bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct and indirect memory performance in patients with senile dementia
Authors: Partridge Fiona M. , Knight Robert G. , Feehan Michael
Published: July 2009

SYNOPSIS

The performance of patients with a presumptive clinical diagnosis of Senile Dementia of the Alzheimer's Type was compared to that of a group of normal elderly on several memory and neuropsychological tasks. The patients were impaired on tasks of free and cued recall, but exhibited normal performance on a word-completion procedure similar to that used by Graf et al. (1984). Reasons for the discrepancy between these findings and those from related research which reports impairment of word completion in patients with Alzheimer's Disease are discussed. Of particular interest is the role the orientating task plays in word-completion performance.
The effect of aircraft noise on the mental health of a community sample: a pilot study
Authors: Tarnopolsky A. , Barker S. M. , Wiggins R. D. , McLean E. K.
Published: July 2009

SYNOPSIS

Results of the investigation of a sample of size N = 200, half of whom live in the vicinity of a main airport, are reported. Three health indicators were examined: (1) annoyance reactions measured with a scale which did not include symptoms; (2) a symptom score, obtained with a screening instrument which identifies possible psychiatric cases; and (3) confirmed psychiatric cases identified with a traditional diagnosis after an interview by a psychiatrist. Noise was undoubtedly associated with annoyance. An association between noise and psychiatric measures was only present in a subgroup of respondents of high education. There was a marked association between annoyance and psychiatric measures. An attempt was made to clarify the nature of this relationship. Hypersensitivity to noise was associated with a high frequency of psychiatric symptoms and should be considered among the high risk factors for psychiatric illness.
The behavioural actions of the hypothalamic peptides: a review
Authors: Donovan B. T.
Published: July 2009

SYNOPSIS

Recent work has shown that the hypothalamic peptides commonly associated with the control of pituitary function have important behavioural actions of possible psychiatric significance. Thus, vasopressin, ACTH and like peptides may influence memory processes, and ACTH and MSH given intracranially induce a peculiar stretching and yawning syndrome accompanied by penile erection and ejaculation. Thyrotrophic hormone-releasing factor potentiates behavioural excitation, somatostatin is depressive, while luteinizing hormone-releasing hormone facilitates sexual behaviour and the newly identified endorphins are markedly opioid in character. These and other activities of the hypothalamic peptides are reviewed and assessed alongside the clinical information available.
Ethnic factors in voluntary and compulsory admissions
Authors: Owens D. , Harrison G. , Boot D.
Published: July 2009

SYNOPSIS

Socio-demographic and clinical aspects of compulsory and informal admissions to general adult psychiatry wards over a two-year period are compared. In addition, Afro-Caribbean patients are compared with white UK-born patients. Relative rates of admission are examined. The study confirms other reports of greater than expected compulsory admissions of Afro-Caribbean patients and pays particular attention to the circumstances preceding compulsory entry to hospital and the persons and agencies involved in that process.
Amnesia for criminal offences
Authors: Taylor Pamela J. , Kopelman Michael D.
Published: July 2009

Synopsis

Nearly 10% of a sample of men charged with a variety of offences claimed amnesia for their offence. The amnesia occurred only among those who had committed violence and was most frequent following homicide. All the amnesics had a psychiatric disorder, four having a primary depressive illness and the remainder being almost equally divided between schizophrenia and alcohol abuse. None of the amnesias had any legal implications. The circumstances of the offences suggested a variety of mechanisms to account for the amnesia, including repression, dissociation and alcoholic black-outs. Psychological defence mechanisms were probably of some importance, even when alcohol was an important factor.
Sudden deaths in the mentally handicapped
Authors: Carter G. , Jancar J.
Published: July 2009

Synopsis

Trends in the incidence and causes of sudden deaths in a hospital group for the mentally handicapped were identified during a 50-year period, and the two halves of the period were compared. There were significantly more deaths in the second 25-year period than in the first. Longevity was greater during the second period, and a decrease in deaths due to status epilepticus was outweighed by an increase in deaths from arterial degenerative disease in the larger number of older patients. In the second period there was also a significant rise in sudden deaths due to asphyxia, probably attributable to modern medication with side-effects giving rise to feeding difficulties.
Precursors and metabolites of 5-hydroxytryptamine and dopamine in the ventricular cerebrospinal fluid of psychiatric patients
Authors: Bridges P. K. , Bartlett J. R. , Sepping P. , Kantamaneni B. D. , Curzon G.
Published: July 2009

Synopsis

Tryptophan and 5-hydroxyindoleacetic acid (precursor and metabolite respectively of 5-hydroxytryptaminę) were determined in ventricular CSF of psychiatric patients undergoing stereotactic subcaudate tractotomy. Tyrosine and homovanillic acid (precursor and metabolite respectively of dopamine) were also determined. Results suggest an association between affective state and the above precursor amino acids with lower concentrations in primary depression and higher ones when anxiety or agitation predominate. This leads to lower 5-hydroxyindoleacetic acid concentrations in depression and higher concentrations in anxiety and agitation.
Dependency of different types in schoolchildren with epilepsy
Authors: Stores Gregory , Piran Niva
Published: July 2009

Synopsis

By means of the Self-Administered Dependency Questionnaire (SADQ), 4 types of dependency on mother were measured in 65 children with epilepsy attending ordinary school, subgrouped according to sex, level of schooling, electrographic type of epilepsy, and drug treatment. The various dependency scores of each subgroup were compared with the appropriate norms available for the SADQ. Compared with normal boys, epileptic boys of primary school age (N = 16) were generally found to be more in need of close physical emotional contact with their mother and her physical proximity when away from home, although they were less ready to talk to her about their practical problems and ask for her help. The needs of epileptic boys of secondary-school age (N = 18) were expressed more in terms of their mother's help with practical matters at home. In contrast, no significant differences were apparent between epileptic and normal girls at either level of schooling. In comparisons between epileptic children who consistently produced only generalized seizure activity in their EEG (N = 31), a right temporal spike discharge (N = 16) or a similar discharge on the left (N = 18), both boys and girls with a left temporal spike discharge tended to show significantly higher need for close physical emotional contact with their mother than children in the other electrographic groups. No clear relationship was seen between dependency scores and type of anti-epileptic drug treatment.
Features of children taken to juvenile court for failure to attend school
Authors: Berg Ian , Butler Alan , Hullin Roy , Smith Rebecca , Tyrer Stephen
Published: July 2009

Synopsis

The social reports on 84 children taken to court for failure to attend school were studied. Independent raters were able to assess reliably the presence and absence of a variety of variables concerned with the individual's behaviour, school, family, and involvement with social work agencies. In 68 instances teachers' questionnaires measuring psychiatric disturbance had been completed. There was no evidence that truancy in these circumstances is a homogeneous condition. At least 3 independent sets of features appear to be involved in most cases. One involves antisocial and educational problems (‘clinical truancy’), a second is concerned with adverse social factors and parental complicity (‘school withdrawal’), and a third set includes a tendency to social isolation (‘school refusal’). There was no evidence that individuals tend to exhibit one of these features to the exclusion of the others.
Serum dopamine-β-hydroxylase in chronic alcoholism
Authors: Sullivan John L. , Stanfield Charles N. , Schanberg Saul , Cavenar Jesse
Published: July 2009

Synopsis

Previous reports suggest that high serum dopamine-β-hydroxylase (DBH) activity may be associated with vulnerability to alcoholism. However, there are also contradictory studies in the literature. Therefore we measured serum DBH in chronic alcoholics followed for 12 months in a treatment programme after psychiatric hospitalization for acute alcoholism. Mean serum DBH activity in the alcoholics was unchanged from controls at 3 months, 6 months and 12 months following hospital discharge. These data imply that serum DBH activity does not provide a useful metabolic screen for vulnerability to chronic alcoholism. However, prospective studies of patients at high risk to develop alcoholism will be helpful in further clarification of this issue.
Genetic and environmental determinants of the lability of trait neuroticism and the symptoms of anxiety and depression
Authors: Mackinnon A. J. , Henderson A. S. , Andrews G.
Published: July 2009

Synopsis

A genetic analysis was conducted on trait neuroticism and symptoms of anxiety and depression in a five-wave study of 462 twin pairs. Models that assessed the relative importance of genetic and environmental factors to the lability (within-individual variability over time) of these measures were fitted to the data. Previous results concerning the substantial genetic involvement in the level of neuroticism and symptoms were confirmed. However, it was found that neither genes nor the shared environment of the twins was a significant cause of lability of these measures. An attempt was therefore made to identify aspects of individuals' environments that might be responsible for lability of neuroticism and symptoms. Adverse life events were found to predict variability of symptoms, but not of neuroticism. The availability of close social ties or having affectionless control in childhood did not contribute to lability.
Type A stress prone behaviour and breast cancer
Authors: Faragher E. Brian , Cooper Cary L.
Published: July 2009

Synopsis

This quasi-prospective study of 2163 women attending breast-screening clinics (and controls), indicates that there is a link between personality factors and breast disease. Certain aspects of Type A behaviour seem to be associated with breast-disease states.
Do mental health surveys disturb?
Authors: Henderson A. S. , Jorm A. F.
Published: July 2009

Synopsis

We have tested the assumption that mental health surveys do not cause distress. At the end of a two-wave community survey of psychiatric symptoms and personality factors, respondents were asked specific questions about how the interviews affected them. Being interviewed was distressing for some individuals, but it was seen as beneficial by a larger number. Those reporting distress were more likely to have had neurotic symptoms prior to both interviews and to have personality characteristics which would indicate proneness to distress. Whether the distress lasted beyond the interview situation is unknown. These results suggest that surveys of mental health should tell intended respondents about the possible effects of the interview, both positive and negative. Some studies should try to estimate the duration of any distress reported to have been induced.
Memory deficit in clinical depression: processing resources and the structure of materials
Authors: Watts Fraser N. , Dalgleish Tim , Bourke Patrick , Healy David
Published: July 2009

Synopsis

Resource theory predicts that the relative memory deficit shown by depressed patients should be greater with unstructured than structured material. Previous data using semantic categories word lists supports this, but lists approximating to text have produced the opposite result. Both types of structure were studied in this experiment. The prediction from resource theory was found to hold only when comparing medium and high levels of structure, and to hold more clearly for word lists approximating to text than for semantic categories lists. When word lists of low and medium levels of structure were compared, depressed patients showed relatively greater deficit with the more structured material. Ways in which this could be accommodated in a revised version of resource theory are discussed.
The Nottingham Study of Neurotic Disorder: relationship between personality status and symptoms
Authors: Tyrer P. , Seivewright N. , Ferguson B. , Murphy S. , Darling C. , Brothwell J. , Kingdon D. , Johnson A. L.
Published: July 2009

Synopsis

Two hundred and ten psychiatric patients with one of three DSM-III diagnoses, generalized anxiety disorder (N = 71), panic disorder (N = 74) or dysthymic disorder (N = 65), were included in a clinical trial in which diazepam, dothiepin or placebo tablets, cognitive and behaviour therapy, or a self-help package were given over ten weeks. Personality status was assessed independently using a structured interview, the Personality Assessment Schedule. One hundred and ninety-eight patients had personality assessments, 89% with a close informant. Thirty-six per cent had a personality disorder and these patients had more severe psychopathology than those with no personality disorder. Personality disorder was more common in patients with dysthymic disorder and this group responded less well to treatment. The category of personality disorder had no apparent influence on symptoms.
The aetiology of childhood autism: a criticism of the Tinbergens' theory: a rejoinder
Authors: Tinbergen E. A. , Tinbergen N.
Published: July 2009

The Editor has kindly offered us space for replying to the paper by Wing and Ricks, in which they reject, and advise their readers to discard, our views on early childhood autism. Rather than using this space for a ‘counter refutation’ we prefer to call attention in this journal to what, after careful study of Wing's and Ricks' criticism, we still consider a potentially fruitful approach to the problems posed by the autistic deviation. We take this course because we feel that our critics have missed the point of our publications. As we see it, the disagreement is not so much a matter of facts per se as one of how to look at the problems. The primary aim of what we have written (as was indicated, for instance, in the subtitle of our joint paper of 1972) has been to sketch a method of approach, to illustrate its potential, and to advocate the application of this approach in child psychiatry. The method has been developed in studies of animal behaviour, where it has led lo valuable insights. But we have not simply extrapolated the results of animal studies. We have looked at certain details in the behaviour of the children themselves. When we applied this ‘ethological’ approach to autistic behaviour, we arrived at certain, naturally tentative conclusions which seemed, and still seem to us, to have the merit of being plausible interpretations of quite a number of hitherto puzzling parts of the syndrome.
Emotional symptomatology in obese patients treated with fenfluramine and dextroamphetamine
Authors: Rickels Karl , Hesbacher Peter , Fisher Ellen , Perloff Milton M. , Rosenfeld Howard
Published: July 2009

Synopsis

Emotional symptomatology data on 78 obese females treated for 3 weeks with fenfluramine, dextroamphetamine, or placebo were evaluated. These obese females were shown to be considerably less emotionally disturbed than neurotic females, and similar in emotional symptomatology to other females seeing physicians for nonpsychiatric complaints. Even within these marginally symptomatic patients, fenfluramine and dextroamphetamine were significantly more effective than placebo in reducing anxious, depressive, and anxious-depressive symptomatology. Fenfluramine was particularly effective in alleviating anxiety in patients who were initially higher in anxiety. Most important, fenfluramine produced significantly greater weight loss than dextroamphetamine in patients with higher levels of anxiety and depression, while dextroamphetamine was an especially effective anorexic in low anxious patients. Differences in initial anxiety and depression, even within relatively normal patients, may well affect results obtained with fenfluramine and dextroamphetamine in the short-term treatment of obesity.
Sturdy childhood predictors of adult antisocial behaviour: replications from longitudinal studies
Authors: Robins Lee N.
Published: July 2009

Synopsis

Results are compared in studies of 4 male cohorts – 1 all white, 1 all black, and 2 racially representative of the population – growing up in different eras, followed past varying portions of their adult lives, living in different parts of the US. Despite sample differences and differences in sources of information and in the variables used to measure both childhood predictors and adult outcomes, some striking replications appear with respect to childhood predictors of adult antisocial behaviour. All types of antisocial behaviour in childhood predict a high level of antisocial behaviour in adulthood and each kind of adult antisocial behaviour is predicted by the number of childhood antisocial behaviours, indicating that adult and childhood antisocial behaviour both form syndromes and that these syndromes are closely interconnected. Also confirmed across studies are: (1) adult antisocial behaviour virtually requires childhood antisocial behaviour; (2) most antisocial children do not become antisocial adults; (3) the variety of antisocial behaviour in childhood is a better predictor of adult antisocial behaviour than is any particular behaviour; (4) adult antisocial behaviour is better predicted by childhood behaviour than by family background or social class of rearing; (5) social class makes little contribution to the prediction of serious adult antisocial behaviour.
Major psychosis and dopamine: controversial features and some suggestions
Authors: Miller Robert
Published: July 2009

Synopsis

Three problems with the dopamine hypothesis of major psychosis are pointed out: the long time-course of neuroleptic therapy; the absence of tolerance to the antipsychotic effects of neuroleptic drugs, or of a supersensitivity psychosis on drug withdrawal; and the absence of potent psychotogenic properties in the direct dopamine agonists. A resolution of these paradoxes is suggested relying on a role for dopamine in learning processes at a relatively high (cognitive) functional level. The hypothesis proposed is also used to explain the origin of some of the more distinctive psychotic symptoms.
Idiot savant calendrical calculators: maths or memory?
Authors: O'Connor N. , Hermelin B.
Published: July 2009

Synopsis

Eight idiot savant calendrical calculators were tested on dates in the years 1963, 1973, 1983, 1986 and 1993. The study was carried out in 1983. Speeds of correct response were minimal in 1983 and increased markedly into the past and the future. The response time increase was matched by an increase in errors. Speeds of response were uncorrelated with measured IQ, but the numbers were insufficient to justify any inference in terms of IQ-independence. Results are interpreted as showing that memory alone is inadequate to explain the calendrical calculating performance of the idiot savant subjects.
A clinical and epidemiological survey of parasuicide and suicide in Edinburgh schizophrenics
Authors: Wilkinson Greg , Bacon Niall A.
Published: July 2009

Synopsis

Between 1968 and 1981 there were roughly equal numbers of male and female schizophrenic parasuicides in Edinburgh: males were significantly younger than females at parasuicide (33 v. 37 years), and had received a diagnosis of schizophrenia for a shorter time (3·4 v. 7·2 years). The clinical, epidemiological and social characteristics of such parasuicides are, by and large, those that might be expected from a knowledge of the epidemiology of schizophrenia.

Eight per cent of a sample of Edinburgh schizophrenic first-ever parasuicides subsequently committed suicide, when followed up for up to 14 years. This percentage is close to what would be expected for later suicide in non-schizophrenic parasuicides. When all the suicides were considered, similar numbers of male and female schizophrenics killed themselves; their mean ages at death were 42 and 43 years respectively; and the mean duration of the schizophrenic illness was 10 years in both cases, according to hospital records.

We found slight evidence that parasuicide is commoner in schizophrenic suicides than in schizophrenic controls but little evidence to support the contention that there may be a specific relationship between suicide (or parasuicide) and the presence of auditory hallucinations, recent discharge from in-patient care, the use of depot neuroleptic medication, or recent parasuicide.

From the point of view of the prevention of suicide and parasuicide in schizophrenics, it is noteworthy that we found few differences between the clinical characteristics and management of schizophrenic parasuicides and suicides, and schizophrenic controls.
Factors affecting survival in Alzheimer's disease
Authors: Burns Alistair , Lewis Glyn , Jacoby Robin , Levy Raymond
Published: July 2009

SYNOPSIS

Factors affecting survival of 178 patients diagnosed using NINCDS/ADRDA criteria for Alzheimer's disease were studied. All patients were drawn from the Camberwell Health Authority Area and so were a representative sample of subjects from a clinical old age psychiatry service. The mortality rate of the sample was 3·5 times that expected after adjustment for age. Younger subjects had a higher standardized mortality ratio than older subjects. The cumulative three-year mortality of the sample was 47%. Factors shown to be associated with a reduced survival included: increasing age, longer duration of illness, male sex, presence of physical illness, poor cognitive function, observed depression and absence of misidentification syndromes. Apraxia was a stronger predictor of early death than aphasia or dysmnesia.
Life events, social problems and physical health status as predictors of emotional distress in men and women in a community setting
Authors: Zimmermann-Tansella Christa , Donini Stefano , Lattanzi Marcello , Siciliani Orazio , Turrina Cesare , Wilkinson Greg
Published: July 2009

SYNOPSIS

The main aim of this study was to construct logistic models of emotional distress (defined as a GHQ-30 score of 6 or greater) in a community sample of 226 men and 225 women. The independent variables included were: sociodemographic characteristics, physical health status, social problems and undesirable life events. Univariate comparisons showed that in both sexes undesirable life events and social problems were associated with emotional distress; in men the presence of physical symptoms and widowed, separated or divorced status also showed such an association. Separate logistic regression models for men and women confirmed the importance of undesirable life events and social problems as predictors for emotional distress. In women there was also a significant interaction effect between the two variables on emotional distress. Sociodemographic characteristics and physical health status did not exert a statistically significant effect in these models.
Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations
Authors: Owens D. G. C. , Johnstone E. C. , Crow T. J. , Frith C. D. , Jagoe J. R. , Kreel L.
Published: July 2009

Synopsis

Using computed tomography, lateral ventricular size was studied in a sample of 112 institutionalized chronic schizophrenic patients (selected from 510 cases to investigate the correlates of the defect state and intellectual decline and the effects of insulin, electroconvulsive and neuroleptic treatment), and compared with matched groups of non-institutionalized schizophrenics, patients with first schizophrenic episodes, institutionalized and non-institutionalized patients with primary affective disorder, and neurotic out-patients. Age was significantly correlated (P< 0·0002) with lateral ventricular size, but the institutionalized schizophrenic patients had significantly larger (P< 0·025) lateral ventricles than the neurotics when age was taken into account. Ventricular enlargement was unrelated to past physical treatment (neuroleptics, insulin coma and electroconvulsive therapy).

Within the group of institutionalized schizophrenic patients few correlates of ventricular enlargement were identified; thus in this population increased ventricular size was not clearly associated with the features of the defect state (negative symptoms and intellectual impairment). however, there was a curvilinear (inverted-U) relationship between intellectual function and ventricular size was significantly related to absence of hallucinations, impairment of social behaviour, inactivity and the presence of abnormal involuntary movements.

The findings confirm that structural brain changes do occur in chronic schizophrenia, but illustrate some of the difficulties in elucidating the clinical significance of ventricular enlargement. Lateral not bimodal; the relationship to particular features of the disease is complex and likely to emerge only in studies with a large sample size.
An investigation of patients' attitudes to ECT by means of Q-analysis
Authors: Cowley P. N.
Published: July 2009

Synopsis

This paper is a preliminary investigation into the application of Q-analysis in clinical psychiatry, Q-analysis is used to describe the interrelationships of attitudes that two groups of patients were observed to hold towards ECT. The data were collected as part of the Leicestershire ECT trial. One group comprised 96 patients who consented to enter the trial. The other group was formed by 23 patients who refused to participate in the trial, but who agreed to be interviewed so that their attitudes could be assessed.

The method of applying Q-analysis is described, and the resultant outputs for the two groups are discussed. The presence of insight, a subjective need for treatment and trust in ECT were significant features in the 96 patients who agreed to enter the trial. However, among this group there was a subset of patients who were very anxious and who had little desire to receive ECT or trust in it. Among the 23 patients who refused to participate in the trial two main viewpoints could be discerned. First, there was a subgroup who seemed accurately to assess their need for treatment, had insight and trust in ECT as well as specifically wanting to receive it. The second was composed of patients who were very apprehensive, did not want ECT and generally were unhappy about being in hospital. In both groups it was considered that level of knowledge was relatively unimportant in the formation of attitudes.
Psychological aspects of dialysis: a Semantic Differential study
Authors: Clark Rosalind , Hailstone J. Donovan , Slade P. D.
Published: July 2009

SYNOPSIS

Twenty-one patients on The Royal Free Hospital dialysis programme and 21 control subjects were examined using the Semantic Differential. Results were analysed by the method of check-style analysis and by a comparison of concept profiles for the 2 groups using a multivariate analysis program.

A highly significant difference (p < 0·001) was found between the check-styles of dialysis and control groups. The implications of this finding are discussed.

Three concepts were selected for particular study: ‘my self’, ‘my ideal self’ and ‘people’. There were significant differences in profiles between the 2 groups on all 3 concepts.

Subgroup analysis showed further differences for sex, age and length of time on dialysis.
Corticosteroid and growth hormone responses to methylamphetamine in depressive illness
Authors: Checkley S. A.
Published: July 2009

SYNOPSIS

It is suggested that, if depressed patients have deficient noradrenergic function at central α-adrenergic receptors, then they will also have impaired corticosteroid responses to methylamphetamine but unaltered growth hormone responses. This prediction has been confirmed when the responses of a group of patients with endogenous depression were compared with the responses of a group of patients with other functional psychoses, a group of patients with reactive depression, and a group of patients with other psychiatric diagnoses. These findings support the hypothesis that there is a functional deficiency of noradrenaline at some central α-adrenergic receptors.
Multicompartmental analysis of amino acids: III. Tyrosine in affective disorder
Authors: Shaw D. M. , Tidmarsh S. F. , Johnson A. L. , Michalakeas A. C. , Riley G. J. , Blazek R. , MacSweeney D. A. , Francis A. F. , Hewland R.
Published: July 2009

SYNOPSIS

Multicompartmental studies of tyrosine in patients suffering from affective disorders and controls gave estimates of 2 major pools of amino acid, together with the associated fractional clearance rates and fluxes. The 2 pools were considered provisionally to represent extracellular and intracellular tyrosine.
Identifying the specific clinical actions of amitriptyline: interrelationships of behaviour, affect and plasma levels in depression
Authors: Katz Martin M. , Koslow Stephen H. , Maas James W. , Frazer Alan , Kocsis James , Secunda Steven , Bowden Charles L. , Casper Regina C.
Published: July 2009

SYNOPSIS

Despite increasing knowledge of the neurochemical bases of the action of the tricyclic drugs, little is known about the sequence of psychological effects which precede recovery in drug-responsive patients. This research was aimed at identifying the specific behavioural effects associated with the therapeutic action of amitriptyline in depression. The design involved measurement (post-hoc) of weekly changes in a severely depressed placebo-resistant group who recovered with drug treatment, compared with a group of similar patients treated for the equivalent four weeks, who showed minimal to no clinical response. The research strategy, in accordance with a dose–response paradigm, was to determine which of the early changes in emotion and behaviour found in treatment responders were systematically associated with plasma concentrations of amitriptyline or its major metabolite. Amitriptyline was found to act within seven days on the components of anxiety and on hostility in the responders, and on sleep disorder in all patients. After 12 to 14 days of treatment these effects increased, with improvements in other significant components distinguishing the responders from the non-responders. At the 12th to 14th treatment days when a steady state concentration of drug in plasma was approached, reductions in anxiety and hostility and in certain somatic components correlated significantly with plasma concentrations of amitriptyline. Implications of the findings for clarifying the specificity of clinical actions of the tricyclic drugs, and for understanding the psychobiological dynamics underlying rapid drug-induced recovery in depression, were explored.
Objective and subjective memory impairment in pregnancy
Authors: Brindle Peter M. , Brown Malcolm W. , Brown John , Griffith Huw B. , Turner Gillian M.
Published: July 2009

SYNOPSIS

Pregnant subjects rated their memories as worse than normal and their ratings differed significantly from controls. Explicit memory tested by both recognition and recall was unimpaired. In contrast, implicit memory was significantly impaired in primigravidae. Impairment in implicit memory correlated with the subjective memory ratings. The dissociation of explicit and implicit memory is discussed.
Clinical issues in the use of carbamazepine in psychiatry: a review
Authors: Elphick Martin
Published: July 2009

Synopsis

Evidence is presented here in support of the efficacy of carbamazepine (CBZ) in a variety of different psychiatric conditions. While there is now considerable evidence to support the use of CBZ in the acute treatment of mania and in the prophylaxis of bipolar affective disorder, particularly as a second-line drug, its usefulness in other conditions is less well documented. Overactivity, aggression and poor impulse control appear to improve in a variety of different diagnostic categories, and it may possibly be more appropriately prescribed to control or prevent these symptoms than as a treatment for a particular disease entity. The use of CBZ as an antidepressant is not well proven. Most of the adverse effects reported are due to rapid initial escalation of dosage, which can be avoided, or are reversible such as drug rashes. Severe adverse effects have been reported but are rare. Frequent monitoring of drug plasma concentration is not required. Some reports of synergism with lithium have appeared and combination therapy may be a useful strategy. Drug interactions, the need for clinical monitoring, and the possible pharmacological mode of action of CBZ are also discussed.
Use and abuse of khat(Catha edulis): a review of the distribution, pharmacology, side effects and a description of psychosis attributed to khat chewing
Authors: Pantelis Christos , Hindler Charles G. , Taylor John C.
Published: July 2009

Synopsis

There have been relatively few reported cases of psychosis due to khat usage despite its heavy consumption in certain East African and Arabian countries. Four cases have been reported in the UK. We report here on three further cases of psychotic reactions to this substance in Somalian males, and emphasize the need to be aware of khat as a potential substance of abuse, with both medical and psychiatric complications. The features of khat psychoses are described and the relationship to amphetamine and ephedrine psychoses is discussed. The forensic aspects of two of the cases which involved homicide and combined homicide and suicide are highlighted, as is the possible role of social dislocation from the culture of origin.
The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study
Authors: Davidson J. R. T. , Hughes D. L. , George L. K. , Blazer D. G.
Published: July 2009

Synopsis

Social phobia was studied in a North Carolina community, using DSM-III criteria. Two kinds of comparison were made: social phobia v. non-social phobia, and comorbid social phobia v. non-comorbid social phobia. Six-month and lifetime prevalence rates were 2·7 and 3·8% respectively. Social phobia had an early onset, lasted a long time and rarely recovered. Predictors of good outcome recovery in a logistic regression analysis were onset of phobia after age 11, absence of psychiatric comorbidity and greater education. The disorder was often missed in medical consultation. Increased rates of psychiatric comorbidity existed, especially for other anxiety disorders and for schizophrenia/schizophreniform disorder. There was increased risk of neurological disorder. Social phobia was also associated with an increased rate of suicide attempts, antisocial behaviour and impaired school performance during adolescence, impaired medical health, increased health-seeking behaviour, poor employment performance, reduced social interaction and impaired social support. Comorbidity accounted for some, but not all observed differences.
Neuroendocrine aspects of primary endogenous depression III. Cortisol secretion in relation to diagnosis and symptom patterns
Authors: Rubin Robert T. , Poland Russell E. , Lesser Ira M. , Martin David J. , Blodgett A. L. Nelson , Winston Robert A.
Published: July 2009

Synopsis

In order to ascertain the extent of hypothalamo-pituitary-adrenal cortical (HPA) hyperactivity in endogenous depression, we determined circadian serum cortisol patterns, cortisol responses to dexamethasone (DEX) administration, and urine free cortisol excretion before and after DEX administration in 40 definite endogenous depressives diagnosed with the Research Diagnostic Criteria. The cortisol measures ranged from normal to clearly elevated. To elucidate the clinical correlates of these hormone measures in the patients, we examined the relationships of the pre- and post-DEX cortisol measures to the diagnosis of endogenous/melancholic depression by different systems and to the overall severity and specific dimensions of depressive symptomatology.

In this group of endogenous depressives, none of the diagnostic schemes for endogenous/melancholic depression which we studied was significantly related to the pre- or post-DEX cortisol measures. Of the other subject and symptom variables, only age and the agitation/anxiety factor of the Hamilton depression scale showed consistent relationships with the cortisol measures. Both were positively correlated, to a moderate degree, with the hormone measures, and they were not correlated with each other. Together they explained approximately 20% of the variance in the cortisol measures. Thus, within a group of moderately to severely ill endogenous depressives, the older and the more agitated anxious patients have a significantly greater likelihood of showing increased HPA activity. These findings indicate that age should be controlled in studies of the HPA axis and that the subjective experience of anxiety may contribute to HPA hyperactivity in endogenous depression.
Locally-based residential services for mentally handicapped adults: a comparative study
Authors: Shah Amitta , Holmes Nan
Published: July 2009

Synopsis

The patterns of daily living, occupation and leisure activities, skills, behaviour and the structure and organization of living units were assessed for 2 groups of mentally handicapped adults, first in a large hospital and second, a year later in the new local units to which they were transferred. Similar assessments were carried out for individually matched control subjects who remained in the large hospital. For the less severely handicapped, more sociable residents who moved to an NHS hostel in the community, there were significant improvements on several of these measures. For the more severely handicapped, socially aloof people who moved to a ward in a small converted hospital in the district from which they had originally come, some changes on the environmental measures were found, but on the whole the unit was run along similar lines to the wards of the large hospital. There was little change in the pattern of the residents' day to day life. The controls who remained in the large hospital experienced very little change in environmental and life-style measures. The discussion focuses on the interaction between environmental factors and the handicaps of the individuals, and the influence of this interaction upon quality of care and life-style. The study was carried out during the early stages of the rundown to closure of the large mental handicap hospital.
Computerized axial tomographic studies following long-term use of benzodiazepines
Authors: Perera K. M. H. , Powell T. , Jenner F. A.
Published: July 2009

Synopsis

Computerized axial tomography was used to compare sex and age-matched groups of controls and long-term benzodiazepine users for evidence of cerebral atrophy. No statistically significant differences were found.
An unusual case of nicotine dependence
Authors: Edwards J. Guy
Published: July 2009

Synopsis

The case of a 49-year-old woman who has been brushing her teeth for 12 years with large amounts of snuff is described. She was dependent on the habit and had plasma nicotine and cotinine levels similar to those found in heavy smokers. Historical and cultural aspects of the use of snuff are discussed.
Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong
Authors: Lee S. , Ho T. P. , Hsu L. K. G.
Published: July 2009

Synopsis

A mixed retrospective–prospective study of 70 Chinese anorexic patients in Hong Kong shows that although they were similar to Western anorexics in most other ways, 41 (58·6%) of them did not exhibit any fear of fatness throughout their course of illness. Instead, these non-fat phobic patients used epigastric bloating (31·4%), no appetite/hunger (15·7%) or simply eating less (12·9%) as legitimating rationales for food refusal and emaciation. Compared to fat phobic anorexics, they were significantly slimmer pre-morbidly (P< 0·0001) and were less likely to exhibit bulimia (P= 0·001). The possible explanations for the absence of fat phobia and the interpretive dilemma this provokes are discussed from historical, pathoplastic and cultural anthropological perspectives. It is argued that anorexia nervosa may display phenomenological plurality in a Westernizing society, and its identity may be conceptualized without invoking the explanatory construct of fat phobia exclusively. As non-fat phobic anorexia nervosa displays no culturally peculiar features, it is not strictly speaking a Western culture-bound syndrome, but may evolve into its contemporary fat phobic vogue under the permeative impact of Westernization. Its careful evaluation may help clarify the aetiology and historical transformation of eating disorder, foster the development of a cross-culturally valid taxonomy of morbid states of self-starvation, and exemplify some of the crucial issues that need to be tackled in the cross-cultural study of mental disorders.
An idiot savant calendrical calculator with Gilles de la Tourette syndrome: implications for an understanding of the savant syndrome
Authors: Moriarty J. , Ring H. A. , Robertson M. M.
Published: July 2009

Synopsis

We describe the existence of the savant syndrome in association with Gilles de la Tourette's Syndrome (GTS). The presentation of savant abilities is typical of that previously described. Similarities between autism, the disorder most characteristically associated with savants, and GTS in terms of obsessionality are noted. Previously reported psychological studies of autistic savants are briefly reviewed and, together with evidence from neuroimaging in GTS, obsessive compulsive disorder (OCD), and autism, used to support a model of the underpinnings of savant skills.
Semantic memory is both impaired and anomalous in schizophrenia
Authors: Chen E. Y. H. , Wilkins A. J. , McKenna P. J.
Published: July 2009

Synopsis

The integrity of semantic memory in schizophrenia was examined in a reaction time task requiring subjects to verify words as members or non-members of a conceptual category, where the words differed in their degree of semantic relationship to the category. Compared to matched normal controls, 28 schizophrenic patients were impaired on the task, showing slower responses in all conditions. In addition, their performance was anomalous in that they took longest to respond to items that were outside the category but semantically related to it, in contrast to the controls who took the longest to respond to ambiguous words at the borderline of the category. The pattern of ‘yes’ and ‘no’ responses of the patients was anomalous in a similar way. In both speed and accuracy of responding, the findings indicate that there is an outward shift of semantic category boundaries in schizophrenia.
Predictors for readmission risk in schizophrenia
Authors: Mortensen P. B. , Eaton W. W.
Published: July 2009

Synopsis

Readmission risk was assessed at the first and subsequent discharges in a total Danish national sample consisting of 8705 first admitted patients who had been discharged alive at least once with a diagnosis of schizophrenia. Predictors for readmission risk were identified using the Cox proportional hazards model. Following the first discharge, 19% of the surviving patients had not been readmitted after 10 years of follow-up. Readmission risk increased with the number of previous admissions. At the first discharge readmission risk decreased with increasing age and was significantly predicted by clinical subtype and gender. At later discharges (5th, 10th, and 15th) the effect of these variables gradually disappeared. At the 15th discharge readmissions were mainly predicted by the duration of the latest admission and discharge periods. Both the increase in readmission risk with the number of previous admissions and the evolving pattern of predictors for readmission risk are interpreted as supporting the existence of a smaller subpopulation among schizophrenic patients with frequent relapses.
Perceived support and adjustment to stress in a general population sample of female twins
Authors: Kessler R. C. , Kendler K. S. , Heath A. , Neale M. C. , Eaves L. J.
Published: July 2009

Synopsis

The stress-buffering effect of perceived support is explored in a large panel survey of adult female twins. The analysis begins by documenting a significant interaction between perceived support and acute stress in predicting DSM-III-R major depression. Various hypotheses are investigated to explain this interaction. These include the possibilities that the interaction is due to a stress-buffering effect of perceived support which is mediated by received support, that perceived support promotes either the increased use or the increased effectiveness of certain coping strategies, or that there is some underlying genetic factor that affects both the perception of support and adjustment to stress. No evidence was found for any of these hypotheses. The paper closes with a discussion of directions for future research aimed at explaining the interaction between perceived support and acute stress.
Latent trait modelling of symptoms of schizophrenia
Authors: Bell R. C. , Low L. H. , Jackson H. J. , Dudgeon P. L. , Copolov D. L. , Singh B. S.
Published: July 2009

Synopsis

Latent trait models were fitted to data for 149 schizophrenic or schizophreniform in-patients rated on the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) using the Rasch Extended Logistic Model. It was found that a reduction in the numbers of rating categories, from six to three or four led to consistencies in response while deletion of several items led to consistent scales of symptoms that accorded with an item response characterization. Behaviours included in the final scales varied in the numbers of categories, and in the range of symptom level covered by a category. Relationships between scores representing symptoms were found to be modelled better by a factor structure that included a third overlapping ‘cognitive’ factor in addition to the now traditional positive and negative factors, than by the original positive and negative factors alone.