bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifetime co-morbidity of panic attacks and major depression in a population-based study: age of onset
Authors: Andrade L. , Eaton W. W. , Chilcoat H. D.
Published: July 2009

Synopsis

We used survival analysis to test for a suspected effect of co-morbidity of DIS/DSM-III major depression and panic attack on the age of onset of each of these disorders, in a population-based sample from four sites of the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area Program (N= 12668). The possible effects of gender and presence of a co-morbid disorder on age of onset of the single disorders were analysed using the Cox proportion-hazard model, with gender as an explanatory variable and the co-morbid disorders as time-dependent covariates. The disorders begin earlier in life when they are co-morbid than when they occur singly. The occurrence of one disorder increases the chance of occurrence of the other. Females have from 1·7 to almost twice the risk for developing panic and/or depression compared with men, even if the co-morbid disorder precedes the index disorder or is lifetime co-morbid. These findings are compatible with a hypothesis of a higher severity in co-morbid cases when compared with a single disorder.
Insight, psychosis and ethnicity: a case-note study
Authors: Johnson Sonia , Orrell Martin
Published: July 2009

Synopsis

Recent literature on insight has paid little attention to patients' social backgrounds and cultures. Discharge summaries from 357 patients with a psychotic illness were examined to investigate factors associated with insight. A highly significant association was found between British white ethnic origin and being thought by the admitting psychiatrist to have some insight. Possible explanations include: different ways of understanding mental illness in different cultures, greater stigma leading to greater denial of illness in some cultures, greater illness severity at admission in some ethnic groups and racial bias in psychiatrists' ratings.
The diagnostic and prognostic significance of the Whitely Index, the Illness Attitude Scales and the Somatosensory Amplification Scale
Authors: Speckens A. E. M. , Van Hemert A. M. , Spinhoven P. , Bolk J. H.
Published: July 2009

Synopsis

The aim of this study was to assess the ability of the Whitely Index, Illness Attitude Scales and Somatosensory Amplification Scale to differentiate in patients with medically unexplained physical symptoms between hypochondriacal and non-hypochondriacal patients and to examine whether the scores on these questionnaires are predictive of long-term outcome in terms of recovery of presenting symptoms and number of visits to the general practitioner. The study population consisted of 183 consecutive patients, who presented with medically unexplained physical symptoms to a general medical out-patient clinic. The Health Anxiety subscale of the Illness Attitude Scales and the Whitely Index were best in discriminating between hypochondriacal and non-hypochondriacal patients. The sensitivity and specificity of the Health Anxiety subscale of the Illness Attitude Scales were 79% and 84%, and of the Whitely Index 87% and 72%. The Whitely Index was negatively associated with recovery rate at 1 year follow-up. The Illness Behaviour subscale of the Illness Attitude Scales appeared to be predictive of the number of visits to the general practitioner. These findings might have clinical implications in helping to distinguish in patients with medically unexplained symptoms those for whom there is a high chance of persistence of the symptoms and/or of high medical care utilization.
The Inventory of Depressive Symptomatology (IDS): psychometric properties
Authors: Rush A. J. , Gullion C. M. , Basco M. R. , Jarrett R. B. , Trivedi M. H.
Published: July 2009

Synopsis

The psychometric properties of the 28- and 30-item versions of the Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C) and Self-Report (IDS-SR) are reported in a total of 434 (28-item) and 337 (30-item) adult out-patients with current major depressive disorder and 118 adult euthymic subjects (15 remitted depressed and 103 normal controls). Cronbach's α ranged from 0·92 to 0·94 for the total sample and from 0·76 to 0·82 for those with current depression.

Item total correlations, as well as several tests of concurrent and discriminant validity are reported. Factor analysis revealed three dimensions (cognitive/mood, anxiety/arousal and vegetative) for each scale. Analysis of sensitivity to change in symptom severity in an open-label trial of fluoxetine (N = 58) showed that the IDS-C and IDS-SR were highly related to the 17-item Hamilton Rating Scale for Depression. Given the more complete item coverage, satisfactory psychometric properties, and high correlations with the above standard ratings, the 30-item IDS-C and IDS-SR can be used to evaluate depressive symptom severity. The availability of similar item content for clinician-rated and self-reported versions allows more direct evaluations of these two perspectives.
Psychological distress among recent immigrants from the former Soviet Union to Israel, II. The effects of the Gulf War
Authors: Lerner Y. , Zilber N.
Published: July 2009

Synopsis

The psychological effects of the Gulf War were studied on a group of Israeli civilians particularly at risk, viz. recent immigrants from the former Soviet Union. A quasi-experimental design was used. A sample of immigrants who had already been screened for psychological distress just before the war were reassessed after the war with the same instrument (PERI demoralization questionnaire). Various parameters related to the war period were also assessed. Psychological symptoms during the war were significantly associated with pre-war level of distress and with actual physical harm from the missiles, but not with exposure to danger (proximity of residence to areas hit by missiles). Correlates of behaviour in the face of life-threatening danger during the war (change of residence and help-seeking behaviour) were also identified. Overall the level of post-war psychological distress was not found to be higher than pre-war levels. This was explained by the immigrants' feelings of shared fate, belonging and sense of cohesion, which characterize the general Israeli population during war time.
Exploring ‘theory of mind’ in people with schizophrenia
Authors: Frith Christopher D. , Corcoran Rhiannon
Published: July 2009

Synopsis

Mentalizing ability was studied in 46 symptomatic schizophrenic patients and 44 non-symptomatic controls. Subjects heard six stories and simultaneously were shown simple cartoon pictures depicting the action sequencing occurring in the stories. All the stories involved false belief or deception, so that it was necessary to infer the mental states of the characters in order to understand their behaviour. After each story, subjects were asked one memory/reality question (concerning an event in the story) and one question that depended on the ability to infer the mental state of one of the characters. Patients with paranoid delusions were impaired on the questions concerning mental states. Patients with behavioural signs (i.e. negative features or incoherence) were also impaired on the mental state questions, but this difficulty was associated with memory impairments. Patients with symptoms of passivity (e.g. delusions of control) and patients in remission did not differ from normal controls. These results are consistent with the hypothesis that certain of the positive symptoms of schizophrenia reflect an impairment in the ability to infer the mental states of others.
Increase of serum creatine phosphokinase in catatonia: an investigation in 32 acute catatonic patients
Authors: Northoff G. , Wenke J. , Pflug B.
Published: July 2009

Synopsis

We investigated serum creatine phosphokinase (CPK) and associated parkinsonic (SEPS) and dyskinetic (AIMS) movements in 32 hospital admitted acute catatonic patients. Thirty-two (N = 24 without neuroleptics on admission) catatonic patients were compared with 32 non-catatonic dyskinetic psychiatric patients, 32 non-catatonic non-dyskinetic psychiatric patients and 32 healthy controls. CPK was significantly higher (p = 0·015) in catatonics (mean 255·75, s.d. ± 226·54) than in healthy controls (38·6, ± 27·4) and non-catatonic non-dyskinetic psychiatric patients (57·1, ± 120·8) whereas there was no significant difference between catatonics and non-catatonic dyskinetic psychiatric patients (453·4, ± 128·5). There were significantly positive correlations between CPK and AIMS, as well as significantly negative correlations between CPK and SEPS, in all three groups. Our results suggest that increased serum CPK in catatonia may be related to occurrence of dyskinetic movements. Furthermore, we were able to distinguish a parkinsonic (low CPK, low AIMS, high SEPS) and a dyskinetic (high CPK, high AIMS, low SEPS) subtype in catatonia.
Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed
Authors: Beats B. C. , Sahakian B. J. , Levy R.
Published: July 2009

Synopsis

The paper reports the profile of impairment across a variety of cognitive functions with special emphasis on tests sensitive to frontal lobe dysfunction, in 24 elderly depressed patients during and on recovery from mood disorder, compared with 15 age- and sex-matched controls. Traditional neuropsychological tests and a recently developed battery of computerized tests (CANTAB) were used. Impairments were found in the depressed group compared to controls and to themselves on recovery across all domains examined. The depressed group showed deficits on visuospatial recognition memory, attentional shifting at the extra-dimensional shift stage and in measures of both processing and motor speed without impaired accuracy in a visual search task. Impairments were also found on a planning task with disproportionately increased numbers of moves needed for more difficult problems and evidence of both slowed motor response and increased processing time once the task was commenced.

Performance on recovery improved across all tasks. Comparisons were made with the performance of patients suffering from dementia of the Alzheimer type (DAT) and Parkinson's disease on similar tests. Response latencies in test performance were found to correlate with the number of episodes of depression suffered and with ventricular size on CT scan, as measured by computerized planimetry. On recovery, residual depression scores correlated with latency of test performance and with ventricular brain ratio. The results, thus, show that depression in the elderly is associated with a significant degree of deficit on tests sensitive to frontostriatal dysfunction. Some of the deficits appear specific to depression and some do not remit following clinical recovery. However, these impairments have to be interpreted in the context of a broad profile of cognitive deficit.
The development and validation of a predictive index for postpartum depression
Authors: Cooper P. J. , Murray L. , Hooper R. , West A.
Published: July 2009

Synopsis

A sample of over 6000 women was recruited in the last trimester of pregnancy and administered a 40-item self-report questionnaire designed to detect the presence of factors that were likely to increase the risk of postpartum depression. The mental state of almost 5000 of these women was determined at around 6 to 8 weeks postpartum. By conducting a series of logistic regressions on two-thirds of this sample the original set of variables was reduced to a predictive index of 17 items with weighted scores calculated for each. This index was then applied to the remaining one-third of the sample as a validating procedure and specificity and sensitivity calculated. The index offers a system for the prediction of postpartum depression that could be of use in both research and clinical practice.
Defence style and behaviour therapy outcome in a specific phobia
Authors: Muris Peter , Merckelbach Harald
Published: July 2009

Synopsis

The Defense Style Questionnaire (DSQ) was administered to patients with a specific phobia (animal type; N = 54) and to control subjects (N = 29). Results indicated that specific phobia patients and non-phobic control subjects exhibit a similar pattern of defences. Also, the study investigated whether specific DSQ defence styles affect behaviour therapy outcome. It was found that an immature defence style, and especially the defence mechanism projection, was related to less favourable treatment results.
A twin study of antisocial and neurotic symptoms in childhood
Authors: Thapar Anita , McGuffin Peter
Published: July 2009

Synopsis

There is some evidence to suggest that the role of genetic and environmental influences may vary for different types of psychiatric symptoms in childhood. The aim of this study was to examine to what extent genetic and environmental factors influence parent-rated conduct and neurotic symptoms in childhood and adolescence, using data obtained from a systematically ascertained sample of twins (198 same sex pairs) aged between 8 and 16 years. For symptoms of antisocial behaviour, transmission could be explained entirely by shared environmental factors. Social class effects were also found to have a significant influence on antisocial behaviour, although these effects only accounted for a small proportion of the variance explained by shared environmental factors. In contrast, transmission of neurotic symptoms was best explained by additive genetic influences alone with no contribution from shared environment. Non-shared environmental factors accounted for a substantial component of the variation for both antisocial behaviour and neurotic symptoms.
The treated incidence of psychotic and affective illness in twins compared with population expectation: a study in the Swedish Twin and Psychiatric Registries
Authors: Kendler K. S. , Pedersen N. L. , Farahmand B. Y. , Persson P-G.
Published: July 2009

Synopsis

Twin studies of psychiatric illness assume that the genetic and environmental risk factors for psychiatric illness are similar in twins and non-twins and in monozygotic (MZ) and dizygotic (DZ) twins. To test this assumption, we examine whether the treated incidence of psychiatric illness in twins deviates from population expectations or differs between MZ and DZ twins. Using first admissions to the Swedish Psychiatric Registry for the years 1979–83 for all twins born 1886–1958 from the Swedish Twin Registries, we calculated Standardized Morbidity Ratios (SMRs) using national incidence rates together with individually computed person-years at risk in the twin cohort. The diagnoses examined, for which there was more than 393000 person-years of risk, were schizophrenia, other non-affective psychoses (ONAP), bipolar affective illness (BPAI), unipolar affective illness (UPAI) and neurotic depression (ND). The SMRs (and 95% CIs) for all twins were: schizophrenia 0·86 (0·69–1·06), ONAP 1·05 (0·88–1·24), BPAI 1·09 (0·90–1·32), UPAI 1·05 (0·85–1·29) and ND 0·99 (0·88–1·10). This pattern of results did not differ substantially when examined separately by gender or birth cohort. Relative risks for first admissions for MZ v. same-sex DZ twins or same v. opposite-sex DZ twins did not differ significantly from unity for any of the disorders examined. In Sweden, the treated incidence of psychotic and affective disorders in twins does not differ from that found in the general population and does not differ across zygosity groups. These results support the validity of the twin method for the study of psychotic and affective disorders.
Confirmation of association between expanded CAG/CTG repeats and both schizophrenia and bipolar disorder
Authors: O'Donovan M. C. , Guy C. , Craddock N. , Bowen T. , McKeon P. , Macedo A. , Maier W. , Wildenauer D. , Aschauer H. N. , Sorbi S. , Feldman E. , Mynett-Johnson L. , Claffey E. , Nacmias B. , Valente J. , Dourado A. , Grassi E. , Lenzinger E. , Heiden A. M. , Moorhead S. , Harrison D. , Williams J. , McGuffin P. , Owen M. J.
Published: July 2009

Synopsis

Recent studies have suggested that expanded CAG/CTG repeats contribute to the genetic aetiology of schizophrenia and bipolar disorder. However, the nature of this contribution is uncertain and difficult to predict from other known trinucleotide repeat diseases that display much simpler patterns of inheritance. We have sought to replicate and extend earlier findings using Repeat Expansion Detection in an enlarged sample of 152 patients with schizophrenia, 143 patients with bipolar disorder, and 160 controls. We have also examined DNA from the parents of 62 probands with schizophrenia or bipolar disorder. Our results confirm our earlier, preliminary findings of an association between expanded trinucleotide repeats and both schizophrenia and bipolar disorder. However, our data do not support the hypothesis that trinucleotide repeat expansion can alone explain the complex patterns of inheritance of the functional psychoses neither can this mechanism fully explain apparent anticipation.
Moderate dieting causes 5-HT2Creceptor supersensitivity
Authors: Cowen P. J. , Clifford E. M. , Walsh A. E. S. , Williams C. , Fairburn C. G.
Published: July 2009

Synopsis

Dieting is a widespread behaviour in developed countries, which in predisposed individuals can lead to the development of clinical eating disorders such as bulimia nervosa and anorexia nervosa. We studied the effect of moderate dieting in healthy women on the prolactin response to the serotonin (5-HT) receptor agonist, m-chlorophenylpiperazine (mCPP), a measure of the sensitivity of post-synaptic 5-HT2Creceptors. Dieting significantly increased the prolactin response to mCPP and lowered plasma concentrations of the 5-HT precursor, tryptophan. We propose that dieting in women is associated with the development of functional supersensitivity of 5-HT2Creceptors, probably in response to lowered levels of brain 5-HT. Alterations in brain 5-HT neurotransmission could play a part in dieting-induced dysregulation of eating and the development of clinical eating disorders in predisposed individuals.
Reliability and procedural validity of UM-CIDI DSM-III-R phobic disorders
Authors: Wittchen H.-U. , Zhao S. , Abelson J. M. , Abelson J. L. , Kessler R. C.
Published: July 2009

Synopsis

We evaluate the long-term test–retest reliability and procedural validity of phobia diagnoses in the UM-CIDI, the version of the Composite International Diagnostic Interview, used in the US National Co-morbidity Survey (NCS) and a number of other ongoing large-scale epidemiological surveys. Test–retest reliabilities of lifetime diagnoses of simple phobia, social phobia, and agoraphobia over a period between 16 and 34 months were K = 0·46, 0·47, and 0·63, respectively. Concordances with the Structured Clinical Interview for DSM-III-R (SCID) were K = 0·45, 0·62, and 0·63, respectively. Diagnostic discrepancies with the SCID were due to the UM-CIDI under-diagnosing. Post hoc analysis demonstrated that modification of UM-CIDI coding rules could dramatically improve cross-sectional procedural validity for both simple phobia (K = 0·57) and social phobia (K = 0·95). Based on these results, it seems likely that future modification of CIDI questions and coding rules could lead to substantial improvements in diagnostic validity.
The architecture of psychological management: the Irish asylums (1801–1922)
Authors: Reuber Markus
Published: July 2009

Synopsis

This analysis examines some of the psychological, philosophical and sociological motives behind the development of pauper lunatic asylum architecture in Ireland during the time of the Anglo–Irish union (1801–1922). Ground plans and structural features are used to define five psycho-architectonic generations. While isolation and classification were the prime objectives in the first public asylum in Ireland (1810–1814), a combination of the ideas of a psychological, ‘moral’, management and ‘panoptic’ architecture led to a radial institutional design during the next phase of construction (1817–1835). The asylums of the third generation (1845–1855) lacked ‘panoptic’ features but they were still intended to allow a proper ‘moral’ management of the inmates, and to create a therapeutic family environment. By the time the institutions of the fourth epoch were erected (1862–1869) the ‘moral’ treatment approach had been given up, and asylums were built to allow a psychological management by ‘association’. The last institutions (1894–1922) built before Ireland's acquisition of Dominion status (1922) were intended to foster the development of a curative society.
Differences in prevalence of dementia based on community survey and general practitioner recognition
Authors: Eefsting J. A. , Boersma F. , Van Den Brink W. , Van Tilburg W.
Published: July 2009

Synopsis

A study was conducted, which simultaneously used GPs and epidemiological assessment procedures (MMSE, CAMDEX), to identify individuals with DSM-III-R dementia in the same population. In addition, a 1-year follow-up assessment was conducted in patients with a CAMDEX-diagnosis of dementia. In the non-institutionalized group, which was assessed both by the GP and with the epidemiological test battery, the prevalence of dementia according to the GP was 2·2%, whereas the prevalence based on the epidemiological approach amounted to 5·2%. In general CAMDEX-diagnoses of dementia were confirmed at 1-year follow-up, and thus the discrepancy between the two prevalence estimates must be attributed to the low sensitivity of the GPs. Sensitivity of the GP was related to help-seeking behaviour, with low sensitivity in patients with a low contact rate. It was also related to the use of less specific diagnostic labels by the GP (cognitive impairment), and to poor recognition of cognitive impairment in patients who visited their GP.
Changes in the prevalence of psychiatric disorder in a community are related to changes in the mean level of psychiatric symptoms
Authors: Whittington Joyce E. , Huppert Felicia A.
Published: July 2009

Synopsis

The paper of Anderson et al. (1993), based on cross-sectional data, showed that minor psychiatric disorder in a population is linearly related to the mean number of psychiatric symptoms in the population. The present investigation asks whether the same relationship holds longitudinally as well as cross-sectionally. Data from a 7-year follow-up of a general population sample demonstrate, for the first time, that a relationship exists between changes in prevalence of psychiatric disorder and changes in the mean number of psychiatric symptoms in a given population. Moreover, the relationship is linear; a one-point decrease in mean scores on the GHQ-30 is associated with a 6% decrease in prevalence of disorder.
Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive–compulsive disorder
Authors: Veale D. M. , Sahakian B. J. , Owen A. M. , Marks I. M.
Published: July 2009

Synopsis

Forty patients with obsessive–compulsive disorder (OCD) were compared to matched healthy controls on neuropsychological tests which are sensitive to frontal lobe dysfunction. On a computerized version of the Tower of London test of planning, the patients were no different from healthy controls in the accuracy of their solutions. However, when they made a mistake, they spent more time than the controls in generating alternative solutions or checking that the next move would be correct. The results suggest that OCD patients have a selective deficit in generating alternative strategies when they make a mistake. In a separate attentional set-shifting task, OCD patients were impaired in a simple discrimination learning task and showed a continuous cumulative increase in the number who failed at each stage of the task, including the crucial extra-dimensional set shifting stage. This suggests that OCD patients show deficits in both acquiring and maintaining cognitive sets.

The cognitive deficits in OCD may be summarized as: (i) being easily distracted by other competing stimuli; (ii) excessive monitoring and checking of the response to ensure a mistake does not occur; and (iii) when a mistake does occur, being more rigid at setting aside the main goal and planning the necessary subgoals. Both studies support the evidence of fronto-striatal dysfunction in OCD and the results are discussed in terms of an impaired Supervisory Attentional System.
Intrusive memories in depression: an index of schema activation?
Authors: Brewin C. R. , Hunter E. , Carroll F. , Tata P.
Published: July 2009

Synopsis

A sample of 31 male and female depressed patients was interviewed to investigate spontaneous, intrusive memories of immediate and past life events. Previous findings that depressed patients experience high frequency intrusive memories were confirmed, as was an association between intrusive memories of childhood abuse and severity of depression. Patients reported intrusive memories for a variety of other events, particularly involving illness and death. Limited support was obtained for the hypotheses that the course of depression would be related to the activation of negative memories, and that immediate life events would trigger the activation of memories of similar events from the past.
Insight and cognitive deficits in schizophrenia: evidence for a curvilinear relationship
Authors: Startup Mike
Published: July 2009

Synopsis

Both motivational and defect theories have been offered to explain variations in insight among schizophrenic individuals but the results of tests of these theories have been inconclusive and inconsistent. The present study was designed to test the hypothesis that both motivation and cognitive deficits affect insight, with a trade-off between the two processes, giving rise to quadratic relationships between insight and cognitive deficits. Twenty-six schizophrenic patients completed battery of neuropsychological tests and participated in an interview designed to assess insight. In a multiple regression analysis predicting test results from insight scores, the linear component was non-significant while the quadratic component accounted for a highly significant 56% of the variance. Theoretical and clinical implications of this result are discussed briefly.
Behaviour problems in childhood and stressors in early adult life. I. A 20 year follow-up of London school children
Authors: Champion L. A. , Goodall G. , Rutter M.
Published: July 2009

Synopsis

The research presented in this paper examined the relationship between the presence of childhood behaviour problems and the rate of life events and difficulties in early adult life. Data are presented from a 20 year follow-up study of a sample of inner London school children first studied when they were aged 10. The key finding was that emotional or behavioural disturbance in childhood was associated with a marked increase in the rate of severely negative events and difficulties some two decades later. This increase was only obtained for stressors with severe negative impact of the type shown in previous investigations to be associated with the onset of psychiatric disorder. Additional results demonstrated that this main finding could not be accounted for by stressors that were a result of adult psychiatric disorder, by the respondent's own behaviour, or by continuing association with the family of origin. The need for a lifespan developmental approach to the well-established stressor-illness link is discussed.
Hysterectomy and psychiatric disorder: are the levels of psychiatric morbidity falling?
Authors: Gath D. , Rose N. , Bond A. , Day A. , Garrod A. , Hodges S.
Published: July 2009

Synopsis

This paper compares the findings of three studies carried out at intervals over the years 1975–1990. The three studies were concerned with different issues, but each study examined psychiatric morbidity among women undergoing hysterectomy for menorrhagia of benign origin.

In all three studies levels of psychiatric morbidity were measured before the operation and 6 months after the operation. Psychiatric morbidity was measured with the Present State Examination (PSE) (Wing et al. 1974), and with established self-report questionnaires. Levels of psychiatric morbidity fell significantly across the three studies. In Study 1, the proportions of psychiatric cases were 58% before hysterectomy and 26% after; in Study 2, 28% before and 7% after; and in Study 3, 9% before and 4% after.

The decline in psychiatric morbidity was not associated with demographic and social characteristics, previous psychiatric history, family psychiatric history, the nature of the women's menstrual complaints, or the women's understanding and expectations of the operation.

In Study 3 anti-menorrhagic drugs were prescribed twice as frequently as in the two previous studies; while the prescribing of psychotropic medication was significantly higher in Study 1 than in Study 2 or Study 3. The implications of these findings are discussed.
Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study
Authors: Fichter M. M. , Rehm J. , Elton M. , Dilling H. , Achatz F.
Published: July 2009

Synopsis

The object of the study was the assessment of the mortality risk for persons with a mental disorder in an unselected representative community sample assessed longitudinally. Subjects from a rural area in Upper Bavaria (Germany) participated in semi-structured interviews conducted by research physicians in the 1970s (first assessment) and death-certificate diagnoses were obtained after an interval up to 13 years later. The sample consisted of 1668 community residents aged 15 years and over.

Cox regression estimates resulted in an odds ratio of 1·35 (confidence interval 1·01 to 1·81) for persons with a mental disorder classified as marked to very severe. The odds ratio increased with increasing severity of mental illness from 1·04 for mild disorders, 1·30 for marked disorders, to 1·64 for severe or very severe disorders. The relative risk (odds ratio) for persons with a mental disorder only and no somatic disorder was 1·22, for persons with only a somatic disorder 2·00, and for those with both a mental and a somatic disorder 2·13. The presence of somatic illness was responsible for most of the excess mortality. Somatic disorders associated with excess mortality in mental disorders were diseases of the nervous system or sensory organs, diseases of the circulatory system, diseases of the gastrointestinal tract, and diseases of the skeleton, muscles and connective tissue (ICD-8).

Thus, while mental illness alone had a limited effect on excess mortality, comorbidity with certain somatic disorders had a significant effect.
The importance of the social and intellectual contexts in a discussion of the history of the concept of psychosis
Authors: Beer M. Dominic
Published: July 2009

Synopsis

This paper shows that, throughout its 150 year history, the concept of ‘psychosis’ has not been static, but has reflected the intellectual and social contexts in which it has been employed. Initially the concept reflected the Romantic psychiatrists' emphasis on the whole personality. With the advent of materialism the concept was applied to all mental disorders. Because of the claims for organic cerebral findings in dementia praecox, it was described by Meyer as fitting the disease concept, with characteristic pathology, symptomatology, course and prognosis. However, the different social milieux of patients being treated by psychiatrists such as Kraepelin and Bonhoeffer led to different emphases regarding the aetiology of the psychoses. In the later twentieth century the influence of urbanization in Europe and Africa and also the rise of Nazism led to changes in relation to the use of the concept of psychosis.
Psychotropic drug use and shift work among French nurses (1980–1990)
Authors: Niedhammer I. , Lert F. , Marne M. J.
Published: July 2009

Synopsis

Use of minor tranquillizers and hypnotics and the association with shift work was examined in a sample of French nurses interviewed in 1980, 1985 and 1990. Permanent night schedule was related to a higher use of hypnotics/tranquillizers, the relation being significant in 1990. At each follow-up date, the use of drugs increased with sleep disorders, symptoms of psychological disorders reported by the nurses themselves, an impaired health and fatigue. Age was linked to the use of hypnotics/tranquillizers; the older the nurses were, the more likely they were to take the drugs. Using a logistic analysis, the following variables were significant: time schedules, self-assessment of health, fatigue, age and marital status. Time schedules involving night work, especially permanent night schedule, were related to a higher proportion of drug use. These findings confirmed the general patterns of psychotropic drug use (age, sleep disorders, physical health and marital status) among women and emphasized the relation between time schedules involving night work and the use of hypnotics/tranquillizers.
Psychological morbidity in patients with chest pain and normal or near-normal coronary arteries: a long-term follow-up study
Authors: Potts S. G. , Bass C. M.
Published: July 2009

Synopsis

Forty-six patients with chest pain but normal or near-normal coronary arteries were assessed using standardized interviews and rating scales at the time of angiography, after 1 year, and again 11·4 years later. Psychological morbidity was substantial and enduring: 61% of patients were designated as psychiatric cases at angiography and 49% at 11·4 years. Both at the time of angiography, and 1 year later, levels of morbidity were significantly greater than in a control group of 53 patients with coronary artery disease. Anxiety disorders were common at all three interviews, with panic disorder (15% of patients) the most common current diagnosis at final follow-up. Current somatoform disorders were diagnosed in 9 patients (22%), and 11 (27 %) reported previous episodes of major depression. Psychological morbidity was associated with continuing chest pain, which was reported in 74% of patients, and with ongoing functional incapacity. These findings suggest that, in a sub-group of these patients, psychological factors contribute in part to the development of chest pain and other physical symptoms, and are also important in maintaining the disorder over long periods. Further research is now required to identify more fully the nature of these psychological factors, and how they interact with cardiac and non-cardiac physical pathology. There is also an urgent need to examine the clinical and economic benefits of specific psychological interventions.
Smooth pursuit performance in patients with affective disorders or schizophrenia and normal controls: analysis with specific oculomotor measures, RMS error and qualitative ratings
Authors: Friedman L. , Jesberger J. A. , Siever L. J. , Thompson P. , Mohs R. , Meltzer H. Y.
Published: July 2009

Synopsis

Smooth pursuit performance in schizophrenia and affective disorders has generally been found to be abnormal using a variety of measures. The purpose of this study was to assess patients with these disorders and normal controls in order to compare the different measures across diagnoses. Smooth pursuit was assessed using quantitative specific measures (gain, catch-up saccade rate and amplitude, square-wave jerk rate, number of anticipatory saccades and total time scored), as well as two global measures: root mean-square error (RMS) and qualitative rating. As previously reported, patients with schizophrenia had low gain, increased catch-up saccade rate and spent less time engaged in scoreable smooth pursuit than normal controls. Patients with affective disorders were not statistically different from controls on any of these measures, and had significantly higher gain than patients with schizophrenia. RMS error and qualitative rating measures were highly correlated (r = 0·87). In linear regression analyses, the quantitative specific measures were highly significant predictors of both RMS error and qualitative ratings (P < 0·0001). Linear regression analyses and a modelling study indicated that one quantitative specific measure, the percent of time engaged in scoreable smooth pursuit (total time scored), was most related to global ratings. However, RMS error and qualitative ratings were less sensitive than total time scored to the difference between controls and patients with schizophrenia. These data indicate two smooth pursuit performance deficits in schizophrenia: patients spend less time engaged in scoreable smooth pursuit and have low gain (accompanied by increased compensatory saccades) when the smooth pursuit is engaged.
Puberty, sexual milestones and abuse: how are they related in eating disorder patients?
Authors: Schmidt U. , Evans K. , Tiller J. , Treasure J.
Published: July 2009

Synopsis

In order to assess the relationship between pubertal development, sexual milestones and childhood sexual abuse in women with eating disorders, 44 patients with restricting anorexia nervosa (RAN), 26 with bulimic anorexia nervosa (BAN), 29 with bulimia nervosa and also with a history of anorexia nervosa (BN/HistAN), and 69 with bulimia nervosa but without a history of anorexia nervosa (BN) completed questionnaires on pubertal and sexual development and unpleasant sexual experiences. Forty-four female college students completed the sexual development questionnaire only. Different eating disorder groups were found to be similar in terms of their pubertal development. All eating disorder groups showed delays in aspects of their psychosexual development (age at first kiss, masturbation, genital fondling and first sexual intercourse) compared with the control group, although to a different degree.

The RAN group was delayed on almost all sexual milestones whereas the other groups were delayed on only some. On some variables, most noticeably on first sexual intercourse, restricters also were more delayed than the other eating disorder groups. Similarly, the median number of sexual partners differed significantly between groups (RAN = 1, BAN = 2, BN/HistAN = 4, BN = 4, controls = 5, P < 0·0001). Eating disorder patients, in particular RAN patients, were less positive about sexual relationships than controls, but did not differ from controls in attitudes to masturbation, marriage, children or pregnancy. Of the eating disorder patients 22−31% had been sexually abused during childhood. A history of abuse affected attitudes to masturbation, but did not appear to affect sexual development.
The stability of the Ways of Coping (Revised) Questionnaire over time in parents of children with Down's syndrome: a research note
Authors: Hatton C. , Knussen C. , Sloper P. , Turner S.
Published: July 2009

Synopsis

The stability of the Ways of Coping (Revised) Questionnaire over time was assessed by comparing the scores of 68 mothers and 53 fathers of school-aged children with Down's syndrome over a 3-year time interval on the five coping strategy subscales described by Knussen et al. (1992). For this analysis, mothers' and fathers' scores were analysed separately. It was shown by t tests that mothers' and fathers' scores on the coping strategy subscales had not significantly changed over the three-year period. Time 1 and Time 2 scores on all of the coping subscales were strongly positively associated, with the exception of fathers' scores on the Stoicism subscale. Test–retest reliability was adequate for all subscales except mothers' scores on the Passive Acceptance subscale and fathers' scores on the Stoicism subscale. These results, by demonstrating the stability of the Ways of Coping (Revised) Questionnaire over a 3-year time period, further illustrate the utility of this instrument for investigating coping in families with special problems.
What happened to the growth spurt of nineteenth-century adolescents? An essay on the history of a scientific omission
Authors: Vandereycken Walter , Deth Ron Van
Published: July 2009

Synopsis

It is common knowledge that puberty is characterized, among other phenomena, by a striking growth spurt. An exploration of the medical literature from previous centuries shows, however, that this feature of adolescence has attracted surprisingly little attention. Although the pubertal growth spurt was known to eighteenth-century physicians, it was neglected for about a century. The influential Belgian scientist Quetelet demonstrated a remarkable scotoma towards the phenomenon. It was only after his death in 1874 that the relationship between puberty and growth spurt became a scientifically established and recognized fact.
Reduced plasma oestrogen stimulated neurophysin and delayed response to oestrogen challenge in Alzheimer's disease
Authors: Christie Janice , Hunter Robert , Bennie John , Wilson Helen , Carroll Sheena , Fink George
Published: July 2009

Synopsis

Plasma concentrations of oestrogen stimulated neurophysin (ESN) were reduced in 28 patients with Alzheimer's disease (AD) compared with 14 age-matched controls, 16 patients with other presenile dementias and 12 patients with major depressive disorder. The ESN response to oestrogen challenge was delayed in 10 AD patients compared with 7 age-matched controls. Reduced basal and oestrogen stimulated plasma ESN may be related to impaired responsiveness of the hypothalamo-neurohypophysial neurons and/or a reduction in the amount of pituitary ESN available for release. Plasma ESN measurements may be of value for excluding the diagnosis of AD in patients with dementia who present before the age of 65.
Dieting reduces plasma tryptophan and alters brain 5-HT function in women
Authors: Anderson I. M. , Parry-Billings M. , Newsholme E. A. , Fairburn C. G. , Cowen P. J.
Published: July 2009

Synopsis

A three week low calorie diet significantly reduced both total plasma tryptophan and the ratio of tryptophan to competing amino acids in a group of 15 healthy volunteers. Despite a similar percentage weight loss the reduction in plasma tryptophan was greater in women than men. In addition, only in women was dieting associated with increased prolactin secretion following intravenous tryptophan, a measure of brain 5-hydroxytryptamine (5-HT) function. These results suggest that dieting reduces the availability of circulating tryptophan for brain 5-HT synthesis. Women appear more vulnerable than men both to this effect and to its consequences for brain 5-HT function. Altered brain 5-HT function may play a part in some of the psychological consequences of dieting, including the development of clinical eating disorders.
The relationship between intellectual impairment and mood disorder in the first year after stroke
Authors: House Allan , Dennis Martin , Warlow Charles , Hawton Keith , Molyneux Andy
Published: July 2009

Synopsis

In a community-based study of patients with a first-ever stroke, intellectual impairment (as denned by scores on a common screening test for dementia, the Mini-Mental State Examination) was found in 26% at 1 month post-stroke, and in 21% at 6 and 12 month follow-up. Low scores on the screening test were associated with greater age, physical disability before the stroke, larger stroke lesion volumes as measured on CT scan, and non-stroke changes such as atrophy and white matter low attenuation on the CT scan. There was a negative correlation between scores on the Mini-Mental State Examination and symptom levels on two measures of mood disorder. However, there was no evidence of a specific relationship between major depression and low scores on the Mini-Mental State. We examined various aspects of the relationship between mood symptoms and low scores on the Mini-Mental State, but found no evidence to support the suggestion that this relationship represented an example of depressive pseudodementia. We discuss the significance of our findings for clinical psychiatry and neuropsychology.
Subjective utility ratings of neuroleptics in treating schizophrenia
Authors: Finn Stephen E. , Bailey J. Michael , Schultz Robert T. , Faber Raymond
Published: July 2009

Synopsis

This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rated the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.
Do statistics lie? Suicide in Kildare – and in Ireland
Authors: Walsh Dermot , Cullen Ann , Cullivan Rachel , O'donnell Brendan
Published: July 2009

Synopsis

This study, reporting a ten-year investigation of suicide in Kildare, found that the suicide rate based on clinical assessment of coroner's records was very close to the Central Statistics Office (CSO) figure for Kildare and for Ireland as a whole for the same period. Dublin data for 1977–1981 confirmed these findings. Since in the 1960s similar clinical assessment concluded that CSO rates underestimated suicide by a factor of two or over, we believe that changes in CSO coding procedures whereby more deaths are now coded to suicide than was the case in the past have resulted in current CSO data reflecting accurately the rate of clinical suicide. There has been more than a three-fold increase in CSO suicide rates in Ireland between 1968 and 1987. Even allowing for improved CSO practices there still remains a considerable excess of suicide deaths which indicates a doubling of ‘real’ suicide in Ireland over these twenty years.
The Gospel Oak Study stage II: the diagnosis of dementia in the community
Authors: Livingston Gill , Sax Karen , Willison Jo , Blizard Bob , Mann Anthony
Published: July 2009

Synopsis

An attempt was made to assess in detail subjects screened as suffering from dementia among a North London community sample of elderly people. Forty-eight (80 %) subjects were interviewed, 7 (12%) were found to have died and 5 (8%) either refused interview or were lost to follow-up. By clinicians' diagnosis of the 48 interviewed, 22 subjects (46%) had probable Alzheimer's disease, one had multi-infarct dementia, five had mixed dementia, five had secondary dementia, 10 had a dementia which could not be further classified and 5 were not demented. No subject had a reversible condition. The prevalence rate for clinical dementia was 6·1 %, and for Alzheimer's disease 3·1 %. According to AGECAT diagnosis the prevalence of organicity was 5·7%. The AGECAT diagnoses and psychiatrists' diagnoses were significantly associated (P < 0·003) and AGECAT was more likely to identify as organic those subjects with dementia diagnosed by psychiatrists as Alzheimer's disease, than those not so diagnosed (P < 0·04). A short psychometric battery, including the MMSE in two versions, was administered and its acceptability to a community sample evaluated. This detailed clinical investigation showed that the Dementia Diagnostic Scale of the Short-CARE was a specific predictor of clinical dementia or death at the time of follow-up, whereas the more inclusive Organic Brain Syndrome scale was a more satisfactory first phase screening instrument.