bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptoms of Emotional Distress in a Family Planning Service: Stability over a Four-Week Period
Authors: Winokur Andrew , Winokur Denise F. , Rickels Karl , Cox Deborah S.
Published: August 2008

The 25-item Hopkins Symptom Checklist (HSCL–25) was used on two occasions four weeks apart to identify self-reported symptoms of anxiety and depression in patients attending a family planning service. Only 28 per cent of patients classified as anxious to start with remained so four weeks later, but 62 per cent of those with high depression scores and 74 per cent of those with high depression and high anxiety scores maintained significant levels of depression. The implications of these findings for routine screening are discussed.
The Effect of Mianserin on Alpha-2 Adrenergic Receptor Function in Depressed Patients
Authors: Charney Dennis S. , Heninger George R. , Sternberg David E.
Published: August 2008

Recent clinical investigations have shown that long term treatment with the tricyclic antidepressants desipramine and amitriptyline reduces the sensitivity of the alpha-2 adrenergic autoreceptor. In order to determine whether the tetracyclic antidepressant mianserin also has this action, the effect of clonidine, an alpha-2 adrenergic receptor agonist, on plasma levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenlethyleneglycol (MHPG), blood pressure, and patient-rated sedation were measured in fifteen depressed patients before and during mianserin treatment. Postsynaptic alpha-2 adrenergic receptor function was assessed by measuring the growth hormone response to clonidine before and during treatment. Mianserin had little or no effect on the ability of clonidine to lower plasma MHPG and blood pressure, and to increase sedation and growth hormone secretion. The findings of this investigation indicates that long term mianserin treatment does not produce significant subsensitivity of the alpha-2 adrenergic receptor and suggests that a reduction in alpha-2 adrenergic autoreceptor sensitivity is not a necessary action for all effective antidepressant treatments.
A Neuroendocrine Study of Stereotactic Sub-Caudate Tractotomy
Authors: Corn T. H. , Honig A. , Thompson C. , Bridges P. K. , Bartlett J. R. , Checkley S. A.
Published: August 2008

The growth hormone and hypotensive responses to clonidine have been measured in six drug free severely depressed patients before, and at two weeks after, the surgical procedure of stereotactic sub-caudate tractotomy. The responses were unaltered two weeks after operation, by which time a small clinical improvement was evident. These findings are discussed in relation to central a adrenoceptor functions in depression, and the effect upon this of antidepressant treatment.
Economic Losses Associated with Chronic Mental Disorder in a Developing Country
Authors: Westermeyer Joseph
Published: August 2008

This study was undertaken in a society without psychiatric services to assess the economic losses associated there with major mental disorder. Such data are important in assessing the cost/benefit of services for major mental disorders.

A survey was conducted in 27 representative villages of Laos, each containing about 200–300 people; 35 mentally ill subjects were identified. Data were obtained on expenditure for treatment, loss of productivity, and other economic losses (eg., destruction of property); demographic data and clinical rating scales were also obtained, and compared with economic variables.

The data show wide variability in expenditures for treatment, but losses of productivity were consistently high; acute losses, while impressive due to their suddeness and obvious wastefulness, were comparatively small relative to others. Demographic data were not associated with loss in productivity. Certain psychopathological parameters, ie., more psychopathology, less productivity, were inversely correlated with productivity. Psychosocial function scales were strongly and directly correlated with productivity.
Psychological Response to Amputation as a Function of Age and Time Since Amputation
Authors: Frank Robert G. , Kashani Javad H. , Kashani Soraya R. , Wonderlich Stephen A. , Umlauf Robert L. , Ashkanazi Glenn S.
Published: August 2008

Much of what is known about the psychological response to amputation is derived from studies of veterans. Most recent amputees come from a different group; they are typically older and have experienced medical problems prior to their amputation. In order to investigate the effects of age and time since amputation on psychological response, 66 amputees were assessed by the Symptom Checklist-90, Beck Depression Inventory and interviewed. When classified by time since amputation and by age, the results indicate that older amputees exhibited less depression and fewer psychological symptoms: in contrast, younger amputees evidenced increased depression and psychological symptomatology the longer the time since their amputation.
Panic Symptoms after Inhalation of Carbondioxide
Authors: van den Hout Marcel A. , Griez Eric
Published: August 2008

The effects of inhaling a mixture of 35 per cent carbon dioxide and 65 per cent oxygen on the occurrence of panic symptoms defined by the DSM III, was investigated. Compared to a placebo (air), carbon dioxide produced more panic symptoms. If carbon dioxide inhalation was preceded by intake of a beta-blocker (60 mg propranolol), less symptoms occurred than if preceded by a placebo. The results are compared with earlier reports on the effects of lactate infusion. It is argued that panic disorders can be conceptualized as a fear of internal (panic) sensations and that inhalation of a mixture of carbon dioxide and oxygen may constitute an effective exposure treatment.
A Comparison of Lenient and Strict Operant Conditioning Programmes in Refeeding Patients with Anorexia Nervosa
Authors: Touyz S. W. , Beumont P. J. V. , Glaun D. , Phillips T. , Cowie I.
Published: August 2008

The present paper compares a lenient and a strict operant conditioning programme in refeeding patients with anorexia nervosa. Sixty-five consecutive in-patients participated in the study. We found no significant difference in the rate of weight-gain between the two treatments. There were, however, a number of practical advantages in using the more lenient programme: it was more economical of nursing time, and patients were more accessible to psychotherapy. The programme was also more acceptable to the patients.
The Relationship between Cognitive Function and Liver Function in Alcoholism
Authors: Everett P. S.
Published: August 2008

Thirty alcoholic patients were investigated for evidence of impaired hepatic function and deficits in cognitive functioning, to see if there was any significant relationship between these two complications of alcoholism. Forty-seven per cent had abnormal γ-glutamyl transpeptidase levels, and 63 per cent had abnormal results on the Category test. Only one significant correlation coefficient was found, between one parameter of hepatic function and one of cognitive function. Possible explanations for this (negative) correlation are discussed, and the value of further study is suggested.
Brain-Type Creatine Phosphokinase Serum Levels Before and After Ect
Authors: Webb M. G. T. , O'Donnell M. P. , Draper R. J. , Horner B. , Phillips J. P.
Published: August 2008

Brain-type creatine phosphokinase isoenzyme (CPK BB) was measured by radioimmunoassay in the serum of 31 depressed patients undergoing bilateral ECT. Samples were taken shortly before and at one hour, two hours, and six hours following ECT. ECT did not cause a significant alteration in serum CPK BB concentration during the six hours following the treatment. Similarly, there was no difference in mean pre-ECT concentration of serum CPK BB between patients receiving the first ECT of their current admission and those receiving subsequent treatments. These findings do not support suggestions that ECT causes alteration in permeability of the blood-brain barrier, nor that it causes detectable brain injury.
Facial Affect Recognition in Schizophrenia is there a Differential Deficit?
Authors: Novic Josh , Luchins Daniel J. , Perline Richard
Published: August 2008

Several studies have suggested that schizophrenics have a deficit in their ability to recognize the affect expressed in photos of human faces. In this study, the performance of 17 chronic schizophrenics was compared to that of 17 controls on both a test of facial affect recognition and a control task involving facial recognition. Compared with controls, chronic schizophrenics tended to perform more poorly on the test of facial affect recognition, but this difference was eliminated when facial recognition was entered as a covariate. When all test items, including those with poor reliability and discriminatory power, were included in the analysis the schizophrenics showed a significant deficit in facial affect recognition which persisted even when facial recognition was used as a covariate.
Amnion's Horn or Hippocampal Sclerosis without Epilepsy in Mental Handicap
Authors: Sylvester P. E.
Published: August 2008

Neuropathological examination of the brain of eight adult mentally handicapped patients showed mesial temporal sclerosis. Three patients had cerebral palsy, one had Down's syndrome, three were retarded, and one had an unspecific mental handicap. Although there was a suspicion of fits in most patients, temporal lobe epilepsy was not diagnosed in life.
The Effects of Non-Prescribing of Anxiolytics in General Practice: II. Factors Associated with Outcome
Authors: Catalan Jose , Gath Dennis , Bond Alison , Martin Pauline
Published: August 2008

Factors associated with psychiatric outcome were examined in a series of 87 patients who had presented in general practice with new episodes of minor affective disorder. Two outcome measures were used: (i) Status on Present State Examination (PSE) seven months after initial consultation; (ii) prescribing of psychotropic medication between one-month and seven-month follow-up assessments. Outcome according to the PSE was significantly associated with: worse measures of psychiatric state (General Health Questionnaire, Profile of Mood states) and of social functioning (SAS-M) at initial consultation and one month later; and with persistent anxious or depressed mood during the follow-up period; but not with life events. During the follow-up period 20 patients received at least one psychotropic prescription; they were significantly associated with worse initial GHQ scores, consumption of tobacco and non-prescribed medication, and initial anxiety. A sub-group of 11 patients received multiple psychotropic prescriptions; they were significantly associated with the same initial measures, and also with poor outcome measures (psychiatric and social).
The Occurrence of Secondary Affective Disorder in an In-patient Population with Severe and Recurrent Affective Disorder
Authors: Stancer Harvey C. , Persad Emmanuel , Jorna Thecla , Flood Christine , Wagener Diane K.
Published: August 2008

One hundred and eighty nine consecutive in-patients with treatment-resistant affective disorder were administered the Renard Diagnostic Interview to determine whether the 45 with secondary affective disorder (SAD) differed from the 144 with primary affective disorder (PAD). The SAD group, including 15 subjects with bipolar disorder, had an earlier mean age of onset of depression and contained more unmarried individuals. The total secondary group could not usefully be differentiated by assessment of clinical symptoms or discriminating analysis of social and clinical variables. While the present study of a severely depressed population does not lend itself to generalisability, this combined sample does have characteristics of patients used in biological investigations. No significant inter-group discrimination was found to support a previous assumption that identification of a prior psychiatric disorder provides the most suitable mechanism for selecting a population for research in affective disorders.
A Comparison of the Growth Hormone Responses to Clonidine and Apomorphine in the Same Patients with Endogenous Depression
Authors: Corn T. H. , Hale A. S. , Thompson C. , Bridges P. K. , Checkley S. A.
Published: August 2008

The growth hormone responses to clonidine (1.3 μg/kgm) and apomorphine (0.005 mg/kgm) have been measured in 8 drug free patients with endogenous depression. In these patients the growth hormone responses to clonidine were significantly smaller than to apomorphine. As these doses of clonidine and apomorphine have previously been reported to cause similar growth hormone responses in normal subjects, these findings support the hypothesis of a defect in the adrenergic but not the dopaminergic regulation of growth hormone in patients with endogenous depression.
A Consensual Validation of Schizoid Personality in Childhood and Adult Life
Authors: Cull Ann , Chick Jonathan , Wolff Sula
Published: August 2008

Life histories and interview descriptions of 23 young men diagnosed as schizoid in middle childhood and adult life and of 20 control subjects not given this diagnosis were presented for diagnostic rating to two independent general psychiatrists. Agreement about the presence or absence of schizoid personality was good. It is concluded that, in the case of boys, the syndrome of schizoid personality in childhood (Asperger's syndrome) corresponds to or is subsumed by the more general clinical picture psychiatrists have of schizoid personality in adult life, and that our original use of this diagnostic label for the youngsters we described was not idiosyncratic.
Psychophysiological Changes during Pharmacological Treatment of Patients with Obsessive Compulsive Disorder
Authors: Zahn Theodore P. , Insel Thomas R. , Murphy Dennis L.
Published: August 2008

Twelve patients with obsessive compulsive disorder were studied with psychophysiological measures during a randomised, double-blind placebo-controlled drug trial. Significant clinical improvement followed six weeks of treatment with the tricyclic antidepressant clomipramine, but was not evident after an equal period of treatment with the monoamine oxidase inhibitor (MAOI) clorgyline. Compared to placebo, both drugs reduced skin conductance indices of baseline arousal, but only clomipramine reduced skin conductance and heart rate responses to loud tones and tonic and phasic skin conductance responses in a two-flash discrimination task. This suggests that reductions in autonomic responses to important and/or aversive stimuli may be critical to clinical improvement in obsessive compulsive disorder.
A Family Study of Bipolar II Disorder
Authors: Coryell W. , Endicott J. , Reich T. , Andreasen N. , Keller M.
Published: August 2008

Professional raters who were blind to proband diagnosis used the schedule for affective disorders and schizophrenia (SADS-L) and the Research Diagnostic Criteria (RDC) to evaluate 1, 210 first-degree relatives of 327 probands with primary major depression, participating in the family sub-study of the NIMH Collaborative Study of the Affective Disorders – Clinical Branch. Bipolar II probands were significantly more likely to have bipolar II relatives than were non-bipolar or bipolar I probands. Bipolar II probands were slightly more likely than non-bipolar probands and slightly less likely than bipolar I probands to have relatives with bipolar I illness. Similar patterns have emerged in two other recently reported family studies of bipolar II illness. Taken together, these data suggest heterogeneity among patients with bipolar II depression. Some appear to be genotypes for bipolar I illness, while a small proportion may be genotypes for non-bipolar illness. A third group, of undetermined size, may breed true.
Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives: A Follow-up Study
Authors: Sturgeon David , Turpin Graham , Kuipers Liz , Berkowitz Ruth , Leff Julian
Published: August 2008

Measurements of skin conductance response frequencies (SCRf) were obtained from 30 acutely ill schizophrenic patients during a standardised videotaped interview, conducted with the patient's key relative present. Significant differences in SCRf's were demonstrated between patients whose relatives had high and low Expressed Emotion (EE) respectively. Patients at high risk of relapse were allocated either to a control or an experimental group, the latter being offered a number of social interventions in order to reduce the relative's EE and/or contact with the patient. Follow-up measurements were obtained on 19 patients nine months after discharge. Although social intervention was highly successful in reducing relapse rates, its effects did not appear to be directly mediated via SCRf, which was found to be independently related to relapse.
Psychotic Children with Hallucinations
Authors: Garralda M. E.
Published: August 2008

In a retrospective study, 20 psychotic children and adolescents with hallucinations were compared with 15 psychotic controls without hallucinations. In the former, auditory hallucinations predominated, which tended to be localised in the internal space of the child. Subjects with hallucinations had significantly more symptoms of depression and anxiety, more precipitants of illness and problems in reading ability. There was a trend for increased laconic speech in them. The findings suggest a link between hallucinations and mood and cognitive changes in children and adolescents with psychoses of late onset.
Depression, Weight Loss and the Dexamethasone Suppression Test
Authors: Coppen Alec , Harwood Janet , Wood Keith
Published: August 2008

The dexamethasone suppression test (DST) was carried out on 143 patients with a major depressive disorder, who were classified into those with a history of weight loss (n = 89) and those without (n = 54). Seventy-three per cent of patients with weight loss and 61% of patients without had an abnormal DST; this difference was not statistically significant. Of the patients receiving prophylactic lithium therapy, 13 were found to have changed their DST status on retesting after a period of 14 months, but there was no significant difference in their weight. It is concluded that weight loss is not a necessary condition for an abnormal DST in depressive illness.
Psychiatric Clinics in General Practice
Authors: Tyrer Peter
Published: August 2008

The patients seen at five psychiatric clinics in general practice (GP) serving an urban population of 78, 200 are described, and their attitudes to the clinic compared with those for conventional out-patient clinics. The GP psychiatric clinics were strongly preferred, mainly because of their ease of access and absence of stigma; 19 per cent of the patients seen would not have attended a hospital clinic. The patients seen encompassed the entire range of psychiatric disorder, but most were treated in the clinic or by other members of the primary care team. It is concluded that GP psychiatric clinics offer a way of achieving better community psychiatry without any need for increased resources.
A Psychiatric Study of Patients with Supposed Food Allergy
Authors: Rix Keith J. B. , Pearson David J. , Bentley Stephen J.
Published: August 2008

Twenty-three patients who believed they suffered from food allergy were studied at the time of their presentation to an allergy clinic. The presence of organic food hypersensitivy could not be confirmed in 19 who attributed common neurotic symptoms to allergy; this group was almost identical, in terms of psychiatric symptomatology and general characteristics, with a group of new psychiatric out-patient referrals. There was no evidence of psychiatric disorder or food-related psychological symptoms in four patients with proven food-related atopic symptoms. The study failed to find evidence that psychological symptoms might be the result of organic reactions to foods.
Children who Poison Themselves I. A Clinical Comparison with Psychiatric Controls
Authors: Taylor E. A. , Stansfeld S. A.
Published: August 2008

Fifty schoolchildren, admitted as medical emergencies after poisoning themselves, were compared with 50 matched controls, resident in the same area of London, referred for psychiatric help for other reasons. The dependent measures were based upon systematically recorded clinical information in both groups. The self-poisoners showed more psychiatric symptoms and more disturbed family relationships than did the psychiatric group; they were more likely to meet criteria for depressive disorder and to come from families showing little warmth. This form of self-injury is not trivial or wholly culturally determined, and it warrants psychiatric intervention.
Effects of Desipramine Treatment upon Central Adrenoceptor Function in Normal Subjects
Authors: Corn T. H. , Thompson C. , Checkley S. A.
Published: August 2008

Six normal subjects were given clonidine infusions after 0, 1 and 3 weeks of treatment with desipramine (2 mg/kgm) and at 1 and 3 weeks after withdrawal from desipramine. The sedative and hypotensive effects of clonidine were inhibited after one and three weeks of desipramine treatment, and returned to normal after stopping treatment without any rebound increase. Such a time-course can be explained in terms of the acute effects of the drug, no adaptive changes at receptors need be invoked.

By contrast, the growth hormone response to clonidine tended to be increased after one week of desipramine, reduced after three weeks of treatment, and further reduced after discontinuation. Such a time-course is consistent with an adaptive down regulation at α2adrenoceptors in response to their acute stimulation, due to noradrenaline re-uptake blockade.
The Validity of Actometer and Speech Activity Measures in the Assessment of Depressed Patients
Authors: Godfrey Hamish P. D. , Knight Robert G.
Published: August 2008

Daily levels of anxious and depressed mood, as well as motor and speech activity were monitored for five depressed and four hypomanic patients during the courses of their in-patient treatment. The data were compared with results from nine matched control subjects. Motor activity was assessed using the actometer—a wrist watch which translates activity into movement of the watch hands—and the speech activity by recording the pause, phonation, and total times taken to recite the digits from one to ten. Validity data for the actometer and for total and pause time were found to be encouraging as outcome monitors for the treatment of depressive affect; the significant results from the total time measure suggest that this simple method is worthy of more widespread use in clinical settings.
Self Shooting of a Phantom Head
Authors: Ames David
Published: August 2008

Medical journals are enlivened by case reports of bizarre and unusual syndromes. Although somatic delusions are relatively common in schizophrenia, reports of hallucinations and delusions of bicephaly are rare. For a patient to attempt to remove a perceived second head by shooting and to survive the experience for more than two years may well be unique, and merits presentation.
Gestalt Therapy in Theory and in Practice
Authors: Tillett Richard
Published: August 2008

Gestalt therapy was developed by Frederick (Fritz) Perls, (1893–1970), a German psychoanalyst originally trained in the Freudian tradition; he left Germany in the 1930's for South Africa and emigrated to the United States in the immediate post-war years. Despite the publication of his book “Gestalt Therapy—Excitement and Growth in the Human Personality” (Perls, Hefferline and Goodman, 1950) his work remained relatively little known until Gestalt Therapy was taken up enthusiastically by the growth movement in the early 1960's. Although it is widely regarded as an established therapy in the United States, Gestalt remains relatively little known in the United Kingdom and there are probably few psychiatrists who are familiar with its theory and techniques. This paper is intended to present an introduction to Gestalt Therapy together with some idea of its application in clinical psychiatric practice.
Neuropsychological Function in Diabetic Patients with Neuropathy
Authors: Lawson J. S. , Erdahl D. L Williams , Monga T. N. , Bird C. E. , Donald M. W. , Surridge D. H. C. , Letemendia F. J. J.
Published: August 2008

Psychometric examination of a group of diabetic patients and a group of age-matched controls failed to provide evidence of impaired intellectual functioning in the diabetic group. The cognitive status of the diabetics was not related to the duration of the illness, the age at diagnosis, or clinical ratings of peripheral or autonomic neuropathy.
The Natural History of Behavioural Symptoms among Severely and Profoundly Mentally Retarded Patients
Authors: Reid A. H. , Ballinger B. R. , Heather B. B. , Melvin S. J.
Published: August 2008

In a study of the evolution of behavioural symptoms in severely and profoundly mentally retarded adults in hospital over a period of six years, items of abnormal behaviour were found to be remarkably persistent. There is a high prevalence rate of psychiatric disorder in this population, when this disorder is defined in a widely descriptive sense. A substantially improved living environment, and increased staff-patient ratios, are prerequisites for improving disturbed behaviour in these patients.
Effect of Anticholinergics on Tardive Dyskinesia
Authors: Greil W. , Haag H. , Rossnagl G. , Rüther E.
Published: August 2008

In a double-blind, placebo-controlled study, ten chronic schizophrenic patients with pronounced symptoms of tardive dyskinesia (TD) were withdrawn from anticholinergic medication. All patients had previously been under long-term treatment with neuroleptics and anticholinergics for at least two years. The rating-scales used were the AIMS, our own TD Scale, and the Simpson-Angus scale for extra-pyramidal side-effects. The severity of TD decreased significantly in nine patients within two weeks; this improvement, most pronounced in the oral region (P <.001), persisted during a six-week placebo period. There was a slight increase in parkinsonian symptoms (P <.05), which was not a prerequisite for improvement in TD. Hence, discontinuation of anticholinergic medication is a possible therapeutic approach in patients with TD.
Depression: A Breakdown of Perceptual Defence?
Authors: Powell Mary , Hemsley David R.
Published: August 2008

The effect of depressed mood on the tachistoscopic recognition of neutral/unpleasant words was investigated in a group of 18 depressed inpatients and in 17 normal controls. A 50% recognition threshold for 30 neutral words was calculated for each subject, in order to exclude the effects of depressive slowness on the experimental task. Each subject was tachistoscopically presented with a series of experimental words (30 neutral/30 unpleasant) at his 50% level, and the ratio of neutral to unpleasant words recognised calculated. Depressed subjects tended to recognise a higher ratio of unpleasant to neutral words.
Motor and Sighting Dominance in Chronic Schizophrenics
Authors: Merrin Edward L.
Published: August 2008

The relationship was examined between sinistral eye and hand preference and age at first hospitalisation, clinical course and social competence in chronic schizophrenics. Motor and sighting dominance were assessed in 52 newly admitted chronic schizophrenic males. Left-handedness in this study was associated with inferior social competence, but left-eyedness with later age of first hospitalisation and proportionally less time spent in hospitals. These findings were only true for paranoid schizophrenics.
Anorexia Nervosa: Long-term Outcome in 50 Female Patients
Authors: Hall Anne , Slim Enid , Hawker Fiona , Salmond Clare
Published: August 2008

Fifty consecutively referred female patients with anorexia nervosa were followed-up to identify those completely healthy at a minimum of four years (mean eight years) since onset. As well as using Morgan's Outcome Measures, an independent psychiatrist elicited details of food/weight pre-occupation and psychiatric state. The outcome results, based on weight and menstruation, (36% ‘good’, 36% ‘intermediate’, and 26% ‘poor’ including 2% dead, and 2% not assessed) did not differ significantly from those of the three similar published studies on similar patients; 62% of patients continued to have some food/weight pre-occupation. DSM III criteria for a psychiatric disorder other than eating disorder were fulfilled by 50%; dysthymic disorder was common (34%), occurring exclusively in patients with continuing eating disorder symptoms, while only 20% of the sample were free of any physical or mental abnormality. Of 52 prognostic factors studied, only four were significantly related to the outcome measures. Length of illness at presentation was the only prognostic factor common to all four similarly conducted studies.
Long-term Outcome of Bereavement
Authors: Lundin Tom
Published: August 2008

With the aid of the Texas Inventory of Grief, 130 first-degree relatives were studied eight years after bereavement. It was found that relatives of persons who had died suddenly and unexpectedly had more pronounced grief reactions than those of persons whose deaths were more expected. The same was observed concerning parents as a group, compared with widows and widowers. The inventory was found to be of value for assessing whether the outcome was good or poor, but it was not possible to identify risk groups with this method.
Suicide in Fiji: A Preliminary Study
Authors: Haynes Ruth H.
Published: August 2008

A survey of police and medical records in a province of Fiji indicated high rates of suicide for Indian women under 30 and for Indian men over that age, especially amongst families engaged in sugar-cane farming. Indian suicide rates were high during the Indenture period (1879–1920), and are still higher amongst Indians than amongst native Fijians: almost 90% of all suicides are Indian, though this group comprises only 50% of Fiji's total population. Age/sex/ethnic distribution, methods, and precipitating factors of recorded suicides were examined for one province of Vanua Levu during the period 1979–82. The increasing use of toxic herbicides, especially paraquat, as a vehicle for suicide is discussed.
Co-existence of the Capgras and Ekbom Syndromes
Authors: McLaughlin Jo-Ann , Sims Andrew
Published: August 2008

A case is described in which a diagnosis of paranoid schizophrenia was made using the criteria of Schneiderian first-rank symptoms. The patient showed the Capgras syndrome, with delusional misidentification of her son and other people in her environment, and also Ekbom's syndrome, with the delusion that she was infested with parasitic worms which migrated between various parts of her body. In this case, the two syndromes are descriptions of a specific delusional content, and occur as part of the psychopathology within a schizophrenic disorder, rather than as distinct disease entities.
Suicides in Exe Vale Hospital, 1972–1981
Authors: Langley G. E. , Bayatti N. N.
Published: August 2008

“Do we have a problem?” said the chief nursing officer. He had a list of 16 Exe Vale in-patients who had committed suicide in a period of 30 months. We looked at the list and then looked for something to compare it with in other hospitals; and that was where the trouble began. Such data as were available had been collected in diverse ways and often in the wake of special difficulties, e.g. the Warlingham Park Hospital enquiry (Croydon Area Health Authority, 1974/75). Comparisons were unrewarding, so we looked at our own 16 cases for indications of local problems. We also extended the study to the ten-year period 1972–81, during which there were 40 in-patient suicides. Since then more deaths have occurred—two in 1982 and four in 1983. These are referred to here only where special features warrant mention. Local monitoring of deaths continues; and certain deaths are notified to the Hospital Deaths Study of the Royal College of Psychiatrists.
Hyperparathyroidism and Paranoid Psychosis
Authors: Alarcón Renato D. , Franceschini José A.
Published: August 2008

Literature on psychiatric manifestations of hyperparathyroidism published in the last four decades confirms the unusual features of a case of paranoid psychosis secondary to a parathyroid-adenoma-induced hypercalcaemia. Affective and organic symptoms are overwhelmingly dominant in hypercalcaemic patients; the majority of cases reported are women of 50 years or older, who have been vaguely ill for a prolonged time before the actual endocrinopathy appears. The severity of the psychiatric symptoms does not seem to be related to the degree of hypercalcaemia. Recent findings link the role of calcium and related ions in the production of psychopathological symptoms to membrane phenomena, dopaminergic activity, and neuroendocrine regulation.
Impact of Psychogeriatric Day Hospital Care on the Patient's Family
Authors: Gilleard C. J. , Gilleard E. , Whittick J. E.
Published: August 2008

The supporters of 129 patients referred for psychogeriatric day hospital care were interviewed and followed-up after three and six months. The majority of their dependents suffered from dementia. Thirty-one per cent were still attending six months later, while 37% had been admitted to institutional care. The most positive effects of day hospital were associated with continued patient attendance, the number of distinct advantages foreseen by the supporter, and the lack of any negative expectations concerning their dependents' adjustment to day care. Positive benefits were also closely associated with reductions in the number of problems faced by the supporter.
A Comparative Evaluation of Two Psychiatric Day Hospitals
Authors: Milne Derek
Published: August 2008

Two psychiatric day hospitals were evaluated in terms of the outcomes after three months' attendance by patients. Multiple measures were made using questionnaires, naturalistic observation, and ratings at the start and end of this period, for a total of 83 patients. The results indicated that although both day hospitals were serving similar patient samples, only one was achieving significant clinical improvements; one plausible explanation for the findings was the differences between their respective programmes. The major implication of the result is the need for evaluation of both the outcome obtained by patients following attendance and the therapeutic process by which these outcomes are achieved.
Disorders with Overvalued Ideas
Authors: McKenna P.J.
Published: August 2008

The overvalued idea, first described by Wernicke, refers to a solitary, abnormal belief that is neither delusional nor obsessional in nature, but which is preoccupying to the extent of dominating the sufferer's life. Disorders conforming to his definition are well documented, though their recognition as such has been variable, and they may not be as rare as is often thought. As well as sharing a distinctive phenomenology, the conditions develop in similar settings and carry a uniformly poor prognosis. Their pathogenesis is obscure and difficult to account for in conventional terms.
The DST and its Relationship to Psychiatric Diagnosis, Symptoms and Treatment Outcome
Authors: Klein Helmfried E. , Bender Wolfram , Mayr Hermann , Niederschweiberer Alois , Schmauss Max
Published: August 2008

The dexamethasone suppression test (DST) was administered shortly after admission to 102 consecutive in-patients with a Hamilton depression score ≥16. Post-dexamethasone cortisol exceeded 6pg/dl in 16 cases, and levels correlated significantly with Hamilton scores; with the AMP syndromes ‘hypochondria’, ‘apathy’ and ‘catatonia’; and with the IMPS ‘retarded depressive’ syndrome. The criterion of suppression/non-suppression did not distinguish significantly between diagnostic categories (RDC or ICD), nor between endogenous and neurotic depression. (Newcastle scale). Both base-line and post-dexamethasone cortisol levels were reduced by prior treatment with minor tranquillisers, but not by major tranquillisers or antidepressants. DST results cannot be used as straightforward indicators of prognosis.
Psychiatric Hospital Admissions in Bristol. I. Geographical and Ethnic Factors
Authors: Ineichen B. , Harrison G. , Morgan H. G.
Published: August 2008

The distribution of in-patient psychiatric admissions throughout the city of Bristol during the period 1978–1981 is described. High rates were found from the central urban areas of low social class and with a high concentration of immigrants. The findings suggest that immigrant groups (mainly of West Indian origin) are no more likely than others living in the city centre to become psychiatric hospital in-patients, but when they do so, they are more likely to require compulsory admission.
Psychiatric Hospital Admissions in Bristol. II. Social and Clinical Aspects of Compulsory Admission
Authors: Harrison Glynn , Ineichen Bernard , Smith Janet , Morgan H. G.
Published: August 2008

Three groups of patients admitted compulsorily from populations with markedly different rates of compulsory psychiatric admissions were compared on a range of social and clinical data. Whilst West Indian and white patients from inner city areas differed in many respects, they were both more likely than other patients to be referred to the psychiatric services through police agencies, with little GP involvement and were often admitted from public places following disturbed behaviour. However, levels of violence and threatening behaviour were no higher among inner city patients, black or white, and once admitted, these groups showed similar treatment compliance to white patients who had been admitted compulsorily from suburban areas. Implications for primary care and delivery of psychiatric services are discussed.
Institutionalisation and the Outcome of Functional Psychoses
Authors: Johnstone Eve C. , Owens D. G. C. , Frith C. D. , Calvert Louie M.
Published: August 2008

The outcome in patients receiving long-term in-patient care for manic-depressive psychosis was compared with that in long-stay schizophrenic in-patients and discharged schizophrenic patients. The manic-depressive and schizophrenic in-patients differed in terms of positive and negative features and in the pattern of behaviour, but were equally cognitively impaired. The pattern of behaviour in both schizophrenic groups was the same. The results offer some support for the use of outcome as a validating criterion for the diagnosis of schizophrenia.
Oral Contraception and Serious Psychiatric Illness: Absence of an Association
Authors: Vessey M. P. , McPherson K. , Lawless M. , Yeates D.
Published: August 2008

The incidence of serious psychiatric illness, as measured by first referral to hospital for specialist advice and treatment, has been investigated among 16,746 women taking part in the Oxford Family Planning Association contraceptive study. Of these women, 9,504 were recruited while using oral contraceptives, 4,144 while using a diaphragm and 3,098 while using an intrauterine device.

The results are reassuring with respect to oral contraceptive use. First referral rates per 1000 woman-years of observation in the oral contraceptive, diaphragm, and intrauterine device entry groups were 3.0, 2.6, and 2.8 respectively for non-psychotic psychiatric disorders and 0.46, 0.43, and 0.53 respectively for psychotic disorders.

Attempted suicide occurred only 40% as often amongst diaphragm users as amongst users of oral contraceptives or intrauterine devices; this finding presumably reflects the characteristics of women who choose the diaphragm as their birth control method.
The Impact of Lithium in South-West Scotland III. The Discontinuation of Lithium
Authors: McCreadie R. G. , McCormick M. , Morrison D. P.
Published: August 2008

A review in South-West Scotland of all patients prescribed lithium for the first time during the years 1972–82 showed that on average, 12 per 100,000 of the general population start this drug each year. By the end of the period, lithium had been stopped in 58% of patients; the most common reason for discontinuation was the development of side-effects, of which tremor was the most frequent. In only 15% was lithium stopped as it was considered no longer necessary; 44% of patients discontinued lithium within one year of starting it.
De Clérambault's Syndrome—A Nosological Entity?
Authors: Ellis Peter , Mellsop Graham
Published: August 2008

The consistency of de Clérambault's syndrome and its relationship to other diagnostic labels is examined in terms of operational criteria derived from the original description of the syndrome. Five new cases of erotic delusions are examined, and 53 cases reported in the recent literature are reviewed; none of these completely satisfies the diagnostic criteria, while the majority of patients actually suffered from another disorder, most commonly schizophrenia. The justification for the retention of the syndrome as a nosological entity is discussed, and it is argued that the term should be seen as principally of historical interest.
The Pisa Syndrome: A Report of Two Cases
Authors: Yassa Ramzy
Published: August 2008

Ekbom et al (1972) described dystonic syndromes that appeared as a side-effect to treatment with the butyrophenone group of neuroleptic drugs. These symptoms consisted of tonic flexion of the trunk to one side, accompanied by its slight rotation, in the absence of other concomitant dystonic symptoms. They called this the ‘Pisa syndrome’. A literature survey of neuroleptic-included extrapyramidal side-effects gave little reference to this syndrome (Sovner & DiMascio, 1978; Berger & Rexworth, 1980), but two cases that fit the description of this side-effect are presented here.
Predicting Improvement in Patients with Non-Endogenous Depression
Authors: Parker Gordon , Tennant Chris , Blignault Ilse
Published: August 2008

Forty-three patients with non-endogenous depressive disorders were assessed shortly after psychiatric referral, and reassessed at six and at 20 weeks. The pattern of improvement appeared to be set shortly after the initial consultation, but could be most clearly predicted by the degree of improvement at the end of the third week. Key baseline factors predicting a more marked improvement at each follow-up were a more severe depression, the break-up of an intimate relationship, and the presence of weight loss. Positive life events occuring after the initial assessment predicted improvement at six and at 20 weeks, while the presence of a neutralising event (which negated an earlier threatening life event) predicted improvement at 20 weeks.
Academic Difficulty among Male Egyptian University Students
Authors: Okasha Ahmed , Kamel Moustafa , Khalil Afaf H. , Sadek A. , Ashour A. , Lotaif F. , Bishry Z.
Published: August 2008

We compared 178 students with academic problems with 77 academically successful students. Academic difficulty showed highly significant associations with low socio-economic status, over-crowded housing, paternal behaviour problems and a poor relationship between the parents; also significant associations with family history of psychiatric disorder and living away from home. Academic achievement at school was no guide to university performance. Failed students had fewer friendships, especially with women, amd more limited recreational activities. They also scored significantly lower on tests of verbal and non-verbal IQ, and worse on the Bender Gestalt and trail-making tests. EPQ results suggested that university students, particularly those with academic difficulties, are more neurotic and introverted than the general Egyptian population.
Epileptic Psychosis: An Evaluation of PSE Profiles
Authors: Perez M. M. , Trimble M. R. , Murray N. M. F. , Reider I.
Published: August 2008

Data are presented on 24 patients with epilepsy and psychosis whose clinical presentation was rated using the Present State Examination (PSE). Seventeen had complex partial seizures and a diagnosis of temporal lobe epilepsy, seven had generalised epilepsy. An association between a CATEGO category of nuclear schizophrenia (NS) and a lesion of the left side was noted. No clear link between depressive symptoms and a right-sided focus was discovered. Affective disorders were noted in both groups of epileptic patients, although paranoid psychoses were commoner in the temporal lobe group. There was also a tendency for the latter to have more delusions of persecution, ideas of reference, and special features of depression. The group rated as NS appear less likely to show evidence of intellectual deterioration than the other psychotic patients; in addition, the interval between the onset of their epilepsy and the onset of their psychosis is shorter. Radiological assessment by CAT reveals few differences between groups, but the psychotic samples do show higher than expected values on a number of variables, in particular the bilateral septum-caudate distance and the size of the third and fourth ventricle.
More and More is Less and Less
Authors: Richman Alex , Barry Arthur
Published: August 2008

The idea of massive unmet need for mental health services is a myth, generated and perpetuated by processes within the system which provides psychiatric care and within society. Diffusion of the traditional boundaries of mental health care, lack of norms and standards, medicalisation and ‘healthism’, specialoid practice and patient selection, diversion of resources from the longterm mentally ill and their absorption by better-functioning patients, substitution and development of new mental health service providers, and changes in the threshold for help-seeking all affect our assumptions of need. Needs are less massive, if the boundaries of psychiatry are defined so as to include only those disorders which the profession is best able to treat.
Organic Delusions: Phenomenology, Anatomical Correlations, and Review
Authors: Cummings Jeffrey L.
Published: August 2008

Organic delusions are common, but have received little systematic study. Review of the literature reveals that they occur most commonly in toxicmetabolic processes and in disorders affecting the limbic system and basal ganglia. A prospective study of 20 consecutive patients with organic delusions revealed four general types of false beliefs: simple persecutory delusions, complex persecutory delusions, grandiose delusions, and those associated with specific neurological defects (anosognosia, reduplicative paramnesia). Simple delusions responded best to treatment, and complex delusions were more resistent. Acting on delusional beliefs was not unusual, and treatment of the delusions was an important aspect of management of the patient.
A Comparison of Elective Mutism and Emotional Disorders in Children
Authors: Wilkins Robert
Published: August 2008

The case notes of 24 children diagnosed as elective mutes were compared with those of 24 matched controls with diagnosed emotional disorders. One-third of the elective mutes (but none of the controls) had experienced delayed development of speech or difficulties in articulation. All the elective mutes lived in two-parent families, but marital discord was noted in half the families in both groups. Compared with the controls, the mute children were more often described as ‘anxious', ‘depressed’ and ‘manipulative’, and their mothers were characterised as ‘over-protective’, and tending to ‘spoil’ their children. Three unusual cases, of mutism at home, are described in detail. It is proposed that elective mutism is associated with particular personal and family characteristics and represents a condition different from any recognised emotional disorder.
The Brain-Fag Syndrome in Nigeria: Cognitive Deficits in an Illness Associated with Study
Authors: Morakinyo Olufemi
Published: August 2008

In a controlled study, intellectual capacity and memory functions were assessed using standard instruments in a sample of 16 patients with ‘brain-fag syndrome’. The intelligence of the affected group was found to be generally above average and not significantly different from that of the control group. However, the patients had more difficulty in learning new words and in retaining such learning. The psychopathology of the syndrome is discussed.