bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Presenile Dementia: The Use of the Visual Evoked Potential as a Diagnostic Indicator
Authors: Harding Graham F. A. , Wright Christine E. , Orwin Arnold
Published: August 2008

The use of the flash and pattern reversal visual evoked potential (VEP) in the diagnosis of primary presenile dementia was investigated. The results from 20 patients with primary presenile dementia were compared with those from a control group of normals of equivalent age and from a control group of 20 patients with cortical atrophy but no dementia. Presenile dementia caused a slowing of the major positive (P2) component of the VEP to flash stimulation. However, the VEP to pattern reversal stimulation (P100) was of normal latency. The difference between these two latencies characterises this unusual combination of results and is found to be a more specific diagnostic indicator of primary presenile dementia than the EEG or CT scan.
Puerperal Mental Illness, Clinical Features and Classification: A Study of 142 Mother-and-Baby Admissions
Authors: Meitzer E. S. , Kumar R.
Published: August 2008

The case notes were studied of 142 mothers admitted to psychiatric hospitals in the south-east Thames region within 12 months of childbirth during the years 1979 and 1980. Only 6% of the sample were categorised as schizophrenics by RDC criteria, whereas affective disorders were found to predominate in 80%. Manic and schizo-affective illnesses almost always began within two weeks of parturition, as did psychotic depressions. A third of the patient sample had suffered relatively minor disorders, and given adequate resources, some might have been better managed in the community. A parallel investigation of diagnostic returns to the Department of Health revealed considerable uncertainty about how to classify puerperal mental illnesses in accordance with ICD-9. There is an urgent need to improve the system for categorising and registering mental illnesses related to childbirth. Until this is achieved, research into aetiology, outcome, and the provision of services will continue to be impeded.
Adverse Drug Reactions to First- and Second-Generation Antidepressants: A Critical Evaluation of Drug Surveillance Data
Authors: Schmidt Lutz G. , Grohmann R. , Müller-Oerlinghausen B. , Ochsenfahrt H. , Schönhöfer P. S.
Published: August 2008

We reviewed data on adverse drug reactions (ADRs) to first- and second-generation antidepressants, recorded by two different drug surveillance systems. The rate of ADRs that led to discontinuation of the drug in the individual case, assessed within a multi-centred hospital-based drug monitoring system (AMüP), was significantly higher in case of exposure to tricyclics (7.4%) than with the second-generation drugs (3.1%). On the basis of voluntary reports to the Medicines Commission of the German Medical Profession (AMK), profiles of ADRs to the drugs under survey were constructed and compared with data compiled by the WHO. The types of ADRs varied more between second-generation drugs than between tricyclics. Special attention was paid to rare but serious ADRs (e.g. seizures during treatment with maprotiline, and blood dyscrasias attributed to mianserin).
Mydriatic Response to Topical Naloxone in Opiate Abusers
Authors: Ghodse A. H. , Bewley T. H. , Kearney M. K. , Smith S. E.
Published: August 2008

Naloxone hydrochloride eyedrops 1 mg/ml dilated the pupils of 36 out of 47 opiate addicts on methadone maintenance treatment, without precipitation of acute withdrawal effects, but not those of healthy unmedicated subjects. The response in addicts was attenuated by certain ancillary treatments and by withdrawal of methadone treatment. The size of the response suggests some potential clinical use for topical naloxone as a diagnostic test of current opioid influence and possibility of physical dependence. The local mydriatic response, which was restricted to the treated eye, indicates that the effect of opiates on the pupil in man is determined, at least in part, by a peripheral action.
Neuroleptic Malignant Syndrome
Authors: Abbott R. J. , Loizou L. A.
Published: August 2008

The neuroleptic malignant syndrome (NMS) occurs as a hypersensitivity response in certain patients exposed to neuroleptics. It is a relatively rare, but potentially lethal complication, the incidence of which may have been underestimated. Recent interest in NMS has arisen due to the recognition that specific therapy may now be available. This review summarises the clinical features and discusses recent ideas regarding aetiology and treatment.
Raised Plasma Cortisol Concentrations a Feature of Drug-Free Psychotics and not Specific for Depression
Authors: Christie Janice E. , Whalley Lawrence J. , Dick Heinz , Blackwood Douglas M. R. , Blackburn Ivy M. , Fink George
Published: August 2008

To determine whether high plasma cortisol concentrations are a distinctive feature of depression or whether plasma cortisol is also elevated in other forms of psychosis, cortisol concentrations were measured in 59 patients with acute functional psychoses, six non-psychotic depressed patients and 37 control subjects, all free of antidepressant and neuroleptic drugs for at least three months. Patients with schizoaffective disorder, manic type, had the highest concentrations throughout the day and those with major depressive disorder, psychotic sub-type had higher concentrations than controls in the afternoon and evening. Manic and schizophrenic patients had cortisol concentrations above controls in the afternoon only. Elevated concentrations were not related to the presence of depressed mood or to duration of stay in hospital, and a return to normal occurred irrespective of the type of treatment used. Thus raised plasma cortisol concentrations are a feature of psychotic illness, but in drug-free patients are not specific for severe depression.
Dexamethasone Concentrations and the Dexamethasone Suppression Test in Psychiatric Disorders
Authors: Morris Howard , Carr Vaughan , Gilliland Judy , Hooper Michael
Published: August 2008

The dexamethasone suppression test (DST) has been widely used in psychiatry as a laboratory aid for the diagnosis of endogenous depression; failure to suppress serum cortisol levels is interpreted as confirming a clinical diagnosis of endogenous depression. We found that serum dexamethasone concentrations in this test vary widely and are determinants of the DST response: non-suppression of serum cortisol levels is associated with low serum dexamethasone concentrations, and suppression is associated with high concentrations.
Depression, Urinary Free Cortisol Excretion and Lymphocyte Function
Authors: Kronfol Ziad , House J. Daniel , Silva Joseph , Greden John , Carroll Bernard J.
Published: August 2008

An impairment in lymphocyte response to mitogen stimulation, a correlate of cell-mediated immunity, has been reported in patients with depressive illness. To investigate whether such impairment in lymphocyte function is related to excessive secretion of cortisol, an immunosuppressive hormone, we compared mitogen-induced lymphocyte proliferation in three groups of subjects: (1) depressed patients with elevated 24-hour urinary free Cortisol (UFC) excretion; (2) depressed patients with normal UFC excretion; and (3) normal controls. Depressed patients in both groups showed significant reductions in lymphocyte mitogenic activity, in comparison with the normal controls, but the two depressive groups did not significantly differ from each other in their lymphocytic responses to any of the mitogens used. Furthermore, no significant correlations were found, within depressed patients, between UFC excretion and lymphocyte mitogenic responses. Depression is therefore associated with an impairment in lymphocyte function that cannot be explained solely on the basis of increased cortisol secretion.
Hormones, Mood and Sexuality in Lactating Women
Authors: Alder E. M. , Cook A. , Davidson D. , West C. , Bancroft J.
Published: August 2008

Of 25 primiparous women, investigated prospectively for six months post-partum, 19 persisted with breast feeding and six changed to artificial during the first six weeks. Sexual activity, mood, and feeding patterns were recorded in weekly diaries. Hormones were measured from weekly urine samples (oestrogen and pregnanediol) and fortnightly blood samples (prolactin, testosterone, androstenedione, and sex hormone binding globulin). In breast-feeding women, testosterone and androstenedione levels were significantly lower in those who reported severe reduction in sexual interest. Changes in sexuality or mood were not related to levels of prolactin or oestrogen, or to the return of follicular activity, which was delayed in persistent breast feeders. The relationships of mood, sexuality, and hormones are discussed.
IV. Expressed Emotion and Relapse
Authors: MacMillan J. Fiona , Gold Aviva , Crow Timothy J. , Johnson Anthony L. , Johnstone Eve C.
Published: August 2008

The relatives of 82 patients in a study of first episodes of schizophrenia were interviewed within six weeks of the index admission; 77 patients were subsequently discharged, and were followed to relapse or readmission. Analysis of relapse-free survival time was used to examine whether the components of ‘expressed emotion’ predicted relapse or response to neuroleptic medication: ‘critical comments' by relatives was the only component present often enough to be used and was inversely related to ‘social contact’. When preadmission duration of illness, and neuroleptic medication following discharge (identified previously as significant predictors of outcome) were taken into account, neither ‘critical comments' nor ‘social contact’ were related to outcome nor to response to medication. The constellation of factors suggested as pathogenic was present only in a minority of cases: many patients lived alone and of those that were with families, most were not in high face-to-face contact with other members. The failure of the components of ‘expressed emotion’ to predict outcome or response to neuroleptic medication suggests that at best, such factors are weak predictors of liability to relapse. Their influence is unlikely to be comparable in magnitude to that of neuroleptic medication.
Parental Loss by Death in the Early Childhood of Depressed Patients and of their Healthy Siblings
Authors: Perris Carlo , Holmgren Sonja , von Knorring Lars , Perris Hjördis
Published: August 2008

The incidence of parental loss by death before the age of 15 was investigated in a series of 200 depressed patients, sub-divided into unipolars, bipolars and neurotic-reactive depressives, and in their healthy siblings at risk. The age of onset of illness of patients who had lost a parent before 15 was compared with that of depressed controls. No excess of parental loss at any age was found in any of the patient sub-groups, as compared with their healthy siblings, nor did parental loss affect the age of onset of later depression. The results do not support the assumption that the loss of either parent by death in early childhood is significantly associated with depression in adult life, though parental death may be an important variable for individual patients.
Perceived Depriving Parental Rearing and Depression
Authors: Perris Carlo , Arrindell W. A. , Perris Hjördis , Eisemann Martin , van der Ende J. , von Knorring Lars
Published: August 2008

Four groups of depressed patients 47 unipolars, 21 bipolars, 34 with neurotic-reactive depression, and 39 with unspecified depressive disorder completed, after recovery, the EMBU, a Swedish instrument aimed at assessing the experience of parental rearing practices. The results for three factors: “rejection”, “emotional warmth” and “over-protection” and the global judgement scores of “severity” and “consistency” in rearing attitudes were compared with those obtained from 205 healthy individuals. Depressed patients, particularly in the unipolar unspecified groups rated both parents lower than the controls on emotional warmth. Patients tended also to rate their parents as less consistent in their rearing attitudes. The variables emotional warmth and overprotection allowed 64% of the patients and 72 of the unipolar depressives to be classified correctly. These results, like those of previous studies, support the hypothesis that deprivation of love during childhood represents an important psychological risk factor in the background of depressive disorders.
Conversion Without Hysteria: A Case Report and Review of the Literature
Authors: Shalev Arieh , Munitz Hanan
Published: August 2008

The term ‘conversion’ implies a correlation between conversion symptoms, hysteria, and hysterical personality. A clinical case of conversion related to chronic post-traumatic disorder, with paranoid features, was successfully treated by anti-psychotic drugs; it illustrates the non-specific nature of conversion symptoms. Mechanic's concept of ‘illness behaviour’ is a frame-work that meets the need for a broader understanding of conversion symptoms.
The Impact of Individual and Family Treatment on the Affective Climate of Families of Schizophrenics
Authors: Doane Jeri A. , Goldstein Michael J. , Miklowitz David J. , Falloon Ian R. H.
Published: August 2008

Measures of parental affective style were compared for families of schizophrenics participating in a controlled treatment study which contrasted individual and family-based therapeutic programmes. The total number of critical statements and non-critical, intrusive remarks was significantly lower after three months for parents of schizophrenics participating in family therapy, compared to those whose offspring received only individual therapy. An increased risk for relapse was associated with an increase in the number of critical and/or intrusive remarks for patients in individual treatment. A significant increase in non-emotional, problem-solving statements was observed in parents who received family therapy, compared with those who did not. The results suggest that a behaviourally-oriented, problem-solving family approach may have reduced the risk of relapse in the first nine months after discharge from hospital by teaching families concrete ways of solving problems and concomitantly reducing the amount of negative emotional relating between family members.
Early Life Events and Affective Disorder Revisited
Authors: Faravelli C. , Sacchetti E. , Ambonetti A. , Conte G. , Pallanti S. , Vita A.
Published: August 2008

The incidence of traumatic events during the first ten years of life was investigated in two groups of patients suffering from major affective disorder, as well as in mixed psychiatric patients and in healthy subjects. While there were no significant differences between the two groups of affective patients or between the two control groups, the incidence of subjects who underwent such trauma was significantly higher in depressives, compared with controls. These differences are small and are further reduced if events secondary to psychiatric disturbances of family members are excluded.
The Evaluation of Illness Behaviour and Exaggeration of Disability
Authors: Clayer J. R. , Bookless-Pratz C. L. , Ross M. W.
Published: August 2008

The evaluation of illness behaviour can be complicated by subjective influences in either the patient or the clinician; these often arise in the evaluation of persons seeking compensation for injuries in which the symptoms are apparently exaggerated. The present study attempts to assess the usefulness of the CE Scale in determining the degree of conscious exaggeration by compensation claimants. Comparisons were made between psychiatrists' clinical evaluations of claimants and the scores obtained on this scale. The relationship between these two measures was found to be significant at the 1% level and specificity and sensitivity for less than 25% exaggeration on psychiatrists rating with a CE Scale cut-off of 11.69% and 100% respectively: for less than 34% exaggeration, they were 88% and 83%.
Cross-national Invariance of Dimensions of Parental Rearing Behaviour
Authors: Arrindell Willem A. , Perris Carlo , Perris Hjördis , Eisemann Martin , van der Ende Jan , von Knorring Lars
Published: August 2008

A psychometric study on Swedish and Dutch samples used the EMBU, a self-report instrument designed to assess memories of parents' rearing behaviour. Of the four primary factors identified previously with Dutch individuals (Rejection, Emotional Warmth, Over-protection, and Favouring Subject), the first three were retrieved in a similar form in the two Swedish groups (depressives and healthy, non-patients). Examination of the metric equivalence of the scales and the strength of the factors for each group indicated that comparisons of patterns and levels between groups from the respective countries on the three factors showing cross-national constancy would be warranted. Scale-level factor analyses of these dimensions produced identical two-factor compositions (CARE and PROTECTION) across national groups which further supported this conclusion.
Brain Indicators of Altered Attention and Information Processing in Schizophrenic Patients
Authors: Barrett K. , McCallum W. C. , Pocock P. V.
Published: August 2008

Late components of brain event-related potentials reflect aspects of selective attention, stimulus evaluation, and possibly memory update mechanisms. Several of these components were measured during an auditory target detection task, performed by 20 schizophrenic and 20 normal subjects. Both the amplitude of those components and a more general late amplitude measure were significantly reduced in schizophrenics, for both target and non-target stimuli. One general late amplitude measure, from the scalp vertex, could alone correctly classify 85% of patients and 95% of controls. The source of these differences may lie in a protracted positive potential shift.
Occupational Mental Health—A Neglected Service
Authors: Mickleburgh W. E.
Published: August 2008

There is insufficient information on the prevalence of psychological morbidity in the workplace. The theoretical base of industrial psychiatry is traced here, and examined within a framework of systems analysis, the input being identified in terms of human and social factors. Internal processes of organisation and management produce conditions of practice which determine the health status of the workplace; some statutory protection is necessary to safeguard mental health in industry.
Diagnostic Significance of Vegetative Symptoms in Depression
Authors: Davidson Jonathan , Turnbull Craig D.
Published: August 2008

The diagnostic importance of vegetative symptoms for melancholia was examined through DSM-III, the Newcastle Scale, and Extracted Criteria for melancholia. Statistically significant differences were diagnostically unimpressive in the case of DSM-III and the Newcastle criteria. With the Extracted Criteria, initial insomnia, early waking, anorexia, weight loss, loss of libido, and worsened mood in the morning were all significantly more common in melancholia than in non-melancholic depression, while increased appetite was more common in non-melancholia. Only diurnal variation of mood (worse in the morning) showed predictive value for melancholia; whereas the other traditional vegetative symptoms (disturbed sleep, weight, and libido) did not. Increased appetite and diurnal variation of mood (worse in the evening) were predictive for non-melancholia.
A Double-Blind Gluten-Free/Gluten-Load Controlled Trial in a Secure Ward Population
Authors: Vlissides Dimitrios N. , Venulet Andrzej , Jenner Frederick A.
Published: August 2008

A double-blind control trial of gluten-free versus a gluten-containing diet was carried out in a ward of maximum security hospital: 24 patients were studied for 14 weeks. Most suffered from psychotic disorders, particularly schizophrenia. Various dimensions of behaviour were rated on the Psychotic In-Patient profile (PIP) at different stages. There were beneficial changes in the whole group of patients between pre-trial and gluten-free period in five dimensions of the PIP, maintained during the gluten challenge period; these changes could be attributed to the attention the patients received. Two patients improved during the gluten-free period and relapsed when the gluten diet was reintroduced.
The Measurement of Body Image Disturbances in Anorexia Nervosa
Authors: Fichter Manfred M. , Meister Irmgard , Koch Hans-Joachim
Published: August 2008

Body image disturbances in anorexia nervosa patients have been assessed in an experimental study which dealt with the following issues: (1) Three different procedures for the assessment of body image disturbances were compared in a discriminant function analysis: (a) a Video Monitor Procedure, (b) the Movable Caliper Procedure and (c) the Image Marking Procedure. The Image Marking Procedure showed the best discrimination between groups. (2) Anorexia nervosa patients showed a statistically significant over-estimation as compared to the control group in the variables ‘waist’, ‘upper thigh’ and the compound measure ‘soft body parts', while they did not overestimate control variables (Kruskal-Wallis-Rank-Analysis of Variance). (3) A standard liquid meal of 240 Kal. had no statistically significant influence on the estimation of body width, irrespective of the amount of calories consumed and instruction given. Possibilities and limitations of various measurement procedures are discussed.
Mindlessness and Brainlessness in Psychiatry
Authors: Eisenberg Leon
Published: August 2008

The theme of this address—that brain and mind are as warp and woof in the fabric of psychiatry—may seem so much a truism as to be a banal choice. I think not. Despite the lip service paid to brain-mind integration, its implications are daily contravened in both theory and practice. At least, this is so in the country where I reside. If the problem is more extreme in the States, as most everything seems to be, recall the words Sir Aubrey Lewis (1953) wrote in commenting on Anglo-American contrasts, some 30 years ago: “the chief differences between your psychiatric scene and ours are differences only of quantity and tempo.” Think of me, then, as an anthropologist describing an exotic foreign culture and reporting on the strange customs of the natives, in hope of shedding light on your own.
A Multivariate Investigation of Postpartum Mood Disturbance
Authors: Gard P. R. , Handley Sheila L. , Parsons A. D. , Waldron Gillian
Published: August 2008

The interrelationships of ‘blues' and later postpartum depression with a number of biochemical, medical, and psychosocial variables have been examined in 52 subjects. The two syndromes shared only an impressive association with a prior history of gynaecological problems. Puerperal ‘blues' was characterised in addition by associations with primiparity, tearfulness during pregnancy, and reduced plasma total tryptophan in the early Puerperium. Depressive symptomatology up to nine months postpartum was related to an excess of male births and to an altered pattern of decline of non-esterified fatty acids immediately postpartum. In each case, the ‘risk’ variables were statistically independent and combined linearly. Stepwise discriminant analysis successfully discriminated ‘blues' and depression from their respective non-cases. ‘Blues and postpartum depression were only weakly related and, apart from gynaecological history, each was associated with separate and independent causative factors.
Positive and Negative Symptoms in Psychiatry
Authors: Trimble Michael R.
Published: August 2008

The terms positive and negative symptoms have slipped into the language of contemporary psychiatry with comparative ease. It is not uncommon for these expressions to be used with little explanation, both at meeting and in written communications, with the implicit understanding that their meaning is understood and that somehow they are of value to our knowledge of psychopathology. However, that there are no clear guide-lines at present for our use of these terms is shown from a recent survey of psychiatrists' opinions from a market research company (Martin Hamblin Research-Personal Communication). As part of a series of questions asked to many psychiatrists of differing age, geographical location, and status, they were asked about the meaning of these terms, positive and negative symptoms and the proportion of schizophrenic patients having them. Of the categories quoted by Crow (1980–81) as positive symptoms, 68% considered that delusions were positive symptoms, 63% hallucinations, and only 35% thought disorder. In contrast, 18% thought that behaviour disturbance was a positive symptom, a similar figure (15%) being given for passivity feelings. Considerable variation was noted, however, with hallucinations being considered positive by only 33% of London psychiatrists, thought disorder by only 11% of those qualified 16–25 years, and one-quarter of all registrars and psychiatrists from Midland Health Districts considered passivity feelings to fall into this category. Even greater disagreement was recorded for negative symptoms. Thus, the symptom most often associated with this category was apathy, by 52% of respondents. Only 26% considered that withdrawal was a negative symptom, the percentage data for lack of motivation and blunting of affect being 37% and 15% respectively.
Comparative Effects of Seven Antidepressant Regimes on Appetite, Weight and Carbohydrate Preference
Authors: Harris Brian , Young John , Hughes Bill
Published: August 2008

Appetite, weight, and preference for carbohydrate-containing food were followed in patients treated in double-blind trials of seven antidepressant regimes. Trimipramine and isocarboxazid combined had a significant effect in increasing appetite, carbohydrate preference, and weight; in patients who had lost appetite at presentation and were on this treatment, improvement in Hamilton score was linked to increase in weight–a finding not true of the other treatments.
Levels of Expressed Emotion and Relapse in Depressed Patients
Authors: Hooley Jill M. , Orley John , Teasdale John D.
Published: August 2008

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Left between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations.
Prevalence of the Fragile X Syndrome in an Institution for the Mentally Handicapped
Authors: Primrose David A. , El-Matmati Rabia , Boyd Elizabeth , Gosden Christine , Newton Marjorie
Published: August 2008

In an investigation to find the prevalence of the fragile X (Martin Bell) syndrome in a mental handicap hospital, chromosomal investigations were carried out in 196 males selected out of a total of 512, and also in 20 female patients who were related to some of the selected males. Fragile X cells were found in 41 of the males and two of the females; in 21 of the males it was associated with macro-orchidism. The overall prevalence in the hospital for males (8.0%) ranks this syndrome next in importance to Down's syndrome as a known cause for mental handicap.
A Comparison of Drug-Related Problems in London Accident and Emergency Departments 1975–1982
Authors: Ghodse Hamid , Stapleton John , Edwards Griffith , Bewley Thomas , Al-Samarrai Muhammad
Published: August 2008

Drug-related incidents dealt with by ten Accident and Emergency departments in Greater London during July 1982 were compared with those obtained from an identical survey in 1975. The number of incidents remained high, but there was a significant reduction in them and in the number of drug dependent attenders, compared with 1975: hynotic drugs were used in a significantly smaller percentage of drug overdoses, but there was increased use of minor tranquillisers. The possibility of using A & E departments to monitor drug misuse on a Regional basis is discussed.
What Happens when Psychiatric Out-Patients are seen Once Only?
Authors: Gask Linda
Published: August 2008

The outcome of 30 new psychiatric outpatient consultations at which the psychiatrist decided to see the patient once only was examined after 3 months. Patients were referred from general practice, and evaluation was primarily from the viewpoint of practitioners; the majority were satisfied with a single consultation. However, only about half the patients were seen again by their GPs within the 3-month period, and most of the treatments recommended by the psychiatrists were not carried out by the GPs. Suggestions are offered to ameliorate this disturbing state of affairs.
Threatening Life Events in the Onset of Schizophrenia, Schizophreniform Psychosis and Hypomania
Authors: Chung Rhoderic K. , Langeluddecke Pauline , Tennant Christopher
Published: August 2008

In a study of cases of recent onset of schizophrenia, schizophreniform psychosis and hypomania (DSM-III criteria), threatening life events were significantly related to the onset of schizophreniform psychosis but not schizophrenia. The results also suggest that threatening events may precipitate hypomanic episodes.
Does Propranolol have an Antipsychotic Effect?
Authors: Manchanda Rahul , Hirsch Steven R.
Published: August 2008

Thirty-six acute schizophrenics were randomly assigned to dextro (d)-propranolol or placebo in a double blind trial lasting four weeks. All patients had a fixed dose of haloperidol during the first week, which resulted in an initial improvement in both groups. Thereafter, a deterioration towards base-line was seen. Six patients on placebo, but none on propranolol were treatment failures at the end of three weeks (P < 0.001). Comparison of change in scores from week 2 to 4 showed significantly greater deterioration in the placebo group; d-propranolol thus had a better effect than placebo in sustaining the initial improvement with haloperidol. The overall magnitude of clinical change from pre-treatment scores is small, the majority of the patients showing little or no overall improvement. It is concluded that d-propranolol has a detectable therapeutic effect, which by inference must have a novel pharmacological basis, but this is not as potent as standard neuroleptics.
Asperger's Syndrome and Tourette Syndrome
Authors: Kerbeshian Jacob , Burd Larry
Published: August 2008

We review the English-language literature on Asperger's syndrome (AS), with particular reference to diagnostic criteria and differentiation from infantile autism and personality disorders, and describe six cases seen in practice; all met DSM-III criteria for ‘atypical pervasive developmental disorder’. Three also developed Tourette syndrome: the co-occurrence of the two disorders, and methods of intervention, are discussed.
Lithium Augmentation in the Treatment of Delusional Depression
Authors: Pai M. , White A. C. , Deane A. G.
Published: August 2008

Five patients suffering with delusional depression, and who were resistant to tricyclic antidepressants, were successfully treated with lithium carbonate. Delusional depression does not usually respond to tricyclic antidepressants, and ECT has been considered the treatment of choice. Such patients often refuse to acknowledge that they are ill. They, therefore, understandably often refuse to accept ECT. In order to treat, the Mental Health Act 1983 must be invoked. Treatment with lithium carbonate is more acceptable to most patients, and in the cases described, patients agreed to take this drug whereas they had refused to accept ECT.
Different Causative Factors in Different Forms of Schizophrenia
Authors: Leonhard Karl
Published: August 2008

Definite conclusions about the origin of schizophrenia concerning hereditary as well as psychosocial factors can be obtained when different forms of schizophrenia are investigated separately.
Control of Auditory Hallucinations through Occlusion of Monaural Auditory Input
Authors: Birchwood Max J.
Published: August 2008

A schizophrenic patient whose severe level of auditory hallucinations had proved refractory to neuroleptic medication was given two treatment techniques derived from Green's theory that hallucinations represent verbal activity in the non-dominant hemisphere. Voice activity was markedly reduced in frequency and severity over a six-month period, and led to general improvements in interpersonal functioning. There was evidence for independent and additive effects of the two techniques.
‘Demand Characteristics' in Body-Size Estimation in Anorexia Nervosa
Authors: Proctor Linda , Morley Stephen
Published: August 2008

We asked 24 patients with anorexia nervosa and 30 normal controls to estimate their body-size several times, each time using different instructions. The degree of over-estimation was found to vary predictably with the wording of the instructions. Informing the subject that she had made an error without specifying the direction of the error resulted in reduced over-estimation on a subsequent trial, for both anorexics and controls. ‘Internally directed’ instructions were associated with a greater degree of over-estimation than ‘external’ instructions in both groups, but particularly in anorexic subjects. Our results indicate the necessity of controlling the ‘demand characteristics' of such experiments.
A Controlled Assessment of Propranolol in the Treatment of Neuroleptic-Induced Akathisia
Authors: Adler Lenard , Angrist Burt , Peselow Eric , Corwin June , Maslansky Robert , Rotrosen John
Published: August 2008

Twelve patients with neuroleptic-induced akathisia were treated in a randomised, double-blind, cross-over design with propranolol and matching placebo. Propranolol caused significant decrements in both subjective and objective ratings of akathisia, but not in anxiety scores. This confirms prior findings of the efficacy of propranolol in akathisia induced by neuroleptic treatment.
Autism and Autistic-like Conditions in Swedish Rural and Urban Areas: a Population Study
Authors: Steffenburg Suzanne , Gillberg Christopher
Published: August 2008

The total population of children under 10 years in one Swedish urban area and one rural area was screened for infantile autism (IA) and autistic-like conditions (AC). A total prevalence of 6.6 per 10 000 was found, which is somewhat higher than in previous similar studies of the same region. Infantile autism accounted for two-thirds of the cases. Boys far outnumbered girls, but this was entirely accounted for by the IA group. The preponderance of autistic boys was less pronounced among the severely mentally retarded children. Mental retardation was seen in almost 90% of cases and only one child had an IQ exceeding 100; clinical and laboratory signs of brain dysfunction were also found in a majority of cases. Distribution by social class was no different in either patient group from the general population.
Two Stage Design in a Community Survey
Authors: Vázquez-Barquero J. L. , Díez-Manrique J. F. , Peña C. , Quintanal R. G. , Lopez M. Labrador
Published: August 2008

By comparison with the PSE-ID system, we showed that the GHQ-60 could be used with good results as a screening instrument in the first of a two stage community survey. Unlike the sensitivity and negative predictive values, the specificity and positive predictive rates reach low figures in this study. The global efficiency and positive and negative predictive values of the test are significantly improved by raising its cut-off score, but at the expense of great reduction in sensitivity. The revised scoring system failed to provide better prediction of caseness' than conventional scoring. The GHQ does not distinguish fully between persons in the community afflicted by ‘transient states of distress' and those whose symptoms would classify them as cases' by the PSE.
Community Care of the Acutely Mentally Ill
Authors: Hoult John
Published: August 2008

Deinstitutionalisation is a two-part process: the first involves discharging patients from hospital to the community, which has been done in many countries. The second part—the provision of adequate resources for good community care—has still to materialise almost everywhere. In New South Wales, the inpatient mental hospital population dropped by two-thirds in 20 years, yet the total number of hospital staff increased considerably during this time; on the other hand, in the community, where most of the patients are, there are relatively few staff. This has important consequences: it means that for many patients, their episode of illness has to progress unchecked until it is of sufficient severity for them to be admitted to hospital. When that happens, there will then be enough staff to give them good quality care, so that their symptoms can subside, but afterwards there will again be hardly anyone available to help maintain them and to prevent relapse.
Witchcraft and Psychotherapy
Authors: Neki J. S. , Joinet B. , Ndosi N. , Kilonzo G. , Hauli J. G. , Duvinage G.
Published: August 2008

Belief in witchcraft, which serves a variety of social functions and personal defences, is bound to emerge in psychotherapy with individuals from a culture that holds such beliefs; endeavouring to understand it can open up new therapeutic possibilities. The nature of witchcraft, the profiles with which it intrudes into therapy, and the socio-psychological functions it fulfills are considered. Referring such patients to witchdoctors is morally unjustifiable, but the witch-doctor's folk-image provides a floating transference, around which the therapeutic relationship can be built. In dealing with witchcraft-ideation, understanding is based as much on cultural as on personal empathy, and to enhance its relevance, therapy may appropriate some of the functional dynamics of the witchcraft system into its own therapeutic manoeuvres.
Family Background of Children with Down's Syndrome and of Children with a Similar Degree of Mental Retardation
Authors: Gath Ann , Gumley Dianne
Published: August 2008

The families of Down's Syndrome children and another group with a similar degree of retardation were compared using data collected at interview. Differences in social class distribution were explained by the maternal age effect in the Down's group. Divorce was more common in the control group but the quality of marriage in those parents still together and the health of parents were similar. No close associations were found between behaviour disorders in the children and family factors, except that behaviour disorders were likely to be associated with similar disturbance in siblings next in age and to be more common in the less happy marriages.
Conditioning and Sensitisation in the Longitudinal Course of Affective Illness
Authors: Post Robert M. , Rubinow David R. , Ballenger James C.
Published: August 2008

Few biological theories of manic-depressive illness have focused on the longitudinal course of affective dysfunction and the mechanisms underlying its often recurrent and progressive course. The authors discuss two models for the development of progressive behavioural dysfunction—behavioural sensitisation and electrophysiological kindling—as they provide clues to important clinical and biological variables relevant to sensitisation in affective illness. The role of environmental context and conditioning in mediating behavioural and biochemical aspects of this sensitisation is emphasised. The sensitisation models provide a conceptual approach to previously inexplicable clinical phenomena in the longitudinal course of affective illness and may provide a bridge between psychoanalytic/psychosocial and neurobiological formulations of manic-depressive illness.
Alterations in Cerebral Laterality during Acute Psychotic Illness
Authors: Wexler Bruce E.
Published: August 2008

A new dichotic listening test (fused rhymed words) was used to monitor changes in perceptual asymmetry (PA) in patients recovering from acute psychotic episodes; some were also given a dichotic nonsense syllables test, a dichotic tone test, and a single visual field dot localisation test. Contrary to expectation, PA on the word test decreased with recovery, while asymmetry on the tone and dot tests did not change; results cut across diagnosis, could not be related to medication, and were independent of changes in overall performance. More specific hypotheses are needed than those of generalised single hemisphere dysfunction in major psychiatric illness, but existing models and concepts are inadequate to explain the findings.
Orofacial Dyskinesia, Cognitive Function and Medication
Authors: Thomas Philip , McGuire Ralph
Published: August 2008

The presence of tardive dyskinesia in a sample of 43 patients with schizophrenia and 37 psychopaths who had been hospitalised for many years and exposed to large amounts of medication was assessed while testing their cognitive function. Subjects who showed no evidence of abnormal movements performed significantly better on the test of delayed recall, but there were no differences in performance on any of the other tests of cognitive function used. Multiple regression analysis revealed that age and the total lifetime dose of neuroleptic medication received (in chlorpromazine equivalents) were the only variables to predict the Abnormal Involuntary Movement Scale score, although a large amount of variance in this variable was unaccounted for. The duration of treatment with neuroleptics did not predict AIMS score.
Depression in Schizophrenia: A Study of Prevalence and Treatment
Authors: Elk R. , Dickman B. J. , Teggin A. F.
Published: August 2008

In an investigation of white, coloured, and black patients admitted to a psychiatric hospital, the prevalence and treatment of depression in schizophrenia was assessed and found to be 30% in group of acute, nuclear schizophrenics. While the prevalence was similar in the three groups, depression was clinically under-detected in black patients.
Mental Illness Among Immigrant Minorities in the United Kingdom
Authors: London M.
Published: August 2008

Cross-cultural studies on immigrants from Pakistan and the New Commonwealth are reviewed, with emphasis on epidemiology and differences in clinical presentation. Their referral to the psychiatric service is also examined and deficiencies are noted. Awareness of transcultural issues among health professionals need to be increased in order to achieve diagnosis and improvements in health care.
Monitoring of Long-Term Motor Activity in Depressed Patients
Authors: Royant-Parola S. , Borbely A. A. , Tobler I. , Benoit O. , Widlöcher D.
Published: August 2008

Wrist motor activity was continuously recorded by a solid-state monitor in 12 patients with major depression throughout their stay in hospital; their clinical state was evaluated using three scales. During the day, activity troughs and immobility peaks occurred before noon and around 1500 hrs. Activity level progressively increased, while the duration of immobility decreased, with clinical improvement. The immobility measurement appeared to be a valuable index of depression and is more sensitive than the activity level, mainly for agitated depressed patients. Immobility episodes during the day could suggest the release of an ultradian sleep-wake rhythm in depression.
Applied Relaxation Training for Generalised Anxiety and Panic Attacks:
Authors: Tarrier Nicholas , Main Chris
Published: August 2008

The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practise at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect.
Panic Attacks: New Approaches to an Old Problem
Authors: Gelder M. G.
Published: August 2008

Anxiety attacks were included in the first descriptions of the syndrome of anxiety neurosis. Recently it has been suggested that such attacks (now usually called panic attacks) characterize a distinct form of anxiety disorder—panic disorder, it has also been proposed that panic attacks result from a biochemical disorder and require pharmacological treatment. Some of the evidence for these ideas is presented, and two other explanations for panic attacks are reviewed: that they are caused by hyperventilation, and that they result from a cognitive disorder. It is concluded that although it is not possible on the present evidence to choose between the three theories, there is strong indirect support for the cognitive theory and good reason to investigate cognitive factors more thoroughly. Future work on biochemical causes of, and pharmacological treatments for panic attacks should take account of such factors.
A Survey of Practising Psychiatrists' Views on the Treatment of Schizophrenia
Authors: Andrews S. , Vaughan K. , Harvey R. , Andrews G.
Published: August 2008

Practising psychiatrists' views about the treatment of schizophrenia were investigated as part of a Quality Assurance Project. A questionnaire which asked for treatment recommendations for each of four case descriptions of patients with schizophrenia was mailed to a one-in-six random sample of Australian psychiatrists; 90% responded. Psychiatrists almost uniformly advocated the use of antipsychotic drugs and usually recommended concurrent supportive psychotherapy or family/social intervention procedures. The recommendations varied systematically, according to the initial history obtained and to the initial response to treatment.
Paranoid Reaction and Underlying Thyrotoxicosis
Authors: Kamlana S. H. , Holms L.
Published: August 2008

Woodbury (1918) described the manifestations of Graves' disease as fatigue, irritability, intolerance to heat, fine tremor, restlessness, insomnia, excitability, labile emotional disposition, nervousness, weight loss, palpitations, doubts, and fears. Similarly, Sachar (1975) included nervousness (manifested as apprehension, restlessness, and inability to concentrate), marked emotional lability, and hyperkinesis as the most common presenting symptoms. That fatigue, irritability, emotional instability, and excitability are all common features of the hyperthyroid state, as are episodes of severe and often disabling anxiety, is therefore, accepted. On the other hand, no clear picture exists concerning any fixed constellation of psychotic symptoms or progression of psychiatric disease. The psychiatric presentations vary from a delirious state to periods of hyperexcitability simulating mania that alternate with periods of exhaustion and depression. Greer & Parsons (1968) reported that some patients do. however, develop a clear schizophrenia-like picture, closely associated with the course of hyperthyroidism, with prominent paranoid symptoms and no pre-morbid history of psychosis.
The Continuum of Psychosis and its Implication for the Structure of the Gene
Authors: Crow T. J.
Published: August 2008

Three observations challenge Kraepelin's binary view of the functional psychoses: a bimodal distribution of the clinical features of manic-depressive illness and schizophrenia has not been demonstrated; affective illness appears to predispose to schizophrenia in later generations; and “schizoaffective’ illnesses cannot be separated in family studies from either of the prototypical psychoses. The alternative concept is that psychosis is a continuum extending from unipolar, through bipolar affective illness and schizoaffective psychosis, to typical schizophrenia, with increasing degrees of defect. According to this concept the genes predisposing to psychosis have a degree of stability that ensures that the form of the psychosis tends to remain the same within families, but there is also the possibility of change, implying that the genetic mechanisms themselves are variable. It is proposed that quantal changes in the “virogene’ are due to replications within the genome (e.g. the generation of tandem repeats of the element or a component of it); that such replications occur at a critical stage (e.g. gametogenesis, fertilisation, very early embryogenesis) in the course of reproduction; and that the “season of birth effect’ reflects the operation of the mechanism responsible for these replications.