bluuebunny/crossref_metadata_2025 huggingface dataset:
DST in healthy volunteers and after sleep deprivation
Authors: Klein H. E. , Seibold B.
Published: August 2007

ABSTRACT– The dexamethasone suppression test (DST) was performed in 46 healthy volunteers and repeated in nine of them following total sleep deprivation (TSD). While only 2 postdexamethasone cortisol values were insufficiently suppressed (> 5 μg%) in control DSTs, 5 postdexamethasone cortisol values were above 5 μg% following TSD. The mean postdexamethasone value was increased from 1.55 ± 1.06 to 4.47 ± 5.86 μg% following TSD at 8.00 h. The authors conclude that sleep deprivation as a therapeutic approach and prolonged sleeplessness may bias DST results.
Urinary free cortisol secretion in habitually violent offenders
Authors: Virkkunen M.
Published: August 2007

ABSTRACT– Male violent offenders (n= 90) and residivious arsonists (n= 10) were investigated by urinary (24 h) free cortisol measurements at mental examination on a psychiatric department. The measurements were made with competitive protein‐binding radioassay. Only among the habitually violent offenders with antisocial personality were the values low when compared with other violent offenders, antisocial personality without the habitually violent tendency, and male clinic personnel. Poor motivation already in school, truancy, attention deficit and undersocialized aggressive conduct disorder problems seemed to be connected with the low cortisol levels.
Psychiatric effects of cannabis use
Authors: Tunving K.
Published: August 2007

ABSTRACT– That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and “amotivation” following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychtropic effects of cannabis.
Too many chronic mentally disabled patients are too fat
Authors: Gopalaswamy A. K. , Morgan R.
Published: August 2007

ABSTRACT– In a survey of 190 chronic mentally disabled patients we found a significantly higher prevalence of overweight and obesity in both sexes, especially women, compared with the general population. The apparent causes were overeating, underactivity, ignorance of correct dietary principles and the differential effects of various psychotropic drugs which we were able to measure. Some preventive ideas are suggested.
A case of Tourette syndrome treated with nifedipine
Authors: Berg R.
Published: August 2007

ABSTRACT– A 22‐year‐old man with severe Tourette syndrome successfully treated with nifedipine is described. Controlled studies are called for.
A study of the septum pellucidum and corpus callosum in schizophrenia with MR imaging
Authors: Mathew R. J. , Partain C. L. , Prakash R. , Kulkarni M. V. , Logan T. P. , Wilson W. H.
Published: August 2007

ABSTRACT– Surface areas of the septum pellucidum, corpus callosum and the brain were measured from mid‐saggital slices obtained with magnetic resonance imaging in 18 patients with schizophrenia and an equal number of normal volunteers. The patients showed larger septa and septo‐brain ratios. These indices correlated with age in both patients and controls. In the patients, septal area also correlated with duration of illness. Changes in the septum pellucidum were unrelated to the intensity of positive and negative symptoms of schizophrenia. The patients had significantly longer corpora callosa, but the two groups did not differ on its size or the ratio between the latter and the mid‐saggital slice area. Dimensions of the corpus callosum did not correlate with age, duration of the illness or positive and negative symptoms of schizophrenia. The anteroposterior elongation of the structure seemed to accompany enlargement of the septum pellucidum.
Characterizing anger in the DSM‐III borderline personality disorder
Authors: Snyder S. , Pitt W. M.
Published: August 2007

ABSTRACT– Anger has traditionally been described as the most intense and prevalent affect in the borderline patient. This study was designed to characterize anger in the borderline patient in an in‐depth analysis by determining whether inpatients with DSM‐III borderline personality disorder differed from controls with dysthymic disorder. Standardized rating instruments including subscales of the Profile of Mood States, Brief Psychiatric Rating Scale, and Minnosota Multiphasic Personality Inventory were utilized. Results generally indicated that borderline patients manifested more severe anger than dysthymic controls. The findings are discussed in light of previous psychodynamic, empirical, and research literature.
The prevalence of psychiatric morbidity in mentally retarded adults
Authors: Lund J.
Published: August 2007

ABSTRACT– 302 mentally retarded adults, sampled by epidemiological criteria, were examined with regard to handicaps, behaviour, skills and psychopathology by use of the MRC HBS‐schedule and a list of psychiatric items. Based on research criteria, a computerized psychiatric diagnosis was made on a hierarchical scale. A psychiatric disorder was diagnosed in 85 (27.1%), which is a smaller prevalence rate than found in other studies. Next to behaviour disorder (10.9%), psychosis of uncertain type (5%) was the most common disorder. Dementia and early childhood autism were found equally often (3.6% each). Neurosis was seldom (2%), while schizophrenia (1.3%) and affective disorder (1.7%) occurred at about the same rates as found in similar investigations. No cases of alcohol or drug abuse were found.
Prefrontal cortex dysfunction as a common factor in psychosis
Authors: Muller H. F.
Published: August 2007

Abstract It has recently become possible to arrive at a testable bio‐psychological model, according to which a dysfunction of the prefrontal cortex is the common factor in psychotic disorders; if persistent, this leads to a dissolution of the highest level of brain function, in the sense of Hugh‐lings Jackson. The model is in agreement with newer findings in normal and pathological physiology and can serve as basis for specific experimental questions. It is compatible with a unitary epistemological viewpoint.
Prevalence of psychological disorders in the Athens area
Authors: Madianos M. , Vlachonikolis I. , Madianou D. , Stefanis C.
Published: August 2007

Abstract A two‐phase cross‐sectional study on the prevalence of psychological disorders was carried out in a sample of 1,574 adult male and female residents of two boroughs in the greater Athens area. The analysis focused on the detection of any possible effects (risk factors) that personal data (such as sociodemographic profile, use of psychiatric services, medication and experience of stressful life events) may have on mental health; information about the latter was assessed by Langner's scale. The findings are that all the independent variables investigated affect the respondents’ psychological status, although interactive effects between variables predicted different patterns of psych op athological symptom formation.
From clomipramine to mianserin: therapeutic relevance of interactions with serotonin uptake and storage, as studied in the blood platelet model
Authors: Lingjaerde Odd
Published: August 2007

Inhibition of active serotonin uptake into neurones and platelets is a common effect of tricyclic and related antidepressants, and has been regarded as one of the more important mechanisms of action of such drugs. However, as is shown in this survey, the antidepressants vary widely in their potency as inhibitors of platelet serotonin uptake, and they also differ in the type of inhibition kinetics, from purely competitive to mixed competitive/non‐competitive. The therapeutic relevance of this effect is discussed. Serotonin uptake inhibition seems to be one of several mechanisms for obtaining the required normalization of monoamine dysfunction in depression. Analysis of efflux from platelets preloaded with a moderate amount of 14C‐serotonin provides information on the storage and compartmentation of serotonin in the platelets, and on the rate of efflux from the different compartments. When present during the preloading phase, some antidepressants seem to produce a relative increase in serotonin in the granular storage compartment when compared to the smaller cytoplasmic compartment. This effect is in some respects opposite to that exerted by reserpine, and possibly may be pharmacologically relevant.
Treatment of childhood and adolescent depression with mianserin
Authors: Dugas Michel , Mouren Marie Christine , Halfon Olivier , Moron Pierre
Published: August 2007

The efficacy of mianserin in treating adult depression is now well established. Since there are no publications concerning the use of mianserin in children, the authors set up an open pilot study of 110 depressed children and adolescents aged 8–19 years. The average dose of mianserin was 1 mg/kg/day. Efficacy of treatment was noticeable by the end of the first week and was maintained throughout the 60 day study period. Evaluation was based on both clinical observations and changes in scores obtained from 80 subjects. Side‐effects were minimal leading to temporary withdrawal of treatment in only seven cases. The profile of mianserin in children and adolescents is similar to that of adults. It is an antidepressant with an anxiolytic component, and has a regulating effect on sleep. In view of its efficacy, compliance, and the very low incidence of side‐effects, mianserin appears to be a useful treatment for depression in children and adolescents. The results of this open study justify the development of further controlled studies.
Mianserin and imipramine in the treatment of elderly depressed patients
Authors: Eklund K. , Dunbar G.C. , Pinder R.M. , Steffensen K.
Published: August 2007

Fifty elderly depressed patients were randomly assigned to double‐blind treatment, using a flexible dose schedule, with either mianserin 20–60 mg or imipramine 75–150 mg. Medication was continued for four weeks. Eleven patients withdrew from the study. At the end of treatment there were no significant differences between mianserin and imipramine in antidepressant efficacy. A significantly greater number of side‐effects occurred in the imipramine group (dry mouth, days 7 and 14; faintness, dizziness, weakness, day 21). When treating elderly depressed patients mianserin may be preferred to imipramine because of a lower incidence of induced side‐effects.
Depression and anxiety: mianserin and nomifensine compared in a double‐blind multicentre trial
Authors: Granier F. , Girard M. , Schmitt L. , Boscredon J. , Oules J. , Escande M.
Published: August 2007

Mianserin and nomifensine were compared in 61 depressive patients in a randomized double‐blind multicentre study. During the first week the antidepressant dosages were low, mianserin 30 mg and nomifensine 50 mg. After the first week dosages were doubled to 60 mg and 100 mg respectively. At baseline there were no significant differences between treatment groups for sex, age, class of depression, previous treatment, somatic symptoms, previous vital events, global clinical appreciation, global sleep appreciation, and depression assessed on the Hamilton Depression Rating Scale (HDRS), Montgomery‐Asberg Depression Rating Scale (MADRS) or the Hamilton Anxiety Rating Scale (HARS). Assessments were made at 7, 14 and 28 days. There were no significant differences between treatment groups for HDRS, MADRS or HARS, either globally or when divided into endogenous and reactive subgroups. Compared with nomifensine there were significantly greater scores with mianserin for global clinical appreciation and global sleep appreciation. There were more withdrawals and dosage changes with nomifensine than with mianserin. Regarding concomitant treatment, significantly less anxiolytics were prescribed to the mianserin group. This study confirms that mianserin is an effective and sedative antidepressant whereas nomifensine is an effective and stimulating antidepressant.
Mianserin in the prophylaxis of migraine: a double‐blind study
Authors: Monro Pauline , Swade Cynthia , Coppen Alec
Published: August 2007

ABSTRACT‐

Evidence is reviewed indicating that instability in central nervous system handling of 5‐hydroxytryptamine may be of primary importance in the pathogenesis of migraine, and that the observed diminution of platelet content and uptake of 5‐hydroxytryptamine related to an attack may merely be a reflection of this. The rationale is discussed for selecting mianserin as a potentially effective migraine prophylactic based on: (i) its ability to restore to normal platelet 5‐hydroxytryptamine uptake when this is decreased in depression; (ii) its effect on the central nervous system; and particularly (iii) its antiserotonergic activity. A double‐blind control trial of mianserin versus placebo in the prophylaxis of migraine is described. There was a significant fall in both frequency and severity of migraine attacks when compared with baseline values in mianserin‐treated patients but not in placebo‐treated patients. There was no accompanying change on the Beck Depression Inventory. It is concluded that mianserin is an effective migraine prophylactic in some patients. There is no evidence indicating which pharmacological property of mianserin is responsible for thiseffect.
PATIENTS ADMITTED FOR COMPULSORY TREATMENT TO SELECTED PSYCHIATRIC UNITS IN ITALY AND IN SWEDEN
Authors: Perris C. , Kemali D. , Dencker S. J. , Malm U. , Rutz W. , Amati A. , Stancati G. , Morandini G. , Minnai G. , Maj M. , Gritti P.
Published: August 2007

Eighty‐five Italian and forty‐nine Swedish patients consecutively admitted for compulsory treatment to either an Italian or a Swedish psychiatric unit in selected areas of the two countries have participated in an exploratory study aimed at assessing the main characteristics of compulsory admitted patients, and in particular, the immediate reason for admission. The two series proved to be quite similar as concerns most sociodemographic variables, and as concerns clinical diagnosis and severity of the morbid condition at admission as measured by means of a rating scale. More Swedish than Italian patients lived alone when admitted to hospital, and for more of them the request for admission was made by other people than relatives, and a larger proportion of them was accompanied to the hospital by medical or social welfare personnel. In both series the largest proportion had a low educational level and belonged to the lower social groups. The same proportion in the two series had previous admissions. The most common reason for admission was “odd or improper behaviour” for the Swedish patients, and “feared or manifest dangerousness” for the Italian patients. The Italian patients remained at hospital on average half the time than the Swedish patients.
Family Factors that Antedate the Onset of Schizophrenia and Related Disorders: The Results of a Fifteen Year Prospective Longitudinal Study
Authors: GOLDSTEIN MICHAEL J
Published: August 2007

The present study evaluates, within the context of a prospective study, whether certain discrete, pathological styles of communication antedate the onset of schizophrenia and schizophrenia‐spectrum disorders. The three parental styles evaluated were: communication deviance (CD; Wynne & Singer), affective style (AS; Doane), and expressed emotion (EE; Vaughn and Leff). These measures were obtained on a sample of 64 intact families who appeared for help, from a psychological clinic, for their moderately disturbed teenager over 15 years ago. The sample of offspring and selected siblings were followed up at two subsequent time periods, 5 and 15 years after the initial family assessments at which times blind psychiatric evaluations were done. The lifetime prevalence of schizophrenia and schizophrenia‐spectrum disorders in the sample were evaluated.

Of the 64 teenagers, follow‐ups were feasible on 50 of the cases. Of these, 45 had all three parental measures available. Within that subsample, schizophrenia‐spectrum disorders were predominantly associated with the combined parental pattern of high CD, negative AS and high EE. When data for siblings was included, the predictive value of CD was even greater.

These findings strongly suggest that disturbed patterns of intrafamilial communication and affect expression antedate the onset of schizophrenia‐spectrum disorders and are not reactions to psychotic behaviors in already schizophrenic offspring.
Interaction of Genetic and Psychosocial Factors in Schizophrenia
Authors: TIENARI P , SORRI A , LAHTI I , NAARALA M , WAHLBERG K‐E , POHJOLA J , MORING J
Published: August 2007

What the genetic and family dynamic theory have in common, is that the cause of schizophrenia could be found in the family. Usually the genetic factors and the rearing factors are confounded in the same family. In a study of adoptive children given away for adoption early enough, discrimination between these two sets of factors is possible.

A nation‐wide sample of offspring of schizophrenic mothers, given away for adoption, has been compared blindly with matched controls, i.e., adopted‐away offspring of non‐schizophrenic biologic parents. The families have been investigated thoroughly with joint and individual interviews and psychological test. In the 91 pairs where both the index and control families have been investigated and rated so far, the total number of severe diagnoses (psychosis, borderline, character disorder) is 28.6% (26/91) in the index group and 16.5% (15/91) in the matched control group. Of the 7 psychotic cases, 6 are offspring of schizophrenics and only one a control offspring. The relation of psychopathology of adoptive families to the mental health ratings of the offspring supports the hypothesis that a possible genetic vulnerability has interacted with the adoptive rearing environment.
The Genetics of Schizophrenia: New Perspectives
Authors: BARON MIRON
Published: August 2007

Despite the evidence for genetic factors in schizophrenia, the underlying hereditary defect is unknown. The author reviews recent advances in genetic research methodologies and discusses their strengths and limitations. He concludes that in the face of genetic heterogeneity current models of segregation analysis are not likely to unravel the mode of inheritance of schizophrenia. The author underscores the potential contribution of both molecular genetics (as a means to generate DNA markers) and studies with biologic vulnerability traits to identifying and quantitating the genetic component in the transmission of schizophrenia.
Characteristics of a Nationwide Cohort of Psychiatric Patients ‐ With Special Reference to the Elderly and the Chronically Admitted
Authors: KASTRUP MARIANNE
Published: August 2007

The pattern of psychiatric care has changed over the last decades with an extension of outpatient facilities, a decrease in the number of chronically admitted and an increase in the number of shortlasting admissions. A cohort of firsttime admitted psychiatric patients to Danish institutions in 1970 was followed for 10 years with the purpose to describe the characteristics of the population with multiple admissions.

The cohort comprised 12737 patients with 35497 admissions. It was divided into 3 groups, one ‐ 6470 patients ‐ consisting of those with 1 admission, one ‐ 744 ‐ consisting of those continuously admitted to the termination of the study period or their death, and one ‐ 5523 ‐ consisting of those with several admissions.

Patients chronically admitted tended to be older, and among them the senile and cerebrovascular disorders were dominating with the non‐organic disorders in total comprising less than 10% of the patients. Significantly more females than males were admitted for more than 5 years. Patients with multiple admissions had in total shorter admissionperiods than the chronically admitted.

Males had significantly more admissions than females and 8.2% compared with 3.9% of females had 10 admissions or more.
Evaluation of Psychosocial Treatments
Authors: LÖNNQVIST JOUKO
Published: August 2007

The most widely chosen dimensions in the evaluation of psychosocial treatments are structure evaluation, process evaluation and outcome evaluation. The measurement of structure focuses on the inputs to a system intended for promoting mental health. The measurement oof process shows how the inputs are used. And finally the measurement of outcome gives information about the efectiveness of the treatment in the terms of outcome. Five basic questions of outcome evaluation are: appropariateness, adequacy, effectiveness, efficiency and side effects of the treatment. Using these concepts this article analyzes different parts of the treatment process and their evaluation. The emphasis is on the problems of evaluation o pscyhotherapy research and especially on outcome research in psychotherapy.
A Family System's Approach in Consultation Liaison Services
Authors: WIRSHING MICHAEL
Published: August 2007

Starting from difficulties in the cooperation of clinical and psychosocial medicine an alternative view is suggested following the principles of general system's theory and family therapy. The request for consultation is under such considerations regarded as the expression of an interactional crisis in which the whole system (patient, family and clinic) has become involved. Practical suggestions are made concerning the treatment setting, the methods of intervention and the initiation of an ongoing therapeutic contact.
Pharmacokinetic implications of different oil vehicles used in depot neuroleptic treatment
Authors: Knudsen Peder , Hansen Lars Bolvig , Larsen Niels‐Erik
Published: August 2007

On separate occasions two male schizophrenic inpatients were given intramuscular injections of equal amounts of perphenazine decanoate dissolved in sesame oil and Viscoleo, respectively.

Substantially more even, but also lower perphenazine plasma concentrations were found within the dose intervals following the injections of perphenazine decanoate dissolved in sesame oil compared to the intervals following the Viscoleo‐preparation.

The occurrence of extrapyramidal side effects were consistent with the magnitude of the perphenazine plasma concentrations. The results support the importance of selecting an appropriate oil vehicle in a depot neuroleptic.
Chemotherapy With Neuroleptics
Authors: Knudsen Peder
Published: August 2007

Attempting to improve long‐term neuroleptic treatment of schizophrenic patients several injectable depot neuroleptics have been developed. Moreover pharmacokinetic data increasingly have been clinically applied. On this background the purpose of the present paper has been to make an updated review of the clinical and pharmacokinetic knowledge of depot neuroleptic treatment.

First, general aspects of antipsychotics have been summarized, and an outline of methodological questions relevant to clinical‐pharmacological trials are given. Subsequently general aspects including pros & cons of depot administration are examined. Finally the available data of the various depot preparations have been scrutinized.

It is concluded that our present pharmacokinetic knowledge of the particular depot preparations is incomplete. Thus more information of clinical relevant aspects are needed, e. g., the existence of a therapeutic range, maximum/minimum concentration ratio, and the significance of active metabolites.

Comparing the various depot neuroleptics, no significant differences are seen regarding the clinical effects. However, the decanoate esters seem clinical superior to the corresponding enanthate esters explained by the more flat concentration curve of the decanoates.

Apart from that, a comparison of the pharmacokinetic data is difficult because of the heterogenecy of the available data.

Haloperidol, clopenthixol and perphenazine decanoates are among the best examined preparations in pharmacokinetic respects. A controlled double‐blind comparative study of these preparations would be of interest.
Computed tomographic scans in ECT‐patients
Authors: Kolbeinsson H. , Arnaldsson Ö. S. , Pétursson H. , Skulason S.
Published: August 2007

ABSTRACT Although the safety and efficacy of electroconvulsive therapy (ECT) is acknowledged by most, concern has repeatedly been expressed that the treatment may have some lasting effects on the brain. To study potential morphological changes, 22 patients with a history of ECT were submitted to a detailed clinical evaluation and a brain CT scan examination. Age‐ and sex‐matched control subjects comprised a group of comparable patients, none of whom had received ECT, and a second control group of healthy volunteers. Patients had larger ventricle brain ratios and cortical “atrophy” scores than normal controls, but no association was found between these radiological measures and a previous history of ECT. Hence, the present data are consistent with recent reports that affective disorders may be associated with enlarged brain ventricles, although the clinical significance of such findings remains unclear. In line with previous investigations age correlated significantly with cortical “atrophy” scores and ventricle/brain ratios for all subjects. Statistical tests of correlations between duration of illness, previous psychotropic drug exposure and CT scan appearances were mainly inconclusive.
Ventricular enlargement in young chronic schizophrenics
Authors: Llandrich J. E. Obiols , Ruscalleda J. , Masferrer M.
Published: August 2007

ABSTRACT The ventricular brain ratio (VBR) was measured in a group of 33 young in‐patient schizophrenics and 25 controls. Results confirmed significant lateral ventricular enlargement in the schizophrenic patients, but could not demonstrate any association between the VBR and age or length of illness. Some aspects of the studied sample are discussed.
Enkephalin analogue in schizophrenia Double blind cross‐over trial
Authors: Joergensen A. , Fog R.
Published: August 2007

ABSTRACT In a double blind, cross‐over study 10 chronic schizophrenic patients with productive symptoms in spite of neuroleptic treatment received the methionineenkephalin analogue FK 33–824 2 mg i.m. daily for 7 consecutive days. Ratings performed by the Brief Psychiatric Rating Scale did not show any significant differences between FK 33–824 and the active placebo pentobarbital. The clinical condition of one patient worsened during and after the administration of FK 33–824. It is suggested that this might be due to a dopamine stimulating effect. The discrepancy between the findings of the present and a previous open study is discussed. The present study does not support the hypothesis of dysfunction of the endorphin system in schizophrenia.
To keep the alcoholic in out‐patient treatment A differentiated approach through treatment contracts
Authors: Öjehagen A. , Berglund M.
Published: August 2007

ABSTRACT Eighty‐two alcoholics were offered a 2‐year out‐patient programme characterized by stressing the patients’ own decisions both in joining the programme and in the choice of objectives and methods, by repeated feedbacks through treatment evaluations, and by relapse prevention. The 58 patients who accepted were more often married than the others. All but eight completed the programme. The most important treatment components were ranked by the patients. Individual counselling was ranked highest, followed by evaluations of contract with therapist, disulfiram and biofeedback by means of gamma‐GT. Patients with alcohol dependence more often preferred instrumental components, such as disulfiram and gamma‐GT, while the others more often preferred psychological components, such as individual counselling and contract evaluations. Preference of psychological components was not found to be related to degree of personality disturbances. It is suggested that to effectively keep the patients in treatment in the present programme depends on the combination of patients’ active engagement, continuous feedback and individualized treatment objectives.
The validity of the Eating Attitude Test in a non‐Western population
Authors: Nasser M.
Published: August 2007

ABSTRACT The Eating Attitude Test (EAT‐40) was administered in the Arabic language to 50 Arab female undergraduates attending London University. The test had a positive predictive value (PPV) of 55%. sensitivity and specificity of 100% and 89% respectively, and proved useful when used in a non‐Western culture.
Chinese diagnostic interview schedule II. A validity study on estimation of lifetime prevalence
Authors: Hwu H.‐G. , Yeh E.‐K. , Chang L.‐Y. , Yeh Y.‐L.
Published: August 2007

ABSTRACT The validity of DIS‐CM (Chinese modified version of Diagnostic Interview Schedule) was examined by analyzing lifetime prevalence of each age group, age at onset, and recency of illness. The magnitude of the discrepancy between the empirical and the estimated data was adopted as the criterion of the degree of deviation. Manic and depressive episodes were found to be seriously underestimated. Schizophrenic, panic, phobic and antisocial personality disorders were probably underestimated. The observed lifetime prevalence figures with DIS‐CM are rather conservative for these disorders. The prevalence data of a recent 1‐year period are less biased and more reliable. The nature of the disease, recall effect, active or passive psychological resistance, mortality, and uncooperative attitude are considered factors that induce an underestimate of lifetime prevalence.
Twenty‐four‐hour serum levels of T4 and T3 in relation to decreased TSH serum levels and decreased TSH response to TRH in affective disorders
Authors: Undén F. , Ljunggren J‐G. , Kjellman B. F. , Beck‐Friis J. , Wetterberg L.
Published: August 2007

ABSTRACT The serum levels of thyroxine and triiodothyronine (T4 and T3) were investigated at 10 different time points during a 24 h period in 31 inpatients meeting the RDC criteria for acute major depressive disorder. Twenty‐three of these patients were also reinvestigated in a state of partial or complete remission. The results show that there was no significant difference in T4 or T3 levels during the 24 h period between depressed patients and 32 healthy controls despite significantly decreased TSH levels and TSH response to TRH administration (Δ TSH) in the patient group. No indications were obtained that the patients’ clinical presentation or depressive symptomatology as revealed by their CPRS scores, psychotropic medication, melatonin levels, or the outcome of the dexamethasone test, significantly influenced the T4 or T3 levels. The depressed patients who were studied longitudinally showed increased T4 levels in the acute phase compared to remission, wheras the T3 levels did not change. However, the levels of thyroid hormones were within the normal range in the acute phase as well as in remission. Furthermore, the changes in thyroid hormones between the state of relapse and remission were not significantly correlated to the corresponding increase in TSH levels and Δ TSH between the two assessments. The present results are consistent with the hypothesis that the mechanism behind the impaired TSH response to TRH in acute major depressive disorder is a downregulation of the pituitary TRH receptors.
Erythrocyte sodium and potassium in affective illness
Authors: Joffe R. T. , Blank D. W. , Berrettini W. H. , Post R. M.
Published: August 2007

ABSTRACTIn a preliminary study, erythrocyte sodium and potassium were measured in 24 affectively ill patients and 24 normal controls. Erythrocyte sodium was significantly lower and erythrocyte potassium was significantly higher in the euthymic and affective depressed patients as compared with controls.
The effects of lithium on neuroendocrine function in affectively ill patients
Authors: Joffe R. T. , Post R. M. , Ballenger J. C. , Rebar R. , Gold P. W.
Published: August 2007

ABSTRACT— Lithium is the primary treatment for manic‐depressive illness. The mechanism of action of lithium and its endocrine effects remain unclear. Therefore, the hormone responses to sequential stimuli, namely arginine, TRH, and LHRH, were studied in eight patients with major depression before and during treatment with lithium. The drug was found to elevate baseline TSH and prolactin and to augment both their responses to TRH. No clinically significant effect on sex hormones was noted. The advantages of the experimental design and the implications of the findings for lithium's mechanism of action are discussed.
Care of “new” long‐stay patients in a District General Hospital Psychiatric Unit The first two years of a hospital‐hostel
Authors: Gibbons J. S.
Published: August 2007

ABSTRACT— The paper describes the need for long‐term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long‐stay were placed in a new hospital‐hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.
Measurements of the perceived ward milieu: a reevaluation of the Ward Atmosphere Scale
Authors: Friis S.
Published: August 2007

ABSTRACT— From a theoretical perspective the effect of hospital treatment depends on how the ward milieu is perceived by the patients. An objection against the measurement of patient perceptions has been that lack of reliability would invalidate the assessment. To investigate this objection 49 inpatient wards were evaluated with the Ward Atmosphere Scale (WAS). The real ward (WAS‐R) scores proved to have acceptable reliability both for patients and for staff. For the ideal ward (WAS‐I) scores the reliability was mostly unacceptable for both groups. The content validity of the WAS subscales was found to be acceptable by a group of experienced psychiatrists. Criterion oriented and construct validity were also acceptable, even if the WAS lacks some seemingly important variables. A comparison of WAS scores from four different countries indicated that the WAS has excellent cross‐cultural properties. The WAS seems to measure fairly stable aspects of the atmosphere. The WAS scores proved to be fairly stable, even on wards where patients and staff desired considerable changes.
Decreasing first‐admission rates of schizophrenia among males in Denmark from 1970 to 1984
Authors: Munk‐Jørgensen P.
Published: August 2007

ABSTRACT: The first‐admission diagnoses of schizophrenia in males aged 15 years and over for the 15‐year interval 1970–84, based on annual reports from the Danish Psychiatric Register, showed a highly significant decrease from 12.6 to 8.5 per 100,000, amounting to 37% by regression analysis. The decrease is almost entirely caused by the age group 15–24 years, in which the incidence fell from 30.7 to 14.6 per 100,000. During the same period a remarkable increase in the corresponding first‐admission rates of “borderline states” (ICD‐8: 301.83, Danish version) and paranoid and unspecified psychoses (ICD‐8: 297, 298.9, and 299) was observed, particularly for the age groups 15–24 and 25–34 years. Changes in diagnostic habits accounting for the decreasing schizophrenia incidence among males are discussed.
Consistent evidence for a biological subtype of depression characterized by low CSF monoamine levels
Authors: Gibbons R. D. , Davis J. M.
Published: August 2007

ABSTRACT Analysis of previously published CSF monoamine data has revealed statistical evidence for a biological subtype of depression, characterized by abnormally low CSF‐5HIAA and CSF HVA. Using maximum likelihood gaussian mixture analysis we were able to resolve the empirical frequency distributions of both CSF HVA and CSF 5‐HIAA into two component normal mixtures. Simultaneous analysis of both CSF 5‐HIAA and CSF HVA revealed a two component bivariate normal mixture distribution in which 35% of the depressed patient sample were classified in the low subgroup. No evidence for mixture distributions was found in controls. Analysis of CSF MHPG revealed a single component normal distribution with virtually identical mean and variance in both patients and controls. These results are shown to be virtually identical to parallel analyses conducted on CSF monoamine data collected as part of the NIMH collaborative study on the psychobiology of depression study.
Anterior pituitary response to thyrotrophin releasing hormone in senile dementia (Alzheimer type) and elderly normals
Authors: M A. El Sobky , Shazly El , Darwish A. K. , Davies T. , Griffin K. , Keshaven M. S.
Published: August 2007

ABSTRACT Sixteen patients with senile dementia of the Alzheimer type (SDAT) were compared with 11 age‐matched normal subjects with respect to their responses of thyrotrophin (TSH) and prolactin (PRL) to thyrotrophin releasing hormone (TRH) challenge. Both groups showed a continuing rise in TSH response at 60 min, and no difference was found between the groups. A significantly exaggerated PRL response at 20 min was found in the SDAT group. There was no difference between sexes with respect to either the TSH or PRL response. These findings, albeit preliminary, may have implications for dopaminergic impairment in SDAT.
Verbal expression of affect in rheumatoid arthritis patients
Authors: Vollhardt B. R. , Ackerman S. H. , Shindledecker R. D.
Published: August 2007

ABSTRACT The claim that alexithymia is associated with specific disease categories is subjected to empirical testing. We report results from a controlled, single blind study in which Thematic Aperception Test (TAT) protocols from 64 arthritis patients attending an outpatient clinic were examined for operationally defined characteristics of alexithymia. We studied two groups of rheumatoid arthritis patients, one with the combination of rheumatoid factor and erosive joint changes and the other without and a third group with other forms of arthritis. Controlling for all variables that may confound alexithymia, we were unable to find any relationship between alexithymia and diagnostic subgroup, duration of illness or functional impairment
Cholinergic mechanisms in affective disorders
Authors: Dilsaver S. C.
Published: August 2007

ABSTRACT Advances in clinical and basic research methodology combined with clearly articulated concepts create new opportunities for researching the roles of cholinergic mechanisms in the pathophysiology of affective disorders. Areas for study include: 1) roles of cholinergic mechanisms in mediating effects of stress and cholinergic mechanisms linking the pathophysiologies of affective and panic disorders, 2) use of pharmacologic agents to produce cholinergic system supersensitivity in modeling biologic aspects of affective illness, 3) use of multigenerational intra‐pedigree studies of cholinergic markers associated with affective disease, 4) research into the neurobiology of lithium and ECT as they pertain to muscarinic cholinergic mechanisms, 5) study of the interrelationship of sodium, calcium and lithium ion metabolism and their relationship to cholinergic‐monoaminergic interaction, 6) the development of brain imaging strategies and techniques, e.g., positron emission tomography (PET), to measure changes in cholinergic receptor density and affinity as a function of clinical state, 7) identification and validation of a peripheral model of the central muscarinic receptor, 8) study of the pharmacology of abusable substances and its relationship to mechanisms regulating mood, affect, psychomotor function and other variables related to the affective disorders, and 9) development of in vitro and in vivo: models useful in studying the physiology and biochemistry of the interaction of cholinergic and monoaminergic neurons. These models may allow us to bridge the traditional cholinergic and monoamine hypotheses of affective disorders.
Introducing community mental health services
Authors: Stefansson C.‐G. , Cullberg J.
Published: August 2007

ABSTRACT By means of a computerised psychiatric case register, the effects on a defined population with 71,371 inhabitants were studied when the mainly hospital‐based psychiatric services in the area were changed to community mental health units with substantial outpatient resources. Diagnostic, social and demographic variables and care utilisation rates were compared. A 29% increase in patients under the new system was observed. Most of the newcomers had acute crisis reactions, were younger, on average, than previous patients and registered alcohol abuse and somatic diseases. Outpatient utilisation increased (170%) and hospital admissions decreased (22%). Compulsory admissions increased (43%), as did sick‐leave registrations (21%). These trends are discussed in light of the new organisation.
Phobias in India and the United Kingdom
Authors: Chambers J. , Yeragani V. K. , Keshavan M. S.
Published: August 2007

ABSTRACT Thirty‐nine phobic patients from India were compared with 39 similarly diagnosed age and sex matched patients from the United Kingdom. The British sample contained significantly more patients with agoraphobia and social phobia compared to the Indian group. Sudden death and illness phobias were more frequent in the Indian group. The Indian phobic patients also had more somatic and depressive symptoms. The influence of culture on the presentation of different phobias is discussed.
Non‐regressive schizophrenia: prediction of regressive course
Authors: Jonsson H. , Nyman A. K.
Published: August 2007

Regressive course during a 14–17 year follow‐up in 54 non‐regressive (pseudoneurotic, borderline, latent) schizophrenic subjects was predicted from about 100 variables studied on first admission. A significant prediction could not be achieved. This finding lends additional support to our previous interpretation that patients with a non‐regressive syndrome are schizophrenics. A large number of them will run a typical schizophrenic course, but we are unable to predict from initial data who will do so. The few possibly predictive variables seemed to be of an unspecific, quantitative and longitudinal nature. They may act in a cumulative manner to increase the vulnerability to psychotic decompensation.
An experimental evaluation of the euphoric properties of antiparkinson drugs on psychotic patients
Authors: Vågen R. , Götestam K. G.
Published: August 2007

Seven psychotic inpatients (two women and five men) aged between 18 and 74 years, treated with neuroleptic and antiparkinson drugs, participated in a double‐blind study with 1/3 DDD (Defined Daily Dose) of procyclidine, orphenadrine, or trihexyphenidyl hydrochloride against placebo. Euphoric effects were scored on a self‐rating scale and extrapyramidal side‐effects on the Simpson‐Angus rating scale at drug administration and 1, 3 and 6 h thereafter. With regard to euphoric effect, there was a significant (P < 0.02) difference between start and end point (0 and 6 h) for placebo but not for the active antiparkinson drugs. There was no significant difference in extrapyramidal side‐effects. No preference of drug was found, and it was not possible to recognize the patient's own drug among the tested drugs. Side‐effects from the antiparkinson drugs were also measured prior to the administration. Five patients did not return to their earlier antiparkinson drugs after the study.
Differences in ratings associated with differences in measures of rater's difficulty with the task
Authors: Carroll Judith , Greist John H.
Published: August 2007

Ratings of need for improvementt in project descriptions, ratings of difficulty in performing the task, and total time spent completing the task were examined to determine whether these measures of task difficulty had any bearing on ratings of social value. The few significant group differences in project value ratings and in hypothetical allocations reflecting research values adn priorities are quite possibly attributable to chance occurrence. The absence of any significant group differences in global project ratings leads to our conclusion that global ratings of project's social value appear to be independent from the amount of difficulty experienced in assigning those ratings. For more specific aspects of a project's social value, there is a slight indication that raters who experience little difficulty with the task, particularly those who indicate little need for improvement in project descriptions, give lower ratings that raters who experience moderate difficulty
Hypnotics and transient insomnia
Authors: Nicholson A. N. , Stone Barbara M.
Published: August 2007

An hypnotic should be used only when there is evidence of sleep disturbance. The wide range of sleep disorders (e.g. delayed sleep onset or problems of sleep maintenance) and the added complication that the patient may be involved subsequently in skilled work demand that the pharmacokinetics of various hypnotics must be understood before the correct hypnotic can be chosen. Impaired performance is more severe and persists far longer with compounds that are slowly eliminated and with the use of higher doses. The particular situations of aircrew and mountaineers have been studied in detail. Caution must be exercised in the management of aircrew coping with irregularity of rest and work. Temazepam has been used for aircrew for over 10 years and the absence of adverse effects ensures that it remains the recommended hypnotic in this area of medical practice. The relationship of insomnia with the hypoxic environment is undetermined. To investigate this, sleep was studied in six individuals during an expedition to the Himalayas. At altitude, temazepam led to less wakefulness and to drowsy sleep ‐ there were no prolonged sleep latencies.
Hypnotics and actual driving performance
Authors: O'Hanlon J.F. , Volkerts E. R.
Published: August 2007

ABSTRACT Several related studies of the residual effects of hypnotic drugs on actual driving performance have been conducted using a standard approach and the most recent is described in detail. In it, 12 female formerly diagnosed insomniacs and hypnotic users acted as subjects. They were treated in two separate series with placebo for 2 nights, then hypnotic medication for 8 nights followed by placebo again for 3 nights. In one series, the medication was nitrazepam (10 mg nocte) and in the other, temazepam (20 mg nocte). Eleven subjects completed both series in a double‐blind, cross‐over (with respect to drugs) design. Their driving performance was repeatedly tested on a 100 km primary highway circuit, in normal traffic, during both the morning and afternoon (10–11 hours and 16–17 hours after drug and placebo ingestion, respectively). Nitrazepam but not temazepam significantly impaired driving performance, the difference lasting throughout the active medication period. These results along with those obtained in the earlier studies are compared to show degrees of driving impairment which follow the use of various hypnotics.