bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Globus Hystericus?
Authors: Wilson Janet A. , Deary I. J. , Maran A. G. D.
Published: August 2008

Forty-six patients, 9 male, 37 female, presenting to an ear, nose and throat department with a principal complaint of globus sensation were investigated by radiology, manometry, endoscopy and prolonged ambulatory pH monitoring to exclude a physical basis for their symptoms. Patients also underwent assessment by the Eysenck Personality Inventory (EPI) and General Health Questionnaire (GHQ). The only organic abnormalities detected were an abnormal degree of oesophageal acid exposure (seven patients) and oesophageal spasm (one patient). Female patients were neurotic introverts on EPI testing; males were stable ambiverts. High GHQ scores were present in 13 females (35%) and one male and there was a significant correlation between N scores (in the EPI) and GHQ scores. We propose that globus is a useful, single-symptom model for the study of conversion disorders.
Criteria for Evaluating Improvement in Schizophrenia in Psychopharmacological Research (With Special Reference to Gamma Endorphin Fragments)
Authors: Manchanda Rahul , Hirsch Steven R. , Barnes Thomas R. E.
Published: August 2008

A review of treatment trials with DTγE revealed widely discrepant results. Relevant variables were the variety of measures employed for monitoring psychotic symptoms, and the different criteria used to judge the degree of improvement. The authors suggest a uniform outcome criterion for early trials of new treatments, which would generate more consistent and comparable results between studies, and give a stronger indication of the value of the treatment under test. When the data from the various treatment trials of DTγE were re analysed, applying a uniform outcome criterion of improvement of a change of 80% or more on rating-scale score, the results were more consistent than would have been suspected from the original reports.
Ethnic Density is Unrelated to Incidence of Schizophrenia
Authors: Cochrane Raymond , Bal Sukhwant S.
Published: August 2008

Data deriving from the Mental Health Enquiry were obtained from the Department of Health and Social Security (DHSS) for all 186 000 admissions in England in 1981 to test the ‘ethnic density hypothesis'. This hypothesis has been used to explain variations in rates of mental illness between ethnic groups in other countries, and suggests that there is an inverse relationship between the size of ethnic groups and their admission rates. The data analysed in the present paper for the main foreign-born immigrant groups to England not only failed to support the ethnic-density hypothesis, but in some cases, showed a significant positive relationship between group size and admission rates. Some possible reasons for these findings are explored.
Anorexia Nervosa Following Torture in a Young African Woman
Authors: Fahy Thomas A. , Robinson Paul H. , Russell Gerard F. M. , Sheinman Brian
Published: August 2008

A case of weight loss from food avoidance and vomiting in a young Ethiopian torture victim is described, and possible aetiological factors discussed.
Palinopsia Posing as a Psychotic Depression
Authors: Gates Todd J. , Stagno Susan J. , Gulledge A. Dale
Published: August 2008

The experience of visual images appearing as well-described persons and objects, either familiar or unfamiliar to the patient, has frequently prompted psychiatric evaluation for apparent psychotic or schizophrenic disorders. A case of apparent psychotic depression is reported, in which the symptoms were due to the patient's experience of palinoptic images. Answers to particular questions in the initial interview can obviate the need for psychiatric consultation, as various consistencies have been reported in the non-psychiatric symptom of palinopsia.
In the Beginning
Authors: Rollin Henry R.
Published: August 2008

In commemorating the 25th anniversary of the British Journal of Psychiatry it is fitting to trace its history to its beginnings, The Asylum Journal, which made its bow on 15 November 1853. The publication of the Journal was a landmark, the prime importance of which can only be appreciated in the context of the history of the Royal College of Psychiatrists. The College itself is descended in direct line from The Association of Medical Officers of Asylums and Hospitals for the Insane, which under different titles has a continuous existence for more than 140 years, and can legitimately claim to be the oldest medical society in its field in the world.
Neuroanatomical Studies of Major Affective Disorders
Authors: Jeste Dilip V. , Lohr James B. , Goodwin Frederick K.
Published: August 2008

Interest in the long-neglected neuropathology of major affective disorders has recently been rekindled, partly because of the emergence of brain-imaging techniques. We review the literature suggesting that attention be given to the neuroanatomy and neuropathology of primary and secondary affective disorders. Computerised tomography studies show that patients with affective disorders tend to be similar to schizophrenic patients and significantly different from normal control subjects in ventricle:brain ratio, sulcal widening, and cerebellar vermian atrophy. As yet, there are few neuropathological investigations of the brains of patients with primary affective disorders. Suggestions for further research in the neuropathology of affective disorders are offered.
Childhood and Adolescent Depression
Authors: Angold Adrian
Published: August 2008

The tremendous increase in interest in childhood and adolescent depression that has occurred since the early 1970s has resulted in a large and contradictory literature. Development of the concept of childhood depression, and the many clinical studies of depression and its concomitants, both psychosocial and biological, are critically reviewed. A number of methodological and theoretical problems are discussed.
Successive Generations of Child Maltreatment
Authors: Oliver J. E.
Published: August 2008

Families were identified, in north-east Wiltshire (UK), (population 200 000), in which there was a pattern of two or more generations of child maltreatment and where there were also two or more children maltreated in the current generation (born between 1960 and 1980). These children had high rates of mental handicap, backwardness, and antisocial behaviour, and there were also characteristic patterns of emotional disturbance. The post-neonatal death rate for the 294 index children was very high, but higher still for their brothers and sisters. Some of the deaths, and at least 11 cases of violence-induced mental handicap (VIMH), were caused by characteristic types of child abuse – particularly violent shaking and throwing of infants, and secret suffocatory practices. There were very strong indications that larger numbers of children than the 11 proven VIMH cases had also suffered blunting of the intellect, physical complications such as epilepsy, and educational problems, as well as emotional and social maladjustment as the consequence of ill-treatment and neglect. Within the families, for children remaining at home, forms of ill-treatment and poor quality care persisted and ultimately affected most, or all, of the children in each family unit. Many families were chaotic, and within each family unit there were children frequently in care who suffered multiple placements, and who needed sustained specialist support throughout their childhood, encompassing a huge range of professional and other social support services. Such detail was generally underplayed or not accessible, and its full significance for children in each family could only be assessed by combining direct personal clinical involvement with record linkage methods, depending in turn on good co-operation from all agencies concerned wholly or partly with child protection.
Psychosis Associated with HIV Infection
Authors: Halstead S. , Riccio M. , Harlow P. , Oretti R. , Thompson C.
Published: August 2008

Five cases of psychiatric illness, presenting as functional psychosis, occurring in male homosexuals with human immunodeficiency virus (HIV) infection are described and compared with similar cases in the literature. The association between psychosis and infection with HIV is discussed with particular emphasis on the significance of functional versus organic presentation.
Father Kills Mother
Authors: Black Dora , Kaplan Tony
Published: August 2008

The child whose mother is killed by his or her father has to cope with the trauma of violence, the grief associated with the loss of both parents simultaneously, dislocation and insecurity regarding where and with whom they will live, stigma, secrecy, and often massive conflicts of loyalty. These issues and how they affected the 28 children of 14 families in which the father had killed the mother are examined. Recommendations for practice based on this clinical experience are proposed.
Aggressive Behaviour: Evaluation of a Non-seclusion Policy of a District Psychiatric Service
Authors: Kingdon D. G. , Bakewell E. W.
Published: August 2008

An increasing number of psychiatric services have non-seclusion policies. Evaluation of a policy of using specified observation levels instead of seclusion was made over a two-year period. The number of violent incidents recorded in health service facilities was low (exactly 50). Community responses elicited from police, probation, and prison services were not generally critical of the policy. Medication levels used were not excessive as determined by peak levels of major tranquilliser and anti-Parkinsonian drugs used. No patient was excluded from the unit because of his or her level of actual or potential aggression, but two were transferred from it for this reason.
A Study of Mortality Experiences in a Mental-Handicap Hospital
Authors: McLoughlin I. J.
Published: August 2008

The study examined the mortality experiences of a population of mentally handicapped in-patients between 1983 and 1987. Demographic data and factors related to terminal illness and cause of death were considered. The findings suggested a continued trend towards increased longevity and indicated a number of groups at risk of early death.
Drugs and Psychological Treatments for Agoraphobia/Panic and Obsessive–Compulsive Disorders: A Review
Authors: Marks Isaac , O'Sullivan Geraldine
Published: August 2008

In the short term, both antidepressants and exposure therapy usually improve agoraphobia/panic (AP) and obsessive–compulsive (OC) disorders and are accepted by most patients; psychological methods omitting exposure are not consistently helpful. Antidepressants have a broad-spectrum rather than specific anti-agoraphobia/panic or anti-obsessive–compulsive action. For long-term efficacy, there is good evidence for the value of exposure, but none for drugs. Because of relapse on ceasing drugs, and their side-effects, medication is less useful as the first line of treatment for chronic agoraphobia/panic or obsessive-compulsive disorder than is the lastingly helpful approach of exposure. Antidepressants are worth trying when patients refuse or fail with exposure therapy, or are dysphoric.
The Fear Questionnaire
Authors: Van Zuuren Florence J.
Published: August 2008

In order to assess some psychometric properties of Marks & Mathews' (1979) short Fear Questionnaire, a Dutch translation of this form was administered to 143 phobic outpatients: 100 women and 43 men. There was a special interest in assessing validity by comparing the scores of agoraphobics, social phobics and simple phobics. The findings were that all scales have sufficient internal consistency, although the Total Phobia scale does not seem to add meaningful information to its subscales. Most scales are significantly related to neuroticism, and the Social Phobia subscale is strongly related to social anxiety. The Agoraphobia and Social Phobia subscales discriminate between categories of phobics in the expected way. For the Blood/Injury subscale the relevant comparisons could not be made. The data presented in this study can be used to develop FQ norms for phobic patients.
Scottish Psychiatrists in Primary Health-Care Settings
Authors: Pullen Ian M. , Yellowlees Alex J.
Published: August 2008

There has been a growing number of reports of psychiatrists moving out into primary-care settings. We report a survey of consultant psychiatrists to assess the extent of this practice in Scotland. Some time spent in the primary-care setting was reported by 56%, the figures being highest in rural areas. An equal number of non-consultant medical staff were involved. Most schemes were initiated by psychiatrists, over half of whom had had some postgraduate general-practice experience. A similar survey in England and Wales showed that only 19% of consultant psychiatrists spent time in primary-care settings, a smaller proportion of non-consultant staff being involved. The value of working in primary-care settings has yet to be assessed.
Plasma Cortisol and Depression in Pathological Gamblers
Authors: Ramirez Luis F. , McCormick Richard A. , Lowy Martin T.
Published: August 2008

Basal serum cortisol and dexamethasone suppression test (DST) results were studied in 21 pathological gamblers who varied on the Beck Depression Inventory and selected scales of the Minnesota Multiphasic Personality Inventory, which had previously been shown to be related to depression in gamblers. All subjects were suppressors on the DST. There was a significant relationship between fluctuation in 08.00 h and 16.00 h basal cortisol levels and the psychological measures, suggesting a subtype of pathological gambler with potential clinical significance.
Demonstration and Treatment of Hyperventilation Causing Asthma
Authors: Hibbert George
Published: August 2008

Ambulant, transcutaneous PCO2 monitoring has been used to show that hyperventilation precedes exacerbation of asthma in a patient. Brief treatment was shown to give him greater control of his breathing and enable him to avoid attacks of asthma.
Attempted Strangulation During Phenothiazine-Induced Sleep-Walking and Night Terrors
Authors: Scott Allan I. F.
Published: August 2008

A patient who resumed sleep-walking as an adult is described. The failure to diagnose his disturbed nocturnal behaviour as sleep-walking kept him from his work for over 8 months, and led to a treatment which exacerbated the behaviour. The diagnosis was made when the patient attempted to strangle his wife.
The Delusion of Inanimate Doubles
Authors: Anderson D. N.
Published: August 2008

The Capgras delusion has long been held to be specific for close personal relationships. This paper presents evidence that this is not the case and the implications of this for accepting psychodynamic explanations of the phenomenon are discussed. Parallels are drawn with the condition prosopagnosia and a hypothesis presented that any specificity is apparent rather than real. It is proposed that both prosopagnosia and the Capgras symptom represent abnormalities of visual perception occurring at different stages of this neurophysiological process.
The Long-Term Outcome of Maudsley Depressives
Authors: Lee Alan S. , Murray Robin M.
Published: August 2008

Eighty-nine consecutive admissions with primary depressive illness were prospectively ascertained and diagnosed in 1965–66 by R. E. Kendell, who also allocated each a position on a neurotic-psychotic continuum on the basis of previous discriminant function analysis. In 1983–84, 94% of the survivors were personally interviewed by a psychiatrist blind to index admission data. Operational outcome criteria were employed and longitudinal data were established for 98% of the series. Mortality risk was doubled overall, and increased sevenfold for women under 40 years at index admission. Less than one-fifth of the survivors had remained well, and over one-third of the series suffered unnatural death or severe chronic distress and handicap. Patients whose index episode marked their first psychiatric contact had a 50% chance of readmission within their lifetime, but those with previous admissions had a 50% chance of readmission within three years. Readmissions occurred even after 12 years of being symptom-free, and conversely patients recovered after as long as 15 years of illness. There was a high incidence of other disorders (schizoaffective disorder, alcoholism, schizophrenia), and only four patients showed pure recurrent unipolar histories. Patients at the psychotic end of the continuum were more likely to be readmitted and to have very poor outcomes.
Depression and Family Relationships
Authors: Birtchnell John
Published: August 2008

The study was carried out on 25–34-year-old, British-born, married women, living on a south-east London housing estate. The reported early and current family relationships of 50 depressed and 40 non-depressed women were compared. Significantly more of the depressed women reported a poor early relationship with their mothers, but not with their fathers. This finding was confirmed by corresponding low care and high overprotection scores (for mothers only) on the Parental Bonding Instrument. On the basis of what the women and their husbands said, the marriages of the depressed women were rated as much poorer. This was confirmed by the women's and their husbands' scores on a Partner Rating Questionnaire and the Ryle–Scott-Heyes Marital Patterns Questionnaire. The depressed women reported a poorer current relationship with their mothers and a much poorer relationship with their husbands' mothers and fathers. Significantly more depressed women reported four or more poor family relationships.
Lifelong Eccentricity and Social Isolation
Authors: Tantam Digby
Published: August 2008

Several scales are described for measuring aspects of eccentricity and social isolation; in particular, for assessing schizoid and schizotypal personality and for rating abnormal non-verbal expression. The latter is shown to be reliable, and the former to have a measure of validity. There was an association between schizoid personality traits and abnormalities of speech and non-verbal expression. However, abnormal non-verbal expression, but not schizoid personality traits or DSM–III schizotypal personality disorder, was particularly likely to occur in those subjects who had evidence of neurological deficit, and childhood symptoms indicative of developmental disorder. Abnormal non-verbal expression, but not personality disorder, was also associated with other characteristic features of Asperger's syndrome, such as unusual, 'special’ interests. It is suggested that Asperger's syndrome is a distinct syndrome from either schizoid or schizotypal personality disorder, but may be a risk factor for the development of schizoid personality disorder.
Intropunitiveness and Parasuicide: Prediction of Interview Response
Authors: Goldberg J. , Sakinofsky I.
Published: August 2008

A recently proposed relationship between intropunitiveness and depressive states was examined in interview intervention with parasuicidal in-patients. To test the prediction that highly intropunitive parasuicidal individuals would be most responsive to cognitive intervention, a sample of 48 parasuicidal in-patients were administered a battery of individual difference measures, including the Hostility Questionnaire. Subjects were randomly assigned to one of three interview procedures, namely a cognitive interview, an affective interview or a waiting period (control). Highly intropunitive individuals in the cognitive interview group showed the most improvements on a self-report depressive symptom change measure. In addition to supporting theoretical models of depressive state changes, the study has important clinical implications because of the need to identify parasuicidal individuals who are most likely to benefit from brief interventions.
The Long-Term Psychiatric Consequences of Accidental Injury
Authors: Malt Ulrik
Published: August 2008

One hundred and seven accidentally injured adults were studied while in hospital and assessed prospectively twice more in a mean period of 28 months. The patients were studied by means of taped clinical interviews, including the Comprehensive Psycho-pathological Rating Scale (which includes the Montgomery-åsberg Depression Rating Scale), and several self-report measures of distress (Schedule of Recent Life Events, General Health Questionnaire, Impact of Event Scale and State Anxiety Inventory) at the three assessments. The total incidence of psychiatric disorders considered to be caused by the accident during the follow-up period was 22.4%. The incidence of non-organic psychiatric disorders caused by the accident was 16.8% at the first follow-up and 9.3% at the final follow-up. Depressive disorders of different severity were most often seen. Only one patient suffered from a posttraumatic stress disorder during the follow-up, and none at the final follow-up (DSM-III). Organic mental disorders were diagnosed in 9.3% of the patients. In 5.6% of the patients this was the only disorder.
Does Erotomania Exist Between Women?
Authors: Dunlop Joyce L.
Published: August 2008

Two cases of homosexual erotomania are described and the recommended diagnostic criteria applied. The symptoms were found to be very similar to that occurring with heterosexual patients. The case for retaining erotomania as a distinct entity is discussed.
Delayed Emergence of Obsessive–Compulsive Neurosis Following Head Injury
Authors: Drummond Lynne M. , Gravestock Shaun
Published: August 2008

A patient with obsessive–compulsive neurosis arising six months after minor head injury is described. The theoretical implications of this case are discussed. A neuropsychological model to explain the onset of the disorder in this and previously reported cases is suggested.
Psychiatric Clinics in General Practice
Authors: Williams Paul , Balestrieri Matteo
Published: August 2008

General-practice-based psychiatric clinics have increased substantially in recent years. We investigated the influence on psychiatric admissions of this style of practice in England over an 18-year period. We utilised data from a previous survey concerned with this type of work (Strathdee & Williams, 1984) and compared them with figures on psychiatric admissions. Parts of the country in which there has been greater development of general-practice-based psychiatric clinics were also those in which there has been a steeper decrease in psychiatric admissions. Further analysis showed this to be due primarily to an effect on admission of non-psychotic patients.
The Chronically Mentally Ill in Community Facilities
Authors: Simpson C. J. , Hyde C. E. , Faragher E. B.
Published: August 2008

The quality of life of chronically mentally ill patients in acute wards in a district general hospital, a hostel ward and group homes was compared. Within the spectrum of care of these patients, the severity of psychopathology corresponded to their placement. Analysis, including adjustments for the influence of psychopathology, showed differences between the three types of facility. Although differences existed between all types of care, residents in group homes and the hostel ward shared more similarities in quality of life than those in the district general hospital. Problems of caring for the chronically mentally ill on acute wards are highlighted.
Negative and Depressive Symptoms in Schizophrenia
Authors: Kulhara Parmanand , Avasthi Ajit , Chadda Rakesh , Chandiramani Kishore , Mattoo Surendra K. , Kota Suresh K. , Joseph Sunny
Published: August 2008

Ninety-five schizophrenic patients were assessed using the Present State Examination, the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Negative and depressive symptoms were frequent, and significant relationships among negative symptom complexes and depressive syndromes were noted. Retardation, lack of energy, slowness, and other symptoms of depression were significantly associated with the negative symptoms of schizophrenia. Depressed affect per se did not have a significant correlation with negative symptoms.
‘Bhanamati’ Sorcery and Psychopathology in South India
Authors: Keshavan M. S. , Narayanan H. S. , Gangadhar B. N.
Published: August 2008

We describe the patterns of illness attributed to sorcery among 209 patients who attended a special clinic in south India. Somatisation and conversion disorders accounted for the majority of patients, although several other psychiatric and medical disorders were also seen. Aspects of treatment of such patients in the sociocultural context are discussed.
Respiratory Control: Its Contribution to the Treatment of Panic Attacks
Authors: Hibbert George A. , Chan Michael
Published: August 2008

Patients who experienced panic attacks, with or without avoidance, were treated for two weeks with either training in controlled breathing or a placebo treatment. Subsequently, both groups received a limited period of conventional anxiety treatments, most commonly in vivo exposure. Patients were subdivided into ‘hyperventilators' and ‘non-hyperventilators' on the basis of the conventional provocation test. Observer ratings of anxiety showed a greater improvement for the group that received breathing training, but there was no evidence that ‘hyperventilators' benefited more from respiratory training than ‘non-hyperventilators'. Self-report measures of anxiety, avoidance, and depression/dysphoria showed no difference between treatments. These findings suggest that training in controlled breathing is not of specific benefit for those identified as ‘hyperventilators' by the provocation test, but that it may have a non-specific effect in the treatment of patients with panic attacks.
Reflections on Psychotherapy with Ageing People, Individually and in Groups
Authors: Hunter A. Joan G.
Published: August 2008

Over the last 10 years I have run 17 psychotherapy groups for aged people who were in hospitals, homes or in the community. The groups were all short, usually running for 12 weeks. The total number in these groups was 121 and their ages ranged from 68 to 100. The average size of each group was seven and there were never more than four men in any group and in 11 groups there were only women. The average attendance was 88% and 36 attended more than one group. One member suffered from motor neuron disease, two from Parkinson's disease and the common causes of infirmity of old age were widely represented. All members had been diagnosed as suffering from senile dementia in two groups. In every group at least one member was hard of hearing and a communicator was used over the hearing aid to facilitate hearing. One member was blind and the sufferer from motor neuron disease continued to attend after losing her speech.
Treatment of Mood Disorder Associated with Binswanger's Disease
Authors: Joyce Eileen M. , Levy Raymond
Published: August 2008

Binswanger's disease is a cerebrovascular disorder affecting deep white matter and is associated with dementia and affective disturbance. In the case reported, the mood disorder was successfully treated with a combination of lithium and amitriptyline, resulting in an improved quality of life despite continuing cognitive decline. This underlines the importance of treating the affective component of organic dementing conditions on its own merit.
Dexamethasone Suppression Test in Dementia and Depression
Authors: Shrimankar J. , Soni Som D. , McMurray J.
Published: August 2008

To determine the usefulness of the DST in differentiating depression from dementia, the test was administered to three diagnostic groups of psychogeriatric patients: depression; dementia; and dementia with depression. Clinical assessments were supplemented by ratings on the HRSD and SCAG, as well as by EEG and CT. All three groups showed a high incidence of abnormal DST results unrelated to presence or severity of affective symptoms, but showing a better association with SCAG and its ‘organic’ subsets. The mechanism(s) underlying these abnormal results may reflect organic brain disease. The usefulness of the DST in differentiating depression from dementia in the elderly was not confirmed.
Lithium Prophylaxis and Expressed Emotion
Authors: Priebe Stefan , Wildgrube Christiane , Müller-Oerlinghausen Bruno
Published: August 2008

Expressed emotion (EE) in key relatives of 21 patients with bipolar affective or schizoaffective psychoses was assessed by the CFI. All patients had been on prophylactic lithium for at least three years and were without psychotic symptoms at interview. The relationship between relatives' EE status and patients' course of illness was studied both retrospectively and prospectively. Two critical remarks designated high EE. The relatives' EE status was not related to number of hospital admissions or to severity and length of recurrences if the entire period of lithium treatment is considered as a whole. However, patients living with high-EE relatives showed a significantly poorer response during the three years before interview, and an even poorer response in the nine-month follow-up.
The Varieties of Human Experience
Authors: Nemiah John C.
Published: August 2008

The basic unit of study for psychiatric investigation is the individual human being in interaction with the environment. The psychological understanding of human biography provided by psychodynamic observation is now being supplemented by knowledge derived from phenomenological and neurobiological research. Phenomenology and neurobiology are at present primarily concerned with detecting correlations between clinical syndromes and pathological brain states; they are static rather than dynamic in approach. However, currently emerging techniques of brain imaging aimed at elucidating neurophysiological processes provide the basis for going beyond structural neuropathology to neuropathophysiology. It is suggested that the observations derived from the psychodynamic study of patients constitute markers of underlying brain function, and that the future investigation of psychiatric illness must include a correlative study of both psychodynamic and neurobiological processes.
Psychiatric Disorders Among Medical In-patients in an Indian Hospital
Authors: Deshpande S. N. , Sundaram K. R. , Wig N. N.
Published: August 2008

Psychiatric symptoms among medical inpatients in an Indian hospital were assessed: the SRQ was used as a screening instrument, and those with probable psychiatric disorders were given the PSE and MSE, for further, detailed assessment. The prevalence of psychiatric disorders was 34%, with a further 15% reporting distressing psychiatric symptoms only. The most frequent complaints were delirium and adjustment disorders. They were largely associated with connective tissue, as well as cardiovascular and endocrine, disorders, and were characterised by depression, worrying and irritability. The reliability of the SRQ varied with the cut-off score, which gave optimal specificity and sensitivity when set at 9.
The Neuroleptic Malignant Syndrome and Pneumomediastinum
Authors: Green Benjamin Hugh
Published: August 2008

A patient is described who suffered from the neuroleptic malignant syndrome, complicated by a pneumomediastinum. This has not been reported previously.
Trichotillomania and Incest
Authors: Singh Ashok N. , Maguire James
Published: August 2008

Trichotillomania is reported in a 33-year-old female victim of incest, with a possible causal connection.
Liaison Psychiatry in a Breast Cancer Unit
Authors: Dean Christine , Hopwood Penelope
Published: August 2008

“The first 50 referrals to a newly established liaison psychiatry service for the breast cancer unit at Guy's Hospital, London, have been examined. The majority of referrals were for psychological reactions to malignant disease; most of these were mood disturbances. Patients with sustained psychological reactions to their malignant disease were more likely to have had treatment for previous psychiatric illness and to lack a confiding relationship compared with those whose psychological reactions were transient. Teaching doctors and nurses to deal effectively with the transient psychological reactions of patients to their malignant disease is an important task of liaison psychiatry.”
Depression-Dependent Exacerbation of Tardive Dyskinesia
Authors: Sachdev Perminder S.
Published: August 2008

A middle-aged woman with a recurrent depressive illness showed worsening of her tardive dyskinesia during the depressive phases, with improvement on remission.
Syphilis Serology Screening in a Psychogeriatric Population
Authors: Boodhoo Jean Antoine
Published: August 2008

The treponemal serological status of 800 patients above the age of 65 was reviewed. Twenty-one were found to be positive and the venereologists advised against treatment in all referred cases. The question is posed whether syphilis serology screening in the elderly mentally ill should be confined to those patients with obvious clinical manifestation of syphilis or with obscure psychiatric presentations.
Psychiatric Manifestations of Frontal Lobe Tumours
Authors: Ron M. A.
Published: August 2008

In a recent article in the British Medical Journal Maurice-Williams & Dunwoody (1988) reported two patients with frontal meningiomas who presented initially to psychiatrists. The correct diagnosis was made in one of them after prolonged, perhaps unnecessary, psychiatric treatment. In the other the diagnosis was made at autopsy. In this case psychiatrists were only briefly involved and neurosurgical referral had been made promptly. The authors, who treat these reports as a cautionary tale, conclude by warning psychiatrists to pay special attention to a number of features in the history and examination of psychiatric patients. In particular we are told that suspicion should arise in the presence of gradual non-remitting symptoms such as irritability, memory loss, self-neglect, dysphasia or incontinence in patients without a previous history of psychiatric disease or clear precipitating factors. They also suggest that we pay attention to the views of relatives when they feel the patient suffers from a physical rather than a psychiatric illness, and emphasise that early diagnosis leads to easier surgical removal and better outcome.
Life Events, Life Difficulties and Confiding Relationships in the Depressed Elderly
Authors: Emmerson Julia P. , Burvill Peter W. , Finlay-Jones Robert , Hall Wayne
Published: August 2008

A total of 101 elderly depressed patients and 85 community residents (matched for age and sex) were interviewed about life events, difficulties, and confiding relationships. Significantly more of the depressed sample reported at least one severe event in the three months before the onset of their illness. Lack of a good confiding relationship was associated with depression in men but not in women. In this relatively affluent Australian sample, life difficulties were rare and, probably as a result, were not significantly associated with depression.
Effects of Ethanol on the NMR Characteristics of Rat Brain
Authors: Besson J. A. O. , Greentree S. G. , Foster M. A. , Rimmington J. E.
Published: August 2008

In rats, neither acute administration of ethanol nor the establishment of ethanol dependence by chronic administration for 28 days produced significant 1H-NMR relaxation changes. However, chronic ethanol intake for six months produced a transient rise in T1, with no change in T2 or water content. The significance of these results for study in man is discussed and a hypothesis is proposed to explain discrepant differences between T1, T2 and water content. It is suggested that T1 change with long-term ethanol exposure is related to altered free/bound water state secondary to cell membrane changes.
Anterior Tumour of the Corpus Callosum with Atypical Depression
Authors: Tanaghow Amgad , Lewis John , Jones G. H.
Published: August 2008

We report a patient with an anteriorly palced tumour of the corpus callosum presenting with primarily depressive symptoms, without any associated neurological abnormality. It is important to be alert to the possibility of an organic cause to depression.
Durkheim and French Psychiatric Views on Suicide During the 19th Century
Authors: Berrios G. E. , Mohanna M.
Published: August 2008

One of the targets of Durkheim's criticism, in his masterly book Le Suicide (1897), is the view upheld (according to him) by all 19th-century French alienists that suicide was, in all cases, a form of madness (henceforth, the ‘absolutist’ or ‘psychiatric’ hypothesis). Durkheim's view is important, particularly among sociologists, and lest they, and other readers, are led uncritically to accept his version of 19th-century French psychiatric views on suicide, it would seem important to put the historical record straight. The relevant literature is vast, and only representative writers are included in this paper. It is not the purpose of this paper to deal, in any way, with Durkheim's sociological views. (This is being done by Mohanna & Berrios (1990)).
Efficacy of Combined Antidepressant Therapy in Resistant Neurotic Disorder
Authors: Tyrer Peter , Murphy Siobhan
Published: August 2008

A 35-year-old woman with persistent affective and phobic symptoms responded dramatically to a combination of isocarboxazid and amitriptyline, and this improvement was maintained over the next three-and-a-half years. Isocarboxazid was replaced by placebo, using double-blind procedure. The change to placebo was accompanied by a marked increase in anxiety and depressive symptoms, which resolved when active isocarboxazid was reintroduced. It is suggested that combined antidepressant therapy still has a place in the treatment of resistant neurotic disorder.
Neonaticide and Hysterical Denial of Pregnancy
Authors: Green C. M. , Manohar S. V.
Published: August 2008

A case illustrating the association between neonaticide and denial of pregnancy is reported. Neonaticide may be a relatively common form of homicide. In some cases it could be preventable, providing the physician responsible for antenatal care is alert.
Heterogeneity of Schizophrenia
Authors: Tsuang Ming T. , Lyons Michael J. , Faraone Stephen V.
Published: August 2008

Schizophrenia is clinically heterogeneous but it is not known whether this is due to the existence of discrete subtypes. For the purpose of explication, ‘indicators' of schizophrenia are divided into three levels: phenomenology, pathophysiology, and aetiology. Five heterogeneity models and a number of quantitative approaches are described. It is imperative to apply rigorous methods of study to the comparison of unitary models and competing heterogeneity models of schizophrenia.
Suicides Among Immigrants from the Indian Subcontinent
Authors: Raleigh V. Soni , Bulusu L. , Balarajan R.
Published: August 2008

Suicides in England and Wales among immigrants of Indian ethnic origin were analysed for the period 1970–78. There were excess suicides among young Indian women, these being disproportionately more among the married. Burning was a common method of suicide among Indian women. Suicide rates were low in Indian men and the Indian elderly. A large proportion of the male suicides were among doctors and dentists.
Couples Referred to a Sexual Dysfunction Clinic
Authors: Catalan Jose , Hawton Keith , Day Ann
Published: August 2008

Two hundred couples referred to a sexual problems clinic were assessed in a standardised way for their suitability for sex therapy. The assessment focused on the nature of the sexual dysfunction, motivation for treatment, marital and relationship problems, psychiatric status, and physical problems. Approximately one-third of the couples were found to have significant marital and relationship problems, and more than 30% were suffering from psychiatric disorders, although these were usually of mild to moderate intensity. A third of males and 18% of females were suffering from physical disorders likely to contribute to the sexual dysfunction. Patients who were offered sex therapy and who completed their course of treatment were more likely to show high levels of motivation and an absence of physical disorders, marital relationship problems and psychiatric disorder. There should be careful assessment of couples suffering from sexual dysfunction before specific treatment is offered.
Outcome and Prognosis of Anorexia Nervosa
Authors: Rosenvinge Jan H. , Mouland Sven O.
Published: August 2008

An investigation was carried out in 1986 of 41 patients, 39 female and 2 male, who had been treated for anorexia nervosa in a psychiatric ward at a general hospital between 1958 and 1980. A follow-up analysis was carried out, in which 30 subjects participated. Using the scores on the 40-item version of the EAT as outcome criteria, validated by the Morgan–Hayward outcome scales, the outcome distribution and rate of mortality was in agreement with previous findings. Further data concerning weight, menstruation, and nutritional, social and psychiatric status were based on a semistructured interview as well as on the scores on the EAT, the GHQ, and the MMPI. Prognostic variables were analysed, indicating that duration of illness, poor motivation for treatment, social withdrawal, and poor family relations were significant as predictors of poor outcome.
Characteristics of Male and Female Schizophrenics at First Admission
Authors: Folnegović Z. , Folnegović-Šmalc V. , Kulčar Ž.
Published: August 2008

Based on information from a case register, patient age and diagnosis at first admission are analysed in a Croatian cohort of schizophrenics first admitted in 1972 and followed up through the register for 12 years. Diagnosis was analysed on the same basis and over the same period. Although the male and female differences in incidence rates for schizophrenia were not large, hospital incidence rates in younger age groups were higher in males. Males were also more commonly diagnosed as schizophrenic at first admission, females more frequently receiving diagnoses of affective psychosis and other organic psychosis, except for alcohol-induced psychosis.
The Positive Triad of Schizophrenic Symptoms
Authors: Landmark J. , Merskey H. , Cernovsky Z. , Helmes E.
Published: August 2008

Using data from the WHO International Pilot Study of Schizophrenia and from our own previously reported series of 120 patients receiving treatment for schizophrenia, we ascertained the degree of agreement between 13 different systems for diagnosing schizophrenia. We identified a triad of symptoms similar to that from the International Pilot Study: auditory hallucinations, passivity feelings, and disturbances of affect. This triad correlated very strongly with the diagnosis of schizophrenia as determined by the 13 diagnostic systems, as well as with response to fluphenazine in our series. The triad should serve as a core set of symptoms in the study of schizophrenic illness. It represents the leading phenomena in a group of patients having what is generally considered to be schizophrenia, although it does not provide a definitive diagnosis. Evidence is needed on its specificity.
In Reply … A Locus Closer to the Telomere?
Authors: Crow T. J. , DeLisi L. E. , Johnstone E. C.
Published: August 2008

Curtis & Gurling quote with approval Sturt & Shur's (1985) critique of same-sex concordance with the implication that the phenomenon has been explained as ascertainment bias. While some of Sturt & Shur's points are valid, we note that these are not relevant to those series of dizygotic (DZ) twins that, by including both concordant and discordant pairs, controlled for sampling bias. In these series a same-sex excess in concordant pairs is present and substantial (Table II of our paper (Crow et al, 1989)).
Hospital Admissions Before and After Shipyard Closure
Authors: Bartley Mel , Fagin Leonard
Published: August 2008

“To determine the effect of job loss on health an investigation was made of admissions to hospitals in 887 men five years before and three years after the closure of a Danish shipyard. The control group comprised 441 men from another shipyard. The information on hospital admissions was obtained from the Danish national register of patients. The relative risk of admission in the control group dropped significantly in terms of the number of men admitted from the study group from 1.29 four to five years before closure to 0.74 in the three years after closure. This was especially true of admissions due to accidents (1.33 to 0.46) and diseases of the digestive system (4.53 to 1.03). For diseases of the circulatory system, particularly cardiovascular diseases, the relative risk increased from 0.8 to 1.60, and from 1.0 to 2.6 respectively.

These changes in risk of illness after redundancy are probably a consequence of a change from the effects of a high risk work environment to the effects of psychosocial stresses such as job insecurity and unemployment.”
Phentermine and Psychosis
Authors: Devan G. S.
Published: August 2008

A case of paranoid psychosis induced by phentermine in a young woman with no previous history of psychiatric illness is presented.
Who Knows Best? Family Interaction and Eating Disorders
Authors: Waller Glenn , Slade Peter , Calam Rachel
Published: August 2008

Links have been established between eating disorders and abnormal patterns of interaction between members of the sufferer's family. Faced with often contradictory information, the clinician needs to know which member of the family will give the most valid description of that family's interaction. This study demonstrated the value of the Family Assessment Device (FAD) as a measure of ‘pathology’ in the families of anorectic and bulimic women. Using the ability to predict the eating disorder as an index of concurrent validity, the sufferers themselves had the most realistic perceptions of their families' interactional styles.
Relatives and Patients as Partners in the Management of Schizophrenia
Authors: Smith Jo , Birchwood Max
Published: August 2008

Considerable advances have been made in the family management of schizophrenia but there remains a major challenge for the psychiatric services to integrate these innovations into clinical practice. A number of important issues need to be considered in developing routine clinical services: the problem of engaging families in a therapeutic programme; the utility of the concept of ‘expressed emotion’; and procedures for clinical practice. The latter include the needs of low-EE families; maintaining quality of intervention in a clinical context; responding to the multiplicity of needs of the patient and family; and integrating family interventions with ongoing rehabilitation practice. A model of service provision is described.
Depression among Elderly Residents of Local-Authority Residential Homes
Authors: Ames David
Published: August 2008

Of 390 residents in 12 local-authority homes for the elderly, 93 had evidence of depression on screening and underwent standard clinical assessment. Half had an affective disorder, and a further third had depressive symptoms in the setting of an organic mental disorder. The 93 residents had a high rate of physical illness and disability, undertook little social activity, and were visited infrequently. A range of interventions for depressed residents, the majority social in type, mostly proved difficult to implement. There was no evidence of efficacy of psychiatric intervention at three months; at one-year follow-up a quarter of study participants had died, and 28% of those who were reassessed for depression showed evidence of recovery.
Impaired Ability of Schizophrenics, Relative to Manics or Depressives, to Appreciate Social Knowledge about their Culture
Authors: Cutting J. , Murphy D.
Published: August 2008

Twenty schizophrenics, 20 manics, and 20 depressives were given two sets of multiple choice questions, one testing the subject's social knowledge of how people tend to act in a social situation and the other tapping their knowledge of events or objects which are relatively free of a social component. Schizophrenics were significantly impaired on the former set of questions relative to manics, and were significantly worse on both than depressives. It is suggested that these results represent an objective measure of the social naïvete of schizophrenics. The significant difference from manics indicates that the results are not merely the general effects of psychosis, particularly because the manics performed worse on an attentional test than the schizophrenics.