bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of the validity of GHQ-12 and CHQ-12 in Chinese primary care patients in Manchester
Authors: Pan Pey-Chyou , Goldberg David P.
Published: July 2009

Synopsis

The present study compares the efficacy of the GHQ-12 and the Chinese Health Questionnaire (CHQ–12) in Cantonese speaking Chinese primary-care patients living in Greater Manchester, using relative operating characteristic (ROC) analysis. We did not find that the Chinese version offered any advantage over the conventional version of the GHQ in this population. Stepwise discriminant analysis however confirmed the value of individual items in the former pertaining to specific somatic symptoms and interpersonal relationships in differentiating cases from non-cases. Information biases, arising from the lack of a reliability study on the second-stage case identifying interview and the unique linguistic characteristics of the Chinese language may have affected the overall validity indices of the questionnaires. The study also examines the effects of using different criteria to define a case, and shows that with increasing levels of severity, there is an improvement in the diagnostic performance of the two questionnaires as reflected by areas under ROC curves and traditional validity indices. Possible explanations of these findings are discussed. The scoring method proposed by Goodchild & Duncan-Jones (1985) when used on these questionnaires had no demonstrable advantage over the conventional scoring method.
The inter-relationship of premenstrual symptoms
Authors: Mira M. , Abraham S. , McNeil D. , Vizzard J. , Macaskill P. , Fraser I. , Llewellyn-Jones D.
Published: July 2009

SYNOPSIS

The prospective symptom reports of women seeking treatment for premenstrual symptoms and control subjects were investigated. In order to compare symptom reports from premenstrual symptom sufferers and control subjects a method of combining and analysing prospectively collected menstrual cycle symptom data is required. A technique that uses the time of onset of menses and the time of ovulation (as measured by urinary luteinizing hormone excretion) to standardize each cycle into 14 time points was developed. Summary factors were then empirically derived from data collected prospectively from 30 premenstrual symptom sufferers and 19 control subjects. Twenty-two mood symptoms were summarized into a single factor and the 29 most frequently occurring physical symptoms were summarized into two factors. Factor scores were calculated on the basis of these factors and the effect of time during the menstrual cycle on these scores examined. Both physical symptom factor scores increased significantly in the luteal phase for both the premenstrual symptom sufferer group and the control group. The single mood factor score increased significantly in the luteal phase for the premenstrual symptom sufferer group but not for the control group, suggesting that the only qualitative difference between the groups was the presence of cyclic mood symptoms in the premenstrual symptom sufferer group. The premenstrual symptom sufferer group recorded significantly higher scores on each of the three factors than the control group. The correlation between the scores on each of the factors over three cycles was high both in the follicular and luteal phase suggesting that these factor scores provide a reproducible measure of menstrual cycle symptomatology.
Prevalence of eating disorders and minor psychiatric morbidity in Central Europe before the political changes in 1989: a cross-cultural study
Authors: Rathner G. , Túry F. , Szabó P. , Geyer M. , Rumpold G. , Forgács A. , Söllner W. , Plöttner G.
Published: July 2009

SYNOPSIS

The prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern European countries and in one Western democracy. A total of 1225 female and male medical students in Hungary, the German Democratic Republic (GDR) and Austria were surveyed. The instruments included the Eating Disorder Inventory and the GHQ. The prevalence of eating disorders was calculated on the basis of simulated DSM-III-R diagnosis. In females, bulimia nervosa prevalence rates of 0·6% (95% CI 0·02, 3·46), 1% (0·2, 2·95) and 0% (0, 2·07) were calculated for Austria, Hungary and the GDR, respectively. For subclinical bulimia nervosa, the rate for Hungary (3·8%; 1·95, 6·72) was twice as high as for Austria (1·9%; 0·39, 5·5) and the GDR (1·7%; 0·36, 4·88). Hungarian subjects indicated more psychiatric ‘caseness’ than their GDR or Austrian counterparts. We conclude that eating disorders represented at least as common a problem in Eastern as Western Europe before the changes in political organization. This may be due to an identification process with Western values. A further increase of eating disorders in these countries induced by the recent changes may be possible.
Symptoms of psychological distress predict 7-year mortality
Authors: Huppert Felicia A. , Whittington Joyce E.
Published: July 2009

SYNOPSIS

As part of the Health and Lifestyle Survey (HALS), 6096 adults from a representative sample of community residents completed a standardized questionnaire which elicited psychiatric symptoms – the General Health Questionnaire (GHQ-30) of Goldberg (1972). Their survival status at 7 years was determined, and 474 had died. Respondents whose GHQ score was above the conventional threshold (4/5), used when screening for psychiatric disorder, were 60% more likely to die over the 7-year interval than respondents whose GHQ score was below threshold (risk ratio 1·64 for men and 1·58 for women). The differences were statistically significant for both sexes when the effects of age, physical disorder, social class and smoking behaviour were taken into account. Personality traits (neuroticism, extraversion) were not related to mortality, neither was self-reported difficulty in sleeping. However, a low subjective rating of one's general health was associated with increased mortality. We explored a range of cut-points and found reliable effects for both sexes at all cut-points from 3/4 to 6/7. Possible differences related to naturalversusunnatural causes of death were explored and found not to explain the results. The findings from this general population study confirm that it is not only psychiatric disorders, but also psychiatric symptoms, which are associated with subsequent mortality, and thereby reinforce the importance of appropriate intervention to alleviate these symptoms.
Gender differences in family attitudes about schizophrenia
Authors: Davis J. A. , Goldstein M. J. , Nuechterlein K. H.
Published: July 2009

Synopsis

Recent studies have found that the expressed emotion (EE) status of relatives of female schizophrenics may not possess the prognostic value found previously for male schizophrenics. In the present study, relatives of 110 recent onset schizophrenic patients were assessed using the Camberwell Family Interview (CFI-EE), the Five Minute Speech Sample Method (FMSS-EE) and a measure of Affective Style (AS) to determine whether affective attitudes or behaviours varied by patient gender. Brief Psychiatric Rating Scale (BPRS) ratings made during in-patient and outpatient periods were examined to assess patient symptomatology. No differences were found by patient gender for CFI-EE, FMSS-EE, or subcomponents of the CFI-EE measure. However, when the subcomponents on the FMSS associated with a high EE critical rating were examined, males were found to be recipients of more harsh criticism than female patients. Similarly, for the AS measure, there was a distinct subgroup of male patients who received a level of criticism not seen in female patients. When the concordance across the two EE measures was examined, relatives of males were more consistent in their affective attitudes than relatives of female patients. Analysis of the BPRS data from the in-patient to the out-patient periods suggested variations by patient gender which may explain some of the differences in relatives' affective attitudes.
Difficult to place patients in a psychiatric hospital closure programme: the TAPS project 24
Authors: Trieman Noam , Leff Julian
Published: July 2009

Synopsis

A group of 72 long-term patients, who were retained in Friern Hospital until the final stage of its closure programme, underwent a comprehensive psychiatric and social assessment shortly before moving to other hospitals. These patients were then compared with the rest of the long-stay patients who were considered suitable for community placement.

The residual group consisted of younger patients with shorter duration of stay, compared with the rest of the hospital population. Although not excessively disabled functionally or physically, the residual patients were slightly more disturbed in mental state in comparison with the rest, with notably higher levels of subjective anxiety.

A range of 13 problem behaviours were designated by staff as a direct impediment to placing a patient in a community setting. Most common problem areas were aggressiveness, non-compliance with medication and inappropriate sexual behaviour. Fourteen per cent of the residual group had none of these special problems. Some other patients have remained in hospital solely because they refused to leave.

It is argued that a distinction should be made between the residual patients who were actually transferred to other hospitals, and a core group of extremely disturbed patients for whom further hospitalization is likely to be the only alternative.
Mental health problems in the Gomel region (Belarus): an analysis of risk factors in an area affected by the Chernobyl disaster
Authors: Havenaar J. M. , Van Den Brink W. , Van Den Bout J. , Kasyanenko A. P. , Poelijoe N. W. , Wohlfarth T. , Meijler-Iljina L. I.
Published: July 2009

Synopsis

The epidemiology of mental problems in the Gomel region in the republic of Belarus was studied in a two-stage survey of a broad based population sample (N = 1617), using the General Health Questionnaire (12-item version) and the Munich Diagnostic Checklist for DSM-III-R. The Gomel region is one of the areas that was most severely affected by the Chernobyl nuclear diaster in 1986. In the studied population sample 64·8% had a GHQ-score above the threshold of 2. A DSM-III-R psychiatric disorder was present in 35·8%, with especially high rates for affective (16·5%) and anxiety disorders (12·6%). Dysthymia, general anxiety disorder, adjustment disorders and ‘not otherwise specified syndromes’ made up almost two-thirds of the observed morbidity (22·9%). A higher prevalence of mental health problems, both in terms of the GHQ and the DSM-III-R was observed among people who have been evacuated and in mothers with children under 18 years of age. These data indicate that the Chernobyl nuclear disaster may be partly responsible for the high prevalence of (milder) psychiatric disorders and psychological distress in the Gomel region, even 6 years after the event. Future studies comparing the data from Gomel region with an unexposed area will have to provide a more definite answer concerning the impact of this nuclear disaster on mental health.
Growth hormone response to clonidine in male patients with panic disorder untreated by antidepressants
Authors: Schittecatte M. , Ansseau M. , Charles G. , Machowski R. , papart P. , Pichot W. , Wilmotte J.
Published: July 2009

Synopsis

We report a non-significantly higher growth hormone (GH) response to intravenous clonidine administration (150 μg) in 10 male patients with panic disorder who had never received antidepressant therapy than in 10 matched controls. These results are consistent with data suggesting a normal or increased adrenergic receptor sensitivity in panic disorder patients.
Aetiology of anxiety and depressive disorders in an inner-city population. 1. Early adversity
Authors: Brown G. W. , Harris T. O.
Published: July 2009

Synopsis

A survey of an inner-city population of working-class and single mothers is described and the prevalence of anxiety and depression reported using two related diagnostic schemes, Bedford College caseness and DSM-III-R. This acts as an introduction to an analysis which indicates that adverse experiences in childhood and adolescence (involving parental indifference, and sexual and physical abuse) considerably raise risk of both depression and anxiety conditions (with the exception of mild agoraphobia and simple phobia) in adult life.
Stupor: a conceptual history
Authors: Berrios G. E.
Published: July 2009

Synopsis

The concept of ‘stupor’ is subjected to historical analysis. Particular attention is given to the nineteenth-century, during which three evolutionary stages are identified. During the first stage stupor is considered as a simple state of non-responsiveness. The second stage recognizes that some stupors are accompanied by rich subjective experiences and separates them as ‘psychiatric stupors’. During the third stage some of its symptoms are reinterpreted as resulting from an interaction between patient and environment. A number of historical sources are reviewed in an attempt to illustrate the evolution of the concept and its association with cognate behavioural states.
Stress arousal and coping with surgery
Authors: Ray C. , Fitzgibbon G.
Published: July 2009

Synopsis

There is little evidence of a curvilinear relationship between pre-operative emotionality and post-operative adjustment, as predicted by a model which supposes that moderate preoperative anxiety assists adjustment. This paper suggests that the negative affect, or stress, associated with the work of worry should be distinguished from the active coping orientation which it also implies. In this study stress and arousal were assessed pre-operatively in a sample of cholecystectomy patients, and correlations between these scores and various indices of post-operative adjustment were computed. Stress before surgery was positively related to stress and pain experienced post-operatively. Arousal, by contrast, was negatively related to pain, medications and period before discharge. Female patients had higher stress scores than the males, while the direction of the difference was reversed in the case of arousal. These findings are interpreted as support for the significance of the role of coping orientation, as represented by arousal, in promoting adjustment, with emotionality or stress playing a less significant and even negative role.
The impact of interviewer variability in an epidemiological survey
Authors: O'Muircheartaigh C. A. , Wiggins R. D.
Published: July 2009

Synopsis

One of the principal sources of error in data collected from structured interviews with respondents is the method of measurement or observation itself. In this paper the differential impact of each of a group of interviewers on the responses obtained in an epidemiological survey is examined. The effect is measured and its impact on the interpretation of individual responses, scale scores and model fitting is shown.
Psychiatric disorder and its declaration in contrasting areas of South Wales
Authors: Ingham J. G. , Rawnsley K. , Hughes D.
Published: July 2009

Synopsis

An earlier study suggested that the mining valleys of South Wales produced a higher rate of declared psychiatric illness than nearby rural areas. A replication during a later period showed that the rural area had now caught up with the mining area but a difference in sex ratios between the two areas had remained remarkably constant. A sampling survey, using self-assessment of symptoms in random samples, indicated that differential selection into the psychiatric services was likely to be a determining factor.
Chronic schizophrenia and discharge from hospital
Authors: Pryce I. G.
Published: July 2009

Synopsis

A group of male chronic schizophrenies in hospital for over two years was compared with a similar group attending a day hospital in respect of severity of handicaps and social circumstances. Inpatients were significatitly more handicapped on all the measures used, and it was concluded that severity of handicaps was the main reason for the failure to discharge them from hospital. The implications for the planning of services for the chronic psychiatric patient are discussed.
Anorexia nervosa and the regulation of intake: a review
Authors: Mawson A. R.
Published: July 2009

SYSNOPSIS

Recent work on the central mechanisms of food intake is reviewed in relation to anorexia nervosa. On the basis of the present review a number of conclusions are drawn as possible avenues for future research. A proposal is outlined for the investigation of L-dopa as a potential treatment for anorexia nervosa.
The psychology and psychiatry of Henrik Sjöbring (1879–1956)
Authors: Essen-Möller Erik
Published: July 2009

SYNOPSIS

Synopsis An outline is provided of Henrik Sjöbring's contributions to psychology and psychiatry. Emphasis is placed on the significance of his work on mental functioning, personality dimensions and lesional disorders.
The reliability of reporting adverse experiences
Authors: Steele G. P. , Henderson Scott , Duncan-Jones Paul
Published: July 2009

SYNOPSIS

The reliability of reporting of life-events was examined in 52 subjects attending clinics. An inventory of events and longer-standing difficulties was administered on 2 occasions, 7–14 days apart. High levels of reliability were found for the number of events, the mean score for distress or change over all events, and for the single event with the highest score. The reporting of individual events was less reliable: only 70 % of those events reported at either interview were reported under the same heading at both interviews. Subjective reactions to events differ in reliability according to the type of response, and they are less reliable for single events than overall. Lastly, the reliability of highly distressing events is in fact lower than for the less distressing. These findings point to some of the shortcomings of inventory methods in life-event research.
Skin melanin concentrations in the affective disorders: possible relationships to the catecholamine hypothesis
Authors: Robins Ashley H.
Published: July 2009

Synopsis

SYNOPSIS Skin melanin concentrations were measured by reflectance spectrophotometry in patients during the active phase of a primary affective illness and in normal subjects. There were no significant differences between 27 females with depression (unipolar illness) and 17 females with mania (bipolar illness) or between a mixed group of 30 male patients with mania and depression (predominantly mania) and a normal sample of 27 male subjects. These negative results are discussed in terms of the catecholamine hypothesis of the affective disorders. A study of brain pigmentation is suggested as being a potentially useful investigation in manic-depressive psychosis.
Changes in glucagon level associated with anxiety or stress
Authors: Bloom S. R. , Daniel P. M. , Johnston D. I. , Ogawa Olivia , Pratt O. E.
Published: July 2009

Synopsis

A sudden loud noise produced a large and rapid rise in plasma glucagon in the conscious primate. A similar rise took place when stresses were applied to anaesthetized animals.
Estimation of corticosteroids in human cerebral cortex after death by suicide, accident, or disease
Authors: Brooksbank Benjamin W. L. , Brammall Margaret A. , Cunningham Ann E. , Shaw David M. , Camps Francis E.
Published: July 2009

SYNOPSIS

The concentration of cortisol (F) has been found to decrease only to a limited extent in intact brain tissue maintained at ambient temperature after death, and the decrease is mainly accounted for as 20-dihydrocortisols (DHF). The sum of F and DHF has therefore been estimated in samples of frontal cortex removed from human cadaver brains collected at necropsy, and taken as a measure of the concentration of cortisol at death. Corticosterone concentration was also estimated. The concentration of cortisol in the cerebral cortex of physically healthy individuals who had committed suicide was consistently as low or lower than in the cortex of control patients who had died suddenly without antecedent severe illness. It is concluded therefore that neither the presumed severe emotional stress preceding suicide nor depressive illness itself is associated with high levels of cortisol in the cerebral cortex. On the other hand, it was found that the cerebral cortical concentration of cortisol in patients who had died from stressful somatic diseases was raised and that the increase was roughly related to the likely degree and duration of the physical stress endured by the patients. There was some indication that the ratio of cortisol (F+DHF) to corticosterone may be lower in the cerebral cortex of suicides than in that of controls.
Daily variations of the urine content of 3-methoxy-4-hydroxyphenylglycol in two manic-depressive patients
Authors: Bond P. A. , Jenner F. A. , Sampson Gwyneth A.
Published: July 2009

SYNOPSIS

Daily measurements of MHPG in urine have been carried out in two patients with manic-depressive psychosis. In both cases, levels in mania were elevated and in depression lowered with interval levels which were intermediate and within the normal range. The results lend some support to the suggestion that there might be an increase in brain noradrenaline metabolism in mania and a decrease in depression.
Medical Research Council Social Psychiatry Unit
Authors: Wing J. K.
Published: July 2009

The Medical Research Council Social Psychiatry Unit was set up at the Institute of Psychiatry in 1948 by Professor Sir Aubrey Lewis, who remained its honorary director until March 1965. The origins of the unit were described by Dr. Neil O'Connor in an introduction toStudies in Psychiatry(Shepherd and Davies, 1968). This book in honour of Professor Lewis contains six chapters by former unit members summarizing the scientific programme up to that date. A new unit, with the same name, was then set up at the Institute of Psychiatry under the directorship of Professor J. K. Wing, with the aim of investigating social and clinical factors which influence the development of chronic disablement in psychiatric patients and of devising and evaluating techniques of treatment and prevention.
The role of language in psychiatric treatment in the French Romantic Age: A note on Dr Laurent Cerise
Authors: Starobinski Jean
Published: July 2009

SYSNOPSIS

At the beginning of the 19th century France had many experts on the ‘moral treatment of insanity’. Very few of them, however, applied their experience and theories to the role of language in the development of behaviour from childhood on, in the pathogenesis of mental disorders, and in psychotherapy. To Dr. Louis Cerise, one of the founders of the Annales Médico-Psychologiques, belongs the great distinction of formulating a theory which tried to take account of the necessary contribution of language to individual development. In his book Des Fonctions et des Maladies Nerveuses (1842), he put forward a view of the relationship between the individual and society. His concept of ‘the goal of activity’ still merits our attention.
Recent life events in schizophrenia and depression
Authors: Jacobs S. C. , Prusoff B. A. , Paykel E. S.
Published: July 2009

SYSNOPSIS

Depressives and matched first admission schizophrenics were compared with respect to life events experienced in the six months before the onset of illness. Depressives reported more events than schizophrenics, but this excess involved only certain types of events. Depressives reported more exits from the social field, and a variety of undesirable events, particularly those involving interpersonal arguments. They reported no more events in some other classes. These findings support previous work involving life events, particularly exits and undesirable events in the genesis of depression, and indicate that qualitative implications of events influence their effects.
Relationship between sleep and growth in patients with reversible somatotropin deficiency (psychosocial dwarfism)
Authors: Wolff Georg , Money John
Published: July 2009

Synopsis

In a partly retrospective, partly follow-up study, 27 patients aged 1 year 10 months to 16 years 2 months with reversible somatotropin deficiency, showed a relationship between the rate of statural growth and sleep, graded as good, poor, or mixed. During periods of good sleep the overall growth rate averaged 1·04 cm per month, and during periods of poor sleep it averaged 0·34 cm per month (t=8·46, df=32, P<0·001). Presumably, good growth, good sleep, and optimal nocturnal somatotropin release intercorrelate in this syndrome of dwarfism, but the data with regard to nocturnal somatotropin release remain to be demonstrated empirically.
Validation of the 30-item General Health Questionnaire in postpartum women
Authors: Nott P. N. , Cutts S.
Published: July 2009

Synopsis

Two hundred consecutive women from five Southampton general practices who were between 8 and 14 weeks postpartum were visited at home. Each subject was given the 30-item General Health Questionnaire (GHQ-30) and a standardized psychiatric interview. Thirty-seven (18%) were identified as ‘cases’ by the psychiatric interview. Eighty-nine (44.5%) scored highly on the GHQ. Analysis of the results indicates that slight modification of the content and a raised cut-off point of the GHQ-30 make it a useful screening instrument for postpartum psychiatric disorder.
A comparison of two different services treating schizophrenia: a cost–benefit approach
Authors: Jones Robert , Goldberg David , Hughes Beverley
Published: July 2009

SYNOPSIS

This study compares the clinical and social outcome for 2 cohorts of patients who had a first admission for schizophrenia 4 years earlier. One cohort was treated in a psychiatric unit attached to a teaching district general hospital (DGH(T)), while the other was treated at an area mental hospital (AMH) with modern rehabilitation facilities. The clinical outcome for the 2 cohorts was broadly similar, but the DGH(T) imposed less of a strain on relatives, and was associated with less unmet need. The DGH unit tended to have significantly shorter durations of stay for its patients, so that its total hospital costs were less than those for the AMH despite higher unit costs. The cost benefit analysis shows that, where these particular patients are concerned, the DGH(T) unit is economically superior to the AMH despite the fact that it supports a large teaching staff, and that these economic advantages are accompanied by various non-monetary advantages.
Brain chemistry and behaviour
Authors: Iversen Susan D.
Published: July 2009

SYNOPSIS

The functional organization of chemically transmitting synapses in the brain are described with special emphasis on recent studies demonstrating the localization of different transmitters to specific anatomical circuitries. The use of pharmacological tools for manipulating levels of chemical transmitters is referred to briefly, but particular attention is given to the problems of studying the function of these pathways with lesion techniques.

Noradrenaline (NA) and dopamine (DA) are selected for detailed consideration and experimental evidence reviewed, suggesting that these two catecholamines in the forebrain serve different functions: NA with processes of attention essential for learning, and DA with the execution of appropriate responses. Hypotheses suggesting dysfunction of forebrain DA and NA systems in schizophrenia are discussed.
Descriptive studies of H-reflex recovery curves in psychiatric patients
Authors: Metz John , Goode David J. , Meltzer Herbert Y.
Published: July 2009

SYNOPSIS

The rate of recovery of the H-reflex, an electrical evoked monosynaptic spinal cord reflex, was abnormally high (fast) in over 20% of unmedicated psychotic patients of all major diagnostic classes. A few patients had significantly lower H-reflex recovery curves. Chronic neuroleptic treatment produced relatively lower recovery curves, whereas fluoxetine, a specific serotonin uptake blocker, produced relatively higher curves.
A follow-up of ‘new’ long-stay patients in Camberwell, 1977–1982
Authors: Wykes Til
Published: July 2009

Synopsis

Since 1977 there have been two major developments in the provision of services for the ‘new‘ long-stay in Camberwell – a hospital-hostel and an associated supervised group-home. This paper looks at the impact of these services over a 5-year period on a group of patients who fulfilled the ‘new’ long-stay criteria at the end of 1977. Both services appear to be extremely successful in containing such disabled patients. The results suggest that some improvements in patients' handicaps can be achieved and that some patients can be discharged with intensive psychiatric support. Excluding those patients in Special Hospitals, only one person was discharged to and has remained in unsupervised accommodation within the 5-year period.
A method for increasing patients' recall of information presented by doctors
Authors: Ley P. , Bradshaw P. W. , Eaves D. , Walker C. M.
Published: July 2009

Synopsis

Within minutes of leaving the consulting room, patients are frequently unable to recall what their doctor has told them. This paper describes a simple, practical method for increasing recall by the organization of medical information into ‘labelled’ categories. The success of this technique was demonstrated first in a laboratory experiment with volunteer subjects, and then in a naturalistic setting with general practice patients.
Assortative mating among in-patients with primary affective disorder
Authors: Merikangas Kathleen Ries , Spiker Duane G.
Published: July 2009

Synopsis

Assortative mating among 56 married in-patients with primary affective disorders and their spouses was studied by determining the prevalence of psychiatric illness among the spouses by means of direct interviews and standardized diagnostic criteria. A high degree of assortative mating among both male and female patients was observed for total psychiatric illness, broad spectrum affective illness and major depression. A significantly higher prevalence of psychiatric and affective illness was found among the first-degree relatives of the ill spouses when compared with the first-degree relatives of the well spouses. There was a high degree of diagnostic concordance between the patients and spouses for both affective illness and alcoholism, with a higher degree of assortative mating among bipolar patients than among unipolar patients. The finding in this study of an increased prevalence of psychiatric disorder in the first-degree relatives of the ill spouses would support the hypothesis that there is a tendency for individuals with a predisposition to psychiatric illness to marry, rather than the existence of a marital interaction which causes an increased concordance for psychiatric illness.
Bilateral auditory acuity of schizophrenic patients: effects of repeated testing, time of day and medication
Authors: Kugler Barbara T. , Caudrey David J. , Gruzelier John H.
Published: July 2009

Synopsis

Higher than normal auditory thresholds were demonstrated in chronic schizophrenic patients. A greater right ear sensitivity than left was exhibited, although right ear superiority diminished with repeated testing over weeks while left ear thresholds remained relatively stable. The results of acoustic impedance measures suggest that these findings are not associated with peripheral outer and middle ear disorders.
Hysterical epidemic in a classroom
Authors: Benaim Silvio , Horder John , Anderson Jennifer
Published: July 2009

SYNOPSIS

An epidemic of falling, confined to one single class of a large comprehensive school in a London suburb, is described. There were 24 adolescent girls in the class, all in the 16 to 17 age group, and the class was involved in examinations. The school authorities decided to close down the class one week before the end of term, when eight girls and a young locum teacher lay unconscious on the floor. Most of the girls affected belonged to the ‘in group’: the very bright, the Greek, the Jewish, and the one coloured girl were unaffected. Although the school refused permission for a sociometric investigation, information was obtained from the school medical officer, from two teachers, and from the two girls who were clearly the most powerful members of the class and the protagonists of the epidemic. They were both referred for medical treatment and, after all physical investigations had proved negative, they were both admitted to a psychiatric hospital for observation and treatment. Their case histories are given in some detail, together with a ‘confession’ written by the girl who started the epidemic. This same girl, during the course of her hospital admission, started a ‘pseudo-pregnancy epidemic’ in her ward. It was discovered that one member of the class had left the school during the course of the previous trimester because she had become pregnant. The epidemic, which appears to follow her childbirth and subsequent death from cerebral haemorrhage, lasted from December to the following July. Possible dynamic factors are discussed.
Psychological and hormonal factors in the treatment of female sexual dysfunction
Authors: Mathews Andrew , Whitehead Antonia , Kellett John
Published: July 2009

Synopsis

Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contary to expectations from earlier work, there was no benefit attributable to testosterone or to the use two therapits; selfrating favoured weekly sessions with one therapist.
Extent of depressive symptomatology among patients seeking care in prepaid group practice
Authors: Hankin Janet R. , Locke Ben Z.
Published: July 2009

Synopsis

A total of 1921 consecutive adult patients seen in the Departments of Internal Medicine and Obstetrics–Gynaecology at a prepaid group practice completed a self-administered depressive symptomatology questionnaire, the Centre for Epidemiologic Studies Depression Scale (CES-D). New health practitioners and physicians, who were not mental health specialists, blindly judged the presence or absence of depressive symptomatology. Twenty-one per cent of the patients suffered from depressive symptoms according to the CES-D, but only 15% of these were judged to be depressed by their physician or new health practitioner. The variables which predict the recognition of depressive symptomatology are discussed.
The relationship between prolactin levels and clinical ratings in manic patients treated with oral and intravenous test doses of haloperidol
Authors: Cookson J. C. , Moult P. J. A. , Wiles D. , Besser G. M.
Published: July 2009

SYNOPSIS

Twelve manic patients were treated for 2 weeks with oral haloperidol; in 6 patients treatment commenced with intravenous haloperidol, and intravenous ‘test’ doses were given after 1, 3–5 and 14 days of oral medication. From 24 hours to 14 days baseline serum prolactin levels rose towards a plateau, as did the improvement in clinical ratings. After the first intravenous test doses of haloperidol, prolactin levels peaked at 1 hour; however, they fell to a low point at 24 hours, and no response to further test doses was seen for 3–5 days. The response tended to return at 14 days. The mechanisms underlying the changes in prolactin levels, and in clinical state, are discussed.
Residential care and social behaviour: a study of rehabilitation needs
Authors: Falloon Ian R. H. , Marshall Grant N.
Published: July 2009

SYNOPSIS

Although most chronically impaired psychiatric patients now reside in community-based residential homes, a substantial number show little progress in their social rehabilitation. To establish the rehabilitative needs of this population, the current study sought to examine the social behaviour of residents of a large residential care facility. After an analysis of the social behaviour of all residents, two groups were selected for detailed study on the basis of their contrasting patterns of social interaction.

These two groups were found to differ significantly with respect to their interpersonal activity, social contact, conversation skill, employment, and participation in community rehabilitation programmes. Psychiatric status was substantially different in each group. The implications of these findings for rehabilitation strategies in the management of severe mental illness are discussed.
Temporal reliability of personality in psychiatric patients
Authors: Tyrer P. , Strauss J. , Cicchetti D.
Published: July 2009

SYNOPSIS

The Personality Assessment Schedule, an interview schedule specifically designed for assessing personality disorder, was administered twice to 28 psychiatric patients, with a mean interval of 2·9 years between each assessment. The first assessment was made by a psychiatrist and the second by a medical student who had no prior knowledge of the patients. The reliability of the 2 assessments was measured using 4 different techniques. Although the reliability of individual personality traits was inconsistent over time, the categorical diagnosis of personality disorder was good (Kωw = 0·64), giving some support to the validity of the schedule. Reasons for discordance in the assessments were examined and appeared to be due mainly to confusion between clinical symptoms and personality traits, retrospective errors in recording past personality in chronic patients, and special difficulties in determining the primary abnormality in severe personality disorder.
Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients
Authors: Mangen S. P. , Paykel E. S. , Griffith J. H. , Burchell A. , Mancini P.
Published: July 2009

SYNOPSIS

In a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.
Mortality in a cohort of long-term users of community psychiatric services
Authors: Sturt E.
Published: July 2009

SYNOPSIS

A cohort of 181 users of community psychiatric services in Camberwell with at least one year's history of contact was traced for two years following a census day. Four of the eight patients who had been given a primary diagnosis of an organic condition dicd during this period. For the others the population-standardized mortality risk was 2·4, similar to rates previously found for in-patients with acute disorders. The causes of death were those that are common in the population. Only one suicide was recorded.
Clinical and experimental aspects of interactions between amine oxidase inhibitors and amine re-uptake inhibitors
Authors: Marley E. , Wozniak Krystyna M.
Published: July 2009

Synopsis

Dangerous and even fatal interactions can occur in man following combinations of antidepressants which include non-selective MAO inhibitors. To ascertain the causation, interactions reproducing the clinical phenomena have been elicited in animals with these combinations, and the mechanisms involved have been explored by various pharmacological strategies; 5-HT re-uptake inhibitors proved especially hazardous in combination. Interactions could, however, be avoided even with the 5-HT re-uptake inhibitors, by combination with relatively selective MAO A or B inhibitors, an approach with potential clinical value.
Parents of patients with obsessive-compulsive disorder
Authors: Insel Thomas R. , Hoover Carol , Murphy Dennis L.
Published: July 2009

Synopsis

Family histories obtained from 27 patients with obsessive-compulsive disorder failed to find a single parent with the disorder. To augment the family history data the Leyton Obsessional Inventory was completed by a subset of 10 patients and by their 20 parents. Although as a group parents showed lower Leyton Obsessional Inventory symptom scores than their obsessional offspring, 3 parents who had not been identified by family history were distinguished by high symptom scores in the absence of significant resistance or interference.
Vanadium: a possible aetiological factor in manic depressive illness
Authors: Naylor Graham J. , Smith Anne H. W.
Published: July 2009

Synopsis

The effect of Vitamin C in manic-depressive psychosis was assessed by a double-blind, placebo controlled, crossover trial. Both manic and depressed patients were significantly better following a single 3 g dose of Vitamin C than following a placebo.

Preliminary results of a double-blind, crossover comparison of normal vanadium intake with reduced intake in manic and depressed subjects are reported. Both manic and depressed patients were significantly better on reduced intake.

These results are in keeping with the suggestion that vanadium may be an aetiological factor in manic depressive illness.
Psychological symptom levels in Indian immigrants to England–a comparison with native English
Authors: Cochrane Raymond , Stopes-Roe Mary
Published: July 2009

Synopsis

A national community survey of psychological symptom levels among samples of Indian immigrants and natives is reported. Using a quasi-random sampling procedure, a sample of 200 Indian-born residents of large towns in England was selected to match the age and sex structure of the total Indian immigrant population. An indigenous population, selected in the same way, was matched with the immigrants for comparison purposes. Psychological disturbance was measured with the Langner 22-Item Scale which has previously been specifically validated for use in this context. Other indices were constructed to test specific hypotheses.

The pattern revealed by mental hospital admission statistics was strongly supported by survey. Indian immigrants as a group experience far less psychological disorder than natives, despite the experiences of migration and of being an immigrant. On other measures Indians also manifested an adjustment superior to that of natives.

Among the Indian sample stable psychological adjustment was related to being young at migration, being acculturated to life in England and being socially integrated. A subgroup of higher social status, Indian females who had been upwardly socially mobile, emerged as the only group with a higher than average symptom level. However, even this group was at least as well adjusted as its English counterpart.
Sex offences against young girls: a long-term record study
Authors: Gibbens T. C. N. , Soothill K. L. , Way C. K.
Published: July 2009

Synopsis

There have been recent attempts to re-define those offenders who are sufficiently dangerous to justify a longer sentence for their current offence than is normally provided in law, but there is little information about the frequency with which serious sexual offenders are reconvicted. Follow-up studies of the re-conviction in the subsequent 24 years and 15 years of those found guilty of rape, incest, and unlawful sexual intercourse with girls under 13 in 1951 and 1961 have therefore been made. The present paper deals with those prosecuted for unlawful sexual intercourse with girls under 13. The results suggest that there is a low but more persistent tendency to re-conviction than is found in property offenders.
The twelve-month outcome of patients with neurotic illness in general practice
Authors: Mann A. H. , Jenkins R. , Belsey E.
Published: July 2009

SYNOPSIS

One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.

The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.

The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.
Epidemiology of mental disorders in Camberwell
Authors: Bebbington Paul , Hurry Jane , Tennant Christopher , Sturt Elizabeth , Wing J. K.
Published: July 2009

SYNOPSIS

A two-stage psychiatric survey of a random sample of adults aged 18–64 from Camberwell is described. Agency interviewers carried out the first stage (N= 800), using the shorter form of the Present State Examination (PSE). MRC interviewers, using the full PSE, saw a stratified sample of these (N= 310) in the second stage. A second interview was sought with all those of Index of Definition (ID) level 5 and above at the first interview (‘cases’) and with a random sample of those below that level. 20·9% refused or were never available for the first interview. Of the 800 subjects successfully interviewed, 10% refused a further interview and 12·4% of those finally selected for this interview were either unavailable or changed their minds. The MRC data, weighted to represent the whole sample, are used in our analyses. The prevalence of psychiatric disorder as defined in our study was calculated at 6·1% for men and 14·9% for women. Women shared a higher prevalence of disorder in the age-groups 25–34 and 45–54, but in men there was no significant association with age.

In contrast to the findings of Brown & Harris (1978), social class did not have a strong association with disorder. Single men had much higher rates than married men, while the reverse was true in women. In both sexes employment was associated with lower rates of disorder. An attempt to explain the high prevalence in women in terms of their role in marriage and child-care was only partly successful.
The relationship between the Rutter A Questionnaire and an interview with mother in assessing child psychiatric disturbance among enuretic children
Authors: Berg Ian , Ellis Maureen , Forsythe Ian , McGuire Ralph
Published: July 2009

SYNOPSIS

Forty-one children who were being treated in a paediatric clinic for enuresis were studied to see how many of them were psychiatrically disturbed on clinical assessment and to ascertain the usefulness of 2 cut-off points of T (total) scores on the Rutter A Scale in identifying them. A score of 13 or more which had previously been recommended was found to be inadequate in this group of cases. There were indications that a cut-off point of 18 or more was more appropriate. The importance of knowing the base rate of psychiatric disorder in the population on which the questionnaire is being used is emphasized, sinec this affects the selection of an appropriate cut-off point.