bluuebunny/crossref_metadata_2025 huggingface dataset:
A City Looks at its Problem of Drug Abuse by Injection
Authors: Bishop B. P. , Cave G. C. , Gay M. J. , Morgan H. G.
Published: August 2008

A retrospective, multi-source screening study has detected 148 users (110 males, 38 females) of intravenous drugs who presented to all relevant agencies between 1971 and 1973 in Bristol, a city where maintenance therapy is a very infrequent practice. The peak prevalence was found in the age group 20–24 years, and it appeared that the chief sources of drugs were burglaries of chemists' shops and general practitioner prescriptions. Sixty-four per cent of our users had not been notified to the Home Office. Suggestions are made for the future monitoring and development of services.
Diencephalic Stimulation and the Effects of Ect in Endogenous Depression
Authors: Abrams Richard , Taylor Michael Alan
Published: August 2008

We compared conventional bilateral ECT treatment electrode placement with simultaneous unilateral electrode placement to both sides of the head (dominant/nondominant unilateral ECT) in 20 patients with endogenous depression. Under double-blind random assignment conditions we found that six bilateral ECT were significantly more effective than six dominant/nondominant unilateral ECT in reducing depression rating scale scores. In the light of data from intracerebral ECT current distribution studies we interpret our findings to support our previously advanced hypothesis that diencephalic stimulation is requisite for the therapeutic benefit of bilateral ECT in endogenous depression.
Behavioural Treatment of Orgasmic Dysfunction: A Controlled Study
Authors: Munjack Dennis , Cristol Alan , Goldstein Alan , Phillips Debora , Goldberg Alice , Whipple Katherine , Staples Fred , Kanno Pamela
Published: August 2008

Twenty-two anorgasmic women received 20 sessions of a multiple-technique behavioural therapy. The design included blind ratings by two independent assessors, multiple assessment instruments, and a waiting list control group.

Treatment was significantly better than no treatment in terms of: (1) the percentage of patients experiencing orgasm during at least 50 per cent of sexual relations; (2) the percentage of women reporting satisfactory sexual relations at least 50 per cent of the time; (3) patients' ratings of positive reactions to various sexual behaviours; and (4) assessors' global clinical ratings.

Significant improvement was also noted on the MMPI, IPAT, and Symptom Check List. Improvement was maintained at a follow-up average 9 months later. These results support the impression that a behavioural approach offers much promise in treating female orgasmic dysfunction.
A Comparison of Deaf and Non-Deaf Patients with Paranoid and Affective Psychoses
Authors: Cooper A. F. , Garside R. F. , Kay D. W. K.
Published: August 2008

A comparison was made of the social and domestic background, prepsychotic personality and symptomatology of deaf (‘hard of hearing’) and non-deaf patients aged 50 or over with paranoid or affective psychoses. The deaf patients were found to be a very heterogeneous group in respect of age of onset, duration, severity and pathological basis of their deafness, but there was a substantial subgroup of paranoid patients with deafness beginning before the age of 45 in whom the personality appeared to have been less deviating than in the remainder. It was thought that the deafness in this subgroup had possibly played a relatively specific role in causing the psychosis. Some problems in identifying deafness and assessing its significance are discussed.
Clozapine versus Perphenazine: The Value of the Biochemical Mode of Action of Neuroleptics in Predicting their Therapeutic Activity
Authors: van Praag H. M. , Korf J. , Dols L. C. W.
Published: August 2008

The chemical structure of a neuroleptic does not reliably predict the exact profile of its therapeutic action. We considered the question whether the biochemical action of a neuroleptic, and specifically the ratio between DA-receptor block and NA-receptor block, might have a higher predictive value in this respect. In this context we carried out a double-blind study of the therapeutic value of clozapine and perphenazine in acute psychoses of varying symptomatology and aetiology. There are strong indications that clozapine has only a slight inhibitory effect on transmission in central DA-ergic neurons, but markedly inhibits transmission in central NA-ergic neurons, and that the reverse applies to perphenazine. In view of these data we expected perphenazine to be a stronger antipsychotic and a weaker sedative than clozapine, andvice versa.The plausibility of this hypothesis was demonstrated. Partly also on the basis of earlier research, we concluded that the biochemical action of a neuroleptic is a more faithful predictor of its therapeutic action profile than the chemical structure.
Depression and Loss
Authors: Brown George W. , Harris Tirril , Copeland John J.
Published: August 2008

Recent losses occurring in the two years before onset of depression in women are distinguished from past losses occurring at any time before this. Of past losses only loss of mother before 11 is associated with greater risk of depression—both among women treated by psychiatrists and among women found to be suffering from depression in a random sample of 458 women living in London. Past loss of a father or sibling before 17 (or a mother between 11 and 17), or a child or husband, is not associated with a greater chance of developing depression. However, among patients all types of past loss by death are associated with psychotic-like depressive symptoms (and their severity) and other types of past loss with neurotic-type depressive symptoms (and their severity). It is argued that these associations probably reflect direct causal links, and a socio-psychological theory to explain them is discussed.
Coefficients of Agreement Between Observers and Their Interpretation
Authors: Maxwell A. E.
Published: August 2008

The measurement of agreement between ratings of patient symptomatology by two or more psychiatrists is discussed. It is noted that coefficients which allow for possible chance agreement are to be preferred, but they involve assumptions about the way in which chance factors may operate. Assumptions which involve prior probabilities of the incidence of a symptom appear to be too stringent, and a new coefficient, called the RE coefficient, is recommended in which chance is assumed to operate in a purely random way. Binary scales are discussed in detail, but methods of dealing with scales of wider range are also referred to.
Is Psychoanalysis a Science? A Reply to Slater
Authors: Kelk Norman
Published: August 2008

In three recent articles, Slater (1972, 1973, 1975) has made certain claims concerning the nature of science, especially as it applies to psychiatry. Most recently (Slater, 1975), he has applied his criteria for assessing science to psychoanalysis, and has found it seriously lacking. In this article Slater's criticisms of psychoanalysis are used as a foil to attack his criteria for science. It is argued that his methodological criteria are extremely conservative and would be likely to cause the demise of scientific activity if at all seriously applied. Further, it is argued that psychoanalysis is a science on any reasonable application of Slater's criteria.
‘Dissolution of the Mental Hospital’: Fifteen Years On
Authors: Early Donal F. , Nicholas Michael
Published: August 2008

The pattern of decline of a mental hospital population over fifteen years is described. Continuing problems are commented on, particularly the presence of ‘old’ long-stay patients and the accumulation of ‘new chronic patients'. The number of beds required for each of these categories is estimated.

The dissolution of the mental hospital service by degradation is deplored, and a suggestion is made that some of the good points of the old service might be salvaged before it is too late.
On the Significance of the Erythrocyte Lithium to Plasma Lithium Ratio
Authors: Marini James L.
Published: August 2008

Correlations between the ratio of erythrocyte to plasma lithium (Le/Lp) and clinical status have been reported by some authors and disputed by others. Examination of the literature on Le/Lp and erythrocyte physiology suggests that Le/Lp is determined by peripheral pharmacokinetic parameters and has no direct relationship to central pathophysiology. Because of this, and because of inconsistencies between studies reporting correlations of the ratio with clinical status, such correlations probably cannot illuminate either the pathophysiology of affective illness or the mode of action of lithium.
Mortality in Patients with Schizophrenia, Mania, Depression and Surgical Conditions
Authors: Tsuang Ming T. , Woolson Robert F.
Published: August 2008

Mortality data are presented from a four-decade follow-up study of 200 schizophrenic, 100 manic, 225 depressive patients, and 160 surgical controls (80 appendicectomy; 80 herniorrhaphy). Data for this analysis were available on 648 (95 per cent) members of the study population. Using sex-age standardized mortality ratios (SMR), the mortality experience of the study population was compared with that of the state of Iowa, the geographical area served by the admitting medical facility for the study group. Results are presented for a four-decade period beginning 1935–44, and ending 1965–74. All three psychiatric groups had a significant increase in mortality risk. This was most pronounced in the first decade following admission, although schizophrenic patients, especially females, continued to show a significant excess of deaths throughout the entire four decades of the follow-up period. During no decade of the follow-up period did the mortality of the surgical controls differ significantly from that of the Iowa population.
What Have Cognitive Deficits to do with Schizophrenic Symptoms?
Authors: Hemsley D. R.
Published: August 2008

This paper considers possible relationships between cognitive deficits and symptomatology in schizophrenia. It is argued that a combination of defective filtering and slowness in response selection results in a state of information overload in acute schizophrenia. The methods by which normal subjects adapt to experimenter-induced overload may therefore be relevant to aspects of schizophrenic behaviour. The considerable intra- and inter-subject variability in symptomatology of schizophrenic patients may represent differing adaptations to similar cognitive disturbance, such secondary abnormalities being prominent in chronic patients. Sections of the literature on acute-chronic differences are consistent with such a formulation, although one cannot infer intra-individual change from cross-sectional studies; there is a clear need for longitudinal investigations in this area. The preferred method of adaptation will be dependent on the severity of overload, the environment, and personality factors independent of the psychosis. The implications for the modification of schizophrenics' behavioural abnormalities by operant procedures are discussed.
Aspects of Intensity of Affective Constructs in Depressed Patients
Authors: Silverman Gerald
Published: August 2008

Two groups, 10 subjects in each, one consisting of depressed patients and the others normal controls, ranked photographs of faces for two sets of six constructs. One set consisted of the critical constructs of the Bannister and Fransella grid test, while the other set of constructs were all related to affect. The depressed patients showed a higher intensity score for affective constructs than did the normal subjects. There was no difference for critical constructs. The affective intensity score decreased on two further retestings for the depressed group; for the normal group they remained reasonably constant. These results may shed light on the reorganization in construing aspects of affect which occurs with depression and its remission.
Obsessional Cognition: Performance on Two Numerical Tasks
Authors: Reed Graham F.
Published: August 2008

It is argued that obsessional indecision reflects a formal cognitive characteristic, and should therefore be detectable in slower performance of insignificant, neutral tasks. The obsessional will not be handicapped in structured tasks requiring concentration and a deductive approach, but he will be slower in less structured tasks requiring a predominantly inductive approach. Results from two neutral (numerical) tasks support the predictions.
Group Exposure for Agoraphobics: A Replication Study
Authors: Teasdale J. D. , Walsh P. A. , Lancashire M. , Mathews A. M.
Published: August 2008

A replication study was conducted of the treatment of agoraphobics by exposure in cohesive groups, as described by Hand, Lamontagne and Marks (1974). The continuing improvement during follow-up, with consequent large overall improvement, reported in the original study was not replicated. However, the present study confirmed the usefulness of this procedure as a highly cost-efficient treatment.

The assumed equivalence of the Gelder and Marks (1966) phobic rating scale and its modification by Watson and Marks (1971) was examined. Large discrepancies between the scales were obtained for initial assessments and change scores. It is suggested that there is a need for workers in this field to agree on methods of measurement.
The Making and Breaking of Affectional Bonds
Authors: Bowlby John
Published: August 2008

An account is given of attachment theory as a way of conceptualizing the propensity of human beings to make strong affectional bonds to particular others and of explaining the many forms of emotional distress and personality disturbance, including anxiety, anger, depression and emotional detachment, to which unwilling separation and loss give rise. Though it incorporates much psychoanalytic thinking, many of its principles derive from ethology, cognitive psychology and control theory. It conforms to the ordinary criteria of a scientific discipline.

Certain common patterns of personality development, both healthy and pathological, are described in these terms, and also some of the common patterns of parenting that contribute to them.
Psychiatry: Science, Meaning and Purpose
Authors: Bebbington Paul E.
Published: August 2008

The Gods did not reveal, from the beginning, all things to us; but in the course of time, through seeking we may learn, and know things better.

Xenophanes
A Simple and Effective Treatment for Flight Phobia
Authors: Shaw H. L.
Published: August 2008

Seventeen patients were treated by group desensitization and auto-hypnotic training over a period of six weeks for flight phobia, with a highly significant, reduction of fear for the group. Expectation of benefit correlated positively with fear reduction.
Psychomotor Traits, Social Desirability and the Personal Illness Hierarchy
Authors: Foulds G. A. , Bedford A.
Published: August 2008

Seventy-eight psychiatric in-patients were allocated to personal illness classes by means of the Delusions-Symptoms-States Inventory (DSSI). Paper and pencil measures of psychomotor speed and scatter of tapping were administered with an immediate retest. It is suggested that from a social desirability position one would have to predict that the more personally ill (i.e. those endorsing the more socially undesirable items) would be slower and more diffuse on these measures. We found, however, such patients to be more constricted and slower. It is concluded that such a combination adds to the utility and validity of the hierarchy of classes of personal illness.
Peptides with Morphine-like Action in the Brain
Authors: Kosterlitz Hans W. , Hughes John
Published: August 2008

The reasons which led to the search in the brain for substances with morphine-like actions are discussed. Two pentapeptides, methionine-enkephalin and leucine-enkephalin, were isolated. The amino acid sequence of methionine-enkephalin occurs also in the pituitary prohormone β-lipotropin, of which longer fragments (endorphins) of up to 31 amino acids exhibit strong morphine-like action.

The physiological significance of these short and long opioid peptides is discussed, particularly with regard to their possible roles as neurotransmitter or neuromodulator.

With regard to the mechanisms involved in the development of tolerance to and dependence on opiates, the importance of interaction between the endogenous opioid peptides and the exogenous opiate alkaloids is stressed.

The possible therapeutic implications are discussed briefly.
Cytogenetic Investigation in Twins with Manic-Depressive Disorders (22 Monozygotic and 27 Dizygotic Twin Pairs)
Authors: Nielsen Johannes , Homma Akira , Bertelsen Aksel
Published: August 2008

Chromosome examination was made in 22 monozygotic and 27 dizygotic twin pairs of whom one or both of each pair suffered or had suffered from manic-depressive disorder. We found a significantly higher frequency of chromosome variations among dizygotic twin pairs than was expected from population studies, but not in monozygotic pairs. There was no association between the chromosome variations and manic-depressive disorders. We found no greater intra-pair correlation in monozygotic twins compared with dizygotic twins as regards hypodiploidy, hyperdiploidy and unstable chromosome aberrations, which indicates that the aetiology of such aberrations is mainly of exogenic nature.
Suicidal Intent in Self-Injury
Authors: Pierce David W.
Published: August 2008

The difficulties in measuring suicidal intent in cases of self-injury are discussed, and a scale is described to measure this intent. This scale has been used in 500 cases of self-injury. It is practical and reliable. Results show that the scores derived from it are closely related to the similar Beck Scale; they are also related to age, sex, social isolation, method of self-injury, previous history of self-injury or of psychiatric treatment, physical health at the time of self-injury and alcohol abuse. These results are discussed with particular reference to suicide prediction and the future validation of the scale by long-term follow-up.
The Course and Outcome in Depressive Illness
Authors: Rao A. Venkoba , Nammalvar N.
Published: August 2008

One hundred and nine out of one hundred and twenty-two cases of endogenous depression were followed-up after their index diagnosis 3–13 years earlier. No recurrence occurred in 28 cases. Forty-two cases turned out to be bipolar and 21 remained unipolar. Manic episodes outnumbered the depressive ones. The change of polarity from depression to mania occurred within three years after the initial depression, though in others the shift occurred between three years and twelve years. The number of episodes of depression before the onset of mania varied from 1 to 3. While the onset of depression before the age of 40 years predisposed to recurrences, there was risk of chronicity in those patients who developed the illness after 40.
On the Prevalence, Diagnosis and Management of Lithium-Induced Hypothyroidism in Psychiatric Patients
Authors: Lindstedt Göran , Nilsson Lars-Åke , Walinder Jan , Skott Annika , Öhman Rolf
Published: August 2008

Fifty-three psychiatric patients who had been receiving treatment with lithium continuously for more than two years were examined to estimate the prevalence of lithium-induced hypothyroidism. It was found to be 20 per cent among women. No men were affected among these patients. In order to study the characteristics of the disorder further cases were drawn from another population. One third of the patients developed hypothyroidism during their first year of treatment, others not until after 9 years. About two thirds of the female patients with hypothyroidism had thyroid antibodies. All cases with lithium-induced hypothyroidism showed elevated levels of serum thyrotropin, which in our experience is the laboratory examination of choice in these as well as other cases of ‘primary’ hypothyroidism. Since the probability of detecting these cases at a given control visit was found to be low, we feel that such visits need not include extensive laboratory investigations. Hypothyroid patients responding well to lithium treatment should continue their medication combined with appropriate thyroxine substitution.
The Significance of Dopamine for the Mode of Action of Neuroleptics and the Pathogenesis of Schizophrenia
Authors: van Praag H. M.
Published: August 2008

Animal experiments have demonstrated the likelihood that all known neuroleptics inhibit transmission in central CA-ergic systems, regardless of their chemical structure and via different mechanisms. For clinical psychiatry this fact prompts a number of questions: (1) is this phenomenon also to be found in human individuals; (2) if so, is it of importance for the clinical (side) effects of neuroleptics; (3) do patients with (schizophrenic) psychoses show signs of central CA-ergic hyperactivity ? This article presents a survey of clinical research focused on these questions which, for the sake of brevity, is confined to DA metabolism. The available data indicate the plausibility of a correlation between inhibition of DA-ergic transmission on the one hand, and on the other hand the therapeutic effects of neuroleptics and the occurrence of hypokinetic-rigid symptoms. The hypothesis that DA-ergic hyperactivity is an important pathogenetic mechanism in schizophrenic psychoses can be based only on indirect arguments; direct studies of the DA metabolism have so far failed to reveal supporting evidence. The possible causes of this failure are discussed.
The Effect of Holidays on a Token Economy Regime
Authors: Elliott Peter A.
Published: August 2008

This preliminary study investigates the effect on patients' performance of a set time off, in the form of a short holiday, from a strict reinforcement (token economy) regime.

Assessment was by the patients' mean token earnings before and after the holiday and their self-care and work performance throughout. The results suggest that a holiday from a token economy has beneficial effects for patients.
Cyclone Tracy and Darwin Evacuees: On the Restoration of the Species
Authors: Parker Gordon
Published: August 2008

A validated objective measure of the state of psychological function was used to determine the incidence and course of psychological dysfunction in a group of evacuees from Darwin following disaster caused by a cyclone (Cyclone Tracy). While psychological dysfunction was increased initially (58 per cent) and at ten weeks (41 per cent), it had returned to an Australian general population control level (22 per cent) at 14 months.

Factors influencing psychological dysfunction were examined, and it is suggested that the sample faced two different stressors at differing times. Initial psychiatric morbidity was most clearly associated with the experience of thinking that one might die or be seriously injured and therefore conceptualized as a ‘mortality stressor’. Psychiatric morbidity at ten weeks appeared to be most closely associated with what has been conceptualized as a ‘relocation stressor’.

Reasons why psychiatric morbidity decreased to a general population control level are discussed.
The Syndrome of Capgras
Authors: Christodoulou G. N.
Published: August 2008

In eleven patients with the syndrome of Capgras, the clinical data and the results of electroencephalographic, echoencephalographic, air-encephalographic, psychological and brain-scanning investigations are presented and discussed. All patients were psychotic: six were schizophrenic, four were depressive and one suffered from an organic psychosis. A paranoid element was marked in all cases.

The present evidence supports the view that organic factors are important in the pathogenesis of Capgras' syndrome.
Coping Behaviour After Shipwreck
Authors: Henderson Scott , Bostock Tudor
Published: August 2008

A description is given of the coping behaviour of seven men who survived a shipwreck and were not rescued until 13 days later. The principal behaviours shown by the men were attachment ideation, drive to survive, modelling, prayer and hope. Particular attention is paid to the first of these, and consideration given to its likely origins in behavioural evolution. It is proposed as a hitherto inadequately recognized coping behaviour. A follow-up examination 12 to 24 months later showed that five of the seven men available had developed substantial psychiatric disorder, while by contrast one was not only well but claimed to have been enriched by the experience. Exposure to extreme adversity or disaster may have long-term effects on mental health. Further longitudinal studies of disaster victims are necessary for the design of informed after-care.
Life Events and Illness: A Three Year Prospective Study
Authors: Schless Arthur P. , Teichman Alicia , Mendels J. , Weinstein Norman W. , Weller Kenneth
Published: August 2008

In an investigation of the relation between life events (stressors) and illness, 87 medical students reported on a prospective basis their health and life events history over a three year period. There were a few positive findings, e.g. that subjects who reported more life events during the period also reported more illnesses during that period. Overall, however, the study showed a lack of statistically significant association between life events and illness.
Validity of the Hamilton Rating Scale for Depression
Authors: Knesevich J. W. , Biggs J. T. , Clayton P.J. , Ziegler V. E.
Published: August 2008

In 26 depressed patients, a high correlation (0·89) was found between the Hamilton score and a psychiatrist's global rating and between the change (0 · 68) in these ratings during treatment. The Hamilton scale was able to differentiate at the 0·01 level four degrees of severity based on the global rating. Limiting the range of severity measured was found to lower significantly the correlation between the ratings. A prospective examination of a six-item sub-scale of the Hamilton scale developed by Beck and associates failed to confirm its claimed improvement in sensitivity or validity.
A Replication Study of Foulds' and Bedford's Hierarchical Model of Depression
Authors: Bagshaw V. E. , Bagshaw V. E.
Published: August 2008

Seventy-eight depressives were assessed on the Delusions-Symptoms-States Inventory. The results supported Foulds' and Bedford's hierarchy model, in that nearly all patients fitted this model, and the relationship between delusions of Contrition and state of Depression was found to be an inclusive, non-reflexive one. Suggestions are made for extensions to this study.
The Relationship Between Extra- and Intracellular Lithium Concentration in Human Red Blood Cells: an in Vitro Study
Authors: Ratey John J. , Mallinger Alan G.
Published: August 2008

Red blood cells (RBCs) from normal volunteers were incubated in vitro at four different extracellular lithium concentrations. Extracellular lithium concentration affected RBC lithium accumulation in several ways. As extracellular lithium concentration increased, the inter-individual variability of RBC lithium accumulation increased. Furthermore, the ratio of RBC lithium concentration to extracellular lithium concentration (lithium ratio) increased in relation to increasing extracellular lithium concentration. A lack of agreement among the authors of recent reports dealing with the significance of the lithium ratio as a psychobiological measure has been noted. It is suggested that this lack of agreement may be due, in part, to the study of patients with differing levels of extracellular lithium.
A Ten-Year Follow-up Study of Chinese Schizophrenics in Hong Kong
Authors: Lo W. H. , Lo T.
Published: August 2008

One hundred and thirty-three Chinese schizophrenic patients first seen in 1965 were traced for a follow-up assessment in 1975. Eighty-two patients attended and were fully evaluated, 47 failed to attend and 4 were known to have died. The course and outcome were graded into four categories, and it was found that 65 per cent of the fully evaluated group had full and lasting remission or showed no or mild deterioration only, despite some relapses. Intra-group comparison showed that being female, a shorter duration of illness, an acute onset, symptom-groups other than disturbances of emotion and volition, and the presence of a supportive relative are factors which affect the prognosis favourably.
Anorexia Nervosa and the Secretion of Prolactin
Authors: Williams Paul
Published: August 2008

Theoretically, one would expect to find increases in prolactin secretion in patients with anorexia nervosa: the evidence for this is reviewed. However, relevant work to date seems to indicate that this is not so. These paradoxical findings are discussed, and areas of further research are outlined.
Writer's Cramp—A Rational Approach to Treatment?
Authors: Bindman Ellis , Tibbetts R. W.
Published: August 2008

The history of writer's cramp is reviewed, and the study of ten cases described. Nine of the patients were male with obsessional personalities, and involved in a conflict with some bearing on the act of writing. Treatment by psychotherapy and re-education produced either temporary or little improvement; biofeedback, used in six cases, produced some benefit in four, of which only one relapsed. Although no statistical weight can be attached to the results of so short a series, biofeedback appears to offer a promise of response which merits further investigation. The use of the electromyograph is discussed also as a means of discriminating between tension and tremor in such cases, with particular reference to their psychosomatic meaning.
The Social Network, Support and Neurosis
Authors: Henderson Scott
Published: August 2008

The psychological function of the social network is considered in terms of attachment theory. Social bonds are proposed as essential for obtaining a commodity commonly but unsatisfactorily referred to as support. Requirements for this complex commodity can be discerned in a wide range of contexts. Examples considered are the evolutionary origin of the social network itself, the concept of psychosocial supplies, the distribution of neurosis in Western and non-Western populations, the use of medical consultations, psychotherapy and habitual responses to adversity or disaster. In these and other contexts, it is apparent that individuals have, quite simply, a requirement for affectively positive interaction with others. Under stressful conditions this interaction is called ‘support’. When support is lacking there is evidence that psychiatric and perhaps medical morbidity rates increase. For research, the objective must now be to determine whether depleted primary group interaction is causally related to morbidity, or whether it is only an associated or a secondary factor in aetiology, or indeed wholly unrelated. Elucidating more precisely why people need people constitutes an important new task for social psychiatry.

‘Thank you for your support; I shall wear it at all times.’

Neddy Seagoon inThe Goon Show

(Spike Milligan, 1959)
Screening Schoolchildren for High Risk of Emotional and Educational Disorder
Authors: Kolvin I. , Garside R. F. , Nicol A. R. , Leitch I. , Macmillan A.
Published: August 2008

Junior schoolchildren were screened for high risk of emotional and educational disorder. The information was gathered from the school, using standard and objective tests. The multiple criterion screen employed, comprised: (a) classroom behaviour scale (Rutter B Scale), rated by teachers; (b) sociometric tests; choice of companions by classmates. From these, lack of positive choices was taken as a measure of isolation and a high rate of negative choices, as a measure of rejection; (c) Reading quotient of 75 or below on the Young Reading Test; (d) Absence from school for reasons considered by teachers to be trivial.

The number of cases identified by the screening was found to be 322 children per thousand. They may be seen as representing a high risk rate.

Using extreme scores as indicative of high risk, approximately 17 per cent of children were identified on the basis of the behaviour test; 12 per cent by the reading test; 9 per cent by the isolation test; 8 per cent by the rejection test and 3 per cent by the absenteeism test. Seventy per cent of the identified children were rated clinically as disturbed. Absenteeism identified the smallest percentage of cases and made the smallest independent contribution to identification. Isolation was not impressively related to neurotic or antisocial beha viour. The three important criteria, therefore, were behaviour, rejection and reading.

Corrected disturbance rates for our population of 7-8-year-old children, including those not identified by the screen, were 6-8 per cent markedly maladjusted and 33.7 per cent somewhat maladjusted.
Development as a Unifying Concept in Psychiatry
Authors: Eisenberg Leon
Published: August 2008

A quotation from Edward Mapother can serve admirably as text for this address: ‘In practically all properly investigated cases of insanity, it is found that it is the result of a summation of multiple causes, effective in combination, though inadequate singly. It is this that renders all controversy between extremists of the physiogenic and psychogenic schools so futile’ (Lewis, 1969, p 1359). In the same year, 1922, in his Salmon Lecture, Adolf Meyer said: ‘The overmechanization of psychiatry … (has) led to too much reliance on chemistry and physiology as curealls in mental ills, while psychoanalysis, by laying too much emphasis on the subconscious and sex, has lost sight of the … functions of the conscious mind and has … disregarded the fact that man is subject to physical … biological … and social laws' (Meyer, 1922).
Drug Dependent Individuals Dealt With by London Casualty Departments
Authors: Ghodse A. Hamid
Published: August 2008

During a study of drug incidents dealt with in one month by 62 casualty departments in Greater London, 395 drug-dependent individuals were identified. The great majority of these patients were seen in hospital following an overdose, and barbiturates were the drugs used most frequently. A high incidence of multi-drug use was noted, and many individuals had obtained their drugs from an illicit source. A history of repeated overdosing was common, and one fifth of the patients behaved aggressively while they were in casualty. The implications of these findings are discussed, with particular reference to the demands that are made on casualty departments by drug-dependent individuals.
The Husbands of Agoraphobic Women and Their Influence on Treatment Outcome
Authors: Hafner R. Julian
Published: August 2008

Thirty-three married women, all agoraphobic but most with additional phobias, were exposed to a standard four-day intensive behavioural treatment programme as out-patients. The effects of this on the patients and their spouses throughout a one-year follow-up are reported and discussed.
Maternal Age and Incidence of Schizophrenia in the Republic of Ireland
Authors: Dalén Per
Published: August 2008

The excess incidence of schizophrenia reported from Ireland may partly be due to the unusual distribution of the Irish population by maternal age at birth.
The Effect of Mental State on EPI Scores
Authors: Bianchi G. N. , Fergusson D. M.
Published: August 2008

This paper develops a structural equation model to assess the effects of mental state on EPI scores. This model is applied to results obtained from a clinical population. The findings show that: (a) the E scale is not influenced by mental state as measured by the Hamilton Anxiety Scale (HAS); (b) the N scale is influenced by HAS. An attempt to revise the N scale to produce an un-contaminated score is discussed.
Season of Birth in the Population of Norway, with Particular Reference to the September Birth Maximum
Authors: ØDegård Ørnulv
Published: August 2008

The monthly number of births in Norway fluctuates between a maximum in January–May and a minimum in October–December. This cyclic seasonality is assumed to be of biological origin, but indirectly it is influenced by social factors and consequently tends to vary a great deal. There is a secondary birth maximum in September, corresponding to a peak of conceptions during the traditional festivities around Christmas and New Year. It is shown that this maximum is much less variable within the country studied, though it probably varies from one country to another in relation to the impact of the mid-winter traditions.

The January–May birth maximum is known to be higher in schizophrenia than in the general population, while no such difference is observed in Norway for the September birth peak. It is felt that there is a fundamental difference between the two birth maxima and a corresponding difference between schizophrenic patients and the general population. Minimal paranatal brain damage of seasonal origin is suggested as an explanation.
Non-accidental Injury in Children
Authors: Scott P. D.
Published: August 2008

Historically, in mediaeval times, the epoch of childhood was less clearly defined. If babyhood was survived, all but the most favoured children became little adults and a convenient source of labour. Instances of the barbarous treatment of children, infanticide, exploitation, starvation, flogging and mutilation, abound (Mause, 1976) and until comparatively recently these seemed to have caused little public reaction.
Outcome in Psychotherapy Evaluated by Independent Judges
Authors: Bloch Sidney , Bond Gary , Qualls Brandon , Yalom Irvin , Zimmerman Erik
Published: August 2008

To overcome common limitations in assessing the outcome of psychotherapy, the following method was used: independent assessment by teams of experienced psychotherapists; individualized measures of outcome; and videotaped clinical interviews to allow the judges to rate, at one sitting, a patient's clinical state before and after eight months of therapy. Agreement between the judges' ratings was low both for the severity of the clinical state and for its outcome. Possible reasons for this low agreement are discussed.
A Survey of Consultant Psychiatrists' Attitudes to their Work, with Particular Reference to Psychotherapy
Authors: Hafner R. J. , Lieberman S. , Crisp A. H.
Published: August 2008

Ninety-six out of 137 consultant psychiatrists working for the majority of their time in the London area outside academic units returned questionnaires concerning attitudes to their work. Analysis of the 88 fully completed questionnaires suggested the existence of four relatively discrete but overlapping patterns of psychiatric practice in the Regions concerned, of which two largely excluded individual psychotherapy. These findings are discussed in relation to the education in psychotherapy of trainee psychiatrists working in mental hospitals.
Handedness in Psychiatric Patients
Authors: Fleminger J. J. , Dalton R. , Standage K. F.
Published: August 2008

Eight hundred psychiatric patients and eight hundred controls completed a handedness preference questionnaire. There was no significant difference in handedness between the two samples, but, contrary to some previous reports, excess of sinistrality was not associated with male sex. The distribution of handedness was similar in neurotics and controls, but among psychotics in general there was a higher proportion of fully right-handed subjects. Among schizophrenics there was a significantly higher proportion of left-handed writers among males than females. There were relatively few left-handed writers of either sex among patients with affective psychosis. Female patients with personality disorders had a significantly higher proportion of mixed handedness than controls. The findings are considered in relation to suggestions that functional psychoses may be associated with asymmetrical cerebral dysfunction, and that poorly lateralized function may be related to anomalous psychological development.
Effects of Lithium Salts on Memory
Authors: Kusumo K. S. , Vaughan M.
Published: August 2008

Thirteen patients diagnosed as having affective disorders, and who were taking lithium, were compared with drug-free controls on short-term and long-term memory tasks. There was some indication that patients on lithium may show an impairment of short-term memory at fifteen-second delay intervals, and possibly enhanced long-term recall of difficult material. Further comparison with results obtained from six patients on tricyclic antidepressants seemed to reduce the possibility that the lithium group's scores were a function of their psychiatric status.

As the group sizes were small, all the findings need to be replicated.
XYY Males
Authors: Hunter Henry
Published: August 2008

A survey of 1,811 mentally handicapped males in eighteen hospitals is described. Males discovered with supernumerary Y chromosomes numbered 15, of whom 12 were 47,XYY. Some of the physical, social, psychological and psychiatric findings are described and compared with groups matched for IQ and height.

The main psychiatric findings are diminished intelligence, retardation in development of secondary sexual characteristics, and poor emotional control leading to inadequate social adaptive patterns which are described and discussed.
Genetical Analysis of Unipolar and Bipolar Endogenous Affective Psychoses
Authors: Trzebiatowska-Trzeciak Olga
Published: August 2008

The mode of inheritance of affective psychoses was studied in 800 first degree and 582 second degree relatives of 122 probands. Morbidity risk for unipolar depression was 12·0±3·2 and 11·4±2·7 per cent respectively for parents and siblings of probands suffering from unipolar depression. Morbidity risk for manic-depressive psychosis for the respective groups of first degree relatives of manic-depressive probands was 15·1±3·2 and 16·9±3·2 per cent. In second degree relatives the morbidity risk was 3·4±1·0 and 5·3±1·4 per cent for unipolar depression and manic-depressive psychosis respectively.

The results indicate the role of genetical factors in the etiology of both types of affective disorder and show that unipolar depression and manic-depressive psychosis are distinct entities. The hypothesis of X-linked dominant transmission was not confirmed in either of these affective disorders. By means of the computational model of Slater, no results compatible with a polygenic inheritance of unipolar depression or manic-depressive psychosis were found.
Antidepressant Drug Therapy in Psychotic Depression
Authors: Davidson Jonathan R. T. , McLeod Malcolm N. , Kurland Albert A. , White Helen L.
Published: August 2008

Imipramine and phenelzine were ineffective in the treatment of five primary unipolar depressives with delusions, even when plasma levels of imipramine and desmethylimipramine or activity of platelet monoamine oxidase suggested that an adequate dose of drug had been given. Four patients went on to receive ECT and all responded well. Five non-delusional patients responded satisfactorily to the antidepressant drug given. Nine out of ten subjects were women. Non-delusional patients showed some placebo response.

ECT is considered to be the treatment of choice in the acute phase of delusional depression in women.
Diagnosis ‘Uncertain’: A Follow-up Study
Authors: Anstee B. H. , Fleminger J. J.
Published: August 2008

During a ten year study, 10 per cent of patients at a general hospital in-patient unit had unsolved diagnostic problems at the time of discharge from hospital. These 132 cases were designated ‘uncertain’ and were followed up. Eighty-three patients were ultimately diagnosed, and 300 consecutive in-patients discharged from the same unit with a definite diagnosis were also studied. The clinical features and diagnoses of the two groups were compared. Special features associated with uncertainty were: a presenting complaint of pain; apathy without apparent mental or physical cause; hallucinosis or major paranoid symptoms without other good evidence of psychosis. Age was found to be relevant; compared with patients receiving confident diagnoses, those with uncertain diagnosis due to depressive psychosis were more often younger, while those due to neurosis or personality disorder tended to be older. Atypical psychotic depression was the condition most commonly associated with diagnostic doubt.
Social Skills Training of Out-patient Groups
Authors: Falloon I. R. H. , Lindley P. , McDonald R. , Marks I. M.
Published: August 2008

Fifty-one out-patients with social skills deficits (two-thirds men) completed ten weekly sessions of 75-minute group treatment; 44 were followed up for a mean of 16 months. Random assignment was to one of three conditions: (1) Cohesive group discussion; (2) Modelling and role-rehearsal; or (3) Modelling and role-rehearsal+daily social homework.

All three treatment conditions produced significant but incomplete improvement at the end of treatment and follow-up. The two role-rehearsal conditions were significantly superior to group discussion on several measures. Patients who completed daily social homework assignments did significantly better than patients who completed control homework. Alcohol and drug abuse patients usually dropped out. Schizophrenic patients in remission had lost their improvement at follow-up. Patients with other diagnoses retained their gains to 16-month follow-up.
Psychological Problems of Pre-School Children in an Inner Urban Area
Authors: Coleman John , Pond Desmond , Rothwell Bernice , Burtenshaw Wendy
Published: August 2008

Attitudes to the treatment of the pre-school child today stem very largely from the mainstream traditions in classical child psychiatry, the most powerful of which is still probably psychoanalysis. Recent articles (e.g. Freud, 1966; Frommer, 1967; Bentovim and Boston, 1973) describing treatment units for very young children exemplify very clearly the influence of these traditions and illustrate the difficulty of breaking new ground in conceptualizing treatment procedures. It will be the purpose of this paper to take issue with such traditions, and to argue that it is time for a new look at pre-school child psychiatry.
A Typology of Parasuicide
Authors: Henderson A. S. , Hartigan J. , Davidson J. , Lance G. N. , Duncan-Jones P. , Koller K. M. , Ritchie Karen , Mcauley Helen , Williams C. L. , Slaghuis W.
Published: August 2008

Parasuicide is not a single syndrome. Subtypes at present recognized are based largely on clinically derived stereotypes. When considering a series of patients, the clinician is unable to handle more than a few attributes at a time. This paper describes the application of three very different clustering algorithms to a material of 350 treated parasuicide patients. Mathematically, three types emerge. Clinically, two of these are interpretable and make sense. The types established are: I (n = 107) a group not characterized by any of the variables we examined; this group is a puzzle, mainly because the reasons for the parasuicidal act are not clear. II (n = 132) a depressed, alienated group with high life-endangerment. III (n = 111) a group whose act was highly operant: they felt alienated and were angry with others. These groups did not differ significantly on demographic variables. The usefulness of this typology, particularly for management, after-care and prevention, has now to be assessed.
Psychiatric Decision-Making by Medical Students
Authors: Mayou Richard
Published: August 2008

Analysis of medical students' formulations and replies to clinical problems indicates difficulty in deciding on the nature and organization of treatment. A programme describing a problem-solving approach was devised, and students taught in this way were shown to be significantly more able to formulate organized treatment plans with more precise aims. It is suggested that problem-solving methods are likely to be much more effective than conventional teaching of psychiatry.
A Controlled Evaluation of the Therapeutic Effectiveness of a Psychiatric Day Centre for Pre-School Children
Authors: Woollacott Susan , Graham Philip , Stevenson Jim
Published: August 2008

The progress over one year of 25 children aged 2½ to 3½ years attending a psychiatric day centre was compared with that of 25 similarly disturbed 3-year-old children identified in a total population study. There were few differences in outcome, and those that were found did not particularly favour either group. Implications for the organization of treatment services are discussed in terms of the need to lay down clear objectives and to pursue systematic controlled evaluation.