bluuebunny/crossref_metadata_2025 huggingface dataset:
A Controlled Study to Evaluate Directed Masturbation in the Management of Primary Orgasmic Failure in Women
Authors: Riley Alan J. , Riley Elizabeth J.
Published: August 2008

This paper presents the results of a prospective controlled study evaluating a programme of directed masturbation against a combined sensate focus and supportive psychotherapeutic approach in the management of female primary orgasmic failure. Of the 20 patients who followed the masturbation programme 90 per cent gained orgasmic capacity compared with 53 per cent of 15 patients who were treated conventionally. Eighty-five per cent of the patients treated by the masturbation programme and 47 per cent of the control group of patients became coitally orgasmic on at least 75 per cent of coital occasions. The difference is statistically significant at the 5 per cent level. The results suggest that directed masturbation is an effective adjunct in the management of primary female orgasmic failure.
The Two-Year Predictive Validity of the Clifton Assessment Schedule and the Shortened Stockton Geriatric Rating Scale
Authors: Pattie A. H. , Gilleard C. J.
Published: August 2008

Assessment of cognitive and behavioural disability on 100 elderly psychiatric admissions was carried out by means of the Clifton Assessment Schedule and the Shortened Stockton Geriatric Rating Scale. The results provided useful predictive indices, confirming the relationship between cognitive impairment and unfavourable outcome at two-year follow up.
Size of Cerebral Ventricles in 66 Psychiatric Patients
Authors: Van Boxel P. , Bridges P. K. , Bartlett J. R. , Trauer T.
Published: August 2008

The routine air ventriculograms of 66 psychiatric patients, aged from 22 to 73 years, taken during the psychosurgical operation of stereotactic subcaudate tractotomy, were studied. Ventricular size was unrelated to progressive ageing, but a minority of patients over 60 years had abnormally large ventricles, not invariably associated with cognitive impairment on testing. Enlargement was associated with a clinical diagnosis of schizoaffective illness but not with past ECT.
Stresses upon the Relatives of Head-Injured Patients
Authors: Oddy Michael , Humphrey Michael , Uttley David
Published: August 2008

As part of a prospective study of closed head injury, 54 relatives were interviewed within a month of the patient's accident and again six and twelve months later.

The degree of stress on the relatives was measured by means of the Wakefield Depression Scale and by interview questions.

The worst period of stress for the majority of relatives appeared to be during the first month after the accident. However, the degree of stress appeared to level off by the sixth month and no further diminution was found at twelve months.

Stress was apparently mediated by the relatives' perception of personality changes and subjective defects. It was not affected by the severity of the head injury or associated disabilities, nor by whether the patient had resumed work and leisure activities.

The nature of the stress is analysed and methods of alleviating it discussed.
Actual Practice of ECT in a Health Region of Britain
Authors: Lambourn J. , Murrills A. J.
Published: August 2008

A field study of 14 treatment centres found broad agreement between clinical practice and the Royal College of Psychiatrists' Memorandum on the use of ECT. Differences in electrode placement and anaesthetic agents and a poor standard of safety and reliability in the electrical equipment was noted.
Humans and Pets and Attachment
Authors: Rynearson E. K.
Published: August 2008

The bond between human and pet depends on their commonality as animals and their mutual need for attachment. Under abnormal circumstances of developmental frustration a human may displace an overdetermined need for attachment to the pet. The attachment relationship is pathological because of its defensive purpose, and its interruption can create enduring psychiatric reactions. The paper details the developmental determinants for this interaction.
British Policies on Opiate Addiction
Authors: Edwards Griffith
Published: August 2008

It is now ten years since the Drug Clinics were set up. In the early 1960's a long established equilibrium broke down, and the number of narcotic addicts known to the Home Office began to rise steeply. The new addicts were predominantly in their early 20's, and drugs were being obtained either from the over-generous prescribing of a handful of doctors or from the spill-over of this prescribing to the black market (Bewley, 1965 (1), 1966 (2)). Heroin was the essential agent of this epidemic, with cocaine as the major ancillary.
Delinquency by Opiate Addicts Treated at Two London Clinics
Authors: Wiepert G. D. , D'Orbán P. T. , Bewley Thomas H.
Published: August 2008

455 male and 120 female opiate addicts were treated at two London drug dependence clinics between 1968 and 1975. The delinquency pattern of 117 female addicts and of a systematic sample of 119 male addicts was analysed in relation to stages of their addiction career and outcome. Treatment had no effect on overall crime rate but there was a significant increase in the proportion of drug offences during the treatment stage. Comparisons between the sexes showed that the outcome of treatment was worse in women. In male addicts a history of delinquency had no prognostic significance, but in females convictions for non-drug offences before entering treatment might predict poor response to treatment of drug dependence.
Schizophrenia: Diagnostic Criteria and Outcome
Authors: Bland Roger C. , Orn Helene
Published: August 2008

The files of a cohort of schizophrenic patients who were admitted to hospital for the first time in their lives in 1963, and who were representative of cases in a large unselected population, were examined, first by exclusion criteria, and then by the diagnostic criteria of Schneider's first-rank symptoms, Feighner et al's criteria, and the New Haven Schizophrenia Index (NHSI). Forty-three such cases were found who were schizophrenic on at least two sets of criteria, and who were followed up in 1977. Examination of the outcome showed no relationship with FRS presence or absence or number of first-rank symptoms, nor with the NHSI score, but did show a relationship to the Feighner et al criteria and an even stronger relationship to a simple score derived from these criteria.
The Sensory Filter in Schizophrenia: A Study of Habituation, Arousal, and the Dopamine Hypothesis
Authors: Horvath Thomas , Meares Russell
Published: August 2008

The possible failure of a notional sensory filter in schizophrenia was studied by means of habituation of the orienting response. Non-paranoid schizophrenics failed to habituate, but paranoids habituated normally. Paranoids, however, showed a different impairment: they responded to a dishabituating tone as if the novel stimulus were somewhat familiar.

The failure of habituation in non-paranoids could not be explained in terms of arousal when the index was the rate of skin conductance fluctuation. Neurotic controls showed considerably higher levels than either group of schizophrenics.

Non-paranoid schizophrenics had lost the normal inverse relationship between habituation and level of arousal as manifested in the rate of spontaneous skin conductance fluctuation.
Disturbances in Body Image Estimation as Related to Other Characteristics and Outcome in Anorexia Nervosa
Authors: Casper Regina C. , Halmi Katherine A. , Goldberg Solomon C. , Eckert Elke D. , Davis John M.
Published: August 2008

Body image distortion in 79 female anorexia nervosa patients were examined on a visual-size estimation apparatus during the emaciated stage of illness. Both they and an age-matched female control group overestimated their body widths, so this overestimation cannot be considered unique to anorexia nervosa. Among anorexia patients the degree of overestimation was associated with less weight gain during treatment, greater denial of illness, and several other pretreatment characteristics indicative of poor outcome.
Comparisons of Weight Concepts in Groups of Neurotic, Normal and Anorexic Females
Authors: Fransella Fay , Crisp A. H.
Published: August 2008

A group of normal women and a group of women in hospital for treatment of a neurosis but without a disorder of eating were compared with a group of anorexic patients in terms of their attitudes to weight. All subjects completed a rank order form of repertory grid. Differences in construct patterning between the anorexic patients and the other female groups could not be accounted for by social class, age or neurotic disorder. The most psychologically significant finding was a positive correlation between the constructs self at normal weight and ideal weight instead of a negative correlation which clinical experience would lead one to expect. Four explanations are proposed to account for this finding.
Offspring of Patients with Affective Disorders
Authors: McKnew Donald H. , Cytryn Leon , Efron Alina M. , Gershon Elliot S. , Bunney William E.
Published: August 2008

All the children (ages 5–15) of 14 consecutive patients admitted to hospital at the National Institute of Mental Health with a diagnosis of bipolar or unipolar affective disorder were studied. The children were seen twice, four months apart, and assessed by an interview and rating scales. The parents were also assessed. Of 14 boys, five were depressed on both interviews and three were depressed on one interview. Four of the 16 girls were depressed on both interviews and 11 were depressed on one interview. The clinical picture and the ratings showed the boys, but not the girls, to have a significant correlation for depression on both interviews. The children diagnosed as suffering from depression showed the symptoms of a primary unipolar affective disorder without other significant pathology.
Mixed Affective States and the Natural History of Manic-Depressive Psychosis
Authors: Nunn C. M. H.
Published: August 2008

Since neither the unipolar nor the bipolar theories of manic-depressive psychosis explain all its features, an alternative model was tested. The hypotheses are that mixed affective psychoses represent a superimposition on hypomania of a second type of depression which can sometimes develop from the depressive phase of manic-depressive psychosis, and that schizophrenia occurring in the course of a manic-depressive illness is an alternative to mixed affective psychosis.

From an examination of the clinical histories of a random sample of people with bipolar manic-depressive psychosis, evidence was found to support both ideas.
Depression — Clinical Aspects
Authors: Paykel E. S.
Published: August 2008

‘Include suggestions for reading which you consider to be important, memorable, relevant, unusual, informative—or whatever’, said the Book Review Editor, his own wording meeting several of these criteria. The informative literature on depression is vast, so that a comprehensive review is not to be considered. I present here an arbitrary selection of what has seemed personally useful or memorable, with a bias, for maximum information value, from each reference, to books and review articles. Apologies for the many fine works of equal quality which have been left out.
Consciousness, Information Processing and Schizophrenia
Authors: Frith C. D.
Published: August 2008

The symptoms of schizophrenia can be interpreted as the result of a defect in the mechanism that controls and limits the contents of consciousness. This defect can be understood as excessive self-awareness. Normally most of the complex information processing which is continuously required by even simple acts of perception, language and thought goes on below the level of awareness; whereas in schizophrenic patients some of this processing, or the results of this processing, not in themselves abnormal, become conscious. This excessive awareness can account for the typical symptoms of schizophrenia and explains many of the specific cognitive abnormalities found in schizophrenic patients.
Self-Poisoning — A Complication of Epilepsy
Authors: Mackay A.
Published: August 2008

From 1972 to 1976 130 epileptics presented 171 times to the Western Infirmary, Glasgow, as medical emergencies with self-poisoning. They constituted 3.5 per cent of 3,733 patients poisoning themselves on 4,121 occasions. Repetition of self-poisoning was commoner in epileptics (18.5 per cent) than in non-epileptics (7.0 per cent). The 130 epileptics have been compared with a non-epileptic group of self-poisoners matched for age, sex, and number of repetitions and have been found to have less alcohol excess but significantly more psychopathy. Possible explanations and prophylactic measures are discussed. In view of the relative incidence of epilepsy and self-poisoning in the community, and of epilepsy among self-poisoners in this and other studies, it is concluded that self-poisoning is a common complication of epilepsy.
Sexual Disturbances in Temporal Lobe Epilepsy: A Controlled Study
Authors: Shukla G. D. , Srivastava O. N. , Katiyar B. C.
Published: August 2008

Seventy cases each of temporal lobe epilepsy and grand mal epilepsy were studied for their sexual functioning. The two groups were similar as regards age, sex, duration of illness, frequency of seizures and menstrual and marital history.

A significantly greater number of temporal lobe epileptics were found to be hyposexual. They had a global loss of performance and interest in the sexual sphere and showed no concern over it.

One case in the group of temporal lobe epilepsy, as against none in the other group, was hypersexual. There were no cases of sexual deviations in either of the groups.

The findings of the study are discussed in the light of the relevant literature.
Morbid Jealousy Featuring as Obsessive-Compulsive Neurosis: Treatment by Behavioural Psychotherapy
Authors: Cobb J. P. , Marks I. M.
Published: August 2008

Morbid jealousy can occasionally be indistinguishable from obsessive-compulsive neurosis and then be partially amenable to broad-spectrum behavioural treatment. This can involve the partner and includes (a) methods to reduce jealousy and (b) other methods where appropriate, such as social skills training, and sex and marital therapy. This pilot study describes such treatment of four jealous out-patients. Rituals improved in three patients but ruminations in only one. Of three patients who were depressed at the start of treatment, two improved in rituals and in mood. The patient who failed was poorly motivated and did not comply with treatment.
Torticollis caused by an Infratentorial Tumour: Three Cases
Authors: Boisen Erik
Published: August 2008

Three cases with torticollis caused by an infratentorial tumour are presented. A father and his son both had a Lindau tumour, and another patient had an ependymoma.

It is stressed that torticollis may be the predominant or only sign of an infratentorial tumour, and that torticollis should always be suspected to have an organic origin.
Electroconvulsive Therapy in Sweden
Authors: Frederiksen Svend-Otto , D'Elia Giacomo
Published: August 2008

In spite of a decrease in the number of electroconvulsive treatments (ECT) administered during the decade 1966–1975, ECT is still commonly used in Sweden. About 4 per cent of all patients admitted for psychiatric treatment during 1975 received ECT. Affective disorders and confusional states appear to be the main indications. Treatment is usually unilateral, with general anaesthesia and muscle relaxants, generally using the same type of ECT machine.
Hospitals, Madhouses and Asylums: Cycles in the Care of the Insane
Authors: Allderidge Patricia
Published: August 2008

The received version of the history of the care of the insane consists largely of myth and folklore, tempered by a strong dash of wilful ignorance, and is capable of absorbing any number of incongruous features. It runs roughly as follows, give or take a century or two here or there (which is about the accepted level of precision): from the dawn of history, or just before, or just after, until about the middle of the nineteenth century, nothing happened at all: or (depending on where you received your version) the mentally disordered were indiscriminately exorcised, or burnt, or left to wander at will, or chained up and beaten, or all four. From the middle of the nineteenth century they were all rounded up and driven into enormous asylums (where, according to a subtle sociological variation, mental illness was invented) and were left to vegetate until the 1950s. Around 1960 dawned the enlightenment, and it was suddenly revealed that everything that had ever happened before—whatever it was—was completely wrong, and probably intentionally malicious too: and over the years following there were gradually also revealed a number of brand-new ways of putting it right, all different and mutually incompatible (not to mention expensive), and revealed respectively to different Departments of State, working parties, committees and unions—or sometimes successively to the same one.
The Nature and Origin of Common Phobic Fears
Authors: Torgersen Svenn
Published: August 2008

By means of a twin study an attempt was made to throw light upon the aetiology and nosology of phobic fears. Factor analyses revealed five factors, namely separation fears, animal fears, mutilation fears, social fears and nature fears. The study demonstrated that, apart from separation fears, genetic factors play a part in the strength as well as content of phobic fears. Environmental factors, affecting the development of dependence, reserve and neurotic traits generally, seemed also to be of some importance. It was further demonstrated that phobic fears were related to emotional and social adjustment and this was true to an even greater extent for separation fears.
Agoraphobia: a Follow-up Study Four Years After Treatment
Authors: Emmelkamp Paul M. G. , Kuipers Antoinette C. M.
Published: August 2008

Seventy agoraphobic out-patients were followed up prospectively for four years after treatment; the improvements manifested during treatment were found to be maintained and partly augmented. At the end of follow-up, 75 per cent of the patients had improved on the main phobia. No clear relationship was found between external control, social anxiety, depression and duration of the complaint at the beginning of treatment on the one hand and the results at follow-up on the other. The disorders remained phobic, no other neurotic symptoms having developed during the follow-up period.
Motivation, Responsibility and Sickness in the Psychiatric Treatment of Alcoholism
Authors: Davies Phil
Published: August 2008

Two dominant themes of alcohological thinking and practice are considered in this paper; the disease concept and the concept of motivation. Both are examined in terms of (a) the rights, obligations and responsibilities associated with different types of illness and degrees of severity, and (b) the routine care and treatment of alcoholism in two out-patient alcoholism clinics. The allocation of responsibility and attribution of motivation in psychiatric alcoholism consultations are examined. Finally, the relationship between responsibility allocation, motivation attribution and judgements of a potentially moral nature is considered. It is concluded that a Mutual Participation model of sickness behaviour and doctor-patient relationship is operative in the psychiatric treatment of alcoholism, based upon patients' self-responsibility and strength of character (willpower). In this respect, the psychiatric treatment of alcoholism contrasts with other (particularly non-psychiatric) conditions and treatments.
Finger Tremor and Extrapyramidal Side Effects of Neuroleptic Drugs
Authors: Collins Paul , Lee Ian , Tyrer Peter
Published: August 2008

Finger tremor and extrapyramidal side-effects (EPSEs) were measured in seven patients before and during neuroleptic drug treatment to assess the relationship between the onset of EPSEs and changes in finger tremor spectra. Tremor and EPSEs were also measured in twelve patients stabilized on neuroleptic drugs to determine whether tremor could provide a reliable index of the presence and severity of extrapyramidal system disturbance. A downward shift in peak tremor frequency was noted within 48 hours of starting neuroleptic drug therapy, usually before the onset of EPSEs, and a significant negative relationship between the severity of EPSEs and tremor frequency (but not tremor amplitude). The peak frequency of finger tremor is thus a sensitive index of extrapyramidal disturbance and might be of value in predicting which patients taking neuroleptic drugs need anti-parkinsonian therapy.
Averaged Evoked Responses in Relation to Cognitive and Affective State of Elderly Psychiatric Patients
Authors: Hendrickson Elaine , Levy Raymond , Post Felix
Published: August 2008

Averaged cortical evoked responses to auditory and somatosensory stimuli were recorded in elderly depressives, dements, patients with a combination of depression and dementia and normal elderly controls. The subjects were also given a battery of cognitive tests and clinical ratings at stated intervals.

The latency of the auditory response was significantly longer in dements than in controls. Depressives had intermediate latencies which did not return to normal after recovery. Although somatosensory stimuli produced the results that pointed in the same direction, the mean response latencies were not statistically significant. Mixed cases were too few for separate statistical analysis but their latencies fell between those of the dements and those of the depressives.

Significant correlations emerged between latencies of auditory responses and some cognitive tests, but not with measures of depressive symptomatology.

The delay in response to auditory stimuli may be a useful adjunct to diagnosis: in depressives it may reflect organic cerebral change playing a part in the emergence of depressive symptoms in old age.
Reality Orientation and Staff Attention: a Controlled Study
Authors: Woods R. T.
Published: August 2008

A trial was carried out of Reality Orientation (R.O.) in a residential home for the elderly mentally infirm with a ‘social therapy’ control group, receiving the same amount of staff attention as the R.O. group, in addition to an untreated control group. R.O. residents improved more on tests of information and orientation and various aspects of memory than controls. These results support the hypothesis that the nature of staff attention is crucial and that it should encourage and reward appropriate behaviour. No differential effects of treatment were found on rating scale assessments of the residents' functioning in the home.
Problems of Repertory Grid Analysis and a Cluster Analysis Solution
Authors: Goodge Peter
Published: August 2008

Statistical and requirement difficulties encountered with existing methods of Repertory Grid Analysis are considered. A simple purpose-built method of Cluster Analysis is outlined, and its extension to the difficult problem of comparative analysis described.
On the Transmission of Dementia: A personal view of the slow virus problem
Authors: Corsellis J. A. N.
Published: August 2008

I came across Creutzfeldt-Jakob disease within a few weeks of starting work in the neuropathological laboratories at the Maudsley Hospital. The time was the 1940's, and Alfred Meyer, who had known both Creutzfeldt and Jakob in Germany, had already published his study on the possible link between amyotrophic lateral sclerosis and Creutzfeldt-Jakob disease (or spastic pseudosclerosis of Jakob as it was then called). Meyer's interest in the condition was therefore well known to British psychiatrists and neurologists, and patients who were thought to be suffering from this illness were referred to him. Routine post-mortem examinations would be duly carried out, perhaps by the psychiatric staff, and the brain, sometimes with the spinal cord, would be hardened in formalin and sent in a parcel to the Maudsley laboratories.
Women who Kill their Children
Authors: D'Orbán P. T.
Published: August 2008

During a 6 year period (1970–75) 89 women charged with the killing or attempted murder of their children were examined in a female remand prison. Six types of maternal filicide were distinguished: battering mothers (36 cases), mentally ill mothers (24 cases), neonaticides (11 cases), retaliating mothers (9 cases), women who killed unwanted children (8 cases) and mercy killing (1 case). Types of filicide were compared on a number of social and psychiatric characteristics and on their offence patterns and court disposals. The operation of the Infanticide Act is discussed in the light of these findings.
Severity of Psychiatric Disorder and the 30-Item General Health Questionnaire
Authors: Finlay-Jones Robert A. , Murphy Elaine
Published: August 2008

The 30-item General Health Questionnaire misclassified 26 per cent of respondents in two samples of women who were interviewed by a psychiatrist using the Present State Examination. False negatives were likely to be women with chronic disorders, particularly anxiety states. False positives were likely to be distressed by severe physical illness, a recent adverse life event, or loneliness. Applying a higher threshold score to their GHQ, responses would help to separate those with a diagnosable psychiatric disorder from those in states of distress.
Dependency upon Salbutamol Inhalers
Authors: Edwards J. Guy , Holgate S. T.
Published: August 2008

A case of dependency on salbutamol inhalers has been described. This has been discussed in relation to abuse of other drugs by alveolar absorption and other effects of salbutamol. It is not known whether the dependency is due to the salbutamol itself or to the fluorinated hydrocarbons used as propellants.
Gilles de la Tourette's Syndrome: Report of Five Cases in the Chinese
Authors: Lieh-Mak F. , Luk S. L. , Leung L.
Published: August 2008

Five cases of Gilles de la Tourette's syndrome occurring in the Chinese are described. The onset, course, symptomatology and family psychopathology are similar to those reported in Caucasians. On the parameters of APGAR score, psychological testing, EEG and psychiatric examination all had at least one abnormality. The response to haloperidol was uniformly good. Follow-up results showed that all were able to lead a fairly normal life after treatment. Though the cases are few in number, the findings seem to support the hypothesis that the syndrome has an organic substratum subject to psychological influences.
Consanguinity and Schizophrenia in Sudan
Authors: Ahmed Ahmed Hassan
Published: August 2008

The rate of first-cousin marriages among the parents of schizophrenics was compared with a control group in an isolated highly inbred Sudanese community, no significant difference being found.
Treatment Settings in Psychiatry: Long-term Family and Social Findings
Authors: Robin A. A. , Copas J. B. , Freeman-Browne D. L.
Published: August 2008

Treatment in a psychiatric unit, as distinct from a psychiatric hospital, held no benefits in the long term (5–8 years after admission) as far as the patient's mental and behavioural status and employment, or the family's burdens, health needs or attitude were concerned. Schizophrenic patients from both settings received more hospital treatment and medication, were more often unemployed, and had more adverse effect on relatives' health than neurotic or depressive patients. Hospital attendence identified relatives who expressed a need for support.
Hostility and Guilt in Obsessive-Compulsive Neurosis
Authors: Manchanda Rahul , Sethi Brij B. , Gupta Suresh C.
Published: August 2008

The enquiry relates to the investigation of 30 cases of obsessive-compulsive neurosis with special reference to the phenomena of hostility and guilt as revealed through Foulds' Five Punitive Scales and the Thematic Apperception Test. Controls consisted of an equal number of subjects suffering from neurotic depression. Analysis reveals acting-out hostility and extrapunitive tendency in the experimental group. No significant difference was found in terms of guilt scores.
Increased Serum Calcium and Phosphorus with the ‘Switch’ into Manic or Excited Psychotic States
Authors: Carman John Scott , Post Robert M. , Runkle Deborah C. , Bunney William E. , Wyatt Richard Jed
Published: August 2008

Small but statistically significant increases in serum total calcium and serum inorganic phosphorus coincided with repeated onsets of psychotic agitation or mania in nine psychotic in-patients experiencing rapid cycles of illness. These increases were not accompanied by changes in magnesium or other constituents, which might suggest non-specific haemoconcentration. Similar increases in calcium or phosphorus were not present in patients without the same cycles of psychotic illness. The observed increases could neither be simulated nor altered by stress or activity, and it remains unclear whether they might be accounted for by dietary changes, sleep disruption, circadian phase shifts or by endocrine alterations.
The use of Screening Investigations in Psychiatry
Authors: Thomas C. J.
Published: August 2008

This is a study of the results of screening tests on all new psychiatric in-patients over a period of one year. Although none of the results indicated definite physical causes for the psychiatric illness, 10 per cent of the tests revealed abnormalities resulting from or co-incidental with the psychiatric illness. Of these abnormal results 61 per cent led to no further investigation or treatment, and the significance of this is discussed.
An XYY Man
Authors: Cowen Philip , Mullen Paul E.
Published: August 2008

This case report describes a young man with a 47, XYY karyotype who was convicted of arson. He suffered from a cardiac disorder which may well have been part of the XYY syndrome rather than a chance association. His abnormal karyotype was disclosed in court and used by the defence in a plea in mitigation.
Compulsory Admission to Hospital: An Operational Review of the Mental Health (Scotland) Act 1960
Authors: Elliott William A. , Timbury Gerald C. , Walker Margaret M.
Published: August 2008

The working of the Mental Health (Scotland) Act 1960 is examined by analysis of compulsory admissions both nationally and to one Glasgow hospital. Comparisons are drawn with England and Wales. Despite a six-fold increase in admissions since 1945 the use of compulsory powers has remained almost constant. It is suggested that an annual number of 45 compulsory admissions per 100,000 population may represent an inevitable basic level as foreseen by the Royal Commission in 1957. Section 31 (‘Emergency Recommendation’) secures 80 per cent of Part IV admissions, and Section 24 (‘Full Recommendation’) is employed in only 25 per cent. Part V accounts for only 300 admissions per annum, mostly remands for psychiatric report. Two suggestions are made for possible future amendments to the Act.
Psychiatrists' Assessments of Mental Illness
Authors: Bean Philip
Published: August 2008

The labelling theory of mental illness and particularly that version formulated by Thomas Scheff has been applied to psychiatry. Studies completed by Scheff have produced considerable evidence to support labelling theory. An attempt is made here to determine to what extent labelling theory applies to a group of British psychiatrists. The results give little support to Scheff's position.
The EEG and Differential Diagnosis in Psychogeriatrics
Authors: O'Connor K. P. , Shaw J. C. , Ongley C. O.
Published: August 2008

A model for differentiating cerebral dysfunction in senile, arteriosclerotic dementia, and depressive states is proposed on the basis of electrocortical topographic measures of EEG coherence. Bipolar EEGs were recorded from central, parietal, occipital and temporal areas in 24 elderly patients with a firm clinical diagnosis of senile dementia, senile arteriosclerosis or depression. Power and coherence spectra were computed on 20 second epochs recorded during eyes open, eyes closed and photic stimulation. Significant group differences were reported in both power and coherence measures. Power results were uniform for all channels but coherence values differed significantly with derivation. The best discriminator between groups was EEG coherence estimates between right parietal and temporal derivation. Correlations between clinical symptomatology and EEG coherence supported the direction of the discrimination between groups. The EEG coherence function is discussed as a potential measure of neuro-functional pathology in psychiatry.
High Dose Flupenthixol Decanoate in Chronic Schizophrenia
Authors: McCreadie R. G. , Flanagan W. L. , McKnight J. , Jorgensen A.
Published: August 2008

In a double-blind trial, female ‘drug-resistant’ chronic schizophrenic in-patients were given high dose or standard dose flupenthixol decanoate for 13 weeks. Plasma flupenthixol levels showed a five-fold interindividual variation, but were consistently higher with the high dose. Analysis of final scores showed no statistically significant differences between groups with regards to mental state, ward behaviour and extrapyramidal side-effects. When compared with pre-trial scores, the extrapyramidal side-effects worsened significantly in the high dose patients and social withdrawal decreased in the standard dose patients. The mental state of a sub-group of patients, possibly drug resistant for pharmacokinetic reasons, improved significantly on the high dose over the 13 weeks.
Artistic Productivity and Lithium Prophylaxis in Manic-Depressive Illness
Authors: Schou Mogens
Published: August 2008

Twenty-four manic-depressive artists, in whom prophylactic lithium treatment had attenuated or prevented recurrences to a significant degree, were questioned about their creative power during the treatment. Twelve artists reported increased artistic productivity, six unaltered productivity, and six lowered productivity. The effect of lithium treatment on artistic productivity may depend on the severity and type of the illness, on individual sensitivity, and on habits of utilizing manic episodes productively.
Assessment of Patients for Psychotherapy
Authors: Bloch Sidney
Published: August 2008

Factors in the patient which have been commonly cited by therapists as relevant in assessment for psychotherapy are examined as well as the research done on them. These factors are discussed under four categories: (a) factors related to the illness, (b) personal factors related to the treatment, (c) personal factors not directly associated with the illness and (d) current life circumstances. Research on methods of assessing patient suitability is discussed together with an account of the reasons for the rather disappointing contribution of systematic research.
The Distinction Between the Affective Psychoses and Schizophrenia
Authors: Brockington I. F. , Kendell R. E. , Wainwright S. , Hillier V. F. , Walker J.
Published: August 2008

In an attempt to demonstrate a valid boundary between schizophrenia and the affective psychoses, discriminant function analyses have been carried out with history, mental state and follow-up data in two populations of patients. A bimodal distribution of discriminant scores was obtained in one of them (a general psychotic sample of 128 patients), using a discriminant function derived from the same sample; but when the function was applied to the second population (a schizoaffective sample of 106 patients) the distribution was ambiguous. Functions derived from the schizoaffective sample produced highly skewed distributions of discriminant scores in the general psychotic sample.

Kraepelin's hypothesis that the functional psychoses consist of two distinct disease entities receives some support from our findings, but there is still no compelling evidence that the universe of psychotic patients falls naturally into these two groups.
Thiamine and Pyridoxine Lack in Newly-Admitted Psychiatric Patients
Authors: Carney M. W. P. , Williams D. G. , Sheffield B. F.
Published: August 2008

One hundred and fifty four patients admitted to a general hospital psychiatric unit with a history of poor diet were examined. Serum pyruvate was estimated in all, red cell transketolase in 74 and red cell aspartate transaminase in 66. Significantly more of the 58 abnormally low thiamine patients than of the normal thiamine group showed clinical signs of malnutrition or were diagnosed as chronic alcoholics, drug addicts, schizophrenics or endogenous depressives. Significantly more endogenous depressives than other patients had a raised aspartate transaminase activity coefficient (pyridoxine lack.) While most low thiamine findings are probably manifestations of malnutrition pyridoxine lack may have some aetiological significance in endogenous depression.
Controlled Studies of the Acute Antidepressant Effects of Lithium
Authors: Worrall E. P. , Moody J. P. , Peet M. , Dick P. , Smith A. , Chambers C. , Adams M. , Naylor G. J.
Published: August 2008

In two randomized double-blind controlled trials on 63 depressed female in-patients subject to recurrent affective disorder (bipolar and unipolar manic-depressive psychosis) lithium was shown to have major acute antidepressant effects. At the end of three weeks lithium produced more uniform improvement than did imipramine; lithium in combination with tryptophan (in the form of Optimax) was superior to tryptophan alone—the latter drug having no discernible antidepressant activity in this group of patients.

Lithium did not produce an antidepressant effect until the second and third week of both trials.
Samaritan Contact Among 325 Parasuicide Patients
Authors: Greer Steven , Anderson Marion
Published: August 2008

With the aim of aiding primary prevention of parasuicide by Samaritans, a study of 325 parasuicide patients admitted to hospital was undertaken to discover the extent of knowledge about Samaritans, the proportion of patients who had contacted Samaritans and the reasons why the remainder had not done so. Ignorance about Samaritans was found in 28 per cent, such ignorance being significantly more common among teenagers than in other age groups. Only 1.4 per cent had sought help from Samaritans immediately before the present parasuicidal act, though a further 13 per cent had contacted Samaritans previously. Suggestions are made for future public education programmes about Samaritans.
The Prevalence and Clinical Presentation of Psychiatric Illness in a Rural Setting in Kenya
Authors: Ndetei David M. , Muhangi Joseph
Published: August 2008

One hundred and forty patients seen in a suburban walk-in walk-out clinic over a period of 30 days were studied. Twenty-eight (20 per cent) of them were found to be primarily psychiatrically disabled, 83 (59.3 per cent) primarily physically disabled and the diagnosis of the rest (20.7 per cent) was uncertain. The psychiatric patients were found to be suffering from anxiety and depressive states. Their sex, age, education, economic status, symptomatology and duration of the illness were analysed.

The findings suggest among other things that the prevalence of psychiatric disorders in the rural setting in Kenya is high and therefore calls for a proportionate provision of mental health care facilities. They also suggest that anxiety and depression in African patients are masked by somatic symptoms, often leading to unnecessary delays in diagnosis and management.
A Case of Tranylcypromine (‘Parnate’) Addiction
Authors: Ben-Arie O. , George G. C. W.
Published: August 2008

A case of addiction to tranylcypromine is described where tolerance occurred and a severe withdrawal illness followed discontinuation of the drug. Previous reports in the literature of similar cases are reviewed and comparisons made, and the implications for management are discussed.
A Better Outlook for Schizophrenics Living in Extended Families
Authors: El-Islam M. Fakhr
Published: August 2008

Cases of schizophrenia and schizophreniform attacks living in extended families have been compared to cases with similar diagnoses in nuclear families. Both diagnostic groups living in extended families presented earlier; they had lower rates of withdrawal symptoms and higher rates of behavioural disturbances and subjective suffering. Inter-generational conflict was a significantly more common precipitating factor in patients living in extended families; this was therapeutically utilized to induce family support. Patients from extended families had a lower tendency to deteriorate into withdrawn, affectively blunted residual states.
Clinical Significance of Plasma Drug and Prolactin Levels During Acute Chlorpromazine Treatment: A Replication Study
Authors: Kolakowska Tamara , Orr Michael , Gelder Michael , Heggie Manuela , Wiles David , Franklin Michael
Published: August 2008

Nineteen patients with acute psychoses, the majority schizophrenics, were studied in the course of chlorpromazine (CPZ) treatment. Plasma levels of the drug, plasma prolactin (PRL), extrapyramidal side-effects (EPS) and changes in mental state were monitored weekly, as in our earlier study. The results confirm some of our previous findings: (a) plasma CPZ levels vary widely among patients and correlate poorly with daily doses of CPZ; (b) increased plasma PRL is associated with higher plasma CPZ levels and is more common among the patients who develop EPS; and (c) none of these three variables differ between groups of patients with good and poor treatment outcome. However we did not confirm our previous finding of a significant association between EPS and higher plasma CPZ, nor did we find that the ratio of CPZ-sulphoxide to CPZ differed between the improved patients and the rest.
Five Variations of Sleep Deprivation in a Depressed Woman
Authors: Knowles J. B. , Southmayd S. E. , Delva N. , MacClean A. W. , Cairns J. , Letemendia F. J.
Published: August 2008

Systematic variation in aspects of the sleep-wakefulness cycle of a depressed woman showed that recovery occurred reliably after 19 to 20 hours sustained wakefulness, unrelated to diurnal rhythm. Depression returned during as little as 15 minutes sleep. The effect of sleep deprivation was a specific response, probably unrelated to REM sleep.
Degree of Sobriety in Male Alcoholics and Coping Styles used by their Wives
Authors: Schaffer Jack B. , Tyler John D.
Published: August 2008

The ‘Coping With Drinking’ questionnaire, administered to 124 A1-anon members, was factor analyzed and revealed nine identifiable styles of coping. Multiple regression analyses between three measures of sobriety and each of the nine styles of coping factors provide support for the general hypothesis that the coping styles used by wives of alcoholics are related to drinking outcome. Further, those modes of coping in which the wife communicates her feelings of distress and frustration to the drinking husband in a way which is minimally threatening for him seem to be most positively related to his attainment of sobriety.
The Hierarchy Model of Psychiatric Symptomatology: An Investigation Based on Present State Examination Ratings
Authors: Surtees P. G. , Kendell R. E.
Published: August 2008

Psychiatric diagnoses are arranged in a rough hierarchy, generally regarded as a convention to enable patients with a wide range of symptoms to be allocated to single diagnostic categories. Foulds, on the basis of self-report questionnaire responses, claimed that patients with symptoms at the higher levels of this hierarchy not only may but characteristically do exhibit symptoms at all lower levels as well. Foulds’ hierarchy model was tested here, using PSE ratings from two large series of in-patients; at least 75 per cent fulfilled the requirements of the model, but up to 50 per cent of schizophrenic and manic patients failed to do so. Almost two-thirds of all patients with psychotic symptoms establishing them in one of the upper two classes of the hierarchy did not exhibit the neurotic symptoms they required lower in the hierarchy.
Pharmacotherapeutic Trials in Tardive Dyskinesia
Authors: Mackay Angus V. P. , Sheppard Graham P.
Published: August 2008

Some of the clinical factors contributing to the currently unsatisfactory state of therapy for tardive dyskinesia are reviewed. Problems such as lack of clear syndrome delineation and phenomenological description, the lack of standardization in rating scales and the lack of attention to trial design have all probably contributed to a rather confusing picture. Controlled trials suggest that several pharmacological agents may be of therapeutic value but that clinical prediction of an individual's response is impossible. The strategy of acute drug challenge has emerged as perhaps the most promising approach to the definition of pharmacological subtypes and therefore the choice of optimal treatment.
Tardive Dyskinesia and Dementia
Authors: Famuyiwa O. O. , Eccleston D. , Donaldson A. A. , Garside R. F.
Published: August 2008

Seventeen schizophrenic patients with tardive dyskinesia (TD) and 33 schizophrenics without tardive dyskinesia were examined by psychological tests of intellectual function and EMI scans were performed. The group as a whole were found to be demented and 31 out of 45 had abnormalities on the scan. On a learning test the tardive dyskinesia group did significantly worse and using a measured parameter of the scan (the Ventricular Index) the tardive dyskinesia group had more abnormality. It is suggested that the higher incidence of pathology in the tardive dyskinesia group may be related to chronic neuroleptic toxicity.
Metoclopramide and Haloperidol in Tardive Dyskinesia
Authors: Bateman D. N. , Dutta D. K. , McClelland H. A. , Rawlins M. D.
Published: August 2008

The effect of single intravenous doses of metoclopramide (10 mg, 20 mg and 40 mg) and haloperidol (5 mg and 10 mg) have been compared to placebo (saline) in a double blind randomised study in 8 patients with tardive dyskinesia secondary to neuroleptic therapy. Tardive dyskinesia rating scores were improved significantly (P <0.01) 6 hours after dosing by metoclopramide 40 mg, and haloperidol 5 mg and 10 mg, when compared to placebo. Single doses of dopamine receptor blocking agents improve tardive dyskinesia. The dose of metoclopramide required to show a beneficial effect was high, and this therefore suggests that it is unlikely to be of therapeutic value as the incidence of adverse reactions would be greatly increased. By monitoring the effects of single doses of dopamine receptor blocking drugs in patients with tardive dyskinesia it is possible to compare the relative potencies of these drugs on dopaminergic systems in vivo in man.
Tardive Dyskinesia in Psychiatric Patients Treated with Neuroleptics
Authors: Perris Carlo , Dimitrijevic Predrag , Jacobsson Lars , Paulsson Paul , Rapp Walter , Fröberg Hans
Published: August 2008

The point prevalence of tardive dyskinesia (TD) as assessed by means of the Simpson rating scale was determined for 14 psychiatric wards with 347 patients (213 and 134 female) at the time of the study. TD was found to occur in 17.3 per cent of the patients, the prevalence being significantly higher in female than in male patients. The frequency of TD increases with age.

A random group of TD patients was matched with a group of patients without TD and the total medication for both groups was calculated. No differences were found as concerns total amount of high or low dosage neuroleptics, or anticholinergic drugs, for the two groups. However, significantly more TD patients than controls had received dosage neuroleptics, or anticholinergic drugs for the two groups. However significantly more TD patients than controls had received anticholinergic drugs.

There was no significant relationship between severity of TD: age, duration of treatment, total amount of high or low dosage neuroleptics. On the other hand a significant relationship was found between severity of TD and amount of anticholinergic drugs. Significantly more patients in the TD-group than in the control group had a past history which might suggest possible brain damage prior to the neuroleptic medication.