bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide by jumping
Authors: Gunnell D. , Nowers M.
Published: November 2007

This review summarizes the published literature on suicide by jumping, in particular focusing on the social and psychological characteristics of people who have chosen this method of suicide, and the opportunities for prevention. Suicide by jumping accounts for 5% of suicides in England and Wales, and there are marked variations in the use of this method world‐wide. A number of locations have gained notoriety as popular places from which to jump. Such sites include The Golden Gate Bridge and Niagara Falls in the USA, and Beachy Head and the Clifton Suspension Bridge in the UK. There is no consistent evidence that those who commit suicide by jumping differ sociodemographically or in their psychopathology from those who use other methods of suicide, although this method is more often used for in‐patient suicides, possibly due to lack of access to other means. Survivors of suicidal jumps experience higher subsequent rates of suicide and mental ill health, but the majority do not go on to kill themselves, suggesting that preventive efforts may be worthwhile. This view is supported by other evidence that restricting access to the means of suicide may prevent some would‐be suicides. Such measures may also reduce the emotional trauma suffered by those who witness these acts. Health authorities and coroners should consider reviewing local patterns of suicide by jumping, and if necessary institute preventive measures.
Ten‐year time trends of psychopathology in Dutch children and adolescents: no evidence for strong trends
Authors: Verhulst F. C. , van der Ende J. , Rietbergen A.
Published: November 2007

The 10‐year time trends in competencies and problem scores in children and adolescents were assessed. Children and adolescents randomly selected from the Dutch general population in 1983 were assessed with the Child Behavior Checklist and the Teacher's Report Form. Their problem scores and competence scores were compared with those obtained by the same method 10 years later. No significant differences were found between the 1983 and 1993 total problem scores obtained from parents or teachers. On the level of problem items and scales, a few differences indicating an increase in problems were found. However, the magnitude of these differences was very small. Our results did not provide evidence for a clear secular increase in malfunctioning of Dutch children and adolescents.
Hopelessness and first‐episode psychosis: a longitudinal study
Authors: Aguilar E. J. , Haas G. , Manzanera F. J. , Hernández J. , Gracia R. , Rodado M. J. , Keshavan M. S.
Published: November 2007

Hopelessness has not been adequately studied in first‐episode psychotic patients, although it is already present at the early stages, especially in schizophrenic patients. We have studied 96 neuroleptic‐naive psychotic patients (49 schizophrenic patients and 47 other non‐affective psychotic patients) over a period of 12 months after their first admission. The total score on the Hopelessness Scale (HS) at first admission was higher in the schizophrenic patients, and correlated with younger age and with negative symptoms. High HS scores at baseline predicted poor short‐term outcome in schizophrenic patients, as evidenced by worse global functioning at the 12‐month follow‐up. These correlations were not observed in the other psychoses group. Our results suggest that young, severely affected schizophrenic patients who experience hopelessness might be at higher risk of poor outcome.
Prevalence, recognition and management of mental disorders in primary health care in Northern Jordan
Authors: Al‐Jaddou H. , Malkawi A.
Published: November 2007

This study examined the prevalence of psychiatric disorders and assessed factors that are assumed to be related to recognition of this morbidity among clinical patients. A total of 794 patients aged 18 years or older participated in the study. Using an Arabic‐translated version of the General Health Questionnaire (GHQ‐28), the prevalence of psychiatric morbidity was found to be 61%. The highest prevalence rates of psychiatric disorders were found in the 40 years and older age group, in female subjects, in uneducated and highly educated groups, in unemployed individuals, and in patients who were perceived to have ‘fair’ or ‘poor’ physical health. Multiple logistic regression analysis revealed that unemployment and perceived severity of physical illness were positively correlated with psychiatric disorders, but no significant correlation was found with sex, age or level of education. The physicians in the present study were able to detect morbidity in only 24% of the patients. Among patients with psychiatric disorders, recognition of this morbidity was significantly greater in women, in patients who had consulted with their family doctors, in patients previously known to their physicians, and in patients with mild physical illness than in their counterparts. The most common lines of psychiatric management used in this study were referral to psychiatrists (47%) and psychotropic medication (16%).
Psychosocial intervention following suicide attempt: a svstematic review of treatment interventions
Authors: van der Sande R. , Buskens E. , Allart E. , van der Graaf Y. , Van Engeland H.
Published: November 2007

Repeated suicide attempts are a common problem. However, few randomized controlled studies on the treatment of suicide attempters have been described. Although some of these studies showed beneficial effects on measures of well‐being, none of them demonstrated lasting positive effects on repeated suicidal behaviour. In an attempt to analyse the results obtained, a systematic review of randomized controlled trials of interventions for suicide attempters is presented. The literature was gathered by means of a CD‐ROM literature reference search (MEDLINE/PSYCLIT). Subsequently, information on study design and treatment efficacy was abstracted. Studies that were homogeneous with regard to therapeutic principles were reviewed accordingly, and pooled analyses were performed. Meta‐analyses accounted for inter‐study variance (random‐effects model) to estimate a commmon‐effect measure (relative risk). Systematic review of the data showed considerable differences in both study design and therapeutic protocols. In view of these differences, a single pooled analysis of all studies appeared to be unfeasible. A pooled analysis of studies that focus on psychiatric management of poor compliance showed no significant effect on the repetition of suicide attempts. Similarly, studies of psychosocial crisis intervention, as well as studies of guaranteed in‐patient shelter in cases of emergency, did not show a significant reduction in repeated suicide attempts. However, the pooled results of four studies on cognitive‐behavioural therapies showed a significant preventive effect on repeated suicide attempts. At present, only the cognitive‐behavioural approach appears to have a beneficial effect on repeated suicide attempts. However, because of methodological variability, the results obtained may be too optimistic. Additional research is required to establish the merits of this type of intervention.
High prevalence of benzodiazepine dependence in out‐patient users, based on the DSM‐III‐R and ICD‐10 criteria
Authors: Kan C. C. , Breteler M. H. M. , Zitman F. G.
Published: November 2007

Despite the fact that there have been many reports on benzodiazepine (BZD) dependence, consensus about its definition has not been reached. Reliable prevalence data to estimate the dependence liability of BZDs are therefore lacking. This study is the first to assess the prevalence of BZD dependence in out‐patient BZD users (115 general practice (GP) patients, 124 psychiatric out‐patients and 33 self‐help patients) on the basis of the DSM‐III‐R and ICD‐10 substance dependence criteria. Past year and lifetime diagnoses of BZD dependence were made by means of the Schedules for Clinical Assessments in Neuropsychiatry (SCAN). High prevalence figures were found, ranging from 40% in the GP patients (DSM‐III‐R past year) to 97% in the self‐help patients (ICD‐10 lifetime), indicating that BZD users run a high risk of developing BZD dependence. The clinical management of BZD use could benefit from further development of diagnostic instruments such as a self‐report questionnaire which reflects the severity of BZD dependence.
The utilization of antidemessants — a key issue in the prevention of suicide: an analysis of 5281 suicides in Sweden during the period 1992‐1994
Authors: Isacsson G. , Holmgren P. , Druid H. , Bergman U.
Published: November 2007

Antidepressants detected by the National Department of Forensic Chemistry in 5281 suicides in Sweden during the period 1992‐1994 were related to data on usage expressed in person‐years of exposure. Antidepressants were detected in 874 subjects (16.5%). In relation to their use, fluvoxamine, citalopram, moclobemide, mianserin and trimipramine were found more often than the reference drug, amitriptyline (i.e. over‐risks). Toxic concentrations of antidepressants were detected in 232 subjects (4.4%). Most people committing suicide were not taking antidepressants immediately before their death, even though 40‐85% may have been depressed. Undertreatment and therapeutic failure are the main problems with antidepressants, not the risk of using antidepressants in overdose. Comparisons of new antidepressants should focus on efficacy in relation to reference tricyclics. The huge increase in the use of antidepressants in Sweden since 1990‐1991 has been paralleled by a significant decrease in suicide rates.
Spectral properties of phototherapy for seasonal affective disorder: a meta‐analvsis
Authors: Lee T. M. C. , Chan C. C. H. , Paterson J. G. , Janzen H. L. , Blashko C. A.
Published: November 2007

The general therapeutic effect of light on seasonal affective disorder (SAD) has been widely acknowledged. However, the antidepressant effect of light does not seem to be the same for different spectra of light. In this study, the authors attempted to study the spectral properties of phototherapy for SAD using a meta‐analytical procedure. The findings suggested that light of short to medium wavelengths (blue/green/yellow) seem to be essential for the therapeutic effect of light on SAD. Red wavelengths were relatively ineffective. It was then postulated that SAD may be predisposed and/or precipitated by the inefficiency of the S and M cones in the retina. Furthermore, ultraviolet (UV) waves did not seem to be essential for SAD symptom alleviation by artificial light. Therefore, these potentially harmful UV waves should be blocked in any clinical application of phototherapy for SAD.
Depression in Finland: a computer assisted telephone interview study
Authors: Isometsä E. , Aro S. , Aro H.
Published: November 2007

We examined the prevalence of depressive disorders and associated factors in the general population in Finland using the Computer‐Assisted Telephone Interview (CATI) method. A total of 2293 (71%) of 3250 individuals randomly drawn from the population registry and representing the adult population of Finland in the age group 25‐79 years were interviewed by telephone in autumn 1994. The interview included a short form of the University of Michigan version of the Composite International Diagnostic Interview (UM‐CIDI) generating probability diagnoses of DSM‐111‐R major depressive episode and dysthymia. The age‐adjusted 6‐month prevalence was 4.1% for major depressive episode and 1.7% for current dysthymia; depressive mood during the preceding month was reported in 17% of cases. Major depressive episodes and depressive mood were significantly more prevalent among females than males. In the logistic regression analyses, factors associated with the depressive disorders were found to vary somewhat depending on sex and type of disorder. Only about 50% of those with major depressive episode or dysthymia reported a self‐perceived need for mental health services.
Therapeutic options in Charles Bonnet syndrome
Authors: Batra A. , Bartels M. , Wormstall H.
Published: November 2007

The term ‘Charles Bonnet syndrome’ refers to visual pseudohallucinations occurring especially in elderly people with reduced visual acuity. Despite numerous case reports, few successful methods of treatment have been described. Therapies with classical neuroleptics, antidepressants or benzodiazepines have generally been found to be unpromising. Only with carbamazepine treatment has improvement been observed in a few cases. In the three cases reported here, we successfully treated the condition with the atypical neuroleptic melperone.
Thyroid hormone and reserpine abolished periods of periodic catatonia: a case report
Authors: Komori T. , Nomaguchi M. , Kodama S. , Takigawa M. , Nomura J.
Published: November 2007

We report the case of a patient whose periods of periodic catatonia were abolished by thyroid hormone and reserpine. A ratio of fractions in the urinary 17‐ketosteroids was a good indicator for the treatments.
The healthy control subject in psychiatric research: impulsiveness and volunteer bias
Authors: Gustavsson J. P. , Åsberg M. , Schilling O.
Published: November 2007

Exciting and demanding biomedical experiments may attract a specific subgroup of people as volunteers. In the present study of selection bias, subjects volunteering in a psychobiological study that included a potentially painful procedure (lumbar puncture) were compared with those who declined to participate, with regard to scores on personality scales administered during a previous investigation of the same subjects. Significant differences were found on the Eysenck Personality Questionnaire and Karolinska Scales of Personality Impulsiveness scale, suggesting an over‐representation of impulsive individuals among the volunteers. If the specific subject of investigation has implications for the type of individual who will participate as a healthy volunteer in biomedical research, variation will be introduced, affecting the independent variable, and the conclusions that can be drawn from such research may be questionable.
Reasons for substance use in schizophrenia
Authors: Addington J. , Duchak V.
Published: November 2007

Abuse of and de pendence on drugs, alcohol and other substances in schizophrenia are being increasingly recognized and well documented in the literature. It has been suggested that up to 60% of patients with schizophrenia use illicit drugs. A total of 41 subjects who fulfilled DSM‐III‐R criteria for schizophrenia and substance abuse or dependence were asked to describe their reasons for using such substances, the reasons why they might stop and the subjective effects of the substances. Drugs were reportedly used to increase pleasure, to‘get high’ and to reduce depression. However, subjective effects of increased depression and positive symptoms were also reported. These results are considered in the context of potential treatment strategies.
Long‐term outcome of depot neuroleptic maintenance treatment among chronic psychotic patients
Authors: Tuninger E. , Levander S.
Published: November 2007

A total of 51 chronic psychotic out‐patients, with a median age of 51 years and median duration of psychosis of 23 years, treated with depot neuroleptics, entered a 5‐year follow‐up study with assessments of symptoms, side‐effects and plasma concentration of the depot drug (follow‐up (FU) patients). The outcome for 38 non‐eligible (NE) patients was obtained from hospital case reports. The relapse rate was higher for NE than for FU patients (71% vs. 50%). The mortality rate was 9%, and the median age at death was 47 years. Half of the FU patients completed 3 years of treatment uneventfully. Of the total of 89 patients, only 18% remained stable over a period of 5 years. The depot dose was approximately the same after 3 years (median 255 mg, range 50–1018 mg chlorpromazine equivalents).
Validation of the Bech‐Rafaelsen Mania Scale using latent structure analysis
Authors: Licht R. W. , Jensen J.
Published: November 2007

The essential criteria of internal validity have not been sufficiently evaluated for any mania rating scale, although the fulfilment of such criteria is a prerequisite for summing the item scores to give a total score reflecting the severity of mania, and for comparing total scores across patient groups that differ with regard to variables such as age and sex. This study investigated the internal validity of the Bech‐Rafaelsen Mania Scale (MAS), based on the ratings of 100 consecutively admitted drug‐free DSM‐III‐R manic patients. Application of logistic latent structure models did not statistically confirm the additivity of the MAS. However, a modified MAS (the MAS‐M) arising from the analyses fulfilled the measurement model. Transferability of the MAS‐M across age and sex was also confirmed. The MAS‐M showed an acceptable concurrent validity and an adequate sensitivity in discriminating between responders and non‐responders among patients participating in a drug trial. The MAS‐M presented here is the first mania rating scale that has been shown to fulfil statistical criteria for internal validity.
The effect of panic attack on mitral valve prolapse
Authors: Yang S. , Tsai T.‐H. , Hou Z.‐Y. , Chen C.‐Y. , Sim C.‐B.
Published: November 2007

It has been reported that panic attacks might cause mitral valve prolapse (MVP) via haemodynamic or indirect effects. Such prolapse can be classified as being physiological (benign course) or pathological (poor course). It is therefore important to consider whether panic attacks, as a risk factor for MVP, are associated with its physiological or pathological type. Our study sample consisted of two groups of patients with panic disorder (PD), one having onset within 1 year (n=24) and the other with a history of more than 10 years (n=21). Demographic data, symptom presentations, auscultatory and echocardiographic findings of both groups were compared, but no significant difference was found except with regard to anticipatory anxiety. It is concluded that panic attack exerts no significant effect on mitral valve prolapse.
The relationships between expressed emotion, affective style and communication deviance in recent‐onset schizophrenia
Authors: Nugter M. A. , Dingemans P. M. A. J. , Linszen D. H. , Van der Does A. J. W. , Gersons B. P. R.
Published: November 2007

The relationships between expressed emotion (EE), affective style (AS) and communication deviance (CD) were studied during hospitalization and after discharge. EE was measured with both the Camberwell Family Interview (CFI) and the Five‐Minutes Speech Sample (FMSS). The study subjects were patients with recent‐onset schizophrenia and related disorders, who were consecutively admitted to an in‐patient unit for adolescents, and their parents. The results revealed that CFI/EE was significantly correlated with AS criticism scores during hospitalization, but did not predict AS scores after discharge. FMSS/EE correlated significantly with AS criticism when both measures were administered after discharge. During hospitalization, FMSS/EE was not significantly correlated with AS. No consistent relationship was found between CD and both affective factors (EE and AS). It is concluded that EE and AS overlap with regard to level of criticism when both measures are administered over a short period of time and independent of the time of assessment. In addition, the results indicate that affective and communication factors identify independent family attributes.
The prevalence of aborted suicide attempts among psychiatric in‐patients
Authors: Marzuk P. M. , Tardiff K. , Leon A. C. , Portera L. , Weiner C.
Published: November 2007

We report the prevalence of aborted suicide attempts in which the essential characteristics are (i) intent to kill oneself, (ii) a change of mind before making an actual suicide attempt and (iii) the absence of physical injury. The lifetime history of aborted suicide attempts was assessed by semi‐structured interview of 733 patients, aged 18–59 years, who were consecutively admitted to a psychiatric hospital. In the study group, 46% of subjects had made a suicide attempt and 29% had made at least one aborted attempt during their lifetime. Subjects who had made aborted attempts were more likely to have made actual attempts. Approximately 11% of the subjects in the study group had a history of aborted attempts of potential high lethality, such as going to a height in order to jump, or holding a gun to the head. There were no major demographic differences between those with and without a history of aborted attempts. However, among those with no prior history of actual attempts, subjects with depression and a family history of suicide were more than twice as likely as those without such a history to have made an aborted attempt. Aborted suicide attempts are a common suicidal behaviour among psychiatric in‐patients. Whether they predict actual attempts or suicide warrants prospective investigation.
A survey of the attitudes of chronic psychiatric patients living in the community toward their medication
Authors: Pereira S. , Pinto R.
Published: November 2007

Because non‐compliance with antipsychotic drug therapy is both common and associated with a substantially increased risk of acute relapse, depot medication must be preferred for most schizophrenic out‐patients. Yet there is a perception that depot medication is unpopular among patients. In the survey of out‐patients reported here, the great majority of patients receiving either oral or depot neuroleptics (with or without oral augmentation) would, given a free choice, elect to continue with their present dose form (94% and 87%, respectively). In virtually all cases, the choice of route was made by the treating physician and readily accepted by the patient. These findings suggest that physicians should more often recommend and prescribe depot medication when antipsychotic maintenance therapy is indicated.
The Dynamic Assessment Interview: testing the psychodynamic assessment variables
Authors: Rosenbaum B. , Selzer M. A. , Valbak K. , Hougaard E. , Sommerlund B.
Published: November 2007

The Dynamic Assessment Interview (DAI) is a semi‐structured interview with anchored scales to rate patients' suitability for psychodynamic psychotherapy. The DAI was inspired by the Personality Assessment Interview developed by Selzer et al. in 1987 and it introduces from the beginning of the assessment interview an explicit focus on the patient's immediate interactions with the interviewer. Seven theoretical derived varables are assessed, namely psychological mindedness, capacity for self‐observation, capacity for empathy, tolerance of frustration, motivation, response to confrontation, and ability to contain and work with affect. In addition, the patient's attractiveness as a psychotherapy patient and his or her assumed confidence in the forthcoming treatment are assessed. The patient's personality organization ad modum Kernberg is measured from a global assessment of the interview. The present paper describes the DAI and presents its psychometric properties. An acceptable level of inter‐rater agreement was found for the theoretically derived variables and for the personality organization diagnosis, with intra‐class correlations or kappa coefficients ranging from 0.68 to 0.80.
Stress and psychiatric disorders in local government officials in Japan, in relation to their employment level
Authors: Nadaoka T. , Kashiwakura M. , Oiji A. , Morioka Y. , Totsuka S.
Published: November 2007

In order to explore an association between psychiatric disorders and employment level, 283 local government officials in Japan were asked to complete a questionnaire consisting of a series of psychometric scales. The Daily Hassles Scale, General Health Questionnaire and Burnout Scale were used to measure stress, psychiatric disorders and burnout syndrome, respectively. As a result of canonical correlation analysis, the first canonical correlation indicated that the higher the level of stress under poorer support systems, the greater the likelihood of burnout syndrome. The second canonical correlation indicated that the stronger the support system, the smaller the tendency toward depression. Officials in higher levels of employment were supported less and were more severely depressed than officials at lower levels of employment.
Tardive dyskinesia: who is at risk?
Authors: van Os J. , Fahy T. , Jones P. , Harvey I. , Toone B. , Murray R.
Published: November 2007

Tardive dyskinesia (TD) has been associated with female gender, affective symptoms and good outcome, but also with negative symptoms, cognitive deterioration and deteriorating illness course. Furthermore, antipsychotic medication is thought to be an important risk factor, yet abnormal movements also occur in patients who have never received such medication. We followed 166 subjects with recent onset of psychotic illness and brief previous exposure to antipsychotic medication. Information on 17 previously reported risk factors was available for 125 patients at baseline and, for factors that vary over time, again at follow‐up 4 years later (median, 50 months; interquartile range, 29‐70). Movement disorder was assessed at follow‐up using the Abnormal Involuntary Movement Scale (AIMS). Six non‐interacting variables were independently associated with the 4‐year risk of TD: male sex (OR, 2.5; 95% CI, 1.1‐5.0), age (OR over quartiles at baseline, 1.6; 95% CI, 1.1‐2.2), lack of insight at baseline (OR over four categories, 2.0; 95% CI, 1.2‐3.2), time on antipsychotics during the follow‐up period (OR over quartiles, 2.3; 95% CI, 1.5‐3.4), an increase in negative symptoms during the follow‐up period (OR over quartiles, 1.7; 95% CI, 1.2‐2.5), and alcohol/drug misuse at follow‐up (OR, 3.0; 95% CI, 1.3‐7.4). The presence of individual risk factors was found to be of little use as a screening test for subsequent clinically relevant TD. Given the absence of a risk factor, however, the probability that an individual would not develop TD was high. These results suggest that two discrete effects may operate to increase the risk of TD, namely an exogenous factor (medication, drugs), and an illness‐related factor, the highest risk being conferred by deteriorating illness course in male patients.
Folie à deux in Japan — analysis of 97 cases in the Japanese literature
Authors: Kashiwase H. , Kato M.
Published: November 2007

In order to clarify the characteristics of folie à deux in Japan, we examined a total of 97 cases of folie à deux in the Japanese literature covering a period of 90 years, and compared them with the cases reported in Western countries. About 75% of the Japanese cases occur in two individuals, and of these are family cases. The most common combinations are mother‐child and married couple. Mother‐child combinations are much more common than father‐child combinations. Female subjects are more often involved than males. The most common diagnosis for the dominant partner is schizophrenia, and the most common diagnosis for the submissive partner is paranoid reaction. Delusion is the most common symptom shared by both partners in Japan. Comparing these Japanese cases to Western ones, sister‐sister combinations are less frequent, younger subjects influence the older ones more, and acute religious delusion is more common in Japan than in Western countries.
Symptoms, standards of living and subjective quality of life: a comparative study of schizophrenic and depressed out‐patients
Authors: Carpiniello B. , Lai G. , Pariante C. M. , Carta M. G. , Rudas N.
Published: November 2007

The subjective quality of life (QOL) (i.e. individual evaluation of one's life experiences) has been studied according to a series of different parameters such as resource availability, and sociodemographic and clinical variables, at times yielding contradictory results. Subjective quality of life and standard of life from a selected sample of 45 chronic out‐patients (25 schizophrenics, and 20 patients with major depression) were evaluated by means of structured interviews. Statistical analysis revealed that subjective QOL was largely independent of standard of living (so long as basic needs were satisfied), diagnosis, and clinical course of illness, and only partly dependent on sociodemographic variables. No correlation was found between clinically evaluated symptoms (both psychotic and depressive) and subjective QOL. On the contrary, significant correlations were found between self‐ratings of depression, depressive cognitive attitudes and subjective ratings of QOL.
Relationship between neurological 'soft signs’and syndromes of schizophrenia
Authors: Malla A. K. , Norman R. M. G. , Aguilar O. , Cortese L.
Published: November 2007

Past research on the importance of 'soft’neurological signs in schizophrenia has often not examined the relationship between specific groups of neurological signs and different dimensions of schizophrenia psychopathology. Gender differences in the reported relationships have never been explored. In this paper we describe a study of 100 DSM‐III‐R (65 male and 35 female) schizophrenic patients who were rated for neurological 'soft signs’with the Neurological Evaluation Scale (NES) (1), and for schizophrenic symptomatology with the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS). Following a factor analysis of NES items, differential relationships were examined between the five derived NES factors and three well‐established dimensions of schizophrenic symptomatology, namely psychomotor poverty, disorganization and reality distortion. Our results failed to show any relationship between NES dimensions and either the reality distortion or disorganization dimensions. There was a modest but differentially significant relationship between psychomotor poverty and an extrapyramidal factor on the NES. This relationship was shown only by male subjects, and was influenced by duration of illness but not by age or neuroleptic medication. On the other hand, female subjects showed a significant relationship between psychomotor poverty and an NES factor reflecting attention and initiative, and between reality distortion and coordination/sequencing of motor activity. These relationships in female subjects were, relative to relationships for male subjects, more independent of the effect of medication and duration of illness.
Prevalence of DSM‐III‐R and ICD‐10 psychiatric disorders in a Spanish population of 18‐year‐olds
Authors: Canals J. , Domenech E. , Carbajo G. , Blade J.
Published: November 2007

The aim of this study was to estimate the current prevalence of DSM‐III‐R and ICD‐10 psychiatric disorders in Spanish 18‐year‐old members of the general population. Subjects were assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Nearly 30% of the study subjects reported at least one current disorder according to ICD‐10 criteria, and almost 21% reported at least one current disorder according to DSM‐III‐R criteria. Women had a significantly higher probability of suffering from any psychiatric disorder than men. The most common disorders were insomnia, dysthymia, major depression and simple phobia. Nearly 40% of the diagnosed subjects had one or more comorbid disorders. Comorbidity was found to be higher among female subjects. Consistent with previous risk factor research, it was found that women had higher rates of mood, anxiety and sleep disorders than men. Good communication between parents and their offspring was found to be a protecting factor for all disorders.
Admission rates for schizophrenia in The Netherlands: an urban/rural comparison
Authors: Peen J. , Dekker J.
Published: November 2007

This article examines admission rates for schizophrenia in terms of degree of urbanization. Patient data was obtained from the Dutch psychiatric register. The scale of urbanization used had five categories and was utilized to establish the degree of urbanization in each municipality (n= 647). Admission rates showed a significant positive correlation with the degree of urbanization in the 15‐34 years and 35‐54 years age groups for both sexes. The average duration of hospitalization and the average number of readmissions showed no association with the degree of urbanization. Taken as a whole, these utilization rates provide evidence of a much higher incidence of schizophrenia in the most urbanized municipalities of The Netherlands.
On the one aspect of generalized anxiety
Authors: Davtian V.
Published: November 2007

Generalized anxiety disorder. considered to be a theoretical and psychopathological construct in the Western world, has emerged as an endemic daily problem in the post‐Soviet republics. The daily uncertainties of life have become such a burden for most citizens of these countries that even clinical scientists in these countries have largely abandoned the study of this condition. Left to the politicians in the leadership of these republics, little alleviation has come by way of ‘social therapies’. The author of this article, who is assigned to the Office of the President of the Republic of Armenia. proposes that much is to be gained by both science and society if scientists from western and newly independent states jointly study the phenomenology of generalized anxiety in these states.
Ethology of anxiety in phylogeny and ontogeny
Authors: Cyrulnik B.
Published: November 2007

Among animals, fear is a signal of an external danger which can be triggered without any learning. Fear is often mediated by the perception of another fear issued from a peer, allowing the contagion of the emotion. Ontogeny of animal fear can be observed in the natural environment, and it can be experimentally manipulated. This suggests the idea that animal fear is an internal signal of a danger, and that it develops by imprinting of external objects which categorizes the animal's world in a familiar tranquillizing world vs. a strange anxiogenic one. In humans, the child's development allows us to observe similar phenomena until such time as the child has access to the semantic world, and will experience emotions released by gestures and words issued from attachment figures or anxiogenic ones.
Juvenile mortality, mental disturbances and criminality: a prospective study of the Northern Finland 1966 birth cohort
Authors: Räsänen P. , Tiihonen J. , Isohanni M. , Moring J. , Koiranen M.
Published: November 2007

Mortality, criminality and mental illness among young adults were studied in an unselected birth cohort of 12 058 children born live in Northern Finland during 1966. The cohort members were followed up to the age of 27 years. The total number of all deaths was 117, and 79.5% of these deaths were from unnatural causes. The mortality of males was more than threefold higher than that of females. There was a significantly higher mortality risk in men with schizophrenia (OR, 9.31; 95% CI, 3.14–25.53), other psychoses (OR, 10.28; 95% CI, 2.40–37.02), personality disorders (OR, 4.28; 95% CI, 1.04–14.67) and combined personality disorders and criminality (OR, 3.27,95% CI, 0.99–9.59). In the group of major mental disorders, 75% of deaths were suicides.
The Finnish National Schizophrenia Project 1981–1987: 10‐year evaluation of its results
Authors: Tuori T. , Lehtinen V. , Hakkarainen A. , Jääskeläinen J. , Kokkola A. , Ojanen M. , Pylkkänen K. , Salokangas R. , Solantaus J. , Alanen Y.
Published: November 2007

This study reports the 10‐year evaluation of the Finnish National Schizophrenia Project. The aims of the national project were achieved. The number of long‐stay schizophrenic patients in psychiatric hospitals decreased by 63% between 1982 and 1992. Both the treatment of schizophrenic patients and the structure of mental health services have changed greatly in Finland. Psychosocial treatment methods in particular have developed. The major innovations of the Project are the acute psychosis teams now serving over 50% of the country, and social skills training programmes. The 10‐year evaluation of the Finnish National Schizophrenia Project shows that it is possible to conduct successfully nation‐wide projects to develop the treatment of schizophrenic patients and psychiatric practices across an entire country.
Calgary Depression Scale for Schizophrenia: a study of the validity of a French‐language version in a population of schizophrenic patients
Authors: Bernard D. , Lançon C. , Auquier P. , Reine G. , Addington D.
Published: November 2007

The Calgary Depression Scale for Schizophrenia (CDSS) is a nine‐item structured interview scale developed by Addington et al. to assess depression in schizophrenics. This paper describes the testing of the reliability and validity of the French version of the CDSS in a population of 70 schizophrenic patients. The validity of the CDSS as a measure of depression was confirmed; a single factor accounted for 41 % of the variance of the nine items. The total score on the CDSS was strongly correlated with those on the Montgomery‐Åsberg Depression Rating Scale (MADRS), the Hamilton Depression Rating Scale (HDRS) and also the G6 item (depression) of the Positive and Negative Syndrome Scale (PANSS). The correlation with the Psychomotor Retardation Scale (ERD) total score was much less significant and was better with the ‘subjective’ subscore. The internal consistency was good, with a Cronbach's alpha of 0.79. A high level of inter‐rater reliability was observed (weighted kappa values were >0.75 in all cases). The CDSS has a lower stability over time than other depression scales. It is a simple, quick and reliable scale for assessing depression in schizophrenic populations.
Factors predictive of referral to psychiatric hospital among general hospital psychiatric consultations
Authors: Viinamäki H. , Tienari P. , Niskanen L. , Niskanen M. , Leppävuori A. , Hiltunen P. , Rahikkala H. , Herzog T. , Malt U. F. , Lobo A. , Huyse F. J.
Published: November 2007

The aim of this paper was to explore the factors necessitating psychiatric hospital care in a Finnish multi‐centre study of general hospital in‐patients referred for psychiatric consultation. The study group consisted of 1251 patients referred to psychiatric hospital (n= 181) and a comparison group (n= 1070) consisting of subjects who were not referred. Differences between groups were studied by univariate analysis. Logistic regression analysis was used both to assess the factors contributing to referral to psychiatric hospital and to create predictive models. The validity of the models was analysed by means of receiver operating characteristic (ROC) curves in an independent sample. Psychiatric hospital care during the previous 5 years was associated with a 3.7‐fold (odds ratio) increased risk of hospitalization. A diagnosis of psychosis was associated with a 2.9‐fold increased risk, and attempted suicide as a reason for consultation was associated with a 2.1‐fold increased risk. Not being married doubled the risk, and the odds ratio was also high in cases of poor psychosocial functioning (as assessed by Global Assessment of Functioning (GAF) score). The predictive model differentiated reasonably well between those patients who were hospitalized and the other patients. In conclusion, this multi‐centre study of factors predictive of referral to psychiatric hospital among general hospital patients revealed that the most important determinants were previous psychiatric care, diagnosis of psychosis or severe depression, attempted suicide, being unmarried, and poor psychosocial functioning as assessed by GAF score.
Towards a ‘map’ of panic: structure of the bodily symptoms
Authors: Pio‐Abreu J. L. , Ramalheira C. , Valente J. M.
Published: November 2007

Despite the large amount of research on panic attacks according to DSM criteria, there are some inconsistencies between this and reports from clinical settings. Some naturalistic and non‐standard studies are needed. The authors of the present study submitted a list of 24 bodily symptoms to 65 panic patients who had sought medical help. The results of principal‐component analysis revealed five factors, four of which represent the forms described in clinical and epidemiological contexts: cephalo‐vertiginous, cervico‐respiratory, thoraco‐cardiac and abdomino‐digestive. Each of these factors is differentially related to some specific fearful anticipations, which may organize the symptoms in a body‐related topographical way.
A psychosocial study of ‘self‐immolation’ in India
Authors: Singh S. P. , Santosh P. J. , Avasthi A. , Kulhara P.
Published: November 2007

The phenomenon of self‐immolation was studied in 22 young people, mostly students, who had indulged in this act to protest against the decision of the Government of India to enlarge the scope of reservations in jobs and educational institutions. Within a short span of time of arriving at one of the two treatment centres after attempting self‐immolation, the subjects were interviewed and assessed on a semi‐structured interview schedule to elicit sociodemographic and attitudinal data. The subjects were also rated on the Brief Psychiatric Rating Scale, Pierce's Suicide Intent Scale, the Superego Paranoia Depression Scale, the Hostility and Direction of Hostility Questionnaire, the PGI Locus of Control Scale and the Alienation Scale. All subjects except one were free of manifest psychopathology. The group as a whole had a high score on Pierce's Suicide Intent Scale and displayed internal locus of control orientation. Most were ambitious, aggressive, hostile and felt alienated. The absence of manifest psychopathology sets this group apart from cases of deliberate self‐harm arising in the context of psychiatric morbidity. Thwarted ambitions, a sense of alienation and intropunitive hostility can lead to protest which at times becomes altruistic and results in self‐immolation.
Criticism and hostility in relatives of patients with schizophrenia or related psychoses: demographic and clinical predictors
Authors: Bentsen H. , Notland T. H. , Boye B. , Munkvold O.‐G. , Bjøge H. , Lersbryggen A. B. , Uren G. , Oskarsson K. H. , Berg‐Larsen R. , Lingjæerde O. , Malt U. F.
Published: November 2007

Relatives' criticism and hostility are important risk factors for relapse in schizophrenia. In order to explain these attitudes, we examined a Norwegian sample of 47 recently hospitalized patients (with schizophrenia or related psychoses) and 72 relatives. Relatives’ expressed emotion was assessed by means of the Camberwell Family Interview. Demographic and clinical data were used as predictor variables in confirmatory regression analyses. The most robust predictors of high levels of criticism were, on the part of the patient, lack of paid employment, more than 3 previous hospital admissions, more troublesome behaviours reported by relatives, especially anxiety/ depression, and better cognitive functioning at admission. Robust predictors of hostility were lack of employment and more than 3 previous hospitalizations. Interventions to reduce criticism should include employing patients and working with relatives' unrealistic expectations.
A comparison of patients' and prescribers' beliefs about neuroleptic side‐effects: prevalence, distress and causation
Authors: Day J. C. , Kinderman P. , Bentall R.
Published: November 2007

Neuroleptic side‐effects adversely affect clinical outcome in schizophrenic patients. Clinicians therefore require an understanding of the impact of such side‐effects. This study compared psychiatrists’ estimates of the prevalence of neuroleptic side‐effects and associated distress with schizophrenic patients’ reports of side‐effects and distress. Psychiatrists were asked to estimate the likelihood of informing patients about side‐effects. Psychiatrists’ estimates of prevalence but not of distress correlated significantly with patients’ reports. Psychiatrists’ avowed decisions to inform patients about side‐effects were significantly correlated with their estimates of prevalence and distress, but not with patients’ reported levels of distress. Patients were unlikely to attribute side‐effects to neuroleptic medication. These results indicate that patients and psychiatrists share similar views about the prevalence and implications of neuroleptic side‐effects. However, psychiatrists’ apparent lack of understanding of which side‐effects are most likely to cause distress to patients may adversely affect the therapeutic alliance between prescribers and consumers.
The long‐term course of autistic disorders: update on follow‐up studies
Authors: Nordin V. , Gillberg C.
Published: November 2007

The majority of children with autism show deviance and socially or psychiatrically handicapping conditions throughout life. Only a small proportion of those with classical childhood autism lead independent adult lives. Others, particularly those with ‘high‐functioning’ autism and so‐called Asperger syndrome will improve enough to live an independent adult life. The level of mental retardation and other comorbid conditions (such as medical syndromes and other neuropsychiatric disorders, including epilepsy) is important in predicting outcome. An IQ below 50 around school age predicts severe restriction of social and adaptive functioning in adult life. The absence of communicative speech at 5–6 years of age is indicative of a poorer long‐term overall outcome. There is a clear co‐variation between IQ and level of communication, but probably there is some prognostic factor in language development apart from this. Measures of flexibility and cognitive shifting abilities tend to be good predictors of social outcome in a few studies. There is a continued need for prospective, longitudinal studies of children with autism spectrum disorders, particularly in Asperger syndrome. The role of interventions of various kinds needs to be addressed in such studies.
Non‐verbal behaviour deficits in schizophrenia: an ethological study of drug‐free patients
Authors: Troisi A. , Spalletta G. , Pasini A.
Published: November 2007

The aims of this study were (i) to define the dimensions of non‐verbal behaviour which distinguish between schizophrenic patients and control subjects and (ii) to examine the relationship between patients' non‐verbal behaviour and clinical symptoms. The non‐verbal behaviour of 28 drug‐free patients with schizophrenia according to Research Diagnostic Criteria (RDC) and 25 control subjects was videotaped during interviews and scored according to an ethological scoring system. Patients' symptoms were rated on the Scale for the Assessment of Negative Symptoms, the Scale for the Assessment of Positive Symptoms and the Brief Psychiatric Rating Scale. As a group, schizophrenic patients showed a global restriction of non‐verbal expressiveness, as indicated by their lower scores on prosocial behaviour, gesture and conflict. However, some patients had normal ethological profiles. Non‐verbal behaviour was largely independent of negative and positive symptoms. Deficits in non‐verbal behaviour may play a role in determining or aggravating dysfunctional patterns of relating in schizophrenia. Ethological analysis provides further support for the model that conceptualizes positive symptoms, negative symptoms and disorders of social relationships as three separate dimensions of the schizophrenic syndrome.
Social adjustment in schizophrenia: factors predictive of short‐term social adjustment in a sample of schizophrenic patients
Authors: Montero I. , Pérez I. Ruiz , Gómez‐Beneyto M.
Published: November 2007

A sample of 60 Spanish schizophrenic patients was studied in order to ascertain the relationship between their relatives' expressed emotion (EE) and social adjustment after 2 years of follow‐up. The average extent of the disability did not increase over time, and differences in dysfunction rates between the various specific social roles were identified. No differences in social outcome were detected between patients with high EE and low EE families. Three factors which predict social adjustment outcome were obtained using logistic regression analysis, namely clinical conditions, baseline social adjustment and the occurrence of a psychotic relapse during the follow‐up period.