bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening
Authors: Chong Mian-Yoon , Wilkinson Greg
Published: July 2009

Synopsis

A study of the validity of the 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) was carried out with a consecutive sample of 386 patients admitted during one year to a medical centre in Taiwan for a 3-day comprehensive general health screening. The Chinese version of the Clinical Interview Schedule was used to derive a criterion measure of minor psychiatric morbidity.

The areas under the Relative Operating Charcteristic curves of both short versions of the CHQ were equivalent (area = 0·85, S.D. = 0·02). The sensitivities of the CHQ-30 and CHQ-12 were found to be 76 and 78% respectively, while the specificity of both was 77%. The estimated prevalence of minor psychiatric morbidity in the sample was 37% (95% confidence intervals 32–41%). In contrast, physicians diagnosed 11% of these patients as having psychiatric disorders, and their sensitivity was 29%.

Taken altogether, the above findings suggest that the CHQ-12 is as effective as and is more efficient than the CHQ-30 in this context, and could be used by physicians in similar settings to improve their identification of minor psychiatric disorders in Chinese patients.
Development of a new self-report questionnaire to measure self esteem
Authors: Robson Philip
Published: July 2009

Synopsis

In constructing a new self-report questionnaire for measuring self esteem, the aim has been to satisfy psychometric requirements without sacrificing the intuitive meaning of the concept. Self esteem is seen as a composite, and examination of its components may have more analytic or predictive value than ‘ global’ scores. Preliminary reliability and validity data are encouraging.
The interrelationship of beta endorphin, ACTH and cortisol in depressive illness: a controlled study
Authors: Ball Rosemary , Howlett Trevor , Silverstone Trevor , Rees Lesley
Published: July 2009

Synopsis

Plasma cortisol, ACTH and beta endorphin were measured before and after dexamethasone in 8 severely depressed patients and 8 age- and sex-matched controls to examine the relationship of ACTH and endogenous opioids to cortisol in depression. Despite having significantly higher plasma levels of cortisol than the controls, the depressed patients did not have correspondingly elevated plasma levels of ACTH. Beta-endorphin levels were also similar in the two groups. All three hormones suppressed to some degree after dexamethasone, but cortisol suppressed less in patients than controls. Our findings suggest that in severe depressive illness abnormalities exist in the hypothalamic–pituitary–adrenal axis peripherally as well as centrally.
Social interaction following severe closed head injury
Authors: Elsass L. , Kinsella G.
Published: July 2009

Synopsis

This paper describes research which sought to investigate and describe the interpersonal relationships and vulnerability to psychiatric disturbance in severely closed head injured subjects. The head injured subjects were severely injured, with mild or extremely severely injured individuals being excluded from this study. Self-report by the injured individual was compared with relatives' reports. Fifteen head injured people were individually matched with non-head injured people from the general population who acted as controls. Each subject nominated one ‘close other’ for comparative interview. The dependent variables included interpersonal relationships, non-psychotic psychiatric disturbance and behavioural change.

The head injured group differed significantly from the control group in the quantity of interaction but not in the perceived quality of interaction. The groups differed significantly on behavioural change. No significant difference was found between responses given by the head injured and their ‘close other’ compared with the controls. Deficient quantity of interpersonal relationships and greater vulnerability to psychiatric disorders was shown in this sample. Further research on the assessment of long-term social outcome and psychiatric stability in the head injured could assist in the improved long-term rehabilitation of the survivors.
Visual and graphic abilities of the idiot savant artist
Authors: O'Connor N. , Hermelin B.
Published: July 2009

Synopsis

Five idiots savants whose artistic output was judged to be at art school entrance standard were matched for performance and verbal IQ with control subjects who had no special artistic talent. Each subject was given tests of reproductive skill with both concrete pictures and unfamiliar and unnameable geometric designs. They were also asked to draw a man, and a test of picture completion was given which involved constructive imagination. In all tests the idiots savants proved clearly superior to IQ-matched controls, indicating the presence of an IQ-independent talent. The results are interpreted in terms of a superior image memory and ready access to a ‘picture lexicon’. In addition, the existence of superior graphically directed motor programmes must be assumed.
Mass hysteria: two syndromes?
Authors: Wessely Simon
Published: July 2009

Synopsis

On the basis of a literature review it is concluded that mass hysteria can be divided into two syndromes. One form, to be called ‘mass anxiety hysteria’, consists of episodes of acute anxiety, occurring mainly in schoolchildren. Prior tension is absent and the rapid spread is by visual contact. Treatment consists of separating the participants and the prognosis is good. The second form, to be called ‘mass motor hysteria’, consists of abnormalities in motor behaviour. It occurs in any age group and prior tension is present. Initial cases can be identified and the spread is gradual. Treatment should be directed towards the underlying stressors but the outbreak may be prolonged. In mass anxiety hysteria the abnormality is confined to group interactions; in mass motor hysteria abnormal personalities and environments are implicated.
A short history of bodily sensation
Authors: Starobinski Jean
Published: July 2009

In one of his Cahiers, Paul Valéry has the note. Somatism (heresy of the end of time),

Adoration, cult of the machine for living.† Have we come to the end of time? The heresy anticipated by Valéry has almost become the official religion. Everything is related to the body, as if it had just been rediscovered after being long forgotten; body image, body language, body consciousness, liberation of the body are the passwords. Historians, prey to the same infection, have begun inquiring into what previous cultures have done with the body, in way of tattooing, mutilation, celebration all the rituals related to the various bodily functions.2 Past writers from Rabelais to Flaubert are ransacked for evidence, and immediately it becomes apparent that we are far from being the first discoverers of bodily reality. That reality was the first knowledge to enter human understanding: ‘They knew that they were naked’ (Genesis 3.7). From then on, it has impossible to ignore the body.
The ventricular-brain ratio (VBR) in functional psychoses: the relationship of lateral ventricular and total intracranial area
Authors: Harvey I. , Williams M. , Toone B. K. , Lewis S. W. , Turner S. W. , McGuffin P.
Published: July 2009

SYNOPSIS

CT scans were performed on 72 consecutive patients with a functional psychosis, and compared with 50 community controls. There was a specific difference in lateral ventricular area between these two groups but it accounted for only 11% of the variance in this measure. In contrast, racial and sexual differences in the ventricular-brain ratio (VBR) related to differences in intra-cranial area. It is argued that analysis of variance, using lateral ventricular area and intra-cranial area, is more informative than VBR in examining these structural changes in functional psychoses.
Psychiatric morbidity in patients with Parkinson's disease
Authors: Brown R. G. , MacCarthy B.
Published: July 2009

SYNOPSIS

Forty patients with Parkinson's disease underwent a detailed assessment of their psychiatric state using a standardized, semi-structured interview, the Present State Examination. Analysis of the interviews yielded a profile of depressive and neurotic syndromes. Comparing the results with population norms, however, revealed that the patients were distinguished only by high levels of depressed mood and loss of interest and poor concentration. In the majority of patients the range and severity of symptoms fell below the criteria for ‘caseness’. Only four patients could be allocated to an ICD-9 class, two to ‘ neurotic depression’, one to ‘ anxiety state’ and one to ‘ phobic state’. This rate was almost identical to that found in the general population. Broader indices of psychiatric morbidity were related to the patients' levels of disability and cognitive function.
A comparison of anorexia nervosa and affective psychosis in young females
Authors: Eagles John M. , Wilson Arlette M. , Hunter David , Callender John S.
Published: July 2009

SYNOPSIS

In a retrospective case note study, 73 young females with anorexia nervosa were compared with 88 young females with affective psychosis. These groups of patients did not differ in terms of place of residence, birth order or social class. They differed very significantly, however, in terms of age at onset of symptoms, marital status, educational attainments and in the pattern of family histories of psychiatric illness. It is concluded that anorexics and young females with affective disorders are two quite distinct groups of patients.
Gender, Social support and recovery from depressive disorders: a prospective clinical study
Authors: Brugha T. S. , Bebbington P. E. , MacCarthy B. , Sturt E. , Wykes T. , Potter J.
Published: July 2009

SYNOPSIS

One hundred and thirty men and women attending psychiatric hospitals with depressive disorders were interviewed at the time of their initial contact. After a mean four month interval, 119 were reassessed in order to test the hypothesis that initial levels of social support predict clinical improvement even when other potential risk factors such as age, sex, diagnosis and severity of depression are controlled. Severity and duration of the episode emerged as the only significant background predictors of recovery. The explained variance in recovery from depression due to social support was equal in men and women, and was not diminished by the background clinical predictors. According to subset analyses however, the aspects of personal relationships and perceived support that predict recovery in men and in women appear to be different. The available multiple regression models of outcome favoured a main effect of social support and provided persuasive if inconclusive evidence for a statistical interaction effect with sex. The implications for further research and for theory are discussed.
Factors and primes: a specific numerical ability
Authors: Hermelin B. , O'Connor N.
Published: July 2009

SYNOPSIS

An autistic young man and a normal control were asked to factorize numbers and to recognize and generate primes. Both subjects made a similar of errors and employed similar strategies, but they differed markedly in the speeds at which the arithmetical operations were carried out.
The validity of diagnostic systems for common mental disorders: a comparison between the ID-CATEGO and the DSM-III systems
Authors: Grayson David , Bridges Keith , Cook Diane , Goldberg David
Published: July 2009

SYNOPSIS

It is argued that latent trait analysis provides a way of examining the construct validity of diagnostic concepts which are used to categorize common mental illnesses. The present study adds two additional aspects of validity using multiple discriminant analysis applied to two widely used taxonomic systems. Scales of anxiety and depression derived from previous latent trait analyses are applied to individuals reaching criteria for ‘caseness’ on the ID-CATEGO system and the DSM-III system, both at initial diagnosis and six months later. The first multiple discriminant analysis is carried out on the initial scale scores, and the results are interpreted in terms of concurrent validity. The second analysis uses improvement scores on the two scales and relates to predictive validity. It is argued that the ID-CATEGO system provides a better classification for common mental illnesses than the DSM-III system, since it allows a better discrimination to be made between anxiety and depressive disorders.
Issues in the development of statistical and epidemiological data for mental health services research
Authors: Kramer Morton
Published: July 2009

Synopsis

The planning of health services consists of a process that generally involves the following steps: (a) situational analysis, or the description, definition and statement of the problem, its characteristics and dimensions in relation to population and time; (b) the formulation of alternative tactical approaches to the handling and solution of the problem; (c) decision analysis or the selection of a plan; (d) discussion and implementation of the plan selected; (e) evaluation of the results achieved in relation to the problem, situations or populations concerned. This paper discusses the content of a programme of mental health services research for collecting and analysing the information needed to apply these processes to the planning of mental health services, monitoring the manner in which the plan is being implemented, and assessing its effectiveness in achieving short-term and intermediate objectives and long-term goals.

Statistical and epidemiological information play an important role in these processes, particularly in the situational analysis and the evaluation processes. Illustrations have been provided of types of data that are produced in the national mental health statistics programme in the United States. Difficulties in using such data to answer questions concerning the needs for mental health services, and manpower requirements for delivering services to meet these needs are discussed. In many instances, currently available data are quite inadequate for answering key issues such as these, plus others related to living arrangements of the population, the effect of services on the persons who receive them, their families and the communities in which they live. Thus, much still remains to be done to develop systematic, comparative morbidity statistics on the incidence, duration and prevalence of mental disorders in the general population, on the needs for mental health services, and on the effectiveness of our efforts to prevent disorders that can be prevented, and to reduce the amount of disability and distress caused by those that cannot be prevented or terminated.

A series of problems have been identified, the solutions to which would assist materially in providing data that would narrow gaps between available knowledge and that which is needed. The importance of establishing well-staffed research units at the catchment area level with stable funding to accomplish this is underscored. It is a matter of the greatest urgency that adequate resources - financial, manpower, scientific and administrative - be made available to solve these problems. If this is not done, then efforts to document quantitatively the effectiveness of programmes to prevent and control mental disorders will continue to suffer from many of the same shortcomings that have impeded our past and continue to impede current efforts to accomplish this.
The concept of prevalence applied to psychiatric disorders and symptoms
Authors: Ingham J. G. , Miller P. McC.
Published: July 2009

Synopsis

Statements about prevalence, of the type ‘x% of the general population are mentally ill’, imply a concept of prevalence that is difficult to define operationally. It requires the specification of a cut-off point, a level of severity from which the presence of an illness can be inferred, and this is largely arbitrary. A more generally useful type of statement compares the frequency distribution of severity for declared cases with that for the rest of the population. This avoids the need for a defined cut-off point. We are still left with the problem of defining a dimension of severity and a declared case, but these should follow easily from a clear statement of the purpose of any specific inquiry. The argument is illustrated from the results of a study of self-referrals to general practitioners.
Cerebrospinal fluid and plasma free cortisol concentrations in depression
Authors: Carroll Bernard J. , Curtis George C. , Mendels J.
Published: July 2009

Synopsis

Cerebrospinal fluid (CSF) cortisol levels were examined in a total group of 65 patients. Those who were not depressed (ND), and those suffering from depressive neuroses (DN) had marginally elevated values. Patients with unipolar depression (UD) and bipolar depression (BD) had levels twice as high as the ND and DN patients. Psychotic UD and BD patients had the highest values, three to four times as high as the ND and DN subjects. A significant reduction of CSF cortisol levels was observed following treatment and recovery. Manic patients had moderately elevated CSF cortisol values. The CSF results were in good agreement with plasma total cortisol levels and with urinary free cortisol excretion. Age and sex effects were not responsible for the observed differences; similar results were found in patient subgroups studied in Australia and in the United States. Preliminary equilibrium dialysis data are presented for plasma and CSF cortisol binding. CSF cortisol was 20% bound and 80% free. Plasma free cortisol levels were in good agreement with CSF free cortisol values. Depressed patients have increased tissue and central nervous system (CNS) exposure to free, physiologically active glucocorticoids. The appearance of severe depressive symptoms which manifest a diurnal rhythm may be determined in part by excessive CNS exposure to glucocorticoids.
Erythrocyte membrane cation carrier, relapse rate of manic-depressive illness and response to lithium
Authors: Naylor G. J. , Dick D. A. T. , Dick E. G.
Published: July 2009

Synopsis

Biochemical studies of manic-depressive psychosis usually correlate biochemical findings with current affective state and hence any significant findings could be secondary to mood change. The present study attempts to correlate measures of the erythrocyte membrane cation carrier with clinical events, remote in time from the biochemical assay.

Erythrocyte sodium concentration, ouabain-sensitive potassium influx and Na-K ATPase were estimated in 11 patients before and after the cross-over point in a 2-year double blind clinical trial of lithium. Patients with the lowest erythrocyte Na-K ATPase and the highest flux sodium ATPase ratio tended to suffer most episodes of affective illness in the 2 years. Patients who had a low initial Na-K ATPase or a high initial flux sodium ATPase ratio, or in whom this ratio fell most with lithium or whose Na-K ATPase rose most with lithium, clinically responded best to lithium.
Mental development of phenylketonuric children on or off diet after the age of six
Authors: Brown Eleanor S. , Warner Robert
Published: July 2009

Synopsis

Eleven children with phenylketonuria (PKU) taken off diet after the age of six showed significant decreases in rate of mental development compared with 26 control children of comparable IQ and with 17 PKU children of comparable IQ who remained on the diet. Changes in rate of mental development were significantly and inversely correlated with plasma phenylalanine levels in treated PKU.
Isle of Wight Studies, 1964–1974
Authors: Rutter Michael , Tizard Jack , Yule William , Graham Philip , Whitmore Kingsley
Published: July 2009

The Isle of Wight Studies began in 1964–65 with a series of epidemiological studies of educational, psychiatric and physical disorders in 9- to 11-year-old children. These early studies were financed by the Department of Education and Science and the Foundation for Child Development (then the Association for the Aid of Crippled Children). The findings were fully reported in two books (Rutter, Tizard & Whitmore, 1970; Rutter, Graham & Yule, 1970) and only brief details are included here.
Mental illness, neuroticism and life events in a Dutch village sample: a follow-up
Authors: Giel R. , Horn G. H. M. M. Ten , Ormel J. , Schudel W. J. , Wiersma D.
Published: July 2009

SYNOPSIS

In a 5-year follow-up of 32 patients identified during a survey of a Dutch village in 1969, approximately two-thirds were found to have recovered. This result was reflected in the scores on a self-reporting questionnaire. A control group showed little change over those years. The persistence of psychiatric problems was related to life experience, as measured by a life-event interview.
Antihypertensive drugs and depression: a reappraisal
Authors: Bant Wendy P.
Published: July 2009

SYNOPSIS

Eighty-nine new referral hypertensive out-patients and 46 new referral non-hypertensive chronically physically ill out-patients completed a mood rating scale at regular intervals for one year. The results showed a high prevalence of depression in both groups of patients, with no preponderance in the hypertensive group. Hypertensive patients with psychiatric histories had a higher prevalence of depression than the comparison patients. This was accounted for by a significant number of depressions occurring in methyl dopa treated patients with psychiatric histories.
Factor analysis of a sleep evaluation questionnaire
Authors: Parrott A. C. , Hindmarch I.
Published: July 2009

SYNOPSIS

A self-completion sleep evaluation questionnaire (SEQ), consisting of 10 cm line analogue rating scale questions, was constructed to investigate subjects' responses to aspects of sleep and early morning behaviour. The questions were grouped into 4 chronological areas: the ease of getting to sleep (GTS), the perceived quality of sleep (QOS), the ease of awakening from sleep (AFS), and the integrity of early morning behaviour following wakefulness (BFW). Five hundred and one SEQs were completed during several investigations into the comparative effectiveness of hypnotic drugs. The classical factor analysis produced 4 factors which corresponded to the 4 aspects of sleep and early morning behaviour listed above. The GTS and QOS factors were positively correlated (+ 0·57), as were the AFS and BFW factors (+ 0·48). The 2 sleeping state factors (GTS and QOS) were orthogonal to the 2 waking state factors (AFS and BFW).
Sex differences in perception of illness and expressed life satisfaction
Authors: Briscoe Monica E.
Published: July 2009

SYNOPSIS

A preliminary survey of 10 married couples was carried out to test the hypothesis that women express greater dissatisfaction with their health and other personal life domains than men. Although the women made more use of medical facilities for minor complaints than their husbands, no difference was found in expressed satisfaction, or in number or severity of symptoms reported at interview. However, there was a discrepancy between husbands' and wives' perception of their spouses' satisfaction levels and experience of illness-symptoms, in the direction of wives being perceived by their husbands as considerably less healthy and more dissatisfied than the husbands were rated by their wives. Some evidence was also found for greater emotionality in women. The results are regarded as indicating that illness is more socially acceptable in women than in men.
Psychological response to cancer and survival
Authors: Greer S.
Published: July 2009

SYNOPSIS

The hypothesis is advanced that the psychological stance which patients adopt in response to cancer can, in some cases, influence the course of their disease. This hypothesis is examined in the light of the author's 15-year follow-up study of women with early breast cancer and of other pertinent studies. The available evidence supports the hypothesis in respect of certain earlystage non-metastatic cancers.
Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients
Authors: Watson Maggie , Greer Steven , Rowden Linda , Gorman Christine , Robertson Bernadette , Bliss Judith M. , Tunmore Robert
Published: July 2009

SYNOPSIS

The possible relationship between psychological responses among breast cancer patients and discase outcome continues to be an area of controversy and debate. Two parallel findings are reported separately in the literature: first, that emotional control is more common among women with breast cancer than in women with benign breast disease or in healthy controls and second, that a helpless attitude towards the disease is related to a poor prognosis.

These previously unrelated psychological responses are examined here in a group of women (N = 359) with early stage breast cancer, who were seen one to three months after diagnosis. The relationships between emotional control, adjustment to cancer and psychological morbidity were examined. Prevalence levels of 16 and 6% were observed for anxiety and depression respectively, which are lower than reported more generally in the literature. The results indicated a highly significant association between scores for the tendency to control emotional reactions and a fatalistic attitude toward cancer. A significant association was observed between anger control and a helpless attitude. Psychological morbidity was also linked to type of adjustment to cancer. The data are interpreted in terms of a process model of psychological responses which suggests that emotional control (an important component of the Type C behaviour pattern) fatalism, helplessness and psychological morbidity are linked.
Cognitive impairment and functional disability in the absence of psychiatric diagnosis
Authors: Bassett Susan Spear , Folstein Marshal F.
Published: July 2009

SYNOPSIS

Data from the 1981 East Baltimore Mental Health Survey were used to examine the relationship between cognitive impairment and psychiatric diagnosis in an adult population. The Mini-Mental State Examination was administered to 3841 household respondents and a subset of 810 received psychiatric evaluations. Of the 810, 23% were found to be cognitively impaired. Over one-third of those with cognitive impairment, however, did not meet DSM-III criteria for a psychiatric diagnosis. Education, geographical background, race and neurological status were predictive of cognitive performance. There was no linear effect of age on cognitive performance with disease status and education controlled. In addition to their cognitive impairment these individuals, who ranged in age from 19 to 89, were found to have significant functional disabilities. Cognitive performance itself, along with physical and emptional health, predicted total functional disability.
Kleptomania: clinical characteristics and associated psychopathology
Authors: McElroy Susan L. , Hudson James I. , Pope Harrison G. , Keck Paul E.
Published: July 2009

SYNOPSIS

A review of research on Kleptomania – the syndrome of compulsive stealing – suggests that kleptomania may be a common disorder, especially among women, and that it may frequently be associated with other forms of psychopathology, such as mood, anxiety, and eating disorders. There appears to be a range of abnormal or non-antisocial stealing behaviours, all with impulsive and/or compulsive features. Kleptomania, as defined by modern criteria, may represent the most compulsive variant. Kleptomania may be related to mood disorder, and might be a form of ‘affective spectrum disorder’.
Psychological, hormonal and biochemical changes following carbohydrate bingeing: a placebo controlled study in bulimia nervosa and matched controls
Authors: Turner M. St J. , Foggo M. , Bennie J. , Carroll S. , Dick H. , Goodwin G. M.
Published: July 2009

SYNOPSIS

The responses of thirteen patients with bulimia nervosa and sixteen controls matched for age and weight are described following the ingestion of a carbohydrate and a calorie-free placebo mixture in simulated binges. Psychological, hormonal and biochemical parameters were measured before and at 15 minute intervals for two hours after the simulated binge.

At baseline, the bulimics were clearly more symptomatic than the controls. The control population showed a specific satiating effect of carbohydrate upon hunger ratings. Bulimic patients responed differently showing a blunting of the normal sensation of hunger and an enhanced rating for nausea.

Prolactin, growth hormone (GH) and cortisol failed to show a carbohydrate-mediated stimulation in either population. The bulimic patients showed a different pattern of GH release, but this was independent of the challenge condition. Large neutral amino acid (LNAA) levels fell following carbohydrate ingestion, but produced an increase of up to 20% in the trytophan: LNAA ratio in both bulimic patients and the control group. Thus, while this increase in tryptophan availability failed to provoke hormone release, the time course of the carbohydrated specific effect on the sensations of hunger and nausea is compatible with a mechanism based on increased tryptophan availability. The confusion of satiety with nauseas may provide a useful focus for the future treatment of patients with bulimia nervosa.
Psychometric assessment of psychiatric disorders in people with learning difficulties (mental handicap): a review of measures
Authors: Sturmey P. , Reed J. , Corbett J.
Published: July 2009

SYNOPSIS

Instruments designed to assess psychiatric disorders in people with learning difficulties (mental handicap) were critically reviewed from a psychometric perspective. Major trends were found in the assessment of psychopathology related to DSM-III and depressive disorders although research in other areas was patchy. Although some psychometrically sophisticated measures were identified the area was characterized by an absence of important psychometric data for many measures. Future research should attend to developing assessments of schizophrenia, psycho-sexual disorders, adjustment disorders and the validation of screening procedures and instrument formats. Future studies should include more people with severe and profound learning difficulties.
Social indicators and psychiatric admission rates: a case-register study in the Netherlands
Authors: Sytema Sjoerd
Published: July 2009

SYNOPSIS

Environmental as well as individual socio-demographic and illness characteristics are related to the risk of admission. This paper addresses the problem of the interrelationships of these factors to admission rates. Using the Groningen Psychiatric Case Register, admission rates (during 1986 and 1987) from 34 administrative areas were calculated. Logit models were fitted in order to test the relationship between the relative risk of being admitted and sex, age, marital status, diagnosis, urbanization and distance from facilities. The effect of urbanization remains under the control of the other independent variables. The concept of ‘need for care’, related to ‘true’ and ‘treated’ incidence, is discussed.
The influence of education and social class on the diagnosis of dementia in a community population
Authors: O'Connor D. W. , Pollitt P. A. , Treasure F. P.
Published: July 2009

SYNOPSIS

We have reported previously that poorly educated elderly people and those of low social class were at much increased risk of scoring below the customary cut-point on the Mini-Mental State Examination, a widely-used, brief cognitive screening test. As part of the same study, subjects who scored 23 or less on the MMSE out of a maximum of 30 points, and a sample of those who scored 24 or 25 points, were assessed by psychiatrists using a structured, diagnostic interview. Assuming that persons who scored 26 points or above were cognitively intact (our data suggest that 2% or less were not), neither educational attainment nor social class had any influence on the likelihood that subjects would be diagnosed as demented. Our data suggest that social and psychological factors contribute substantially to cognitive test scores and serve to emphasize the importance of detailed assessment procedures in epidemiological surveys of dementia.
An HLA and family study of Alzheimer's disease
Authors: Renvoize E. B.
Published: July 2009

Synopsis

Histocompatibility antigens were examined in 124 patients with Alzheimer's disease (AD), and the frequency of HLA-B15 was found to be significantly increased over controls. Pooling of data from the present and similar studies suggests that AD is not strongly associated with any particular HLA antigen, although there may be a weak association with HLA-A2, B15 and Cw3. In a family study of 34 patients with AD, secondary cases of AD were identified in 9·7% of the first-degree relatives, and cases of presenile dementia and senile dementia of the Alzheimer type were found to occur within individual families.
The therapeutic effect of ascorbic acid and EDTA in manic-depressive psychosis: double-blind comparisons with standard treatments
Authors: Kay D. S. G. , Naylor G. J. , Smith A. H. W. , Greenwood C.
Published: July 2009

Synopsis

The effect of ascorbic acid and ethylene diamine tetra acetic acid (EDTA) in the treatment of manic-depressive psychosis was compared, using double-blind procedures, with recognized treatment regimes. There was no significant difference between the response of depressed patients to amitriptyline or ascorbic acid and EDTA. Manic patients responded significantly better to lithium than to ascorbic acid and EDTA. These results are in keeping with the suggestion that vanadium may be of aetiological importance in depressive psychosis, but do not support such a suggestion for mania.
Unemployment and psychological ill-health: the moderating role of duration and age
Authors: Jackson Paul R. , Warr Peter B.
Published: July 2009

Synopsis

The relationship between length of unemployment and psychological ill-health was examined in a sample of 954 unemployed working-class men, selected to cover all levels of age and several levels of duration of unemployment. The association between length of unemployment and psychological ill-health was found to be strongest in the middle age groups, with greater ill-health among those with a longer duration since job loss. No association between duration and ill-health was found for those who had recently entered the labour market or who were close to the end of their working lives. Desire for a job and financial stress were shown to be additional mediators of psychological ill-health during employment. A cumulative stress model is proposed to account for these findings.
‘Psychosocial’ interventions with families and their effects on the course of schizophrenia: a review
Authors: Barrowclough Christine , Tarrier Nicholas
Published: July 2009

Synopsis

Recent interest in the way social factors influence the course of schizophrenia has led to attempts to monitor and manipulate these factors. The work on the Expressed Emotion of the relative has been especially influential in this area. A number of studies have now been conducted in which a psychosocial intervention has been employed in an attempt to prevent relapse after discharge from hospital. These studies are reviewed with an emphasis on their methodological adequacy and on the nature of the intervention used. Recent studies have demonstrated a positive result for psychosocial interventions used in combination with neuroleptic medication. However, analysis of these studies does not allow us to conclude that we can identify the ‘active ingredients’ in these psychosocial treatment regimes. Although there is cause for optimism, further investigation is required.
Suicidal intent and repeated self-harm
Authors: Pierce David
Published: July 2009

Synopsis

The value of identifying self-harm patients who repeat with rising suicidal intent is discussed. A study is described measuring changes in intent with repetition by means of an intent scale. Patients repeating once in 5 years scored significantly higher in intent for their second episodes, while multiple repeaters tended to score lower for second episodes. Patients under the age of 35 were most at risk for repetition with increasing intent within 2 years. No correlation emerged between the rise in intent and the time interval between episodes over a 7-year period. The 5-year suicide rate was higher among rising intent repeaters than other cases. These findings are discussed.
Variable clinical response to choline in tardive dyskinesia
Authors: Nasrallah Henry A. , Dunner Frederick J. , Smith Robert E. , McCalley-Whitters Mona , Sherman Arnold D.
Published: July 2009

Synopsis

Tardive dyskinesia is widely believed to be a state of relative hyperdopaminergic and hypocholinergic imbalance in the striatum of patients chronically treated with neuroleptics. However, not all patients with tardive dyskinesia respond to cholinergic drugs, which theoretically should restore the balance and improve the symptoms. We report a controlled, double-blind, crossover study of choline chloride in 11 patients with persistent tardive dyskinesia. Seven patients showed partial or minimal improvement, while two did not change and two deteriorated. The results are discussed in the light of other similar findings in the literature, and the implications for pharmacological subtypes of tardive dyskinesia using cholinergic probes are explored.
Possible association of schizophrenia with a disturbance in prostaglandin metabolism: a physiological hypothesis
Authors: Feldberg W.
Published: July 2009

Synopsis

Schizophrenia may be associated with increased prostaglandin synthesis in certain parts of the brain. This hypothesis is based on the following findings: (1) Catalepsy, which is the nearest equivalent in animals to human catatonia, develops in cats when prostaglandin E1 is injected into the cerebral ventricles and when during endotoxin or lipid A fever the prostaglandin E2 level in cisternal c.s.f. rises to high levels; however, when fever and prostaglandin level are brought down by non-steroid anti-pyretics which inhibit prostaglandin synthesis, catalepsy disappears as well. (2) Febrile episodes are a genuine syndrome of schizophrenia.
The effects of clomiphene citrate on the hypothalamic–pituitary–gonadal axis in anorexia nervosa
Authors: Wakeling A. , Marshall J. C. , Beardwood C. J. , de Souza V. F. A. , Russell G. F. M.
Published: July 2009

Synopsis

Serum luteinizing hormone(LH) responses to a course of clomiphene citrate were studied in eleven patients with anorexia nervosa at different stages of the illness. In malnourished patients basal levels of LH were invariably low. With the resumption of a normal weight a small but definite rise in LH levels was observed but this spontaneous response to weight gain was variable in that many patients continued to exhibit abnormally low LH levels.

The response to clomiphene in terms of a rise in basal LH levels after administration of the drug, followed by a second peak of LH and subsequent menstrual bleeding, was clearly dependent in part on the patient's nutritional state. In the malnourished state the response to clomiphene was usually either absent or incomplete. After the resumption of a more normal weight, the patients invariably showed an initial rise in LH after the clomiphene, but the second LH peak and subsequent menstruation were frequently not demonstrated. Six patients maintained a normal body weight for at least six months after a course of clomiphene, but only three of them resumed cyclical menstrual bleeding. It was concluded that factors additional to the nutritional state contribute to the prolonged amenorrhoea in anorexia nervosa and that clomiphene appears to have only a limited role in the treatment and management of patients with the disorder. Some aspects of current knowledge of the endocrine mechanisms that regulate normal menstruation and of the mode of action of clomiphene are outlined.

The results of the present study are discussed against this background in an attempt to elucidate further the hypothalamic disorder underlying the amenorrhoea in anorexia nervosa.
A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule: I. Development and reliability
Authors: Copeland J. R. M. , Kelleher M. J. , Kellett J. M. , Gourlay A. J. , Gurland B. J. , Fleiss J. L. , Sharpe L.
Published: July 2009

Synopsis

A standardized, semi-structured interview for examining and recording the mental state in elderly subjects is described. It allows the classification of patients by symptom profile and can demonstrate changes in that profile over time. It is believed that good reliability is demonstrated between psychiatric raters both for psychiatric diagnosis made on the basis of the schedule findings and for individual items. The Geriatric Mental State Schedule (GMS) consists mainly of items from the eighth edition of the PSE (Wing et al. 1967), together with additional items from the PSS (Spitzer et al. 1964), and extra sections dealing with disorientation and other cognitive abnormalities. Modifications have been introduced to facilitate interviewing elderly subjects.
A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule: II. A factor analysis
Authors: Gurland B. J. , Fleiss J. L. , Goldberg K. , Sharpe L. , Copeland J. R. M. , Kelleher M. J. , Kellett J. M.
Published: July 2009

Synopsis

One hundred geriatric psychiatric patients were examined with the Geriatric Mental State Schedule in New York and London, and a correlation procedure involving both clinical and statistical operations was carried out on the psychopathological data thus collected. Twenty-one factors were produced, including three dealing with cognitive impairment. Although it was found that elderly depressives show a profile of psychopathology quite different from that shown by patients with organic disorder, it was also found that patients with an apparently functional disorder may sometimes be diagnosed as an organic disorder, that subjective complaints of intellectual impairment are not good indicators of organic disorders and may be associated with a depressive factor, and that complaints that could be dismissed as attributes of ageing may actually be indicative of a depressive disorder in the elderly. The methodological implications, as well as the limitations of the sample size, are discussed.
The prediction of outcome in elderly psychiatric patients
Authors: Whitehead Antonia
Published: July 2009

Synopsis

Clinical and psychometric characteristics of a sample of elderly psychiatric patients were established soon after admission and they were then followed for 1 year. Anoutcome was most successful for an unfavourable type which was predictable by measures related to intellectual impairment.
Interpersonal relationships - in quest of a science
Authors: Hinde R. A.
Published: July 2009

Synopsis

Interpersonal relationships pose problems additional to those arising from social behaviour. If there is to be a science of interpersonal relationships, it must rest on a firm descriptive base. It is suggested that the following categories of dimensions are likely to prove useful: the content of the interactions within the relationship; their diversity; their qualities; their relative frequency and patterning; the nature of their reciprocity v. complementarity; and the intimacy, interpersonal congruency and commitment between the participants. A science of relationships will also require principles concerned with their dynamics. Three likely categories are those concerned with social constraints, with learning, and with positive and negative feedback. Principles concerned with learning will require an adequate categorization of the resources used in interpersonal interactions. The specification of these principles depends on the adequacy of the descriptive base.
Behavioural syndromes identified by cluster analysis in a sample of 100 severely and profoundly retarded adults
Authors: Reid A. H. , Ballinger B. R. , Heather B. B.
Published: July 2009

Synopsis

Very little is known about psychiatric disorders in severely and profoundly retarded adults. We have investigated these disorders by systematically recording and collecting data about the behaviour of 100 severely and profoundly retarded hospitalized adults and subjecting the data thus derived to cluster analysis. Eight clusters were isolated. The clinical psychiatric significance of these clusters is discussed and their relationship to cause of retardation, duration of stay in hospital and visiting is considered. A diagnostic framework for psychiatric disorder in severely and profoundly retarded adults is put forward and some possible treatment approaches are suggested.
Have the Samaritans lowered the suicide rate? A controlled study
Authors: Jennings C. , Barraclough B. M. , Moss J. R.
Published: July 2009

Synopsis

Suicide rates in towns with a Samaritan branch were compared with rates in matched control towns without a branch. Four methods of choosing controls are described, all of which have advantages over those used by Bagley (1968). No statistically significant differences between Samaritan and control towns were found. The scientific case for the effectiveness of the Samaritans in reducing the suicide rate is therefore seriously weakened.
The striatonigral fibres and the feedback control of dopamine metabolism
Authors: Tulloch I. F. , Arbuthnott G. W. , Wright A. K. , Garcia-Munoz M. , Nicolaou N. M.
Published: July 2009

Synopsis

It proved possible to make lesions which interrupted the striatonigral GABA-containing pathway in the rat brain without causing concomitant damage to the nigrostriatal dopamine containing system. Estimations of striatal concentrations of dopamine (DA), dihydroxyphenyl-acetic acid (DOPAC) and homovanillic acid (HVA) indicated that these lesions had no influence either on normal striatal DA turnover or on the enhancement of DA turnover induced by neuroleptics. Behavioural experiments suggested a motor output function for the striatonigral pathway.
The feasibility of tracing a sample of school-boys after a lapse of fifteen years
Authors: Mitchell Sheila , Jackson Derek
Published: July 2009

Synopsis

Although the relationship between childhood behaviour and adult adjustment is often presented as established fact, relatively few non-retrospective studies have actually examined this perceived association. This paper presents a description of the attempt to establish the feasibility of tracing children after a lapse of 15 years and suggests that this may present fewer insuperable difficulties than might be imagined.
Clinical Research Centre Division of Psychiatry 1974–1977
Authors: Crow T. J.
Published: July 2009

The Clinical Research Centre was established by the Medical Research Council as a major focus for patient-orientated research and as the clinical counterpart of the National Institute for Medical Research at Mill Hill which for 40 years has been the Council's largest establishment for basic research. In cooperation with the Department of Health and Social Security the Council embarked upon the Northwick Park project in which the Clinical Research Centre is closely integrated with a district general hospital – Northwick Park Hospital – built at the same time, and designed to serve the population of the Harrow Health District. Across each of the major specialties the Clinical Research Centre has Divisions with varying degrees of involvement in patient care. While there are 600 (District) beds allocated to local District needs, there are further 200 (National) beds which, in principle, are available for investigating and treating patients from outside the District admitted for research purposes. In practice, the extent to which research takes place on patients admitted for special investigations and, on the other hand, on patients admitted from the District as part of the service commitment, varies widely with specialty. In psychiatry it is predominantly the case that patients under investigation have been admitted from the District.