week of light treatment. A subgroup of 9 patients received light in addition to ongoing drug treatment. The mean reduction in total extended MADRS score at week 1 was 48% in patients receiving only light and 56% in patients receiving light in addition to drugs. In spite of the low dose of light given, this is comparable to other reported results using light treatment for winter depression. In contrast to most other studies, however, the improvement at week 1 was maintained for the rest of the season in most patients. Only 5 patients were given another light treatment course, and another 5 were switched to drug treatment due to their unsatisfactory response to light treatment.
A 30‐year follow‐up study of the sons of alcoholic men
Authors: Knop J. , Goodwin D. W. , Jensen P. , Penick E. , Pollock V. , Gabrielli W. , Teasdale T. W. , Mednick S. A.
Published: August 2007

The nature‐nurture question in the etiology of alcoholism is discussed. The research results from twin and adoption studies indicate a considerable genetic (= biological) component in the etiology of alcoholism. A longitudinal high‐risk study of alcoholism is presented. The sons of alcoholic men and matched controls have been followed prospectively since before birth. The main results from previous phases of the study and a recent 30‐year follow‐up assessment are presented.
A self‐report Insight Scale for psychosis: reliability, validity and sensitivity to change
Authors: Birchwood M. , Smith J. , Drury V. , Healy J. , Macmillan F. , Slade M.
Published: August 2007

Lack of insight is a frequent concomitant of psychosis and has traditionally been viewed as a binary, all or none phenomenon. Recent conceptualization has formulated insight as a continuum representing the juxtaposition of 3 factors – awareness of illness, need for treatment and attribution of symptoms. Measurement of insight has been exclusively based on interview; this method does not easily lend itself to frequent repeated measurement and requires interrater reliability to be established. A self‐report Insight Scale is presented, and evidence in support of its reliability, validity and sensitivity is provided that includes a sample of 30 patients monitored during recovery from an acute psychosis. The scale is a quick and acceptable measure that may find application in investigations of acute care, cognitive therapy of psychotic symptoms and as a method of augmenting clinical judgements of insight.
Clinical heterogeneity in schizophrenia and the pattern of psychopathology in relatives: results from an epidemiologically based family study
Authors: Kendler K. S. , McGuire M. , Gruenberg A. M. , Walsh D.
Published: August 2007

Individuals with schizophrenia vary widely in their symptoms, course of illness and outcome. Family background is the strongest known risk factor for schizophrenia. We know little of the relationship between clinical variability in this disorder and the level of familial vulnerability to schizophrenia and other major mental disorders. Therefore, in schizophrenic probands meeting DSM‐III‐R criteria (n= 126) from the epidemiologically based Roscommon Family Study, we systematically assessed 9 major symptoms, course, global outcome, Schedule for Negative Symptoms and the Levels of Functioning Scale. These clinical characteristics were related to the risk of mental disorders in first‐degree relatives assessed by personal interview or hospital records (n= 354) utilizing both the “familial/sporadic” and the Cox proportional hazard models. Using either statistical method, no consistent and significant relationship was found between any of our measures of symptoms, course or outcome and the risk for schizophrenia or schizophrenia spectrum disorders in relatives. Similarly, no relationship was found between these clinical measures and the risk for affective illness, alcoholism or anxiety disorders. Our results are not consistent with previously articulated hypotheses that negative symptoms or poor outcome in schizophrenia reflect a high familial liability to illness. While familial factors contribute substantially to an individual's vulnerability to schizophrenia, our results suggest that once an individual is affected, these same factors do not strongly influence either the kinds of symptoms displayed or the course and outcome of the illness.
Prevalence of mental disorders among children in Valencia, Spain
Authors: Gómez‐Beneyto M. , Bonet A. , Catalá M. A. , Puche E. , Vila V.
Published: August 2007

A 2‐stage survey was carried out to establish the point‐prevalence of mental disorders and help‐seeking behaviour in children aged 8, 11 and 15 living in the city of Valencia. Global prevalence rates, rates by age and rates by sex, as well as rates of specific diagnosis according to DSM‐III‐R criteria are described. Help‐seeking behaviour was found to be related to an interaction between internalizing and externalizing symptoms and sex.
New versions of World Health Organization instruments for the assessment of mental disorders
Authors: Janca A. , Üstün T. B. , Sartorius N.
Published: August 2007

Over the past 3 decades, the development of reliable and cross‐culturally applicable diagnostic criteria and instruments for the assessment of mental disorders has been one of the major goals of the WHO mental health programme. The most important step in this endeavour of WHO was the production of the ICD‐10 Classification of Mental and Behavioural Disorders and the following instruments: Composite International Diagnostic Interview (CIDI), Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and International Personality Disorder Examination (IPDE). This article outlines the basic characteristics of the latest editions of CIDI, SCAN and IPDE and provides descriptions of their newly developed versions and modules.
Mania
Authors: Fogarty F. , Russell J.M. , Newman S.C. , Bland R.C.
Published: August 2007

3258 randomly selected houshold residents of Edmonton, Alberta were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). The lifetime prevalence of mania was 0.6%, for both sexes combined. Lifetime morbidity risk was 1.4% for men and 0.6% for women. The mean age of onset was 20 years of age for both men and women. Ninety‐five percent of bipolar individuals had had their first onset by age 26, and less than 5% had their onset before the age of 10. The mean number of manic episodes was 23. Comorbidity with other disorders occurred in 92% of the manic subjects. Depression (62%), alcohol abuse (45%), substance abuse (35%), and phobias (54%) had an increased lifetime prevalence in individuals with a history of a manic episode(s).
New perspectives on biological treatment of schizophrenia
Authors: Lingjærde Odd
Published: August 2007

Recent research seems to indicate that many schizophrenics suffer from a defective brain development, which is reflected by basic disturbances in cognitive, information‐processing, volitional and emotional functions. Positive symptoms like hallucinations and delusions may be secondary to the more basic disturbances. Varying degrees of defective brain development places a ceiling on the functional improvement that can be obtained in this illness. However, whereas positive symptoms usually respond best to neuroleptics, even negative symptoms can be improved, for instance by clozapine. To obtain such improvement, it seems necessary, in addition to blocking dopamine D2 receptors, to influence other receptor systems, as for instance serotonergic 5HT‐2 and possibly dopaminergic D1 and/or D4 receptors. Stimulation of glutamatergic NMDA receptors also seems to be a promising possibility.
Cognitive therapy with schizophrenic patients: conceptual basis, present state, future directions
Authors: Hodel Bettina , Brenner Hans D.
Published: August 2007

Schizophrenia may nowadays be most readily understood as a systemic disorder in which changes in the brain structure underlie individual cognitive abnormalities which for their part interact with environmental factors at the onset of the illness and during its course. From this, one may deduce the rationale for cognitive therapy for schizophrenic patients. Existing approaches may be systemised as direct, indirect and combined procedures. The latter are based on the assumption of the pervasive effects of elementary and complex cognitive dysfunctions at the levels of open behaviour. However, in a mirror‐design study with 21 schizophrenic patients according to DSM‐III‐R in which the effects of various intervention sequences were examined, it was not possible to find confirmation for this. This and other open questions have led to doubts expressed in current literature concerning the utility of cognitive therapy, especially with respect to the locus, nature and malleability of cognitive disorders, as well as the possibility of generalizing cognitive improvements. The latter are discussed in detail and possible future directions in cognitive therapy for schizophrenic patients are shown.
Changing cognitive functioning in rehabilitation of schizophrenia
Authors: Spaulding William D. , Sullivan Mary , Weiler Martin , Reed Dorie , Richardson Charles , Storzbach Daniel
Published: August 2007

A three‐factor model is proposed for clinical assessment of cognitive and neuropsychological impairments in schizophrenia. The first factor is stable, pervasive and vulnerability‐linked. The second and third include executive, memory and conceptual abilities and are episode‐linked. The third factor may be amenable to psychosocial treatment.