bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship Between Serum Lithium Level and Clinical Response in Acute Mania Treated with Lithium
Authors: Prien Robert F. , Caffey Eugene M. , Klett C.James
Published: August 2008

In 1968, the Veterans Administration and the National Institute of Mental Health organized a multi-hospital collaborative study on the effectiveness of lithium carbonate in acute mania. Two hundred and fifty five newly-admitted patients with this disorder were randomly assigned to lithium or chlorpromazine treatment for a three-week period. Patients were classified as highly active or mildly active on the basis of hyperactivity shown at admission. Results have been reported in a previous paper (7). Briefly, it was found that chlorpromazine was significantly superior to lithium in treating the highly active patient: chlorpromazine acted more quickly than lithium, produced significantly fewer treatment failures, and had a lower incidence of severe side effects. The difference between treatments was less clear-cut with mildly active patients, although lithium appeared to be the better treatment. Both drugs effectively reduced manic symptomatology, but lithium produced fewer severe side effects and left the patient less sluggish and fatigued. The poor results with lithium among highly active patients were attributed to the drug's relatively slow onset of action. As a group, highly active patients on lithium showed relatively little change in manic behaviour during the first week; it was ten days before some patients showed any improvement. Almost 40 per cent of the highly active patients had to be taken off lithium before the end of three weeks because of unmanageable behaviour or toxicity. In contrast, chlorpromazine, with its quick onset of action, generally controlled manic symptoms
Pitts' and McClure's Lactate-Anxiety Study Revisited
Authors: Grosz Hanus J. , Farmer Barbara B.
Published: August 2008

Pitts and McClure (Pitts and McClure, 1967; Pitts, 1969) have recently suggested that all symptoms of anxiety and anxiety neurosis itself are caused by a raised blood and body fluids lactate level. As the biochemical mechanism underlying anxiety neurosis they proposed that the excess lactate complexes with, and reduces, the concentration of ionized calcium at the surface of excitable membranes to an extent that causes a disordered nerve activity to manifest itself in the form of anxiety symptoms. In support of this speculation, according to which anxiety neurosis is a biological disease essentially brought on by a lactate-induced hypocalcaemia, Pitts and McClure (1967) quote investigations that have shown that on standard exercise anxiety neurotics tend to produce higher blood lactate levels than do normal controls, and their own lactate infusion study. As pointed out elsewhere (Grosz and Farmer, 1969), neither the former nor the latter, however, can be considered satisfactory evidence.
Early History of Psychiatry in Newcastle upon Tyne
Authors: Gassicke John Le
Published: August 2008

The development of psychiatry in England in the eighteenth century is particularly interesting because it shows the growth of public concern for the insane which led to the establishment of Public Subscription Hospitals and, later, the County Asylums. The general history of the period has been covered in works by Kathleen Jones, Denis Leigh, and Hunter and Macalpine, and books have also been devoted to the history of individual hospitals founded during those years, such as Bethel Hospital, Norwich (1725), St. Luke's Hospital, London (1751), the Manchester Lunatic Hospital (1766), and the Retreat, York (1792). For affluent patients there were, of course, a number of private madhouses, later officially ‘Licensed Houses', scattered about the country; in 1880 there were 40 of these outside the metropolitan area, and in London and Middlesex 14 are recorded in 1807 and 20 in 1815. The Private Madhouse Act (1774) provided for the provincial houses to be inspected by the local justices. In practice this Act was not very effective (11).
A Psychiatric Unit for the Deaf
Authors: Denmark John G. , Warren Frank
Published: August 2008

Lack of speech, i.e. dumbness, has long been equated with backwardness, and probably for this reason and because of success in teaching some hearing impaired children to speak, the terms ‘deaf and dumb’ and ‘deaf mute’ have fallen into disrepute. When deafness is profound and prelingual (i.e. congenital or acquired in early infancy), there is a formidable barrier to the development of language. Many deaf children still leave school with poor language, incomprehensible speech and little ability in lip reading and consequently come to rely upon manual communication methods (finger spelling and signing).
A Psychiatric Service for the Disturbed Adolescent
Authors: Evans J. , Acton W. P.
Published: August 2008

The recognition of the need for psychiatric services for disturbed adolescents led to the opening of the first two adolescent in-patients units in Great Britain in 1949. As a result of community pressures and active encouragement by the Department of Health and Social Security since 1964, an increasing number of units have opened. Although the provision of psychiatric services specially designed to cater for the adolescent has gained momentum only in the past three to five years, the demands of this section of the population is underlined by Rosen et al. (1965) who showed, in an American survey of 750,000 clinic patients seen in 1962, that approximately one-quarter were aged between ten and nineteen years—a number representing 6 · 2 per thousand adolescents of the population served. Similar figures, namely, 6 · 6 per thousand (Kidd et al., 1968), were found in Aberdeen, and 5 · 6 per thousand (Henderson et al., 1967) were found in Edinburgh. Since an adolescent psychiatric service was opened in Edinburgh in 1967, there has been a continual increase in the demand for its services, as follows:

This suggests that the previous figures were an underestimate and that psychiatric disturbance amongst adolescents may be much greater than formerly estimated. Furthermore, such referrals do not indicate the demands for help that Approved Schools and children's homes have made. The authors believe that psychiatric skills are most effectively deployed in these settings if the psychiatrist acts as a consultant to the staff, rather than by assessing and treating individual children (Evans, 1963). Even so, demands have far outstripped the available supply of psychiatric time.
Neurological Anomalies in XYY Males
Authors: Harrison M. J. G. , Tennent T. G.
Published: August 2008

A high incidence of men with the 47 XYY karyotype has been repeatedly demonstrated amongst inmates of prisons (Bartlett et al., 1968; Griffiths et al., 1967) and institutions of psychologically abnormal offenders (Jacobs et al., 1968; Casey et al., 1968). Although genetic surveys of the newborn suggest that there must be many more males with this karyotype who remain undetected in the general population, the high incidence of this karyotype amongst these highly selected groups remains unexplained. The initial hypothesis that the extra Y chromosome was associated with aggressiveness no longer appears tenable, at least in its extreme form, as studies indicate that men with this karyotype are less aggressive than other men in the same institution (Price and Whatmore, 1967). It has also been suggested (Hunter, 1966) that because of their increased stature they are more likely to be seen as aggressive and dangerous, and that emotional disturbances arise from problems consequent to being tall. Forssman and Hambert (1969) have suggested that some cerebral abnormality might account for the behaviour of these individuals, and point to reports of EEG abnormalities as being in keeping with this. In support of this idea, Daly (1969) has reported finding neurological abnormalities in 10 out of 12 XYY males that he examined. He further suggested that neurological deficits might prove valuable in identifying individuals of this karyotype. Criticism has been made of such conclusions (Kessler and Moos, 1970) on the grounds that all such studies have been carried out on patients in special institutions, and that the prevalence of similar abnormalities in the rest of these populations is not known. The following report describes neurological findings in 23 XYY men and in a group of patients with a 46 XY karyotype from the same institution, matched in respect of age (6 months), intelligence (15 points on WAIS), and length of stay (within two years). All patients were from Rampton and Moss Side Hospitals (two of the English Special Hospitals) and had been karyotyped in a previous survey (see Casey, 1971). Apart from those on anticonvulsant medication, all patients had been off drugs for at least the preceding four weeks. Controls and index cases were seen in a randomized order by one of us (M.J.G.H.) who did not know at the time of examination to which group the patient belonged. The neurological anomalies detected in the two groups are shown in the table below.
Cluster Analysis
Authors: Sims Clive A.
Published: August 2008

B. S. Everitt's excellent article on cluster analysis (Journal, February 1972, p. 143) provides a much needed warning of the difficulties involved in the use of this technique. One way, however, of avoiding at least some of the pitfalls of this method needs to be stressed. This is the application of what is perhaps the universal panacea for scientific flights of fancy, namely, common sense. Common sense is particularly applicable to the choice of variables to be measured, and, of course, to the problem of naming the groups once they have been found. The use of mathematical techniques without the concurrent application of common sense is one of the greatest traps for the unwary and the overenthusiastic.
Correlates and Outcome of Illicit Drug use by Adolescent Girls
Authors: Noble Peter , Hart Tom , Nation Ron
Published: August 2008

Illicit drug taking, particularly by young people, has increased substantially in recent years. Cannabis offences increased from 51 in 1957 to 4,683 in 1969, and offences involving amphetamines and LSD increased from 1,216 in 1966 to 3,762 in 1969. Most drug taking is undetected by the police, and is hence underestimated by conviction rates. Weiner (1969) found by questionnaire an incidence of drug-taking by London schoolchildren of 5·39 per cent, and Webb (1969) found an incidence of 24 per cent on a university campus.
Manic-Depressive Illness: A Comparative Study of Patients with and Without a Family History
Authors: Mendlewicz J. , Fieve R. R. , Rainer J. D. , Fleiss J. L.
Published: August 2008

Early studies (21, 22, 25, 12) have pointed to a genetic component in the aetiology of manic-depressive disorders. More recently, careful clinical observation has suggested the division of the affective disorders into two distinct groups: the so-called bipolar or manic-depressive group and the unipolar type with recurrent depressions only (14, 27, 1). Although genetic differences in terms of family risk have been demonstrated between the so-called bipolar and unipolar psychoses, it is not yet evident whether each group constitutes a homogeneous entity. Moreover, the diagnosis of unipolar depressive disease for the authors cited above includes such syndromes as involutional psychotic reactions, psychotic depressive reactions, and probably also psychoneurotic depressions.
A Physiological Comparison of ‘Endogenous' and ‘Reactive’ Depression
Authors: Noble Peter , Lader Malcolm
Published: August 2008

The classification of depressive illness has long been a source of controversy in British psychiatry. In particular, phenomenological and statistical studies have failed to agree about the existence of a valid distinction between ‘endogenous' and ‘reactive’ depression (Carney, Roth and Garside (2); Eysenck (3); Kendell (7); Maxwell (9)).
47, XYY Syndrome, Height and Institutionalization of Juvenile Delinquents
Authors: Borgaonkar D. S. , Unger W. M. , Moore S. M. , Crofton T. A.
Published: August 2008

From a sex-chromatin survey of patients in hospitals for the subnormal, Hunter (1966) concluded that the great height and large build of XYY (and XXYY) males might present such a frightening picture that when such a person was convicted of an offence, judges and psychiatrists would be biased towards directing them to Special Hospitals in the interests of community safety. In a study of 464 defective delinquents we found 97 inmates who were at least 72 inches tall (Welch, Borgaonkar and Herr, 1967). There were two 47, XYY and four 47, XXY males in this group. Nielsen and Tsuboi (1970) have indicated that patients with tall stature have a comparatively pronounced disposition to character disorder and criminality. However, Baker et al. (1970) believe that the role of extraordinary height in generating both antisocial behaviour and selective commitment to maximum security facilities remains undefined. Although all these reports have been concerned with adult offenders, we considered about a possible relationship between 47, XYY karyotype, height and admission to institutions of juvenile delinquents.
Use of Bayes's Theorem in Clinical Decision Suicidal Risk, Differential Diagnosis, Response to Treatment
Authors: Kraus J.
Published: August 2008

Among the theories of making rational choices under uncertainty, the one which originated with an eighteenth-century English clergyman, the Reverend Thomas Bayes, and which uses observed evidence to modify prior judgements concerning different possible ‘causes' of the evidence, is logically nearest to the paradigm of clinical diagnosis. A simple illustration of this theorem is the classical Bertrand Box problem (Fry, 1928), and its wider implications for decision making have been discussed by Birnbaum and Maxwell (1960). An example of the use of the theorem in clinical classification has been given by Maxwell (1961).
The Influence of the Wives on the Treatment Outcome of Alcoholics:
Authors: Rae John B.
Published: August 2008

The literature on the role of the wife of the alcoholic in his illness and its management has been critically reviewed by Bailey (1961). She points out that research findings are contradictory and that a unitary view of the wife's role is unwarranted. Kogan and Jackson (1964) have demonstrated within-group differences among alcoholics' wives with regard to their perception of their husbands' illness, and have suggested that such differences may have important prognostic implications. Rae and Forbes (1966) have offered a psychometric dichotomy based on the M.M.P.I. which appeared to distinguish a group of wives whose attitudes to their husbands' illness were supportive and realistic, in contrast to a group whose attitudes appeared to be the reverse. These latter wives were characterized by the M.M.P.I. as having the Psychopathic Deviate scale as a prominent feature of their personality profile. There have been no follow-up studies to assess the influence of the wife on her husband's response to treatment, and the present research attempts to assess this and to relate clinical variables to the psychometric characteristics of the marital partners.
The Pattern of Psychiatric Referrals in a General Hospital
Authors: Anstee B. H.
Published: August 2008

There have been a number of reports of psychiatric referrals in general hospitals. The most recent papers have been by Guy Edwards and Angus (1968) from Bergen Pines County Hospital, New Jersey; Crisp (1968) from the Middlesex Hospital, London; Bridges et al. (1966) from King's College Hospital, London; and MacLeod and Walton (1969) at the Western General Hospital, Edinburgh. The last report from Guy's Hospital, London, was over a five-year period from 1955–60 by Fleminger and Mallett (1962). It was therefore thought useful to review psychiatric referrals from the general wards at Guy's over a recent period of one year, approximately ten years after the first study, to see if there had been any change in the pattern or nature of the referrals.
British Psychiatric Ward Treatment Environments
Authors: Moos Rudolph H.
Published: August 2008

During the past two decades the psychosocial environments of psychiatric wards have become of increasing concern. Different investigators have described the importance of the therapeutic milieu of such wards and have implied that treatment environment strongly influences treatment outcome. At first there were detailed observations and naturalistic descriptions indicating the importance of ward social structure in facilitating or hindering treatment goals (Stanton and Schwartz, 1954; Caudill, 1958). Then came a variety of different types of ward programmes designed to use the ward environment as an important treatment modality (Jones, 1953; Cumming and Cumming, 1962; Fairweather, 1962). These different approaches present quite different specific recommendations about the most effective types of treatment environments; however, they do all agree on one essential point: that the immediate psychosocial environment in which patients function is an important determinant of the outcome of the treatment process.
Changes During Weeks in Effects of Tricyclic Drugs on the Human Sleeping Brain
Authors: Dunleavy D. L. F. , Brezinova Vlasta , Oswald Ian , Maclean A. W. , Tinker M.
Published: August 2008

The tricyclic antidepressants are established in therapy but not in mode of action. Effects on mouse or rat brain of single and relatively enormous doses provide the basis for theories. Yet it may be inferred that the clinical use of tricyclic antidepressants relies upon an induction of brain changes on a time-scale of weeks. Studies of tricyclic drug actions upon human brain physiology are as scanty as are easily-measurable human brain functions. Electrophysiological techniques, however, can conveniently be applied during one principal brain-state, namely sleep, when there is a relative freedom from uncontrollable extraneous variables.
On the Slowness of Action of Tricyclic Antidepressant Drugs
Authors: Oswald Ian , Brezinova Vlasta , Dunleavy D. L. F.
Published: August 2008

It is widely believed that tricyclic antidepressants such as imipramine bring little benefit for ten days, that three or four weeks are needed to be sure, and that five or six weeks are needed to get the patient really back to health. Why should it take so long? Is it even true? If true it seems remarkable that such a challenge should have been largely ignored by theorists content to rest their arguments upon acute experiments with animals.
Psychiatry in Latin America
Authors: Leon Carlos A.
Published: August 2008

For the purposes of the present report we will include under the generic term of Latin America a group of 20 countries with geographic, historical, political and cultural common links, which because of being former colonies of Spain and Portugal might better be called Iberoamerica. Tied together in regional groups during colonial days, they became independent at the beginning of last century and initiated their republican life as separate countries. In almost all of them Spanish is spoken as the exclusive or major language, the two exceptions being Brazil and Haiti.
Studies in the Classification of Affective Disorders
Authors: Gurney Clair , Roth Martin , Garside R. F. , Kerr T. A. , Schapira Kurt
Published: August 2008

This is the second of two papers dealing with the classification of affective disorders in which the relationship between anxiety states and depressive illnesses is examined. The question at issue is whether a line of demarcation may be drawn between the two disorders or whether they are more appropriately regarded as merging insensibly along a continuum of affective disturbance.
“Senile Dementia”: A Changing Perspective
Authors: Alexander D. A.
Published: August 2008

To demonstrate how 'senile dementia emerged as an important psychiatric concept is not an easy task. Although the history of general psychiatry can be satisfactorily traced to the spirited endeavours of Hippocrates (460–375 B.C.), Celsus (circa 30 a.d.), Soranus the elder (circa 100 a.d.), and Aretaeus (circa 150 a.d.), the psychiatry of old age unfortunately lacks such a clear and well-defined genealogy. The term 'senile dementia’ itself seems to have been first used by Aretaeus, the physician of Cappadocia, but exactly how it had evolved and how it was differentiated, if at all, from normal senescence is not at all clear. Certainly modern psychiatry has inherited a wealth of graphic description of old age in general, and for a detailed account of the relevant ethnographic literature the reader is referred to the excellent article by Rosen (1961). From a scientific point of view, however, it is unfortunate that the spirit of enquiry and the descriptive contributions of the early writers seem to have been tempered more by the degree of optimism or pessimism with which they anticipated the intellectual and behavioural foibles of old age, than by a desire to explore and evaluate systematically its possible deviations.
Influence of Family Life on the Course of Schizophrenic Disorders: A Replication
Authors: Brown G. W. , Birley J. L. T. , Wing J. K.
Published: August 2008

In spite of the new methods of treatment and care introduced during the past fifteen years, schizophrenic patients are still liable to relapse with a recurrence of florid symptoms such as delusions, hallucinations and disturbed behaviour, and great suffering can be caused to all concerned (Brown et al., 1966). It has been shown that the onset of florid symptoms is often preceded during the previous three weeks by a significant change in the patient's social environment (Brown and Birley, 1968; Birley and Brown, 1970). Other studies have focused on the influence of more persistent environmental factors, such as the emotion expressed towards the patients by relatives with whom they were living. In an exploratory survey of discharged long-stay men it was found that close emotional ties with parents or wives indicated a poor prognosis (Brown, Carstairs and Topping, 1958; Brown, 1959). In a further study, patients were seen in hospital just before discharge, and their relatives were interviewed at home at the same time, and both were seen together at a joint interview shortly after discharge. It was found that those patients who returned home to live with relatives who were highly emotionally involved with them (as judged by ratings of the relatives' behaviour) were more likely to suffer a relapse of florid symptoms, even when the severity of psychiatric disturbance at the time of discharge was taken into account (Brown et al., 1962). Ratings of the patient's own expressed emotion showed much less involvement, and were much less highly associated with subsequent relapse. There was also a suggestion that short-term and long-term influences might have a cumulative effect; for example, that a raised level of tension in the home made relapse more likely in the event of a critical change in the patient's social environment (Brown and Birley, 1968). These facts, together with the contrasting but just as handicapping reaction of schizophrenic patients to an under-stimulating social milieu, were brought together in a more general theory of environmental influences on the course of schizophrenia (Wing and Brown, 1970). This also took account of the high physiological arousal which had been found in the most withdrawn schizophrenic patients (Venables, 1968; Venables and Wing, 1962). It was argued that in a socially intrusive environment acting upon a patient whose thought disorder was in any case liable to become manifest whenever circumstances became too complicated, a patient would tend to attempt to protect himself by social withdrawal; but this process might easily go too far, both in hospital and outside it, leading to complete social isolation and inability to care for himself. The optimum social environment, for those who remained handicapped, was seen as a structured and neutrally stimulating one with little necessity for complex decision making.
Quantitative Brain Measurements in Chronic Schizophrenia
Authors: Rosenthal Randall , Bigelow Llewellyn B.
Published: August 2008

Despite extensive gross and microscopic scrutiny, no consistent pathological findings have emerged from studies of autopsy material from schizophrenic patients. Dunlap (1924) carried out the first controlled study involving schizophrenic and control brains and concluded that ‘there was not even a suspicion of consistent organic brain disease as a basis for the psychosis of schizophrenia’. More recently both Wolf and Cowen (1952), and Weinstein (1954), reviewed the neuropathological literature and concluded that there were no consistent findings at autopsy that could be construed as characteristic of schizophrenia. These authors felt that earlier claims were based on failure to appreciate the range of normal variation in the brain as well as a failure to include an adequate control population in the study.
A Case of Movement Epilepsy with Agoraphobia Treated Successfully by Flooding
Authors: Pinto Robin
Published: August 2008

Seizures induced by movement were first described by Gowers (1901), who considered them a variant of epilepsy. Several reports have appeared since then of attacks of choreo-athetoid movements precipitated by sudden movement (Lishman et al., 1962; Whitty et al., 1964; Stevens, 1966; Kertesz, 1967). The case described here is one of Lishman's et al's original group (Case No. 5); along with the movement-induced seizures he had developed over the years an increasing agoraphobia which had grossly restricted his activities. This paper reports on the successful treatment of this agoraphobia by ‘flooding’ and the associated amelioration of his movement-induced seizures.
Physical Illness in Psychiatric Hospital Patients in Jamaica
Authors: Burke Aggrey W.
Published: August 2008

The present study describes certain characteristics of an in-patient population of newly-admitted patients at the only psychiatric hospital (approximately 3,000 beds) serving the two million inhabitants of Jamaica.
The Role of Thiamine Deficiency in the Aetiology of the Hallucinatory States Complicating Alcoholism
Authors: Blackstock E. E. , Gath D. H. , Gray B. C. , Higgins G.
Published: August 2008

Excessive alcohol consumption over a prolonged period of time may result in a variety of neuropsychiatric complications (Victor and Adams, 1953). The most frequent of these is alcoholic tremulousness which may be complicated in 25 per cent of cases by perceptual disturbances ranging from transitory misinterpretations of familiar objects to visual and auditory hallucinations (Victor and Adams, 1953). Closely related to this condition are delirium tremens (Victor and Adams, 1953; Lundquist, 1961; Nielsen, 1965), and acute or chronic auditory hallucinosis (Benedetti, 1952; Victor and Hope, 1958). In clinical practice intermediate or atypical forms of these syndromes are seen (Sabot, Gross and Halpert, 1968).
Deliberate Self-injury (Attempted Suicide) in Patients Admitted to Hospital in Mid-Sussex
Authors: Jacobson Solomon , Tribe Patricia
Published: August 2008

The incidence of deliberate self-injury without fatal outcome (‘attempted suicide’), and with consequent referral to casualty departments and wards of general hospitals, is a constant and growing concern for the medical and social professions. The situation may be described as a steady, never-ending epidemic, with no ready remedy capable of halting it. Indeed, for many hospitals all over the country the epidemic seems likely to overwhelm existing facilities for the treatment of psychiatric, and even non-psychiatric conditions.
Suicide Prevention, Recurrent Affective Disorder and Lithium
Authors: Barraclough Brian
Published: August 2008

Affective disorder is a serious and disabling illness which has a high suicide rate. Suicide is estimated as the eventual cause of death in 15 per cent of those given this diagnosis (4). Lithium carbonate has been convincingly shown to be an effective prophylactic against further attacks of depression (1, 3). Because suicide is such a common end in those with depressive illness, and per contra depressive illness is found in at least half of those dying by suicide (5, 2), the suicide rate may well go down once lithium is in general use. The reduction will depend on how many cases of suicide are recurrent depressives who might respond to lithium.
A Case of Sexual Asphyxia Without Fatal Termination
Authors: Edmondson John S.
Published: August 2008

The sexual asphyxias have, in the past, often been described by forensic pathologists after an apparently accidental death has brought the condition to light. The following case is exceptional in that it came to light before a fatality occurred and suggests that intense self-punitive tendencies may play a part in some cases.
The Future of Psychiatry: Predictions Past and Present
Authors: Ødegård Ørnulv
Published: August 2008

Human consciousness includes the dimension of time: As history it reaches back into the past, and as prediction it gropes towards the future. Knowledge of the future must have been felt as a necessity as long as the human mind has existed, and the need for such knowledge was being met on a high level of organization even before culture reached a written stage. Prophets came before authors. At one time prophecy was more important than history because it was nourished by the ancient and powerful mental force of anxiety, anxiety in its true psychiatric form as fear of the unknown.
Mutism Induced by Phenothiazines
Authors: Behrman Simon
Published: August 2008

The purpose of this communication is to present a group of patients who, while receiving treatment with one of the phenothiazine derivatives in average range of doses regarded as suitable for adults, developed a syndrome comprising mutism and a number of other neurological features. In the majority of these patients speech loss is almost complete; but, unlike aphasics, they may respond to repeated questioning by simple utterances usually spoken in a whisper, or else are capable on rare occasions, quite unexpectedly, of delivering remarks which are appropriate and may be spoken normally. Speech deprivation is as a rule associated with an inability to communicate either by gestures or writing and also an inability to perform many customary tasks. Mutism is, therefore, not an isolated disability, but is associated with a wide range of disturbances of behaviour and of level of consciousness. In addition, some of the patients exhibit one or more of the neurological toxic phenomena encountered in the course of medication with phenothiazine derivatives, e.g. akathisia, buccal dyskinesias, dystonias, tremor and parkinsonism.
A Social Rehabilitation Programme for the Long-Stay Mental Hospital Patient
Authors: Bland R. C. , Nixon G. W. H.
Published: August 2008

An account is given of an active treatment programme at a Canadian Provincial Mental Hospital. This programme was designed to reintegrate institutionalized patients, mainly schizophrenics, into the community.
Undiagnosed Psychiatric Patients
Authors: Liss Jay L. , Welner Amos , Robins Eli
Published: August 2008

In a previous report records were studied of 256 in-patients who were discharged as undiagnosed, i.e. in-patients who at the time of discharge did not have a definable psychiatric illness (Welner, Liss, Robins and Richardson, 1972). In that study it was shown that when rigorous criteria for psychiatric research (Feighner, Robins, Guze, Woodruff, Winokur and Munoz, 1972) were used 68 per cent of these patients met the criteria for an established psychiatric disorder. It was concluded that: (1) The chart review diagnoses for a population of undiagnosed patients consisted of a variety of established psychiatric disorders and the population was not homogeneous. (The chart review diagnosis is a diagnosis obtained by review of the patients' hospital records and evaluating the information by using diagnostic criteria for psychiatric disorders.) (2) The most efficient way to arrive at a diagnosis was by structured rather than conventional narrative interview. This study is a follow-up study of these patients and attempts to evaluate the validity of the chart review diagnosis. A concordance between the chart review diagnosis and follow-up diagnosis supports the above conclusions. The follow-up study also served to establish diagnosis in patients who had too few symptoms initially to meet the criteria for a diagnosis.
‘Acute’ and ‘Chronic’ Hysteria
Authors: Meares Russell , Horvath Thomas
Published: August 2008

The diagnosis of hysteria has seemed a hazardous one since Slater (1965) pronounced it ‘not only a delusion but also a snare’. His conclusion was based on the demonstrable fragility of the diagnosis when usually accepted criteria are used. Against this, Guze (1967) has put forward evidence which suggests that when his criteria are applied the diagnosis is a stable one. Lader and Sartorius (1968), in a study of 10 patients, also seemed to show that those with conversion hysteria were a single group on the criterion of their failure to habituate to 20 repetitions of a standard stimulus, a disability which distinguished them from other neurotic groups. Slater, however, in criticizing the Perley and Guze (1962) concept, remarked that two residual groups, rather than one, remained as diagnostically unchanged in his 10-year follow-up.
The Development of Neurosis in the Wives of Neurotic Men Part I. Symptomatology and Personality
Authors: Ovenstone Irene M. K.
Published: August 2008

Several researchers, among them Penrose (1944), Slater and Woodside (1951), Pondet al.(1963), Kreitman (1962, 1968) and others, have found that psychiatric disturbance occurs in both members of marital pairs more often than can be expected by chance. It appears that symptoms in the spouse are more evident when it is the husband who is the patient, and that neurosis rather than psychosis is associated with higher levels of disturbance in the spouse (Kreitman, 1962, 1964).
Psychiatric Sequelae to a Civil Disturbance
Authors: Tan Eng-Seong , Simons Ronald C.
Published: August 2008

On 13 May 1969, intercommunal rioting broke out between the Malay and Chinese sections of the population of Kuala Lumpur and continued for a full week. Subsequently a state of emergency was proclaimed, parliamentary government was suspended and the country was placed under the rule of the National Operations Council (a council of top ministers, civil servants and the chiefs of the armed forces and police) which ruled by edict.
A Short Anorexic Behaviour Scale
Authors: Slade P. D.
Published: August 2008

The successful investigation and development of effective treatment programmes for any disorder is closely dependent on the development of reliable and valid assessment procedures. Anorexia nervosa would seem to be no exception in this respect. At present, while the diagnosis of anorexia nervosa seems fairly easy to establish, the assessment of severity, response to various treatment regimes, and prognosis pose rather more of a problem. Reliance on criteria such as weight status and gain, return of menstruation, psychosexual adjustment, etc., is inadequate, especially in the assessment of short-term effects of various therapeutic conditions. Recently Slade and Russell (1972) have described an objective technique for measuring ‘perception of body size‘, an area in which they found anorexia nervosa patients to be defective. Clearly, however, other reliable, objective assessment techniques are needed as well.
A Controlled Follow-up of Gases Involved in an Epidemic of ‘Benign Myalgic Encephalomyelitis’
Authors: McEvedy Colin P. , Beard A. W.
Published: August 2008

In 1955 an epidemic occurred among the staff of a London Teaching Hospital group. The nature of the epidemic remains uncertain. One view is that the illness was a viral encephalomyelitis (Medical Staff Report, 1957); an alternative is that it was a manifestation of anxiety spreading through a population consisting largely of young women (McEvedy and Beard, 1970). This paper reports the results from the follow-up study carried out in 1968–69 on the nuclear group affected by the epidemic and on a matched series of controls.
Severe Shock Caused by Chlorpromazine Hypersensitivity
Authors: Man Pang L. , Chen Calvin H.
Published: August 2008

The value of chlorpromazine in combating psychosis and its various symptoms has been firmly established in the last twenty years. The occurrence of sudden death and severe hypotensive reaction after being given the drug has been documented in the world literature (Kelly et al., 1963; Graupner et al., 1964; Rosati, 1964; Hollister et al., 1965; Grollman, 1965; Leestma et al., 1968).
Use of a Category System in the Diagnosis of Abnormal Personality
Authors: Walton H.J. , Presly A. S.
Published: August 2008

From beginnings in imaginative literature and philosophy, the study of abnormal personality was taken up by clinicians who founded their investigations on the methods of observation and intuition. On the basis of case notes, experience and recollection, the pioneering psychiatrists constructed descriptive classifications which served as an initial taxonomy and enabled diagnostic and therapeutic work to proceed.
A Study of Dichotomous Thought Processes in Accident-prone Drivers
Authors: Plummer Lynette , Das S. Sunder
Published: August 2008

When a frequency distribution of motor vehicle accidents in any particular group is analysed, there is found to be a number of individuals who have a greater proportion of accidents than can be explained by chance alone. Research on the psychology of accident causation has been aimed largely at isolating particular personality characteristics which seem to be associated with high accident liability. However, the results from past research have been far from encouraging. Very little has been conclusively proved regarding the bearing of any one attribute on the accident rate, and there is still no single specific factor that is psychometrically capable of being identified as a predictor of accident liability.
A Day Hospital's Function in a Mental Health Service
Authors: Morrice J. K. W.
Published: August 2008

Nowadays the idea of a day hospital is familiar and no longer seems revolutionary or slightly suspect. Considerable growth of such units has occurred since the Marlborough Day Hospital opened in London in 1946. However, there has been no real attempt in this country to accept the challenge of Epps and Hanes (1964) who estimated that 50–75 per cent of patients in psychiatric hospitals could be cared for equally well in day units.
The View-point of the Mentally Subnormal Patient
Authors: Ballinger Brian R.
Published: August 2008

Many patients in hospitals for the mentally subnormal are very isolated from the community (Ballinger, 1970). McKeown and Leck (1967) suggested that many individuals in these hospitals do not require hospital care and there have been recommendations that hospitals for the subnormal should be smaller in the future (Department of Health and Social Security, 1971).
The Reason for Admission as a Focus of Work for an Adolescent Unit
Authors: Bruggen Peter , Byng-Hall John , Pitt-Aikens Tom
Published: August 2008

In recent years provision of care for psychiatrically disturbed adolescents has received increasing attention. The present situation was summarized in a leading article in theBritish Medical Journal(1971) which emphasized one aspect of this provision—the need for adolescent in-patient facilities based within the community. This paper describes the ideas and practices of an adolescent unit which was opened at Hill End Hospital, St. Albans, in September 1969 to take younger adolescents (up to 16) of both sexes, from the area of the North-West Metropolitan Regional Hospital Board. This area covers 13,000 square miles and has a population of 4½ million, which the Unit aims to serve with 11 available beds. Who should be admitted to these places is clearly a critical question.
Psychiatry and its Critics
Authors: Roth Martin
Published: August 2008

It is ironic but not unexpected that, at a time when psychiatry is moving out of isolation and into closer proximity with other disciplines in general hospitals, the relationship of psychiatry with medicine should be called into question. The anti-medical critique of psychiatry represents one approach within a wider movement which has assumed international proportions and adopts a critical or derogatory stance towards psychiatry's methods, aims and social role; it is anti-medical, anti-therapeutic, anti-institutional, and anti-scientific, either by expressed aim or implicitly through the dogmatic, hortatory, diffuse and inconsistent character of its utterances.
Aspects of the Relationship Between Sleep and Nutrition: A Study of 375 Psychiatric Out-Patients
Authors: Crisp A. H. , Stonehill Edward
Published: August 2008

Weight change and sleep disturbance are well documented features of psychiatric illness. Complaint about difficulty in getting off to sleep is a common feature of neurotic illness, especially anxiety states. Early morning waking has for many years been regarded by some as a clinical feature—almost a diagnostic pointer—for ‘endogenous depression‘. Motor restlessness is also commonly described as a feature of this disorder. However, other clinicians have concluded that such depressive illness is merely one end of the spectrum of the depressive response. In particular, McGhie (1966) has shown that sleep disturbances of all kinds, as reported by the patients themselves, may occur in a variety of psychiatric illnesses. For instance he found that early morning waking was reported in 16 per cent of non-depressed psychiatric patients as distinct from 17 per cent of patients presenting with depression. Moreover, Hinton (1963) has shown that early morning waking when carefully measured does not specifically characterize those types of depressive illness described by others as ‘endogenous', but that it can occur in all types of depressive illness. He also reported his observation that sleep disturbance amongst depressed patients is mostly related to the phenomenon of agitation. Agitated patients lost more sleep, most apparent in the latter part of the night. On the other hand Carney et al. (1965), in their study of over 100 patients with depression, found that certain symptoms clustered into two groups reflecting the usual concepts of ‘endogenous' and ‘neurotic’ depression respectively. Early morning waking and weight loss were important characteristics of their group of patients designated ‘endogenous' depression, and were regarded as important indicators for them of the value of ECT. There was a positive inter-symptom correlation of 0.234 between weight loss (7 lb.+) and early waking. Most studies do not suggest a causal link between weight change and sleep disturbance, but by inference regard these features as being more integral aspects of an underlying biological factor which also promotes the disturbed mood.
Persistent Dyskinesia
Authors: Crane George E.
Published: August 2008

The first three cases of tardive dyskinesia were described in a brief communication by Schonecker (1957), and in the following ten years some 600 new cases were reported in 37 papers. Since the literature up to 1967 has been reviewed by Ayd (1967a) and myself (1968a), this communication will deal mainly with the publications of the last five years. I will also report a few personal observations of the last two years, hitherto unpublished.
Serum Magnesium, Diagnosis, ECT and Season
Authors: Carney M. W. P. , Sheffield B. F. , Sebastian J.
Published: August 2008

Mild alterations in serum magnesium are said to be symptomless (D. N. S. Kerr in Cecil and Loeb, 1971). Cade (1964) reported high levels in depression but Frizelet al.(1969) found low values restored to normal with clinical recovery. Raised serum magnesium concentrations have been reported in manic patients (Nielson, 1964; Goodwin, Murphy and Bunney, 1968) and schizophrenics (Cade, 1964). These results suggested that serum magnesium had predictive value in the treatment of psychiatric patients, so we estimated pre- and post-treatment serum magnesium concentrations in a number of patients and investigated their relationships with diagnosis and clinical course.
Doctors' Attitudes to Homosexuality
Authors: Morris Philip A.
Published: August 2008

In Autumn, 1971, the Director of the Office of Health Economics stated that ‘the majority of the population regard homosexuality as an abnormality justifying medical treatment‘.
Measures of Depressive Mood at Monthly Intervals
Authors: Little J. Crawford , McPhail Neil I.
Published: August 2008

Various inevitably indirect attempts to quantify mood states have recently been reviewed by Aitken and Zealley (1970). In the present study, the results of administering two depression rating scales to the same group of patients were compared and their usefulness appraised.
An Age-specific Analysis of the Neuroses
Authors: McDonald Carrick
Published: August 2008

Hare, Price and Slater (1971) plotted the age distribution of first admissions to hospital of patients suffering from schizophrenia and neurosis. (I.C.D. 7th Revision, Nos. 300, 303, 310–318). They found a close correspondence between the curves, and contrasted this with the deviation shown by similar age distribution curves plotted for mania, depression and personality disorder (I.C.D. 7th Revision, Nos. 301.0, 301.1, 301.2, 302, 320 and 321). Hare et al. argued from these curves that the environmental factors precipitating an attack are the same for schizophrenia as for neurosis.
Neurotic and Thyrotoxic Anxiety: Clinical, Psychological and Physiological Measurements
Authors: Greer Steven , Ramsay Ian , Bagley Christopher
Published: August 2008

Among the various methods of assessing morbid anxiety the psychiatric interview remains pre-eminent. By this means, we attempt to elicit what patients actually feel—the criterion against which all other measurements are validated. Dissatisfaction with the subjective nature of psychiatric interviews and with their low reliability (Cattell and Scheier, 1958; Kreitman, Sainsbury, Morrissey, Towers, and Scrivener, 1961) has led, on the one hand, to the use of rating scales which quantify subjective clinical judgements (Kellner, Kelly and Sheffield, 1968), and, on the other, to the development of techniques which purport to measure anxiety objectively. The latter fall into two broad categories: (i) questionnaires such as the Manifest Anxiety Scale (Taylor, 1953) and the IPAT Anxiety Scale (Cattell and Scheier, 1963), and (ii) measurements of somatic correlates of anxiety, in particular the various endocrine and physiological responses reviewed by Mason (1968) and Lader (1969), respectively.
The Depression of Widowhood after Thirteen Months
Authors: Bornstein Philipp E. , Clayton Paula J. , Halikas James A. , Maurice William L. , Robins Eli
Published: August 2008

Bereavement is a crisis from which few people are spared. In spite of its universality, there have been few carefully designed, well documented, systematic studies describing its natural history and its relationship to other affective disturbances.
Electroconvulsive Treatment and Short Term Memory
Authors: Stones M. J.
Published: August 2008

Much of the recent work on electroconvulsive shock has been concerned with retrograde amnesia. These studies have generally produced results consistent with Ribot's Law (1885), which states that the susceptibility of a memory to impairment in retrograde amnesia bears an inverse relationship to the age of the trace (Chorover and Schiller, 1965; Kesner and D'Andrae, 1971).