bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative Symptoms, Tardive Dyskinesia and Depression in Chronic Schizophrenia
Authors: Barnes Thomas R.E. , Liddle Peter F. , Curson David A. , Patel Meena
Published: August 2018

The existence of a definable and distinct negative syndrome within schizophrenia remains to be established (Barnes & Liddle, 1989). Addressing this issue, Sommers (1985) discusses three stages required to demonstrate validity for a syndrome. These are first, that the signs and symptoms must be shown to occur together. Second, operational definitions must be developed which will reliably identify and rate and features, and third, the relationships between the syndrome and other variables must be shown to be predictable. With respect to the second and third stages, this paper reports briefly on two recent studies which explored the relationship between negative features and other clinical features, specifically depressive symptoms and drug-induced movement disorder. The results of such studies (see also McKenna et al; and Lindenmayer & Kay, this volume) allow some assessment of the ability of the rating methods used to discriminate between negative symptoms and features such as drug-related bradykinesia and depressive features.
Do Negative Symptoms Respond to Pharmacological Treatment?
Authors: Kane John M. , Mayerhoff David
Published: August 2018

The introduction of neuroleptic (or anti-psychotic) medication into clinical practice was a major advance in the treatment of schizophrenia. Numerous well-controlled, double-blind clinical trials have established the therapeutic efficacy of these agents in both the acute and long-term treatment of schizophrenia (Klein et al, 1980; Kane & Lieberman, 1987). In general, the therapeutic benefit of medication has been assessed in terms of the relative reduction in the more florid signs and symptoms of schizophrenia (e.g. hallucinations, delusions, thought disorder, agitation, and hostility) and the ability of maintenance medication to reduce the rate of recurrence of these symptoms and in turn rates of rehospitalisation. At the same time it has been quite apparent that anti-psychotic drugs do not necessarily eliminate some of the major chronic disabilities of patients with this illness, disabilities reflected in impoverished affect, lack of drive and ambition, impaired spontaneity, reduced ability to relate to others, and diminished pleasure capacity. These symptoms have at times been described as negative in that they reflect an absence of or reduction in certain aspects of psychologic, cognitive, and emotional functioning in an attempt to distinguish them from the distortions or exaggerations in normal function which characterise positive symptoms (Strauss & Carpenter, 1974; Jackson, 1904).
A Study of Depression in Old Age Using Single-Photon Emission Computerised Tomography
Authors: Upadhyaya A. K. , Abou-Saleh M. T. , Wilson K. , Grime S. J. , Critchley M.
Published: August 2018

There is evidence to suggest that organic cerebral changes occur in elderly depressed patients. Quantitative studies of elderly depressed patients have demonstrated that they have reduced ‘radio-attenuation’ on computerised tomography (CT) scans and as a group resembled more closely a group of demented patients than normal controls (Jacoby et al, 1983). Many biochemical changes associated with ageing are similar to the pathophysiological abnormalities in depression and in dementia (Alexopoulos et al, 1988). These changes, coupled with the high frequency of depressive syndromes in demented patients, suggest a complex relationship between depression and dementia in old age. Mahendra (1985) has suggested that a variety of brain abnormalities can produce a spectrum of clinical manifestations, ranging from depression with minimal cognitive dysfunction at one end to dementia with minimal depression at the other.
The Context of Childhood Depression
Authors: Berney T. P. , Bhate S. R. , Kolvin I. , Famuyiwa O. O. , Barrett M. L. , Fundudis T. , Tyrer S. P.
Published: August 2018

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.
Length of Lithium Treatment Needed to Eliminate the High Mortality of Affective Disorders
Authors: Ahrens B. , Müller-Oerlinghausen B. , Grof P.
Published: August 2018

Recent studies have indicated that long-term lithium treatment reduces the expected suicidal activity and overall mortality of patients with affective disorders. Based on the data from the lithium clinics in Berlin and Hamilton (n = 512), a minimum length of two years of continued lithium treatment is needed to reduce the high mortality resulting from affective disorders.
Predicting Therapeutic Results with Levoprotiline and Maprotiline in Major Depression: The Role of the Outcome Criteria
Authors: Filip V. , Höschl C. , Karen P. , Seifertová D. , Bornová L. , Praŝková H. , Praŝko J.
Published: August 2018

We describe a double-blind study involving 58 in-patients with major depression (DSM-III). After one week on placebo, the patients were randomly assigned to either levoprotiline or maprotiline treatment for three weeks. In the next three weeks, responders were maintained on the same medication and non-responders were shifted to treatment with the complementary drug. After the initial three weeks' treatment, 31% of levoprotiline patients and 58% of maprotiline patients had responded. Both in the initial three-week treatment period and after shifting non-responders to the complementary drug, there were significant differences in favour of maprotiline. The comparison of properties of different outcome criteria in prediction analyses shows that the final score gives the best agreement with global evaluation; using the delta score (final minus baseline) or ratio score (final/baseline) as the outcome criterion may yield paradoxical results.
Understanding the Mechanism of Action of Atypical Antipsychotic Drugs
Authors: Lieberman Jeffrey A.
Published: August 2018

The thrust of development of new antipsychotic drugs has been to identify new compounds that have enhanced antipsychotic efficacy and have lesser side-effects than standard neuroleptic compounds. Drug development strategies no longer concentrate on D2 receptor antagonism but aim to produce novel compounds. The following have been pursued: (a) selective dopamine receptor antagonists; (b) serotonin receptor agonists and antagonists (5-HT1a,e, 5-HT2, 5-HT3) or mixed 5-HT2 - D2 receptor antagonist; (c) selective dopamine agonists or partial agonists; and (d) sigma-site and excitatory amino-acid antagonists. Such compounds are at various stages of development. The only drug which has truly distinguished itself as ‘atypical’ is clozapine. Its mechanism of action is unknown and the search for it, in large part, has been the impetus for development of the compounds listed above.
Metabolism of Phenothiazine and Butyrophenone Antipsychotic Drugs
Authors: Hubbard J. W. , Midha K. K. , Hawes E. M. , McKAY G. , Marder S. R. , Aravagiri M. , Korchinski E. D.
Published: August 2018

Whereas some metabolites of antipsychotic drugs are psychoactive and contribute to clinical improvement, recent studies have provided evidence that certain metabolites contribute to side-effects which can be disabling enough to negate clinical improvement as regards the psychosis. The route of administration of the drug can determine the amount of metabolite produced in the body and affect how the patient feels in response to the treatment.
Adjunctive Medication in the Maintenance Treatment of Schizophrenia and its Conceptual Implications
Authors: Siris Samuel G.
Published: August 2018

Beyond the continuing use of neuroleptic medication, psychopharmacological treatment approaches during the maintenance phase of schizophrenia often involve adjunctive medication. Appropriate use of such ‘polypharmacy’ can be crucial to patients in achieving their optimal levels of symptom management and functional capacity, although the risks of side-effects and medication interactions must be weighed. This paper reviews the use of adjunctive anti-Parkinsonian medication, benzodiazepines, propranolol, antidepressants, lithium, and carbamazepine in this context. It also explores a strategy of identifying secondary syndromes in the longitudinal course of schizophrenia which can be approached psychopharmacologically.
Psychotherapy in the Maintenance Treatment of Depression
Authors: Weissman Myrna M.
Published: August 2018

A review of epidemiologic and clinical data on depression suggests that psychotherapy is both an important alternative as well as a supplement to medication for the maintenance treatment of depression. Psychotherapy is an alternative for patients during periods when medication may not be suitable or feasible (e.g. pregnancy, nursing, before or during major surgery, or in the elderly). Psychotherapy also has a role in maintenance treatment in dealing with the social and interpersonal consequences or triggers of recurrent depression. Although the number of continuation or maintenance treatment trials that include psychotherapy is quite limited, the efficacy of maintenance treatment in the delay of recurrence and enhancement of social functioning is best established for interpersonal psychotherapy. There are also some results concerning cognitive and behavioural therapies for maintenance treatment of depression.
Cost Containment and Mental Health Outcomes: Experiences from US Studies
Authors: Wells Kenneth B.
Published: August 2018

Background. Cost containment mechanisms, such as prepayment, are being considered or implemented in the US and elsewhere, but there have been few studies of the effects of such mechanisms on quality or outcomes of care for individuals with serious psychiatric disorders.

Method. Key results from US studies on cost containment and their implications are reviewed.

Results. Cost savings in out-patient mental health care can be achieved through increasing the share of costs paid by the covered individual or through prepayment, but individuals with the greatest psychological distress or poor people may achieve worse outcomes under greater cost containment. Quality of care may be poorer under some forms of prepayment than under fee-for-service care, yet a national prospective payment mechanism for depressed elderly in-patients was not associated with a marked drop in quality or outcomes of care among those admitted.

Conclusions. Prepayment, relative to fee-for-service is not always associated with lower outcomes or quality of care for affective disorders. Under cost containment, quality and outcomes of care, especially for the sick poor, should be monitored to identify adverse consequences.
Costs and Benefits of Hospital and Day Treatment with Community Care of Affective and Schizophrenic Disorders
Authors: Wiersma D. , Kluiter H. , Nienhuis F. J. , Rüphan M. , Giel R.
Published: August 2018

Background. A randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a period of two years.

Method. Seventy patients, of whom 34 had affective and 36 had schizophrenic disorder, were assigned to the experimental condition (day treatment with ambulatory and domiciliary care), and 33 patients, of whom 16 had affective and 17 had schizophrenic disorder, were assigned to the control condition of standard clinical care.

Results. Day treatment with community care was feasible for 40.6% of the affective patients and 33.3% of the schizophrenic patients. The direct treatment costs of both disorders, based on numbers of in- and day-patient days and out-patient contacts over two years, appeared more or less the same. Patients benefited equally from day treatment as from in-patient treatment, although there were some gains in self-care and in functioning in the household among experimentals. Although schizophrenics were socioeconomically worse off, and also suffered from more (severe) symptoms and social disabilities than the affective patients at entry into the study, they were similar at two years. This finding is unexpected, compared with other follow-up studies. Extra cost for patients and families were not observed. Patients and their families in the experimental condition were significantly more satisfied with the treatment. Experimental patients spent much more time at home during admission, remained much less time in secluded wards, and were more compliant with treatment.

Conclusions. Day treatment could be considered a cost-effective alternative to in-patient treatment.
Systematic review of the outcome of anxiety and depressive disorders
Authors: Emmanuel J. , Simmonds S. , Tyrer P.
Published: August 2018

Background Although there have been many changes in the diagnosis of anxiety and depressive disorders in the past 20 years there have been few comparative enquiries into the clinical outcome of greater diagnostic categories. We therefore compared the outcome of all studies which compared the outcome of specific anxiety and depressive disorders using the standard procedures of systematic review.

Method A Medline search was carried out of all studies comparing the outcome of anxiety and depressive disorders or mixed anxiety-depressive disorders in which information was available separately for each disorder.

Results Eight studies satisfied the search criteria (all involving a period of observation of two years or greater); only one of these included randomisation of treatment and comparison between specific anxiety disorder outcome. There was a somewhat better outcome in patients with depressive disorders compared with anxiety ones, and strong evidence that both anxiety and depressive disorders singly had better outcomes than comorbid mixed disorders.

Conclusion Comorbid anxiety-depressive disorders have a poor outcome compared with single anxiety and depressive disorders, and there is some evidence that anxiety disorders have a worse outcome than depressive ones.
The Classification of Anxiety Disorders
Authors: Gelder M. G.
Published: August 2018

The classification of anxiety disorders is a controversial subject, and this controversy is reflected in the differences between the systems adopted in DSM-III-R and in the draft of ICD-10. The scheme in ICD-10 is the simpler: anxiety disorders are divided into phobic disorders and other anxiety disorders, and each is divided further into three subgroups. The three phobic disorders are: agoraphobia, social phobia, and specific phobia. The three subgroups of ‘other anxiety disorders’ are panic disorder, generalised anxiety disorder, and mixed anxiety and depressive disorder. The subdivisions of phobic disorder are those now generally adopted in most countries, and are uncontroversial. The subdivisions of generalised anxiety disorder, and mixed anxiety depressive disorder are also widely accepted, the latter group being particularly frequent among patients seen in general practice and not referred on to psychiatrists. Only the category of panic disorder is controversial. In addition to these categories which are specifically allocated to anxiety disorders, two others are relevant: ‘reactions to severe stress and adjustment disorders’, and anxious personality disorder.
On Multiaxial Psychiatric Diagnosis for General Medical Patients
Authors: Lobo A.
Published: August 2018

Criticism of the validity of traditional psychiatric diagnosis include concerns about its inability to capture both the meaning of the patient's problems, and the factors involved in the gestation of disorder, as well as its limited usefulness with regard to prognosis and treatment. However, the main drawback of traditional diagnosis seems to be that it leads to treating the disease rather than the individual. Against these fears, the role of diagnosis has been emphasised in enhancing communication among professionals, organising clinical experiences, planning services, building scientific theories, and pointing to new research directions (Kendell, 1975).
Mediating Processes in Schizophrenia
Authors: Strauss John S.
Published: August 2018

To paraphrase Kant, theory without data is mere intellectual play, but data without theory are blind. “Mediating Processes in Schizophrenia” is a topic demanding theory as well as data. Although the topic may seem limited in scope, it actually probes the causes of schizophrenia. The causes involved in ‘mediating processes’, however, are not the usually considered primary or distal causes of schizophrenia, such as genetics or early environment. Instead they are the more proximal causes – mechanisms that are closer to illness onset, exacerbation, or improvement. It is amazing how little attention is paid to this kind of cause.
Electrodermal Activity and its Relevance to Vulnerability Research in Schizophrenics
Authors: Olbrich Robert
Published: August 2018

Current interest in vulnerability to schizophrenia has been stimulated mainly by the work of Zubin and associates (Zubin & Spring, 1977; Zubin & Steinhauer, 1981). Figure 1, which was first published by Zubin & Spring in 1977, illustrates the basic idea common to every diathesis-stress model: The outbreak of a psychotic episode cannot be explained solely by referring to environmental events: a susceptibility of the individual has also to be taken into account. Ways to identify vulnerable individuals were discussed by Zubin & Steinhauer (1981), who introduced the important distinction between trait as opposed to episode markers. Only stable characteristics relate to vulnerability.
Dissemination of Skills Training Modules to Psychiatric Facilities
Authors: Liberman Robert P. , Eckman Thad A.
Published: August 2018

The current wisdom in psychiatric rehabilitation suggests that social and instrumental skills training combined with judicious neuroleptic therapy, prosthetic environments, and assertive case management confers the greatest degree of protection from relapse while promoting an optimal quality of life for patients suffering serious and long-term mental illness.
VI. Comparison of the 1975—85 Cohort with the 1970—75 Cohort
Authors: Johnstone Eve C. , Owens D. G. C. , Leary J.
Published: August 2018

As part of a study of the contribution of institution-alisation to the disabilities of schizophrenia (Johnstone et al, 1985), all patients fulfilling the St Louis criteria (Feighner et al, 1972) for schizophrenia and discharged from Shenley Hospital between 1 January 1970 and 1 January 1975 were followed up five to nine years later (Johnstone et al, 1981, 1984). Until Northwick Park Psychiatric Unit opened in 1975, psychiatric facilities for Harrow patients were all in Shenley Hospital. In the follow-up study the patients were examined in detail and an account of their social circumstances and functioning was obtained. It was considered that the study provided an opportunity to examine the success of community care in a group of schizophrenic patients who left hospital before very active policies of discharge for such patients had been developed. The results had both positive and negative aspects. For example, 18% of the patients examined had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily, but more than 50% had definite psychotic features. No patients and few relatives sought a return to in-patient care, but severe emotional, social and financial difficulties were commonplace. Moreover, 27% of the sample had no contact with the medical or social services.
VII. Police Contact
Authors: Johnstone Eve C. , Leary J. , Frith C. D. , Owens D. G. C.
Published: August 2018

Although there has been no truly satisfactory study of the association between antisocial behaviour and psychosis, a variety of sources suggest a greater than chance association between the two (Taylor, 1987), and in particular there is evidence of a substantial increase in violent behaviour in association with schizophrenia (Taylor & Gunn, 1984). There is also evidence of the possibility of over-representation of mentally ill people in arrest statistics, because of an increase in police concern (Teplin, 1985; Taylor, 1987). Studies in this area may concern rates of psychiatric disorder among persons in judicial circumstances (e.g. Taylor & Gunn, 1984), but the Harrow study provided an opportunity of examining the extent and nature of behaviour leading to police contact in a large, unselected sample of schizophrenic patients followed up for up to 13 years.
Long-Term Use of Tianeptine in 380 Depressed Patients
Authors: Lôo H. , Ganry H. , Dufour H. , Guelfi J. D. , Malka R. , Olié J. P. , Scharbach H. , Tignol J. , Marey C. , Kamoun A.
Published: August 2018

Tianeptine is a new tricyclic compound whose principal action is to increase the reuptake of serotonin. In a multicentre trial in which 380 depressed patients were treated for one year, tianeptine produced a significant reduction in the MADRS scores from day 14, with a sustained reduction maintained for up to 12 months; other measures of efficacy (HRSA, HSCL, and CGI) also reflected the improvement. Only 11% of patients withdrew because of recurrence of depression and 2% because of side-effects, which were mainly drowsiness, irritability, and gastrointestinal disturbance. Apart from a minor reduction in heart rate, unaccompanied by any conduction changes, no clinically relevant changes in vital signs or laboratory tests were seen. Seven subjects who attempted suicide by tianeptine overdose had favourable outcomes, in spite of also taking other psychotropic drugs or alcohol. No evidence of tolerance or withdrawal symptoms was seen after treatment was stopped. These results suggest that tianeptine has the potential to provide safe antidepressant activity in both the acute and chronic phases of treatment.
IV. Social Origins of the Brain Fag Syndrome
Authors: Guinness E. A.
Published: August 2018

The aetiology of psychiatric morbidity associated with education in Africa was explored using two different screening methods (as described in paper III, this supplement). The interactive effect of psychosocial variables was examined by Log linear analysis which demonstrated five independent factors: (a) the financial implications of education which represented the change from subsistence to cash economy; (b) fear of envy and bewitchment which represented the intense cultural response to education; (c) parenting in the pre-school years which was the independent family variable; (d) academic ability; (e) attributes of the school. Age of starting school and birth rank had a marginal effect. Current family adversity in terms of unstable parental union, paternal use of alcohol, polygamy and sibship size operated by interactive or additive effect. Gender and social status had no effect. The brain fag syndrome can be related to the complex social changes during rapid social transition where education is a major agent of change.
Clozapine-Associated Agranulocytosis: Risk and Aetiology
Authors: Krupp P. , Barnes P.
Published: August 2018

This paper reviews the epidemiology and pathogenesis of clozapine-associated agranulocytosis. According to present clinical experience, granulocytopenia can be expected in approximately 3% of patients during clozapine treatment. The risk of serious sequelae of granulocytopenia can be minimised by regular white blood cell count monitoring. Although research suggests that some patient groups may be at higher risk of developing this serious adverse reaction, we cannot yet predict the susceptible patients, so all patients exposed to clozapine should receive regular blood monitoring throughout treatment. Because of the risk of agranulocytosis, clozapine should only be used in schizophrenic patients who are resistant to, or intolerant of, conventional antipsychotic medications. Unless compliance with blood monitoring is assured, clozapine treatment should not be recommended.
Population and Family Studies in Depression and Mania
Authors: Mendlewicz J.
Published: August 2018

Recent progress in molecular genetics and neurobiology has attracted much attention and provided a new insight into the nature-nurture controversy in respect of the aetiology of psychiatric disorders. Affective illness, including the various subtypes of depressive and manic syndromes, has been the subject of a considerable amount of research on the relative importance of hereditary and environmental factors. This paper provides a critical review of the most relevant literature on the genetics of depression and mania.
The Prophylactic Efficacy of Fluoxetine in Unipolar Depression
Authors: Montgomery S. A. , Dufour H. , Brion S. , Gailledreau J. , Laqueille X. , Ferrey G. , Moron P. , Parant-Lucena N. , Singer L. , Danion J. M. , Beuzen J. N. , Pierredon M. A.
Published: August 2018

The efficacy of antidepressants is measured primarily by their ability to treat the acute symptoms of depression yet the underlying process may take longer to resolve. A period of emotional frailty follows resolution of the acute stage, during which the patient, although apparently symptom-free, is prone to suffer relapse of the original symptoms. Antidepressants should not be stopped immediately a response is observed, but should be given for a longer period to prevent early relapse. In those suffering from recurrent depression, long-term treatment may prevent later recurrences of new episodes of depression.

The distinction between relapse of old symptoms and recurrence of new episodes is of particular importance, both in assessing efficacy of antidepressants during the continuation phase of acute treatment and in the separate assessment of their prophylactic efficacy. Unfortunately, though, many investigations have failed to distinguish between these two distinct phenomena. Klerman & Paykel (1970) emphasised the need to distinguish between early return of depressive symptoms, which they label ‘relapses’, from the later new episodes which they term ‘recurrence’. However, there has been a general lack of systematic investigation of this question, as well as a failure to use sufficiently precise methodology to distinguish between relapse and recurrence. Some studies which purported to be of prophylaxis were in effect only examining the continuation phase of acute treatment.
A Pharmacological Profile of Fluoxetine and Other Antidepressants on Aspects of Skilled Performance and Car Handling Ability
Authors: Hindmarch Ian
Published: August 2018

The measurement of the effects of an antidepressant on psychomotor ability and cognitive processing tests is important for three reasons. Firstly, because a change in psychomotor and cognitive function is one of the truly objective assessments of psychotropic activity of a drug. Secondly, since batteries of psychological tests are often analogues of the essential aspects of real-life behaviour, performance changes can reflect the potential impairment of the activities of everyday living such as car driving, operating industrial machinery, and domestic tasks. Thirdly, since Widlocher (1983a,b) has proposed that mental and psychomotor retardation are a primary expression of depressive illness, psychomotor and cognitive tests can be used to measure the extent to which a putative antidepressant affects these psychological functions. Psychopharmacological testing can thus indicate the ‘safety’ of the drug in clinical usage by establishing an index of the behavioural ‘toxicity’ of the substance. It can also objectively determine the magnitude of the drug's psychoactive properties, and the extent to which a particular compound affects information processing and cognitive function. Substances which have a negative action on these aspects of psychological integrity could be regarded as counter-therapeutic, as they are making psychomotor and mental functions worse.
An Overview of Fluoxetine in Geriatric Depression
Authors: Feighner John P. , Boyer William F. , Meredith Charles H. , Hendrickson Gordon
Published: August 2018

During the past 75 years, the proportion of elderly individuals in the USA has grown twice as fast as the general population. Depression in this age-group occurs four times more frequently than in the general population (Butler, 1975), and the suicide rate for people over 65 years of age is 15 times greater than that of the general population (Lehman, 1980).

The elderly may be more susceptible to depression due to biological and/or psychosocial variables. Elderly people experience significant losses associated with increasing age, including death of spouse and friends, loss of work, social status, and physical and mental abilities (Lehman, 1980). The biogenic amine hypothesis suggests that the aging brain may experience a decrease in the functional availability of neurotransmitters (Lehman, 1980); this decrease may also play a role in the aetiology of depression.

Due to age-related changes in the body, the elderly can be more sensitive to drug therapy. Older patients may require careful dosage adjustments and may also be more prone to experiencing drug-related adverse events. The elderly often receive medication for various indications, and drug interactions are a concern (Thompson et al, 1983). Therefore, efficacy and safety studies of new antidepressants in elderly patients are particularly important. We pooled data from both double-blind and open-label studies to evaluate the efficacy and safety of fluoxetine in geriatric outpatients with DSM-III major depression. Positive results of fluoxetine in the treatment of geriatric depression were reported in one of these studies (Feighner & Cohn, 1985). The favourable safety and side-effect profile of fluoxetine in the general population has been discussed elsewhere (Wernicke, 1985). Plasma concentrations of fluoxetine in elderly subjects are similar to those in younger individuals (I.emberger et al, 1985). These findings, combined with a lack of cardiovascular effects (Fisch, 1985), and low lethality with overdose, indicated promise for fluoxetine as a geriatric antidepressant.
Early intervention for schizophrenic disorders
Authors: Falloon Ian R. H. , Coverdale John H. , Laidlaw Tannis M. , Merry Sally , Kydd Robert R. , Morosini Pierluigi ,   THE OTP COLLABORATIVE GROUP
Published: August 2018

Background Early detection and intervention in schizophrenic disorders is an important challenge for psychiatry.

Method Review of literature on effective biomedical and psychosocial intervention strategies.

Results Comprehensive programmes of drug and psychosocial interventions with adults who show early signs and symptoms of schizophrenic disorders may contribute to a lower incidence and prevalence of major episodes of schizophrenia. These programmes combine early detection of psychotic features by primary care services, with close liaison with mental health professionals. Long-term monitoring of signs of recurrence, with further intervention, appears essential to maintain these benefits.

Conclusions Field trials demonstrate that effective early treatment strategies can be routinely applied in clinical practice.
Early intervention in psychosis
Authors: Birchwood Max , Todd Pauline , Jackson Chris
Published: August 2018

Background We consider the evidence for the proposition that the early phase of psychosis (including the period of untreated psychosis) is a critical period' in which (a) long-term outcome is predictable, and (b) biological, psychological and psychosocial influences are developing and show maximum plasticity.

Method First-episode prospective studies, predictors of outcome and the genesis of patients' key appraisals of their psychosis are reviewed.

Results The data support the notion of the ‘plateau effect’, first coined by Tom McGlashan, which suggested that where deterioration occurs, it does so aggressively in the first 2-3 years; and that critical psychosocial influences, including family and psychological reactions to psychosis and psychiatric services, develop during this period.

Conclusions The early phase of psychosis presents important opportunities for secondary prevention. We outline a prototype of intervention appropriate to the critical period. The data challenge the widely held assumption that first-episode psychosis is a benign illness posing little risk.
Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo
Authors: Hohagen F. , Winkelmann G. , Rasche-Räuchle H. , Hand I. , König A. , Münchau N. , Hiss H. , Geiger-Kabisch C. , Käppler C. , Schramm P. , Rey E. , Aldenhoff J. , Berger M.
Published: August 2018

Background We investigated whether the combination of multimodal behaviour therapy (BT) with fluvoxamine is superior to BTand placebo in the acute treatment of severely ill in-patients with obsessive-compulsive disorder (OCD).

Method In a randomised, double-blind design, 30 patients were treated for nine weeks with BT plus placebo and 30 patients with BT plus fluvoxamine (maximum dosage 300 mg, mean dose 288.1 mg). BT included exposure with response prevention, cognitive restructuring and development of alternative behaviours.

Results Both groups showed a highly significant symptom reduction after treatment. There were no significant differences between the groups concerning compulsions. Obsessions were significantly more reduced in the fluvoxamine and BT group than in the placebo and BT group. Furthermore, the group BT plus fluvoxamine showed a significantly higher response rate (87.5 v. 60%) according to a previously defined response criterion. Severely depressed patients with OCD receiving BT plus placebo presented a significantly worse treatment outcome (Y–BOCS scores) than all other groups.

Conclusions The results suggest that BTshould be combined with fluvoxamine when obsessions dominate the clinical picture and when a secondary depression is present.
Extrapyramidal Syndromes and New Antipsychotic Drugs: Findings in Patients and Non-human Primate Models
Authors: Casey Daniel E.
Published: August 2018

Since neuroleptic drugs were introduced in the 1950s they have become the primary mode of therapy for managing both acute and chronic psychoses. Although some antipsychotic drugs are free of disturbing extrapyramidal side-effects (EPS), most have a very narrow therapeutic/toxic index. Clozapine is the best example of an antipsychotic with a wide separation between antipsychotic actions and liability to EPS, but its side-effect profile of sedation, salivation, seizures, and agranulocytosis are factors that limit its use, and clearly indicate the need for further advancement in neuroleptic therapy.
Role of murine macrophage in temporal regulation of cortisol and serotonin induced adipogenesis in pre-adipocytes when grown together
Authors: Priyadarshini Sushri , Pradhan Biswaranjan , Aich Palok
Published: August 2018

Regulation of adipogenesis, root cause for obesity, is very poorly understood. Studies, however, have laid several evidences of immuno-metabolic regulations of adipose tissue in chronic psychological stress, leading to visceral obesity and atherosclerosis as some of various severe outcomes of stress manifestation. Despite pronounced associations of hormonal markers of stress with dys-regulated metabolic states, the contributing signaling events are yet to be established. It is apparent that to understand contributing signaling events we need a model. Although an in vivo model is preferred but difficult to establish. Current report, therefore, represents an in vitro model system for simulation of adipose tissue in a chronic stress micro-environment by growing pre-adipocytes with macrophages in presence and absence of stress hormones. In this report, effects of cortisol and serotonin on the kinetics of immune and metabolic changes in adipocytes and macrophage alone and co-cultured was studied through whole genome transcriptome profiling. A transition from pro- to anti-inflammatory response in the immune profile of pre-adipocytes with increasing time in co-culture with macrophages was observed. This transition was reversed by stress hormones cortisol and/or serotonin.
Drosophila melanogaster as a function-based high-throughput screening model for antinephrolithiasis agents in kidney stone patients
Authors: Ali Sohrab N. , Dayarathna Thamara K. , Ali Aymon N. , Osumah Tijani , Ahmed Mohamed , Cooper Tyler T. , Power Nicholas E. , Zhang Dongxing , Kim Dajung , Kim Rachel , St. Amant Andre , Hou Jinqiang , Tailly Thomas , Yang Jun , Luyt Len , Spagnuolo Paul A. , Burton Jeremy P. , Razvi Hassan , Leong Hon S.
Published: August 2018

Kidney stone disease involves the aggregation of stone-forming salts consequent to solute supersaturation in urine. The development of novel therapeutic agents for this predominantly metabolic and biochemical disorder have been hampered by the lack of a practical pre-clinical model amenable to drug screening. Here, Drosophila melanogaster, an emerging model for kidney stone disease research, was adapted as a high-throughput functional drug screening platform independent of the multifactorial nature of mammalian nephrolithiasis. Through functional screening, the therapeutic potential of a novel compound commonly known as arbutin that specifically binds to oxalate, a key component of kidney calculi, was identified. Through isothermal titration calorimetry, high-performance liquid chromatography and atomic force microscopy, arbutin was determined to interact with calcium and oxalate in both free and bound states, disrupting crystal lattice structure, growth and crystallization. When used to treat patient urine samples, arbutin significantly abrogated calculus formation in vivo and outperformed potassium citrate in low pH urine conditions, owing to its oxalate-centric mode of action. The discovery of this novel antilithogenic compound via D. melanogaster, independent of a mammalian model, brings greater recognition to this platform, for which metabolic features are primary outcomes, underscoring the power of D. melanogaster as a high-throughput drug screening platform in similar disorders. This is the first description of the use of D. melanogaster as the model system for a high-throughput chemical library screen.

This article has an associated First Person interview with the first authors of the paper.
História do varejo
Authors: Varotto Luís Fernando
Published: August 2018

A história do varejo no Brasil acompanha os principais momentos da formação econômica e social do país. Inicialmente baseado no oferecimento de itens básicos de subsistência, o sistema vai se modernizando e se sofisticando até chegar aos modelos de grandes hipermercados e shopping centers. Na recapitulação dessa história, fica evidente a clara tendência de concentração do setor.
Mercado de idéias
Authors: Faria Alexandre
Published: August 2018

O fenômeno da globalização popularizou a crença de que vivemos em um mundo onde idéias, informação e conhecimento circulam de forma livre e democrática. Na área de conhecimento em gestão, em particular, análises mostram que referenciais produzidos em países desenvolvidos, notadamente nos EUA, tendem a predominar sobre a produção local. O artigo analisa o mercado de idéias na área de gestão e discute a posição do Brasil nesse valioso contexto.
Velhice como destino
Authors: Freitas Maria Ester de
Published: August 2018

A velhice não é apenas um fenômeno biológico e psicológico. Depende do modo como cada cultura e sociedade concebem o que é ser jovem e velho, bem como a intensidade do valor atribuído a cada uma dessas etapas da vida. Particularmente hoje, com a aceleração do tempo e a apologia da boa forma e da performance, a velhice é repetidas vezes negada. O artigo destaca que ser velho é um destino, e que, na passagem do tempo, é a condição humana que prevalece.
Congestionamentos urbanos
Authors: Maciel Vladimir Fernandes
Published: August 2018

Grandes engarrafamentos tornaram-se parte da paisagem das grandes metrópoles mundiais. Somadas ao aborrecimento causado pela situação, há também perdas econômicas expressivas. A solução para o problema depende de uma melhor compreensão do uso e da ocupação do solo urbano
Radiografia de medos
Authors: Freitas Maria Ester de
Published: August 2018

A lista de medos experimentados pelos seres humanos é, com certeza, extensa. Neste artigo, baseado em uma pesquisa inédita, são apresentados alguns medos comuns, cuja intensidade pode ter um impacto alegórico como também paralisante
The Impact of Quality Management on Profitability: An Empirical Study
Authors: Pignanelli Alexandre , Csillag João Mário
Published: August 2018

The article investigates the impact of quality on profitability, following the evolution duringa ten years period of 31 firms recognized by Brazilian National Quality Award (PNQ). Data of other companiesfrom the same sectors were also considered, reaching 5354 observations. The statistical analysesincluded regressions, parametric and non-parametric analyses.
Cobb-Douglas, Translog Stochastic Production Function and Data Envelopment Analysis in Total Factor Productivity in Brazilian Agribusiness
Authors: Constantin Paulo Dutra , Martin Diogenes Leiva , Rivera Y Rivera Edward Bernard Bastiaan de
Published: August 2018

The objective of this paper is to apply a Cobb-Douglas, Translog Stochastic Production Function and Data Envelopment Analysis in order to estimate inefficiencies over time as well as respective TFP (Total Factor Productivity) sources for main Brazilian grain crops - namely, rice, beans, maize, soybeans and wheat - throughout the most recent data available comprising the period 2001-2006. The results indicate that, although positive changes exist in TFP for the sample analyzed, a decline in the use of technology has been evidenced for all grain crops in which it is observed a historical downfall in the use of inputs in Brazilian agriculture
Service Profit Chain in the Technical Assistance Environment: an Exploratory Study
Authors: Barbosa Frederico , Leone Rodrigo , De Souza Tereza , Nóbrega Kleber Cavalcanti
Published: August 2018

One of the strongest relationships among the elements of Heskett, Sasser and Schlesinger's service profit chain is verified between employee satisfaction and client's satisfaction. This paper reports the results of an exploratory study on the Brazilian operation of a world-wide leader of elevator technical assistance, in which the relationship between these two elements and their influence on the client retention rate was evaluated. The research data were treated with statistical discriminant and cluster analysis. The findings identified the relationship between employee and client satisfaction in 25 of the 27 business units studied. On the other hand, the factor that largely influences the client retention rate in this business environment is client satisfaction, while employee satisfaction is almost null. The results have important academic and managerial implications, given the limited amount of studies in this area and drive actions for the business success.
Supply Chain Networks for Perishable and Essential Commodities: Design and Vulnerabilities
Authors: Apte Aruna
Published: August 2018

This paper presents the results of our case-based research into the causes and remedies of fresh produce supply chain disruptions resulting from contamination. The research was motivated by the incident of E-coli outbreak in packaged spinach in the US. We base our analysis on information gathered from published literature and data collection in the region from personnel involved in Agriculture. Our research is aimed at addressing the following research questions: What key factors contribute to the vulnerability to disruption from contamination and what are the interrelationships between these contributing factors? What managerial actions may be taken to minimize the fresh produce supply chain's vulnerability to disruption? In this research we develop a conceptual framework consisting of the contributing factors: product type, topological structure, exposure to contamination, product traceability, and communication. The practice related contributions of this research are managerial insight and recommended actions derived from the proposed conceptual framework.
ORGANIZATIONAL STRUCTURE, INTEGRATION, AND MANUFACTURING PERFORMANCE: A CONCEPTUAL MODEL AND PROPOSITIONS
Authors: Teixeira Rafael , Koufteros Xenophon , Peng Xiaosong David
Published: August 2018

One major characteristic of studies in operations and supply chain management literature is a focus on how integration can lead to superior operations and manufacturing outcomes. Most of these studies, however, focus only on internal or external integration and few have been dedicated to understand how both internal and external integration influence performance outcomes. In addition, few studies, if any, have looked to the antecedents of organizational structure as a driver for such forms of integration. To help filling this gap, we draw on organizational structure and resource-based view theoretical perspectives to present a conceptual model that proposes a relationship between organizational structure and integration. The model also considers major antecedents of organizational structure and the manufacturing performance consequences of integration. As a result, we introduce a series of propositions to be subject to empirical scrutiny as well as serve as a reference for future conceptual and empirical models.
A Supply Chain Model for Library Quality and Service Improvement
Authors: Kress Nancy , Wisner Joel
Published: August 2018

The key to a library’s success is its ability to effectively and economically deliver services and information that users value. Additionally, the objective of supply chain management is to coordinate the focal firm’s processes and activities with those of its suppliers and customers, such that the firm’s delivered products and services meet or exceed customer requirements. It thus seemed appropriate to analyze a library from a supply chain perspective to assess and improve its ability to serve its users. Consequently, the authors employed an action research methodology to work with library personnel from two departments, User Services and Technical Services, as they merged into one division, to map the information resources supply chain of the University of Nevada, Las Vegas Lied Library. Once the supply chain model was completed, key processes were analyzed and performance measures designed, with the goal of improving division products and services. This paper reviews the relevant literature, presents the Lied Library information resources supply chain model, and provides the performance measures along with several improvement examples.