bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors
Authors: Harrison Glynn , Holton Anthony , Neilson David , Owens David , Boot Daphne , Cooper John
Published: July 2009

Synopsis

Forty-two consecutively identified Afro-Caribbean patients with a first episode of psychosis were compared with a similar group of non-Caribbean patients. A number of differences emerged, although the same proportion of patients in each group had symptoms for 6 months or more prior to psychiatric contact. Afro-Caribbean patients showed greater delay in seeking help, more ‘disturbance’ later in the course of their illness and were more likely to be admitted compulsorily. The social geography of the two groups suggests that the high rates of schizophrenia and related psychoses that we previously reported cannot be explained simply by differences in area of residence at the time of presentation.
A framework for the adaptation of psychological questionnaires for epidemiological use: an example of the Bortner Type A scale
Authors: Gallacher J. E. J. , Smith G. Davey
Published: July 2009

Synopsis

A model for the systematic adaptation of psychological questionnaires for epidemiological use is presented. Application of the model is illustrated using variants of the Bortner Type A scale in a representative age/sex stratified sample of 256 persons. Through the application of the model the Bortner scale was adapted to compare the effects of scale direction, scale format and example position. Overall the Bortner scale was shown to provide robust measurement which was little affected by response rate, age, sex or by the adaptations of the scale. An association was found of sex with response rate. Interaction effects of sex and scale direction on mean Type A scores, and of example position and scale format on both response rate and Type A score variability were also found. In identifying critical aspects of questionnaire performance, and in providing a coherent framework for their interrelationship, the model acts as a guide to the systematic assessment of questionnaire performance. The use of this model will, therefore, facilitate greater confidence in the interpretation of questionnaire data in epidemiological studies.
Needs for care among the relatives of long-term users of day care: A report from the Camberwell High Contact Survey
Authors: MacCarthy B. , Lesage A. , Brewin C. R. , Brugha T. S. , Mangen S. , Wing J. K.
Published: July 2009

Synopsis

We report the results of a survey of the burdens and needs for items of care of 45 supporters of long-term users of psychiatric day care facilities in Camberwell. The supporters reported high levels of disturbed behaviour and low levels of self-care skills in the attenders. They were also subject to high levels of social and economic burden, not all of which could be attributed to the attenders' problems. The needs assessment identified a large number of unmet needs, although the supporters themselves were largely resigned to their situation and expressed little dissatisfaction with the services they were offered. The advantage of conducting this kind of assessment of supporters' needs as a routine part of clinical practice was discussed.
The General Practice Research Unit at the Institute of Psychiatry
Authors: Wilkinson Greg
Published: July 2009

The General Practice Research Unit (GPRU) was established at the Institute of Psychiatry in the late 1950s, under the honorary directorship of Professor Michael Shepherd. For 30 years it has been staffed by medically qualified workers and social scientists supported, at various times, by the Nuffield Foundation, the Mental Health Research Fund, and the Department of Health and Social Security, as well as by university monies.
Thyroid dysfunction in institutionalised Down's syndrome adults
Authors: Kinnell H. G. , Gibbs N. , Teale J. D. , Smith J.
Published: July 2009

Synopsis

This study of 111 institutionalised Down's syndrome subjects and 74 controls found a relatively low risk of hypothyroidism in both groups compared with certain other studies of Down's subjects, which found very high rates of thyroid hypofunction. However, the Down's syndrome group had a significantly raised risk of hypothyroidism (9%), hyperthyroidism (1·8%) and the presence of thyroid microsomal antibodies (29%) compared with the controls and with laboratory reference data. It is recommended that thyroid function testing should be routine in older Down's syndrome subjects, with special attention being given to the clinical status of those with microsomal antibodies present.
Isolation and characterization of a nuclear depressive syndrome
Authors: Grove W. M. , Andreasen N. C. , Young M. , Endicott J. , Keller M. B. , Hirschfeld R. M. A. , Reich T.
Published: July 2009

Synopsis

We investigated the nosology of endogenous depression by numerical taxonomy. Five hundred and sixty-nine patients diagnosed as having unipolar major depressive disorder in the NIMH Clinical Research Branch Program on the Psychobiology of Depression – Clnical were studied. Thirty-six symptoms which might distinguish endogenous from non-endogenous depressions were chosen from the literature. Patients' symptom profiles assessed by structured interview were grouped by two methods: aK-means improvement of Ward's method of cluster analysis, and a latent class algorithm. The methods produced very similar groups and several internal validity criteria suggested that the groups were not spurious. Cluster 1, ‘nuclear depression,’ included a nucleus of patients common to multiple definitions of endogenous depression. The non-nuclear group scored as less neurotic than the nuclear group on personality tests administered during the index episode. The groups do not differ in frequency, number or severity of reported life events prior to onset of the index episode. The nuclear group shows a poor prognosis on two-year prospective follow-up, greater disturbance on personality inventories, and increased heritability of depression in siblings.
Italian version of the organic brain syndrome and the depression scales from the CARE: evaluation of their performance in geriatric institutions
Authors: Spagnoli Alberto , Foresti Giovanni , Macdonald Alastair , Williams Paul
Published: July 2009

Synopsis

The Organic Brain Syndrome (OBS) and the Depression (D) scales derived from the Comprehensive Assessment and Referral Evaluation (CARE) were translated into Italian and used in a survey of geriatric institutions in Milan. During the survey validity and reliability tests of the scales were conducted.

Inter-rater reliability (total score weighted kappa) was highly satisfactory for both scales (0·96 for OBS and 0·83 for D scale). Reliability was assessed three times during the survey and showed good stability for both scales, with a slight but significant trend towards reduction over time for the D scale. Reliability of the D scale was significantly lower when the subjects interviewed scored highly on the OBS scale (severe cognitive impairment).

Criterion validity was highly satisfactory both for the OBS scale (cut-off point 4/5: sensitivity 77%, specificity 96%, positive predictive value 91%) and the D scale (cut-off point 10/11: sensitivity 95%, specificity 92%, positive predictive value 84%).

Results are discussed with special reference to longitudinal assessment of reliability, the choice of the cut-off point, and the context-dependent properties of questionnaires.
Psychiatric disorder in patients with insulin-dependent diabetes mellitus attending a general hospital clinic: (i) two-stage screening and (ii) detection by physicians
Authors: Wilkinson G. , Borsey D. Q. , Leslie P. , Newton R. W. , Lind C. , Ballinger C. B.
Published: July 2009

Synopsis

Two-stage screening for psychiatric disorder was carried out with a sample of 99 male and 95 female outpatients with insulin-dependent diabetes mellitus, using the General Health Questionnaire and the Clinical Interview Schedule. The estimated prevalence of psychiatric disorder in this sample was 18%: only 28% of the psychiatric morbidity so identified was detected by physicians. In contrast, physicians rated 10% of the sample as psychiatric ‘cases’ using a simple 6-point scale.
The effect of the dopamine agonist, apomorphine, on regional cerebral blood flow in normal volunteers
Authors: Grasby P. M. , Friston K. J. , Bench C. J. , Cowen P. J. , Frith C. D. , Liddle P. F. , Frackowiak R. S. J. , Dolan R. J.
Published: July 2009

Synopsis

Apomorphine, a non-selective dopamine agonist, has been used as a pharmacological probe for investigating central dopaminergic neurotransmission in psychiatric illness. In this study repeated measurements of regional cerebral blood flow (rCBF) were made in normal volunteers before, and after, the administration of apomorphine (5 or 10 μg/kg), or placebo. The difference in rCBF, before and after drug (apomorphine versus placebo), was used to identify brain areas affected by apomorphine. Compared to placebo, both doses of apomorphine increased blood flow in the anterior cingulate cortex. Apomorphine 10 μg/kg also increased prefrontal rCBF (right > left). No decreases in rCBF were noted following either dose of apomorphine. Apomorphine-induced increases of anterior cingulate blood flow might serve as an in vivo index of central dopamine function. Such an approach would complement established neuroendocrine challenge paradigms for investigating central dopamine neurotransmission in psychiatric illness.
Clinically diagnosed presenile dementia of the Alzheimer type in the Northern Health Region: ascertainment, prevalence, incidence and survival
Authors: Newens A. J. , Forster D. P. , Kay D. W. K. , Kirkup W. , Bates D. , Edwardson J.
Published: July 2009

Synopsis

Potential cases of presenile dementia of the Alzheimer type (PDAT) in the Northern Health Region (estimated population aged 45–64, 655800) were ascertained for the years 1979–86 from in-patient ICD-9 codes and other sources. An algorithm was applied to the casenote information to distinguish between Alzheimer-type and other forms of dementia. A search of the NHS central register was made to establish date and place of death. Estimates were made for patients with missing case records. The point prevalence rate for PDAT was estimated as 34·6 per 100000 with an annual incidence of 7·2 per 100000 in the 45–64 age range. These rates are compared with those reported in other studies. Five-year survival following diagnosis for incident cases of PDAT was 64% with a longevity quotient (LQ), the percentage of expected time actually survived, of 69%. There was no evidence of a more malignant course in PDAT when compared with survival in older patients with dementia of the Alzheimer type (DAT) in other studies. Sixty-six per cent of deaths occurred in hospital, 19% at home and 15% in residential homes.
Setting the scene for eating disorders: childhood care, classification and course of illness
Authors: Schmidt Ulrike , Tiller Jane , Treasure Janet
Published: July 2009

Synopsis

The aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN).

There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.
Inter-rater and temporal reliability of the Standardized Assessment of Personality and the influence of informant characteristics
Authors: Pilgrim J. A. , Mellers J. D. , Boothby H. A. , Mann A. H.
Published: July 2009

Synopsis

The Standardized Assessment of Personality (SAP) is a short, semi-structured interview designed to be used with an informant of the patient. The informants of 52 patients were interviewed separately by two raters for an inter-rater reliability study. The overall level of agreement was excellent, kappa = 0·76, with a range between 0·60 and 0·82 for the individual categories of personality disorder. For a temporal reliability study, the relatives of 77 patients were interviewed. The overall level of agreement was good, kappa = 0·65, with a range between 0·54 and 0·79 for individual categories. Characteristics of informants whose reports were rated with greater levels of reliability were female gender and greater length of acquaintance with the patient.
Diazepam alters brain 5-HT function in man: implications for the acute and chronic effects of benzodiazepines
Authors: Nutt D. J. , Cowen P. J.
Published: July 2009

Synopsis

The effect of diazepam on brain 5-HT-mediated neuroendocrine responses was studied in healthy male volunteers. An acute dose of diazepam (15 mg) significantly attenuated the prolactin and growth hormone responses to intravenous L-tryptophan. After 3 weeks administration of diazepam (25 mg/d) these responses had returned to normal despite much higher plasma diazepam concentrations, suggesting that tolerance had occurred. A reduction in brain 5-HT function may underlie some of the acute therapeutic actions of benzodiazepines. It is possible that excessive ‘rebound’ 5-HT activity may contribute to the abstinence syndrome seen on benzodiazepine withdrawal.
Diagnoses of dementia and depression: a latent trait analysis of their performance
Authors: Grayson D. A. , Henderson A. S. , Kay D. W. K.
Published: July 2009

Synopsis

Four diagnostic systems for dementia and depression are compared on a community sample of 274 subjects. They are: DSM-III, Gurland's system, AGECAT and a clinician's ratings. These are compared, not in the usual terms of prevalence rates and cross-tabulations of diagnostic categories, but by examining the performance of each system in terms of hypothetical, continuously distributed traits underlying the symptoms of dementia and depression, as in the latent trait model described by Duncan-Jones et al. (1986). Each diagnosis is characterized by the level of severity (threshold) at which it operates, and its accuracy. Evidence is given to support a dimensional view of dementia.
Physical and psychological correlates of severe heart disease in men
Authors: Bass Christopher , Akhras Fawaz
Published: July 2009

Synopsis

Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient.

Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one in five men was designated a psychiatric ‘case’. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD).

Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis.
Dimensions of social insecurity and their relation to coronary-prone behaviour in college undergraduates
Authors: Yarnold Paul R. , Bryant Fred B.
Published: July 2009

Synopsis

Research suggests that Type A behaviour and ‘social insecurity’ (SI) may represent independent additive task factors for coronary disease. Research examining SI and Type A behaviour, however, has not rigorously evaluated the structure of the SI scale. The present study examined the structure of a previously used eight-item SI scale, and its relation to a questionnaire measure of Type A (the student Jenkins Activity Survey), for a sample of 504 undergraduates. Exploratory and confirmatory factor analyses of responses to the SI items revealed a three-factor solution was most appropriate for Type As, and a two-factor solution for Type Bs. For both As and Bs, the first factor reflected insecurity regarding one's own capabilities and worth (self-specific insecurity), and the second factor reflected insecurity specific to a group or social context (group-specific insecurity). A third factor emerging only for Type As reflected insecurity regarding others' capabilities (other-directed insecurity). Semipartial correlations revealed Type A total score was marginally negatively related to group-specific insecurity and marginally positively related to other-directed insecurity, corroborating previous angiographic and prospective medical research. The hard-driving/competitive subscale was significantly negatively related to self-specific insecurity, supporting evidence regarding Type A and interpersonal dominance, competitiveness, and aggression.
Gender and mortality in schizophrenia: do women act like men?
Authors: Goldstein J. M. , Santangelo S. L. , Simpson J. , Tsuang M. T.
Published: July 2009

Synopsis

The effect of gender on mortality was explored for a sample of DSM-III diagnosed schizophrenics followed for up to 42 years. The data for 332 cases and 304 matched normal controls were from the retrospective cohort family studies, the Iowa 500 and non-500. Survival analysis and Cox regression models were used to test the effects of gender, illness status and their interaction on the risks for natural and unnatural deaths. The control men experienced significantly more unnatural deaths than the control women, which was not found for schizophrenic men and women. The unnatural death rate among schizophrenic women was similar to the rate for schizophrenic and control men, and significantly higher than for control women during the early phase of the illness. Findings suggest that some factors that predict suicide may be similar for schizophrenic women and men.
Sex differences in minor psychiatric morbidity among three aboriginal groups in Taiwan: the effects of lineage
Authors: Cheng Tai Ann , Hsu Mutsu
Published: July 2009

Synopsis

Sex differences in minor psychiatric morbidity (MPM) have been investigated among three aboriginal groups in Taiwan. The study included both ethnographic observation and a sample survey (N = 733) using a modified Clinical Interview Schedule. The findings lend support to the hypothesis that although a female excess of MPM will be found among the patrilineal group (the Bunun), the reverse will be observed in the matrilineal group (the Ami); no such difference will be found in the bilateral group (the Atayal). Further analysis revealed sex differences in the mean duration of MPM and similar incidence ratios between two sexes in these three groups. Possible sociocultural explanations are proposed.
Comorbidity and co-transmission of alcoholism, anxiety and depression
Authors: Merikangas K. R. , Risch N. J. , Weissman M. M.
Published: July 2009

Synopsis

This paper applies data from a family study of depression to assess patterns of comorbidity and co-transmission of alcoholism, anxiety disorders, and major depression. We found that all three disorders were strongly transmissible; however, alcoholism demonstrated the greatest degree of familial aggregation. The pairwise associations among depression, anxiety and alcoholism indicated that the traits are co-transmitted in families, especially depression and anxiety. Individual associations between traits (or comorbidity) were entirely explained by transmitted (perhaps genetic) agents, because the correlations between traits due to random environment were not significant. These findings have important implications for treatment, psychiatric nosology, and aetiological investigations of these conditions.
GP consultation as a factor in the low rate of mental health service use by Asians
Authors: Wilson Mona , MacCarthy Brigid
Published: July 2009

Synopsis

Patients attending five Health Centres in areas of NW London with a high Asian population were asked to complete a questionnaire screening for non-psychotic psychiatric illness and to state why they had come to see their doctor. The GPs were also asked to rate the purpose of the consultation for those patients who scored above the cut-off point on the questionnaire. The screening questionnaire revealed equivalent rates of non-psychotic psychiatric morbidity in the White and Asian samples and no differences in the way their symptoms were presented. The differences that did emerge showed that Asian patients scoring above the cut-off for psychiatric caseness were more likely to state that they were consulting their GP about a physical problem and GPs were more likely to identify psychiatric morbidity in White than Asian patients who exceeded the cut-off threshold. The results suggest the possibility of an interaction between the ways in which patients experience and communicate psychological distress, their ethnic origin, and their GP's mode of responding.
Further reliability and validity studies of a procedure to assess the needs for care of the chronically mentally ill
Authors: Haaster I. Van , Lesage A. D. , Cyr M. , Toupin J.
Published: July 2009

Synopsis

The Needs for Care Assessment Schedule (NFCAS; Brewin et al. 1987) is an itemized and systematic procedure that aims to evaluate the needs for care of long-term mentally ill patients. The present study pursues reliability and validity related issues with the NFCAS in a different cultural context applying the procedure to 98 severely mentally ill patients belonging to different patient groups: short-term, long-term, in-patient and out-patient.

Inter-rater reliability was found to be excellent. The results suggest that a clinician with little practical experience and adequate training may effectively use the procedure. The assessment of clinical relevance suggested that the procedure is both applicable and pertinent to all the patients in the study. Additional guidelines were developed for its use with long-term in-patients.
The differential response of chronic fatigue, neurotic and muscular dystrophy patients to experimental psychological stress
Authors: Wood G. C. , Bentall R. P. , Gopfert M. , Dewey M. E. , Edwards R. H. T.
Published: July 2009

Synopsis

A group of patients suffering from chronic fatigue (CF) attending a medical clinic were compared with a group of muscular dystrophy (MD) patients from the same clinic and a psychiatric control (PC) group who were attending a psychiatric unit. A checklist was used to assess the patients' subjective physical and psychological state before and after exposure to a psychological stressor. For both physical and psychological symptoms the CF group had the largest response, the PC group was intermediate, and the MD group had the least response. Explanations may involve physiological arousal and attentional focusing.
Sampling the form of inner experience in three adults with Asperger syndrome
Authors: Hurlburt R. T. , Happé F. , Frith U.
Published: July 2009

Synopsis

Three adults with Asperger syndrome were invited to talk about their inner experiences, using an experience sampling and interview technique. They reported thoughts primarily or solely in the form of images. By contrast, normal adults previously tested with this technique reported inner experiences of a variety of forms. The present report suggests the feasibility and potential interest of the experience sampling method with high-functioning individuals with autistic disorder.
Phenomenology, demography and diagnosis in late paraphrenia
Authors: Howard Robert , Almeida Osvaldo , Levy Raymond
Published: July 2009

Synopsis

One hundred and one patients with late paraphrenia were examined using the Present State Examination. The established high prevalence rates of female gender, the unmarried state and sensory impairment were confirmed. All of the symptoms of schizophrenia, with the exception of formal thought disorder, were found in the subjects with approximately the same prevalence as reported in schizophrenics with a symptom onset in younger life. The presence of visual hallucinosis was significantly associated with visual impairment, but the same association was not found between auditory hallucinations and deafness. Mean age at onset of symptoms was high at 74·1 years. Using ICD-10 diagnostic criteria the patients were categorized as schizophrenia (61·4%), delusional disorder (30·7%) and schizoaffective disorder (7·9%). Patients in these diagnostic categories differed in their pre-morbid IQ estimations, current cognitive state measured by the Mini-Mental State Examination and in the number of scored positive psychotic PSE symptoms and their systematization of and preoccupation with delusions and hallucinations. There were no significant differences between the patients in the ICD-10 schizophrenia and delusional disorder groups in terms of age at symptom onset, sex ratio, response to treatment, being unmarried, the presence of insight or sensory impairment. The high degree of clinical similarity between patients with late paraphrenia combined with the inability of ICD-10 to define diagnostic subgroups that correspond to patient clusters derived from clinical symptoms or which are meaningfully different from each other in terms of demographic and prognostic factors provide a strong argument for the retention of late paraphrenia as the most appropriate diagnosis for such patients.
Regional cerebral blood flow (rCBF) in schizophrenia during verbal memory activation: a 99mTc-HMPAO single photon emission tomography (SPET) study
Authors: Busatto G. F. , Costa D. C. , Ell P. J. , Pilowsky L. S. , David A. S. , Kerwin R. W.
Published: July 2009

Synopsis

Regional cerebral blood flow (rCBF) was investigated in a group of medicated DSM-III-R schizophrenic patients and age, sex and handedness matched normal volunteers using a split-dose 99mTc-HMPAO Single Photon Emission Tomography (SPET) protocol. Measures were taken during the performance of a verbal memory task aimed at activating the left medial temporal lobe, a region repeatedly suggested to be structurally abnormal in schizophrenia. In normal subjects, the performance of the task was associated with significant rCBF increases in the left medial temporal, left inferior frontal and anterior cingulate cortices, and right cerebellum. Despite their significantly poorer performance on the memory task, the degree of medial temporal activation measured in the schizophrenic patients was not significantly different from that found in the control group. This finding suggests that memory deficits in schizophrenia do not necessarily imply failure to activate the left medial temporal lobe as assessed by 99mTc-HMPAO SPET.
A survey of dementia in the Canberra population: experience with ICD-10 and DSM-III-R criteria
Authors: Henderson A. S. , Jorm A. F. , Mackinnon A. , Christensen H. , Scott L. R. , Korten A. E. , Doyle C.
Published: July 2009

Synopsis

A community survey of 1045 persons aged 70 years and over was conducted to identify cases of dementia in the cities of Canberra and Queanbeyan. Cases were identified using the Canberra Interview for the Elderly, administered by lay interviewers. When diagnostic criteria were rigidly applied, the point prevalence of dementia in the combined sample of community and institutional residents was considerably lower by ICD-10 than by DSM-III-R. Both criteria showed a similar rise in prevalence with age, and no gender difference. Agreement between the two systems had a kappa of only 0·48. ‘Probable’ cases by either criteria were identified solely from respondent-provided information in order to include persons for whom no informant was available. The point prevalence of such ‘probable’ cases was more similar for the two systems, and the kappa coefficient of agreement rose to 0·80. Analysis of the various components required for a diagnosis of dementia showed that the prevalence of all increased with age. Components involving cognitive assessment were correlated with education, but other components were not. The results of the study point to important differences between ICD-10 and DSM-III-R diagnoses of dementia.
An experimental phenomenological approach to delusional memory in schizophrenia and late paraphrenia
Authors: David Anthony S. , Howard Robert
Published: July 2009

Synopsis

A preliminary model is described to account for the ‘reality testing’ of memories (after Johnson & Raye, 1981) in an attempt to explain delusional memory. Two routes are proposed: route one involves evaluation of the factual content of the memories against stored general knowledge. Route two relies on the evaluation of the perceptual and narrative characteristics of memories with the assumption that the stronger these characteristics, the more likely the memory is to be real. The integrity of these routes is examined in four patients with delusional memories, using standardized tests. The results suggest that in these cases, general knowledge is essentially intact while the perceptual characteristics of delusional memories are stronger than real memories which in turn, are stronger than fantasies. This could lead the evaluation system to accept delusional memories as true memories despite their implausibility. The roles of rehearsal and affect are probably important in this and require further study.
An unusual presentation of multiple sclerosis
Authors: Hotopf M. H. , Pollock S. , Lishman W. A.
Published: July 2009

Synopsis

Two male patients who presented with unusual pictures of dementia in the absence of other obvious symptoms or signs are reported. Investigations demonstrated changes highly suggestive of multiple sclerosis (MS) on magnetic resonance imaging, cerebrospinal fluid analysis and electrophysiological tests. We suggest this represents a rare presentation of multiple sclerosis.
The psychological impact of motor neurone disease
Authors: Hogg K. E. , Goldstein L. H. , Leigh P. N.
Published: July 2009

Synopsis

Self-report measures were completed by 59 individuals with motor neurone disease (MND) in order to assess whether: (a) MND affects patients' psychological well-being and quality of life; (b) if greater affective disorder is associated with greater physical disability; (c) whether accepting the illness and ways of coping have an impact on psychological distress, and (d) if beliefs over control of their health shift as the disease progresses. Results indicated that the effects of MND on everyday functioning accounted for incidence of depression and low self-esteem. Acceptance of illness was related to severity of symptoms and was a significant factor irrespective of level of physical symptomatology. Ways of coping with the illness did not relate in any significant way to severity of symptoms. Mild physical impairments were associated with an ‘internal’ view of control over health.
Psychosocial factors and chronic fatigue syndrome
Authors: Lewis Suzan , Cooper Cary L. , Bennett Derrick
Published: July 2009

Synopsis

This study investigated the number and severity of life events, Type A behaviour, coping strategies and social support differences between chronic fatigue and irritable bowel syndrome patients prior to illness and between these groups and healthy controls. Although few differences were found between the groups for life events, a number of interesting results emerged with regard to different aspects of Type A behaviour, various coping strategies and social support. These findings are discussed with respect to existing research in the field.
Development and validation of the Computerized Clinician Administered Post-Traumatic Stress Disorder Scale-1-Revised
Authors: Neal L. A. , Busuttil W. , Herapath R. , Strike P. W.
Published: July 2009

Synopsis

A computer administered version of the clinician administered post-traumatic stress disorder (PTSD) scale-1 was developed to assess PTSD in subjects presenting with psychological symptoms following exposure to a traumatic event. Both forms were administered to 40 subjects who met the Diagnostic and Statistical Manual, third edition, revised (DSM-III-R) criteria for exposure to a significantly traumatic stressor. Inter-observer reliability was demonstrated with a kappa statistic of 0·90. The computer version had a sensitivity of 0·95 and a specificity 0·95. A correlation of 0·95 was found between the two versions and the mean score difference was non-significant. The computer form demonstrated adequate internal reliability and test–retest reliability. Overall results suggest the computer version is a valid and reliable measure of PTSD.
Social problems as factors affecting medical consultation: a comparison between general practice attenders and community probands with emotional distress
Authors: Pini S. , Piccinelli M. , Zimmermann-Tansella Ch.
Published: July 2009

Synopsis

Comparison between general practice attenders and community subjects with emotional distress (as measured by GHQ–12) showed that women from a general practice sample reported more social problems than those from the community. In both men and women, problems with their spouse or partner were far more likely among general practice attenders than among community probands. Furthermore, women who consulted the general practitioners could count less often on the availability of friend confidants and had more well-defined physical disorder than their community counterparts. Results from a logistic regression analysis showed that in women (but not in men) problems in the relationship with spouse or partner increased the probability of being a general practice attender more than twofold. Physical health status did not exert a significant effect either in men or in women.
Determinants of the help-seeking process: Goldberg and Huxley's first level and first filter
Authors: Verhaak Peter F. M.
Published: July 2009

Synopsis

This paper discusses minor psychiatric morbidity in the community and its relation to help-seeking. The research is aimed at identifying the demographic and social characteristics that enhance the likelihood of minor psychiatric morbidity, as measured by the General Health Questionnaire, and to reveal how these determinants relate to health status. In the second stage of the study, the same characteristics are related to their effect on the decision to consult a general practitioner and, more specifically, on presenting psycho-social problems to the GP. At the population level, the likelihood of a high GHQ score was greater for women, divorced persons and the unemployed, other variables remaining equal. However, GHQ score was contaminated by poor subjective health perception, especially for unemployed persons. Chronic physical illness did not have an independent effect on the GHQ score. Chronic physical illness did influence help-seeking. In addition, several socio-demographic characteristics showed an independent effect on consulting behaviour for both GHQ-positive and GHQ-negative patients. Women, unemployed persons and publicly insured patients with a minor psychiatric disturbance were more apt to visit their GP, regardless of their physical health status. However, no socio-demographic characteristics increased the likelihood that a GHQ-positive patient would present unambiguous psycho-social complaints as a reason to see their doctor.
Detecting psychiatric disorders in medical practice using the General Health Questionnaire. Why do cut-off scores vary?
Authors: Van Hemert A. M. , Den Heijer M. , Vorstenbosch M. , Bolk J. H.
Published: July 2009

Synopsis

In this study we assessed the accuracy of the General Health Questionnaire in detecting psychiatric disorders in general medical out-patients. A total of 290 newly referred patients were interviewed with the Present State Examination. Prior to the interview, 112 patients completed the full GHQ-60, 100 completed the GHQ-30 and 78 completed the GHQ-12. Data from the first group were used to study the full GHQ-60, together with the GHQ-30 and and GHQ-12, when disembedded from the full questionnaire. In a comparison between the disembedded and the separate versions of the GHQ-30 and GHQ-12 we observed considerable variation in the cut-off scores where a certain sensitivity and specificity was attained. In ROC-analysis, the versions were not materially different in their discriminatory capacity (area under the curve). The use of different criteria to define a ‘case’ demonstrated that case severity was another source of increasing cut-off scores. Our data demonstrate that the use of disembedded or separate versions of the questionnaire, together with variation in the case criteria can be a major explanation for variation in cut-off scores that was observed in previous studies.
Attempted suicide in Oxford University students, 1976–1990
Authors: Hawton Keith , Haigh Rex , Simkin Sue , Fagg Joan
Published: July 2009

Synopsis

During the 14 years between the beginning of academic year 1976–7 and the end of academic year 1989–90, 216 Oxford University students (119 females and 97 males) were referred to the general hospital in Oxford because of suicide attempts (254 in all). The rate of attempted suicide during university term-time (106/100000) was lower than in other young people of similar age in Oxford City (164/100000). The difference was particularly marked in females (178/100000 v. 269/100000). The lower rate in the students may in part reflect their generally higher socio-economic status. Very few of the attempts by the students appeared to be failed suicides. The most frequent problems faced by the students at the time of their attempts were interpersonal, especially difficulties regarding partners, followed by academic problems. The latter were usually problems with ongoing course work rather than with the Finals examinations. Approximately a quarter of the students had psychiatric problems, with personality disorders and depression being most common. At least 30% had a history of previous attempts. Suggestions are made concerning measures for improving the management and prevention of attempted suicide by students.
Genetic influences on eating attitudes in a normal female twin population
Authors: Rutherford J. , McGuffin P. , Katz R. J. , Murray R. M.
Published: July 2009

Synopsis

The Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI) were administered to a female volunteer twin population aged 18 to 45 years. Both members of 147 monozygotic (MZ) and 99 dizygotic (DZ) twin pairs completed the questionnaires. Thirty-five subjects scored over the cut-off point of the EAT-26. Interviews of these high-scoring twins and their co-twins identified three subjects with a past history of anorexia nervosa, and three others with a history of a partial syndrome. A heritability value of 41% was obtained for the overall EAT scores, while factor analysis produced a ‘dieting’ factor with a heritability of 42%. The ‘body dissatisfaction’ and ‘drive for thinness’ subscales of the EDI had heritability values of 52 and 44% respectively. The genetic contribution to the variance in body mass index in the twin sample was estimated at 64%. For all the above phenotypes, an environmental model of transmission with heritability constrained to be zero, could be rejected. Conversely, we were unable to reject a purely additive genetic model with shared environmental variance constrained at zero, suggesting that family environment has little or no effect on the transmission of many of these traits.
A latent trait analysis of an inventory designed to detect symptoms of anxiety and depression using an elderly community sample
Authors: Mackinnon A. , Christensen H. , Jorm A. F. , Henderson A. S. , Scott R. , Korten A. E.
Published: July 2009

Synopsis

An 18-item inventory designed by Goldberget al.(1987) to detect symptoms of anxiety and depression was administered to an elderly general population sample. Latent trait analysis was used to assess the dimensionality of the inventory and the location and discriminatory ability of the symptoms. The items showed different patterns of discrimination in this group compared to the sample of general practice attenders on which the inventory was developed. Overall, the items did define two correlated dimensions of anxiety and depression. In addition, a third dimension of sleep disturbance was detected. Both individual scales and the total symptom scores were sensitive and relatively specific detectors of depressive disorders assessed according to ICD-10 and DSM-III-R criteria. The retention of sleep items on their original scales did not affect the sensitivity of the scales to detect depressive disorders. A two-step administration procedure suggested for use in the administration of the scales was investigated but found to be sensitive to differences between the current sample and the sample on which the inventory was developed. This symptom inventory can be recommended for use in epidemiological investigations as a brief, valid and acceptable method of detecting elevated levels of anxiety and depression in elderly persons.
Cerebral ventricle dimensions as risk factors for schizophrenia and affective psychosis: an epidemiological approach to analysis
Authors: Jones P. B. , Harvey I. , Lewis S. W. , Toone B. K. , Van Os J. , Williams M. , Murray R. M.
Published: July 2009

Synopsis

A case–control study was undertaken of volumetric computerized tomographic scan measures in 216 consecutive admissions for functional psychosis and 67 healthy community controls. Odds ratio analysis demonstrated significant linear trends in the association between increasing lateral and third ventricle volumes, and both RDC schizophrenia (N= 121) and schizoaffective disorder (N= 41); cases were consistently associated with larger volumes than controls. There was an association between larger third, but not lateral, ventricle size in affective psychoses (N= 54). These associations were statistically independent of intracranial volume, sex, social class and ethnicity, factors which were significantly associated with ventricular measures in the controls. There was no evidence of a threshold corresponding to the notion of normalversusenlarged ventricles.

Within the schizophrenia group, there were no large or significant associations between ventricle dimensions and age at onset, duration of illness or pre-morbid social functioning. Neither obstetric complications nor a family history of schizophrenia or other psychiatric illness was associated with large ventricles in these cases.
The selection of long-stay hospital patients for hostels: a study of patients selected for an experimental hostel and for local authority hostels
Authors: Pryce I. G.
Published: July 2009

synopsis

Chronic in-patients from a sample population of 48 women and 43 men were selected for an experimental hospital-hostel and for local authority hostels. Two-thirds were found suitable for the former but only a sixth for the latter. The problems of selection for and management at the experimental hostel are described, and the overall results discussed in relation to recent proposals for the residential care of chronic patients.
The many faces of human ageing: toward a psychological culture of old age
Authors: Baltes Paul B.
Published: July 2009

SYNOPSIS

In an effort to distil major findings about the nature of human ageing, seven propositions are presented as a guiding frame of reference. This propositional framework is then used to specify some conditions for a positive culture of old age and to advance one possible model of good psychological ageing. This model focuses on the dynamic interplay between three processes: selection, optimization, and compensation. The model is universal in its basic features, but at the same time emphasizes individual variations in phenotypic manifestation.
Work stress, family stress and depression in professional and managerial employees
Authors: Phelan Jo , Schwartz Joseph E. , Bromet Evelyn J. , Dew Mary A. , Parkinson David K. , Schulberg Herbert C. , Dunn Leslie O. , Blane Howard , Curtis E. Carroll
Published: July 2009

SYNOPSIS

Detailed interviews were conducted with 1523 married professional and managerial employees of a major US corporation to test associations of acute and chronic occupational and domestic stress with DSM-III-R major depression and current depressive symptoms. After controlling for demographic and clinical risk factors, both sources of stress were significantly associated with the two measures of depression. On the other hand, neither the demographic and clinical risk factors, nor several psychosocial characteristics (social support, sense of mastery and organizational commitment) moderated the relationship between stress and depression.
Evaluation of a brief psychological treatment for emotional disorders in primary care
Authors: Catalan J. , Gath D. H. , Anastasiades P. , Bond S. A. K. , Day A. , Hall L.
Published: July 2009

SYNOPSIS

A randomized trial in general practice compared: (i) a brief psychological treatment (problem-solving) given by a psychiatrist; (ii) any treatment of the GP's choice, whether psychological or pharmacological. The patients had recent onset emotional disorders of poor prognosis. Patients in the problem-solving group showed significantly greater reductions in symptoms. Problem-solving as given by a psychiatrist was feasible in primary care and acceptable to patients. Problem-solving is now being evaluated as given by general practitioners trained in the method.
The contribution of list length to the absence of the primacy effect in word recall in dementia of the Alzheimer type
Authors: Bemelmans K. J. , Goekoop J. G.
Published: July 2009

SYNOPSIS

It has repeatedly been demonstrated that patients with dementia of the Alzheimer type (DAT) show an absence of the primacy effect when asked to recall a list of items. The results of the present study show that the absence of the primacy effect in DAT patients is related to list length but probably in a way that is qualitatively not specific since it follows the same pattern as in normal ageing. It is also demonstrated that DAT patients differ in learning style. It is suggested that this indicates a reduced capacity to maintain controlled processing.