bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-Psychotic Psychiatric Disorder After Childbirth
Authors: Cooper Peter J. , Campbell Elizabeth A. , Day Ann , Kennerley Helen , Bond Alison
Published: August 2008

The psychiatric state of 483 women was examined antenatally and at 3, 6, and 12 months postpartum. Comprehensive assessments were made of all women antenatally and of subgroups of the full sample postnatally. Psychiatric state was assessed using the General Health Questionnaire, the Present State Examination and the Montgomery and åsberg Depression Rating Scale. In terms of PSE criteria, the point prevalence of non-psychotic psychiatric disorder antenatally was found to be 6.0%; and postnatally it was estimated to be 8.7% at 3 months, 8.8% at 6 months and 5.2% at 12 months after delivery. These prevalence rates were compared to the rate in a general population sample of non-puerperal women and found to be no greater. In a subgroup of the full sample, the incidence of psychiatric disorder in the year following delivery was estimated to be 15.1%, which is close to a figure previously reported for women in the community. The onset of psychiatric disturbance was soon after delivery in most instances; and, for the majority, the episode of disturbance lasted for 3 months or less. The distribution of PSE Catego classes and syndromes among the antenatal and postnatal samples were found to be similar to those in the non-puerperal comparison sample. Thus, the prevalence, incidence, and nature of non-psychotic psychiatric disorder in the 12 months following delivery do not appear to distinguish it from such disorders arising at other times.
Pica as a Cause of Death in Three Mentally Handicapped Men
Authors: McLoughlin I. J.
Published: August 2008

In Prudhoe Hospital, a large mental-handicap hospital of 1000 residents, it was found that of the 94 deaths that occurred between 1982 and 1986, three were closely associated with the habit of pica. These deaths occurred in severely and profoundly handicapped males, whose average age was 32, compared with an average age of death of 58 for the combined groups of severely and profoundly mentally handicapped patients (22 cases), and an average age of death of 60 for all degrees of handicap (94 cases). It seems likely that the habit of pica constitutes a cause of considerable morbidity and mortality in certain institutionalised patients.
The Mentally Handicapped Criminal Offender a 10–year Study of Two Hospitals
Authors: Kearns Anthony , O'Connor Art
Published: August 2008

With mentally handicapped people now being moved into the community, information on mentally handicapped criminal offenders is valuable. A group of such offenders was examined by reviewing the case-notes of 92 patients referred on hospital order to two mental-handicap hospitals over 10 years. Compared with the general criminal population, these offenders' ages were higher, the ratio of male to female offenders was similar, and the proportion of married people was lower. The offences committed were for the most part serious, with a greater number of offences against property and public order in the subgroup whose intelligences were in the mentally handicapped range. Their tested intelligences fell almost entirely into the normal and mild mental-handicap range, suggesting that factors other than intelligence testing, such as social skills, were considered in their admission to the hospitals.
Monosymptomatic Hypochondriasis Treated with a Tricyclic Antidepressant
Authors: Fernando Noel
Published: August 2008

A case of a patient with monosymptomatic hypochondriasis exhibiting koro-like symptoms is reported. The patient did not respond to pimozide, but improved with a tricyclic antidepressant and has remained symptom-free for 1.5 years.
Assessing the Epidemiology of Suicide and Parasuicide
Authors: Farmer R. D. T.
Published: August 2008

Suicide is a rare phenomenon – in most countries, it explains between 0.5 and 1% of all deaths – no more than 15 per 100 000 population. Although rates increase with age, its impact on the total mortality of the young is greater than its impact on the elderly. Despite its rarity, the subject has attracted, and continues to attract, wide interest among academics and popular writers.
The Relationship Between Psychiatric Research and Public Policy
Authors: Eisenberg Leon
Published: August 2008

The rationale upon which public policy for the support of psychiatric research has been fashioned and the extent to which the results of that research are used to shape public mental-health policy are examined. Support for research competes with other claims for resource allocation and the decisions made reflect the relative strength of the interested constituencies. When research findings promise cost savings, they are readily adopted (sometimes unwisely so), but when they require substantial new outlays or changes in bureaucratic agencies, they are all too often ignored.
The Aetiology of Aggression in Temporal-Lobe Epilepsy
Authors: Herzberg J. L , Fenwick P. B. C.
Published: August 2008

A retrospective case-note survey was carried out on 31 subjects admitted with temporal-lobe epilepsy to the Maudsley hospital from 1974–1983 inclusive. Fourteen aggressive subjects were compared with the non-aggressive patients on 95 organic, developmental, and social variables. Aggressive behaviour was associated with male sex, early onset of seizures, and a history of long-standing behavioural problems. Aggressive subjects had lower mean IQ scores and poorer occupational records than controls. No relationship was found between aggression and the presence of specific EEG or CAT scan findings, or a history of psychosis. The results demonstrate the complex interplay between organic and socially mediated factors underlying aggressive behaviour in temporal-lobe epilepsy.
Depression and the Physical Environment
Authors: Birtchnell John , Masters Nigel , Deahl Martin
Published: August 2008

A depression-screening instrument (DSI) was administered to all 25–34-year-old, British-born, married women registered with a health centre on a south-east London housing estate. A disproportionate number of high scorers lived in those dwellings with the highest disadvantagement score. The dwelling interiors of the high DSI scorers were significantly poorer in appearance compared with those of the low scorers. Significantly more of the high scorers (and of their husbands) described the estate as unpleasant, and bad for their children. They raised significantly more objections to other residents' (including children's) behaviour. Their complaints were only partly explicable in terms of their less favourable accommodation.
Hyperventilation in Panic Attacks
Authors: Hibbert George , Pilsbury David
Published: August 2008

Transcutaneous carbon dioxide monitoring has been used to investigate directly the frequency and role of hyperventilation during naturally occurring panic attacks in freely ambulant volunteers and patients. Illustrative preliminary data from healthy subjects and from four patients with panic attacks are presented. These confirm that some patients do hyperventilate during their attacks but indicate that some do not. The unreliability of traditional methods for identifying hyperventilators is demonstrated. These data indicate the potential of ambulant monitoring in research into hyperventilation and panic.
Psychosocial Sequelae of Head Injury – Anatomy of a Relationship
Authors: McClelland R. J.
Published: August 2008

The nature and extent of psychological and social disability following head injury remain issues of considerable practical and theoretical interest. Practical because of the size of the problem and the resulting burden of care; theoretical because head injury should provide a powerful model for an improved understanding of the relationships between cerebral disorder and psychological impairment. (Lishman, 1973)
Dementia Praecox Revisited
Authors: Goldberg Terry E. , Kleinman Joel E. , Daniel David G. , Myslobodsky Michael S. , Ragland John D. , Weinberger Daniel R.
Published: August 2008

Thirty-nine patients with DSM–III diagnoses of schizophrenia were examined for age disorientation, an inability to produce one's correct chronological age upon request. Six patients were age-disoriented and demented (as defined by Mini-Mental State evaluation), while two patients had delusions concerning their age, but were not demented. Age-disoriented, demented patients had very large cerebral ventricles and very low Mini-Mental State scores. This group differed on the cognitive and neuroanatomic variables from other demented, but not age-disoriented, patients, as well as from non-demented patients who were age-oriented. The age-disoriented patients appeared to be at an extreme end of the dementia spectrum in schizophrenia.
The Identification of Clustering in Parasuicide
Authors: Smeeton Nigel , Wilkinson Greg
Published: August 2008

A straightforward test for detecting clustering in patterns of parasuicide in individual patients is described and applied to data from the Edinburgh Regional Poisoning Treatment Centre.
Prediction of Outcome After Treatment for Stuttering
Authors: Andrews Gavin , Craig Ashley
Published: August 2008

Predicting who will relapse after behavioural or dynamic psychotherapy is important. A search for variables likely to predict individuals at risk of relapse was conducted in two groups of successfully treated stutterers. The most powerful predictors were the attainment of three goals by the last day of treatment; namely, skill mastery as evidenced by no stuttering, normal attitudes to communication, and an internalisation of the locus of control. Of the subjects who achieved these three goals, 97% maintained their improved speech in the long term. No subject who failed to achieve any of these goals remained fluent, while those who achieved one or two goals had intermediate outcomes. No single goal was necessary and none alone was sufficient to maintain improvement. Both actual and perceived mastery over stuttering appear to be important if the long-term outcome is to be satisfactory.
Koro Secondary to a Tumour of the Corpus Callosum
Authors: Durst Rimona , Rosca-Rebaudengo Paola
Published: August 2008

The concurrent appearance of the koro syndrome and pathology of the central nervous system is quite rare. A case of a patient with a diagnosed tumour in the genu of the corpus callosum, who displayed typical koro symptoms, is presented. A short series of electroconvulsive shock treatments brought about resolution of the koro symptoms. Neurological investigation of all sporadic cases of koro is deemed necessary, to exclude cerebral involvement.
Chronic Depression
Authors: Scott Jan
Published: August 2008

Defining chronic depression as persistent symptoms for 2 or more years, a prevalence of chronic depression of 12–15% is found in the literature. A four-part classification of chronic depression is proposed: Chronic Primary Major Depression; Chronic Secondary Major Depression; Characterological or Chronic Minor Depression (Dysthymic Disorder); and ‘Double Depression’. The literature indicates several factors predicting chronicity in primary major depression: more at risk are female patients, particularly those with premorbid neurotic personality traits, individuals with unipolar disorders, and those with higher familial loading for such disorders. Other factors are the adequacy and appropriateness of the treatment given, and the length of illness episode prior to treatment being received. Larger studies with well-matched controls are needed.
Melancholia and Depression During the 19th Century: a Conceptual History
Authors: Berrios G. E.
Published: August 2008

The meaning of ‘melancholia’ in classical antiquity is opaque and has little in common with 20th-century psychiatric usage (Drabkin, 1955; Heiberg, 1927). At that time, melancholia and mania were not polar opposites (i.e. one was not defined as having opposite features to the other). Melancholia was defined in terms of overt behavioural features such as decreased motility, and morosity (Roccatagliata, 1973; Simon, 1978). Hence, in medical usage, ‘melancholia’ referred to a subtype of mania and named, in general, states of reduced behavioural output. These included disorders that might “exhibit depressed, agitated, hallucinatory, paranoid and even demented states … the ancient diagnosis of melancholy has no correct analogue in modern psychiatric practice …” (Siegel, 1973, p. 274).
The Relationship between Schizophrenic Patients' Perceptions of Their Parents and the Course of Their Illness
Authors: Warner Richard , Atkinson Monte
Published: August 2008

Sixty-two schizophrenic patients completed the Parental Bonding Instrument (PBI), a measure of perceived parental characteristics, rating their parents on care and protection. PBI ratings were related to a one-year course of illness. Patients who perceived their parents positively tended to experience a milder course of illness if they were in frequent contact with them, and a more severe course if they were not; the reverse was true for patients who perceived their parents negatively. PBI ratings were unrelated to the age at onset of illness. This suggests that patients' perceptions of parental attitudes influence the course of schizophrenia by a current stress effect. The PBI, used alone or in conjunction with other predictors, distinguished good- and poor-outcome cases and appears to be a potentially clinically valuable tool.
Lithium Combined with Haloperidol in Schizophrenic Patients
Authors: Lerner Yaacov , Mintzer Yaacov , Schestatzky Miguel
Published: August 2008

Previously, the addition of lithium to haloperidol has been reported to be of modest benefit to schizoaffective patients. To test this treatment on a different sample, 36 mainly schizophrenic patients were subdivided on the basis of the median of their initial depression score on the BPRS into depressive and non-depressive schizophrenic subjects. Each group randomly received haloperidol plus placebo or haloperidol plus lithium for 8 weeks. The schizophrenic patients who were on the depressive side of the median BPRS depression score were found to be the most resistant to neuroleptic treatment alone, and benefited from the addition of lithium.
‘Early-Onset Schizophrenia’ After Teenage Head Injury
Authors: O'Callaghan Eadbhard , Larkin Conall , Redmond Oonagh , Stack John , Ennis Joseph T. , Waddington John L.
Published: August 2008

A 14–year-old youth sustained an Injury to the left frontoparietal area, which was followed by evident change in personality and subsequently by an early-onset schizophrenia-like psychosis. Magnetic resonance imaging revealed ventricular dilatation, slightly more marked in the left hemisphere, and cortical atrophy. Some implications of this case for research on schizophrenia itself are discussed.
Brain Imaging and Treatment Response in Spasmodic Torticollis
Authors: Besson J. A. O. , Ebmeier K. P. , Gemmell H. G. , Sharp P. F. , McFadyen M. , Smith F. W.
Published: August 2008

A patient with spasms of the neck, occurring when he turned his head to the left, responded to treatment with benzhexol. Cerebral blood flow imaging demonstrated reduced uptake in the right corpus striatum compared with the left. The study demonstrates the presence of an abnormality in the basal ganglia; it also illustrates response to drug treatment. Cerebral blood flow imaging may be useful in the detection of basal ganglia abnormalities in spasmodic torticollis and assist in the selection of cases which should be targeted for treatment with drugs.
Physiogenesis and Psychogenesis in the ‘Post-Concussional Syndrome’
Authors: Lishman W. A.
Published: August 2008

The aetiological factors relevant to the development of post-concussional symptoms are reviewed. From the numerous studies carried out to date, it would appear that both physiogenic and psychogenic influences are important in their genesis. However, where mild-to-moderate injuries are concerned, organic factors are chiefly relevant in the earlier stages, whereas long-continued symptoms are perpetuated by secondary neurotic developments, often of a complex nature.
Psychiatric Aspects of Terrorist Violence: Northern Ireland 1969–1987
Authors: Curran Peter S.
Published: August 2008

For 18 years, Northern Ireland has suffered a changing pattern of civil disorder. Early years were marked by widespread sectarian rioting, shootings, and bombings, which heightened community tension and caused much social and commercial disruption. However, in recent years, terrorist organisations have been more selective in their acts of violence. There are methodological difficulties in assessing the psychological impact of civil disorder and terrorism. But, as well as can be judged from community surveys, hospital admissions and referral data, psychotropic drug usage, suicide and attempted suicide rates, and from assessment of the actual victims of violence, society has not ‘broken down’ nor has the impact been judged considerable. Possible explanations are discussed.
Schizophrenia as a Recent Disease
Authors: Hare Edward
Published: August 2008

The hypothesis that schizophrenia is a recent disease can explain why descriptions of schizophrenia-like disorders were rare before 1800, why the prevalence of insanity in the Western world increased during the 19th but remained low in the non-Western world until the 20th century, and why schizophrenia has become milder in the West during recent decades. It also explains why schizophrenia has ‘persisted’ in spite of its associated low fertility. The evidence for the hypothesis is somewhat frail, but perhaps not more so than that for alternative hypotheses.
Oedipus' Parents Were Child Abusers
Authors: Taylor David C.
Published: August 2008

The enigmatic title is taken from my first professorial lecture given on 21 December 1980 at the Royal Manchester Children's Hospital. It linked psychiatry, mythology, and Christmas, bringing together three incredibles, in trying to bridge the credibility gap that makes paediatric/psychiatric liaison so tricky. The hospital psychiatrist is, like Tiresias in Sophocles' play, a bisexual (equally as available as repellent). Blinded when he once saw truth (mythically he peeped at Athena bathing), he was given the gift of prophecy by way of consolation. Tiresias, like the psychiatrist, although blind, knows all but, tiresomely, will not speak what he knows. “How does he know?” whisper the non-psychiatrists. “He is blind, he knows nothing”, they muse.
Sex Chromosomes and Psychosis
Authors: Crow T. J.
Published: August 2008

Although the incidence of the recurrent psychoses (bipolar affective illness and schizophrenia) in the two sexes is approximately equal, gender influences a number of aspects of major psychiatric disease: unipolar depressive illness is twice as common in females, onset of schizophrenia is earlier and outcome is worse in males, and pairs of psychotic first-degree relatives are more often than expected of the same sex. In addition, sex chromosomal aneuploidies (e.g. XXY and XXX) are more frequent in patients with psychosis. Some of these findings can be explained if there is a major locus of predisposition to psychiatric disease in the ‘pseudoautosomal’ region of the sex chromosomes – that distal segment of the short arms in which there is genetic exchange between X and Y chromosomes at male meiosis. A gene located here would be transmitted in an autosomal manner, but would be passed above chance expectation to children of the same sex when inherited through a male. In that this segment of the sex chromosomes is subject to a high rate of recombination (which could generate new mutations), and may include determinants of brain lateralisation, it appears that the pseudoautosomal region could carry the genes which predispose to the major psychoses.
Pre-Pubertal Depressive Stupor: A Case Report
Authors: Powell J. C. , Silveira W. R. , Lindsay R.
Published: August 2008

A case of childhood affective disorder with episodes of depressive stupor in a 13-year-old pre-pubertal boy is described. Changes in the patient's clinical state were accompanied by changes in the dexamethasone suppression test. A family history of affective illness on the maternal side, with phenomenological similarities, is noted.
Schizophrenia, Season of Birth, and Maternal Age
Authors: Dalén Per
Published: August 2008

Maternal age is a neglected variable, with obvious implications for aetiology, in psychiatric research. In samples of schizophrenic patients, the distributions by month of birth and maternal age at birth show remarkable anomalies. These phenomena may be connected, because the seasonal distribution of births varies with maternal age, probably as a result of the age-dependent changes of fertility. Preliminary attempts to describe the seasonal effect in schizophrenia as a function of the shift in mean maternal age are not wholly successful at the quantitative level. Southern-hemisphere findings do not seem to fit the predicted pattern. Examples from other areas of research are discussed (sudden unexpected death in infants, congenital dislocation of the hip, and handedness) in which the seasonal distributions of births, and the findings on maternal age, conform to different varieties of the expected relationship.
Autoscopy, Mental Handicap and Epilepsy
Authors: Collacott Richard A. , Deb Saumitra
Published: August 2008

A case of autoscopy in a 43-year-old epileptic and mentally handicapped woman is described. The possible significance of this phenomenon to the patient is discussed.
Mania Induced by Lithium Augmentation
Authors: Yuvarajan R. , Yousufzai N. M.
Published: August 2008

A case of mania subsequent to the addition of lithium in unsuccessful treatment by antidepressants is presented. It is suggested that lithium might potentiate some properties of antidepressants which affect their capacity to induce mania.
Secondary Affective Disorder in Survivor of Cardiac Arrest
Authors: Kumar Anil , Agarwal Meena
Published: August 2008

A case of hypomania following cerebral anoxia due to cardiac arrest is reported. The concept of secondary affective disorder is reviewed and the need for early recognition of such cases is emphasised.
Concomitant Treatment of Neuroleptic Malignant Syndrome and Psychosis
Authors: Goldwasser Harry D. , Hooper James F. , Spears Nicki M.
Published: August 2008

Two cases are presented in which psychotic patients with neuroleptic malignant syndrome were treated with bromocriptine and thioridazine simultaneously, with a resulting control of both problems. The authors feel that this method needs further study, in the light of the potentially large number of patients at risk for these illnesses. The use of creatinine phosphokinase level as an indicator of value in NMS is also discussed.
An Uncontrolled Study of Cognitive Therapy for Morbid Jealousy
Authors: Bishay Nagy Riad , Petersen Neil , Tarrier N.
Published: August 2008

Thirteen patients presenting with morbid jealousy were treated using a cognitive approach adapted from Beck's cognitive therapy for depression. Cognitions in morbid jealousy showed the characteristics of automatic thoughts as described by Beck, and were based on faulty assumptions derived from interpretations of past experiences. The cognitive treatment directed mainly at the faulty assumptions resulted in improvements in ten patients and no change in one; two patients dropped out of treatment. The results are considered encouraging.
Zuclopenthixol-Induced Neuroleptic Malignant Syndrome at Rechallenge and its Extrapyramidal Effects
Authors: Kemperman Charles J. F.
Published: August 2008

This is the first report of a zuclopenthixol-induced NMS. The lack of previous reports may be because the receptor-binding profile of thioxanthenes gives rise to fewer extrapyramidal effects than comparable neuroleptics. It is important to know more of the relationship between the potential for induction of extrapyramidal effects and success in NMS rechallenge.
The Impact of Molecular Genetics on Our Understanding of the Psychoses
Authors: Mullan Michael J. , Murray Robin M.
Published: August 2008

Studies demonstrating the linkage to separate chromosomal locations of Alzheimer's disease, manic depression, and schizophrenia require re-evaluation of our ideas of their genetic aetiology. This article reviews the findings, and explores the increasing contribution of the ‘new genetics' to our understanding of the organic and functional psychoses.
Family History and Cerebral Ventricular Enlargement in Schizophrenia
Authors: Owen Michael J. , Lewis Shôn W. , Murray Robin M.
Published: August 2008

Ventricular size was measured from CT scans in 48 patients meeting RDC for schizophrenia who had a first-degree relative with a history of treatment for major psychiatric disorder, in 48 age- and sex-matched schizophrenic patients with no such history in first- or second-degree relatives, and in 48 matched, healthy controls. There was no difference in ventricular size between those with and without a positive family history, although both groups showed ventricular enlargement with respect to normal controls. Ventricular enlargement was demonstrated in the subgroup of 23 patients with a family history of schizophrenia, but not in the subgroup of 18 patients with a family history of affective disorder. These observations provide further evidence that schizophrenics with a family history of affective disorder may constitute an aetiologically distinct subgroup.
A Comparison of In-patient and Out-patient Prescribing
Authors: Anderson D. N.
Published: August 2008

The prescribing of psychotropic medication to 96 attenders at a lithium clinic was compared with their prescriptions while inpatients. As outpatients, they received fewer psychotropic drugs fewer times a day. This suggests that psychiatrists do not adopt intransigent stances in favour of polypharmacy and irrational psychotropic prescribing, as previous studies have implied. Caution is advised before attributing apparently irrational prescribing to bad clinical practice, or advocating remedial action aimed at changing the habits of prescribers.
‘Asneezia’ – Some Further Observations
Authors: Shukla G. D.
Published: August 2008

Absence of sneezing or inability to sneeze was found in 2.6% of psychiatric patients, although only half complained of the symptom spontaneously. This was the most frequent of a triad of features, the others being infrequent attacks, of coryza and light-headedness. Endogenous depression was the commonest psychiatric diagnosis, followed by schizophrenia, but ‘asneezics' differed significantly from controls in their diagnostic distribution; they also tended to be older, poorer, and less educated. The course and outcome of the asneezic triad ran almost parallel to those of the primary psychiatric illness.
Counselling the Relatives of the Long-Term Adult Mentally Ill
Authors: MacCarthy Brigid , Kuipers Liz , Hurry Jane , Harper Rod , LeSage Alain
Published: August 2008

The efficacy of implementing a clinically feasible psychosocial intervention which addresses the needs of carers of the long-term mentally ill is reported. All the relatives of patients in continuous high contact with one clinical team in a local day-care facility were offered the intervention. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion and to alleviate burden. Patients and relatives were assessed. The controls were the patients in contact with the other teams in the day-care facility, and their relatives. The intervention was effective at reducing EE and improving family relationships. Offering this kind of support to people who are providing long-term care for the severely mentally ill can contribute significantly to the quality of life of both supporters and patients.
The use of Rating Scales to Identify Post-natal Depression
Authors: Harris Brian , Huckle Philip , Thomas Roger , Johns Sandra , Fung Hedi
Published: August 2008

One hundred and forty-seven mothers were screened for major depression at six to eight weeks postpartum. Using predetermined cut-off points, the Edinburgh Postnatal Depression Scale and the Beck scale were compared in their abilities to identify the 15% of subjects who had major depression according to DSM-III criteria. The sensitivity of Edinburgh scale was 95% and its specificity 93%. The performance of the Beck scale was markedly inferior, with a sensitivity of 68% and specificity of 88%.
A Dementia Syndrome of Dependency?
Authors: Howells Roger , Beats Barbara
Published: August 2008

The diagnostic process in a case of dementia associated with physical and emotional dependence is described. The utility of sodium amylobarbitone abreaction is considered. The role of both psychodynamic and organic factors are emphasised in the aetiological work-up. The organic factors discussed include alcohol, sedative tranquillisers, solvents, and metals. The term ‘pseudodementia’ is not favoured, and the phrase ‘dementia syndrome of dependency’ is proposed.
Tardive Dystonia
Authors: Cooper S. J. , Doherty M. M. , King D. J.
Published: August 2008

Tardive dystonia is a rare movement disorder. We outline the development of tardive dystonia in a young schizopohrenic, and demonstrate the importance of applying a double-blind, placebo-controlled, crossover trial of any putative successful treatment.
Physical Illness in Chronic Psychiatric Patients from a Community Psychiatric Unit
Authors: Honig A. , Pop P. , Tan E. S. , Philipsen H. , Romme M. A. J.
Published: August 2008

The prevalence and significance of physical diseases, and health-care-seeking behaviour, were examined in a sample of 218 chronic psychiatric patients from an urban community psychiatric unit. Only 14% declined medical screening. Of the respondents, 53% had one or more probable or certain physical diseases warranting further medical attention. The majority of the diseases found were minor and typical of primary care problems. A severe (i.e. life-threatening) disease was present in 7% of respondents. Of the patients, 87% visited their GP at least once a year. The implications are that frequent consultation with primary care specialists and health-care-seeking behaviour should be noted, and included in any evaluation of the medical needs of chronic patients in community psychiatric care.
Mood Changes After Right-Hemisphere Lesions
Authors: Starkstein Sergio E. , Robinson Robert G. , Honig Marc A. , Parikh Rajesh M. , Joselyn John , Price Thomas R.
Published: August 2008

Ninety-three patients with acute stroke lesions restricted to the right hemisphere were examined for the presence of mood changes. While 46 patients showed no mood changes, 19 were unduly cheerful, 17 had developed major depression, and 11 had developed minor depression. Although there were no significant between-groups differences in other demographic variables, neurological deficits, activities of daily living, cognitive impairment, or quality of social support, patients with major depression had a significantly higher frequency of familial history of psychiatric disorder and lesions of the parietal cortex than patients with either no mood change or major depression following left-hemisphere lesions. On the other hand, undue cheerfulness was significantly associated with lesions of the right frontal operculum. These findings suggest that major depression following right-hemisphere lesions may have a different aetiology and mechanism than major depression following left frontal or basal ganglia lesions.
Resettlement of Old Long-Stay Psychiatric Patients: the use of the Private Sector
Authors: Perkins Rachel E. , King Sylvia A. , Hollyman Julie A.
Published: August 2008

A follow-up study of 17 old long-stay psychiatric patients resettled in private facilities for the elderly is reported. Resident satisfaction with the placement and functioning (using the CAPE Behaviour Rating Scale) was assessed, together with the quality of the physical and social environment, and the regime characteristics in the establishments. All residents were satisfied with life and their functioning had improved significantly. The private facilities were more resident-orientated, and had a generally superior social environment to their local authority ‘old people's home’ counterparts. The physical amenities, safety features, and architectural choice available were of a similar standard to those in local authority old people's homes, but there were fewer prosthetic and orientational aids and on-site recreational amenities.
Physical Health of the Long-Term Mentally Ill in the Community
Authors: Brugha Traolach S. , Wing John K. , Smith Brian L.
Published: August 2008

A clinical assessment was made of 145 long-term users of hospital and social-services day psychiatric facilities, and 84 consented to laboratory pathological screening. We recorded data on relevant medical care where that was being provided. Based on clinical assessment, 59 patients (41%) were judged to have medical problems potentially requiring care. Based on pathological screening 39 (44% of those assessed) had unmet needs, and this rating was associated with poor compliance with attendance and treatment plans. Altogether, 12 patients had important unmet needs, mainly for detailed medical investigation, although none required immediate hospital admission. Long-term patients should be medically reassessed and supervised at appropriate intervals.
The Prevalence and Patterns of Care of Huntington's Chorea in Grampian
Authors: Simpson S. A. , Johnston A. W.
Published: August 2008

The prevalence of Huntington's chorea in Grampian region is high at 9.94 per 100 000. The 46 individuals (26 female, 20 male) were ascertained from 98 pedigrees. Difficulties in ascertainment, family studies, sex ratio and use of resources are discussed.
Hyperventilation: Is It a Cause of Panic Attacks?
Authors: Hibbert George , Pilsbury David
Published: August 2008

During transcutaneous PCO2 (PtcCO2) monitoring of 15 freely ambulant patients suffering from panic attacks, all the patients experienced a typical attack. Seven were identified as hyperventilators, as PtcCO2 fell to abnormally low levels during the attack. This group could not be distinguished on the basis of either their usual symptoms of panic or the hyperventilation provocation test. There was no apparent association between absolute levels of PCO2 and the nature of symptoms. The anxiety ratings of hyperventilators were lower than those of non-hyperventilators. These data do not support the hypothesis that hyperventilation causes panic attacks or contributes to their severity. Hyperventilation may be better understood as a consequence of panic.
The Psychiatric Consequences of Spontaneous Abortion
Authors: Friedman Trevor , Gath Dennis
Published: August 2008

Sixty-seven women were interviewed four weeks after spontaneous abortion. As determined by the Present State Examination, 32 of these women were psychiatric cases. This rate is four times higher than in the general population of women. In each case the diagnosis was depressive disorder, a finding confirmed by scores on three depression rating scales. Many women showed typical features of grief. Depressive symptoms were significantly associated with a history of previous spontaneous abortion, and less so with childlessness.
Studying the ‘Grammar of Psychotherapy’ Course Using a Student and Control Population
Authors: Lieberman Stuart , Cobb John , Jackson Coral H.
Published: August 2008

In a study of the effects of the teaching of the ‘Grammar of Psychotherapy’ Course, 26 subjects were matched with 27 controls. The students were found to have significantly better interviews than the controls as rated by their patients and by independent blind assessment of their audiotapes six months later. There are some trends which were of interest, although not statistically significant.
The Effect of Research on Readmission to a Psychiatric Hospital
Authors: Ben-Arie O. , Koch A. , Welman M. , Teggin A. F.
Published: August 2008

The effects on outcome of research into the course of psychiatric illness are controversial. This study examines a cohort of research patients involved in an outcome study in which the research and clinical teams were kept separate. While research intervention of this nature would not be expected to influence outcome, the research cohort had fewer readmissions than non-research controls. This occurred despite the presence of factors which would be expected to be associated with a contrary result. It is stressed that the confounding effects of research need to be taken into account when designing follow-up studies and evaluating outcome results.
Clusters of Obsessive-Compulsive Phenomena in Obsessive-Compulsive Disorder
Authors: Khanna Sumant , Kaliaperumal V. G. , Channabasavanna S. M.
Published: August 2008

Clusters of phenomena were obtained by two clustering techniques, using the form and content of obsessions and compulsions. Significant clusters which emerged involved washing, checking, thoughts of past, and embarrassing behaviour. Depression occurred as a discrete cluster. Eighty-nine per cent of subjects could be fitted into at least one cluster; over half could be fitted into only one cluster. Washers and checkers made up more than half of the sample studied.
Patients Leaving Hospital Without the Knowledge or Permission of Staff–Absconding
Authors: Falkowski J. , Watts V. , Falkowski W. , Dean T.
Published: August 2008

A series of 100 consecutive psychiatric in-patients who absconded from a psychiatric hospital a total of 231 times over ten months was studied. The reasons given for absconding, duration of absence, and mode of return are described. The legal status and ethnic origins of absconders differed significantly from those of the base hospital population.
5-HIAA in Cerebrospinal Fluid and Deficit Schizophrenic Characteristics
Authors: Csernansky John G. , King Roy J. , Faustman William O. , Moses James A. , Poscher Margaret E. , Faull Kym F.
Published: August 2008

Higher CSF 5-HIAA concentrations and lower CSF HVA concentrations have been associated with various measures of slowed motor behaviour and communication in schizophrenic patients. To derive a single, reliable measure of deficit characteristics in schizophrenic patients, we entered four items of the BPRS reflecting negative symptoms, a work history measure derived from the Strauss-Carpenter scale, and three subscale scores of the WAIS-R into a principal-components analysis to derive a single factor score. The CSF 5-HIAA concentrations were within the normal range of values, and correlated directly with this factor score, but CSF HVA concentrations were not associated with the deficit factor score. These findings add support to the hypothesis that brain serotonin function is associated with deficit schizophrenic characteristics.
Sight and Insight: Regional Cerebral Metabolic Activity in Schizophrenia Visualised by Positron Emission Tomography, and Competing Neurodevelopmental Perspectives
Authors: Waddington John L.
Published: August 2008

Over the past several years there has emerged a family of highly sophisticated but technically complex procedures for the visualisation of a range of cerebral functions in living man (Andreasen, 1988). The images they produce are so beguiling not just because of their potential to give new insights into the pathophysiology and treatment of major psychiatric disorders, but because they convey information through a quite fundamental modality: people are only convinced by what they can see. However, initial applications of such new technology have appeared just as likely to generate new questions and contradictions as to provide answers to current issues. This is readily illustrated by recent studies on the imaging of brain dopamine receptors in schizophrenic patients by positron emission tomography (PET) (see Waddington, 1989a).
The TAPS Project. I: Previous Psychiatric Diagnosis and Current Disability of Long-Stay Psychogeriatric Patients
Authors: Anderson Jeremy
Published: August 2008

Of all 89 long-stay residents in four psychogeriatric wards at a large London psychiatric hospital, 18 had a previous functional psychiatric diagnosis. Although the total group was markedly impaired overall, male sex, younger age, and a previous functional diagnosis were independently associated with better cognitive performance. Males and those with previous functional disorders also had less behavioural disability. These subgroups within the psychogeriatric inpatient population must be recognised if an in-built distortion in community reprovision of hospital psychogeriatric services is to be avoided.
Responses of Growth Hormone to Desipramine in Endogenous and Non-endogenous Depression
Authors: Dinan Timothy G. , Barry Siobhan
Published: August 2008

Desipramine, a monoamine reuptake inhibitor, was used to stimulate release of growth hormone (GH) in 29 DSM-III major depressives and in 10 healthy controls. Eighteen of the depressives showed a blunted response. The GH-stimulation test was unable to distinguish endogenous from non-endogenous patients. The 13 dexamethasone non-suppressors were more likely to have a blunted GH response than the 14 suppressors. The results indicate that at least a subset of non-endogenous depressives have significant neuroendocrine abnormality.
Biperiden and Piroheptine Do Not Affect the Serum Level of Zotepine, a New Antipsychotic Drug
Authors: Otani K. , Hirano T. , Kondo T. , Kaneko S. , Fukushima Y. , Noda K. , Tashiro Y.
Published: August 2008

The effects of biperiden and piroheptine on the serum level of zotepine were studied in 15 schizophrenic and 6 mentally retarded in-patients. Neither of these anticholinergic drugs affected the serum level of zotepine nor caused significant side-effects. In the schizophrenics the total scores on the BPRS did not change significantly with either combination of drugs.
Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood
Authors: Burns Alistair , Jacoby Robin , Levy Raymond
Published: August 2008

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.
Multimodal Imaging in Alzheimer's Disease
Authors: Besson J. A. O. , Crawford J. R. , Parker D. M. , Ebmeier K. P. , Best P. V. , Gemmell H. G. , Sharp P. F. , Smith F. W.
Published: August 2008

Patients with a clinical diagnosis of Alzheimer's disease were studied using MRI, SPECT, and psychometric tests. Significant correlations between focal perfusion deficits and focal cognitive deficits were found. Significant correlations between regional relaxation time of white matter and psychometric tests of diffuse and focal categories were also found. Pathological examination confirmed Alzheimer's disease as the only diagnosis.
Firesetting in an Adolescent Boy with Asperger's Syndrome
Authors: Everall Ian Paul , Lecouteur Ann
Published: August 2008

Firesetting in children and adolescents is commonly associated with other antisocial acts that comprise conduct disorders. Asperger's syndrome is a rare pervasive developmental disorder. In the case presented we argue that the firesetting arose from the disabilities inherent in Asperger's syndrome. This also indicates that antisocial acts may be symptoms in other psychiatric syndromes as well as a specific conduct disorder.
The Validation of the Edinburgh Post-natal Depression Scale on a Community Sample
Authors: Murray Lynne , Carothers Andrew D.
Published: August 2008

The Edinburgh Post-natal Depression Scale (EPDS) was validated on a community sample of 702 women at six weeks post-partum using Research Diagnostic Criteria for depression. The estimates of sensitivity, specificity and positive predictive value, being based on a large random sample, offer improved guidelines for the use of the EPDS by the primary care team.
Rabbit Syndrome – a Rare Complication of Long-Term Neuroleptic Medication
Authors: Deshmukh D. K. , Joshi V. S. , Agarwal M. R.
Published: August 2008

A case of rabbit syndrome, a complication of long-term neuroleptic medication, is reported. It is important to differentiate it from tardive dyskinesia and continuous therapy with an antiparkinsonian agent may be required for control of symptoms of rabbit syndrome.
Psychiatric Diagnoses as Predictors of Suicide
Authors: Allebeck Peter , Allgulander Christer
Published: August 2008

In a cohort of 50 465 Swedish men conscripted for military service in 1969–70, the relative risk for suicide was 3.1 (95% CI 2.3–4.0) among those who had a psychiatric diagnosis at conscription, and 16.7 (95% CI 13.8–20.1) among those who had a psychiatric diagnosis in in-patient care during a 13-year follow-up. Of the diagnoses at conscription, only neurotic disorder, personality disorder and drug dependence were associated with a significantly increased risk for future suicide. Among those who were admitted to hospital, almost all inpatient diagnoses were associated with a significantly increased suicide risk. Although a psychiatric diagnosis in in-patient care was a strong predictor of suicide, only 44% of all 247 men who committed suicide had ever been treated in in-patient psychiatric care.
The Functional Psychoses in Afro-Caribbeans
Authors: Harvey I. , Williams M. , Mcguffin P. , Toone B. K.
Published: August 2008

When 54 Afro-Caribbean and 49 white British consecutive psychotic in-patients were prospectively studied for clinical differences in course of illness and pattern of symptoms, no major differences were found. This does not support the hypothesis that misdiagnosis within the psychoses can explain the higher admission rates of schizophrenia calculated for Afro-Caribbean populations.
Vasopressin in Chronic Psychiatric Patients with Primary Polydipsia
Authors: Delva Nicholas J. , Crammer John L. , Lawson J. Stuart , Lightman Stafford L. , Sribney Michael , Weir Barbara J.
Published: August 2008

Twelve chronic in-patients with primary polydipsia were studied, during free drinking and after fasting, by concurrent measurements of plasma AVP, serum sodium and osmolality, and urine volume, AVP, osmolality, and creatinine. A majority of the patients showed inappropriately high levels of AVP: plasma AVP estimations demonstrated that seven had Type I SIADH and two had Type II SIADH. Urinary AVP estimations confirmed inappropriately raised AVP in seven of the subjects tested, and there was a significant agreement between the plasma and urine diagnoses. Although able to concentrate their urine in response to fluid deprivation, the patients showed a decreased renal sensitivity to AVP. Despite the mitigating effect of decreased renal sensitivity to AVP, the SIADH seen in these patients appears to contribute to the development of water intoxication caused by polydipsia.
Gender-Mediated Clinical Features of Depressive Illness the Importance of Temperamental Differences
Authors: Perugi G. , Musetti L. , Simonini E. , Piagentini F. , Cassano G. B. , Akiskal H. S.
Published: August 2008

In a consecutive clinical series of 538 subjects with primary mood disorders the male: female differences were most skewed (1:4) in recurrent unipolars, 1:2 in single episode and bipolar I subtypes, and about even (1:1) in bipolar II. The sexes did not differ in age at onset of depression, stressors preceding index episodes, endogenous features, psychotic symptoms, suicide attempts, and rates of chronicity. Females had lower mean number of hypomanic, and higher mean number of depressive, episodes. Females also exhibited more anxiety and somatisation, and were more likely to endorse psychopathological items on self-report instruments, which were not reflected in objective measures. Finally, they were more likely to have been admitted to hospital. These gender differences could in part be explained by the higher prevalence of the depressive temperament in women, and of the hyperthymic temperament in men.