bluuebunny/crossref_metadata_2025 huggingface dataset:
Electroconvulsive therapy vs. paroxetine in treatment‐resistant depression — a randomized study
Authors: Folkerts H. W. , Michael N. , Tölle R. , Schonauer K. , Mücke S. , Schulze‐Mönking H.
Published: November 2007

Failure to respond to adequate pharmacological treatment for major depression is now the most common indication for the use of electroconvulsive therapy (ECT). The advantages of ECT with respect to both speed and quality of response are clinically important issues, but surprisingly few studies have examined the efficacy of ECT in relation to newer antidepressant agents such as selective serotonin reuptake inhibitors (SSRIs). A total of 39 subjects with major depression and with at least two failed antidepressant trials (mean 4.9 trials) were randomized to either paroxetine treatment (n= 18) or right unilateral (RUL) ECT (n=21). Up to the end of the study treatment we found a reduction in the HAMD score of 59% for the ECT group and of 29% for the paroxetine group (P<0.001 paired t‐test). In the ECT group, 71% of subjects fulfilled the response criteria (at least a 50% decrease in total HAMD score). The present study found ECT to be superior to paroxetine in medication‐resistant major depression, in terms of both degree and speed of response.
Citalopram in the treatment of obsessive‐compulsive disorder: an open pilot study
Authors: Koponen H. , Lepola U. , Leinonen E. , Jokinen R. , Penttinen J. , Turtonen J.
Published: November 2007

Obsessive‐compulsive disorder (OCD) is a common anxiety disorder, which often causes significant impairment of the affected individual's social, occupational or interpersonal functioning. Previous reports suggest that the disorder may be treated with the tricyclic antidepressant clomipramine, and also with the more recently introduced selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, fluvoxamine, sertraline and paroxetine. The present 24‐week open pilot study was designed to examine the efficacy, appropriate dose range, side‐effects and clinical usefulness of citalopram in OCD. A total of 29 OCD patients were included in the study, of whom 76% showed alleviation of symptoms as evaluated by various self‐and observer‐rated scales, such as the Yale‐Brown Obsessive Compulsive Scale. In most cases the citalopram doses used were in most cases 40 or 60 mg daily, and the treatment was well tolerated. The most commonly experienced adverse events during the study were nausea, vomiting, increased dreaming and decreased sleep. Diminished sexual desire and orgasmic dysfunction were also reported. Despite having the limitations of an open study, our results suggest that citalopram may be effective in the treatment of obsessive‐compulsive disorder.
Suicide attempts in a cohort of drug abusers: a 5‐year follow‐up study
Authors: Johnsson E. , Fridell M.
Published: November 2007

A group of 125 drug abusers admitted consecutively for detoxification and short‐term rehabilitation were followed up 5 years after discharge. They were asked about possible suicide attempts in a semi‐structured face‐to‐face interview. Nearly half of the group (45%) reported having attempted suicide at some point in their life. The most common reasons given were the loss of a person whom they loved, and feelings of loneliness. Only three respondents reported using their drug of choice in the attempt(s). The suicide attempters were more often found to have been in child psychiatric treatment earlier, and to have experienced loss of significant others in childhood, than those who did not report attempting suicide. At follow‐up the suicide attempters indicated that they experienced more depressive moods and more severe psychological problems than those who had never made a suicide attempt. The importance of assessing the risk of suicide attempts among drug addicts in order to be able to take measures to prevent future suicidal behaviour is emphasized.
A comprehensive method of assessing routine CT scans in schizophrenia
Authors: Smith G. N. , Flynn S. W. , Kopala L. C. , Bassett A. S. , Lapointe J. S. , Falkai P. , Honer W. G.
Published: November 2007

Morphological brain abnormalities are common in schizophrenia, although the aetiological and clinical significance of these findings is largely unknown. Substantial between‐subject variability suggests that large samples are needed to study the full implications of brain pathomorphology. Computerized tomography (CT) is frequently used routinely in schizophrenia, and large numbers of scans are available for study. This article describes the development and statistical properties of a rapid and simple method of assessing CT scans. The CT Rating Scale for Schizophrenia (CTRSS) is minimally affected by variability in scanning procedures, is reliable, and accurately estimates area and volumetric measures of brain spaces. By promoting the comprehensive assessment of large numbers of routinely obtained scans, the CTRSS would allow the investigation of variables that may systematically affect results (e.g. gender and age) and variables with low prevalence. The CTRSS provides a useful adjunct to technologically more sophisticated methods of assessment such as magnetic resonance imaging (MRI).
Effects of child‐rearing by schizophrenic mothers: a 25‐year follow‐up
Authors: Higgins J. , Gore R. , Gutkind D. , Mednick S. A. , Parnas J. , Schulsinger F. , Cannon T. D.
Published: November 2007

We conducted a 25‐year follow‐up study of 50 children of schizophrenic mothers, consisting of 25 children reared by their mothers and 25 children reared apart. The children's adult psychiatric status was evaluated in a 3‐h structured interview employing a battery of syndrome check‐lists and scales. A slightly higher incidence of psychopathology (including schizophrenia‐spectrum disorders) was found among the reared‐apart subjects. This may possibly be attributed to their greater genetic predisposition, as suggested by their mothers' more severe illnesses. Lifetime diagnoses do not provide evidence that psychopathology in offspring at genetic risk is increased by rearing by a schizophrenic mother.
First‐onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology
Authors: Varma V. K. , Wig N. N. , Phookun H. R. , Misra A. K. , Khare C. B. , Tripathi B. M. , Behere P. B. , Yoo Eun S. , Susser E. S.
Published: November 2007

As part of a World Health Organization collaborative study in 12 centres in developing and developed countries within defined urban and rural catchment areas with populations of 348 786 and 103 865, respectively, a total of 155 and 54 cases of first‐onset schizophrenia, respectively, were identified over a 24‐month period by a comprehensive and active recruitment of all cases. Approximately 50% of the subjects in both cohorts were in the age range of 15–24 years. There was a preponderance of males in the younger age group and of females in the older age group. The majority of cases had no family history and had shown good adjustment in childhood and adolescence. The onset was much more frequently acute and much less often insidious in our samples and (more so in the rural cohort), compared to the figure for all developed countries’ sites. With regard to early manifestations of the disorder, there was a much higher incidence of loss of interest in appearance and cleanliness, being irritable and angry without reason, and loss of appetite, sleep or interest in sex in both of our samples, and of being excited or overactive for days or weeks in our rural cohort than in the developed countries’ centres as a whole. On the other hand, claiming impossible things, behaving as if hearing voices and feeling persecuted, harmed or bewitched were much less frequent in our rural cohort than in the urban cohort or the developed countries’ centres as a whole. With regard to the clinical diagnosis of schizophrenia, paranoid, hebephrenic/ disorganized and residual types were under‐represented in our samples (more so in the rural sample), and catatonic type and acute schizophrenic episode were over‐represented compared to the developed countries’ centres. Moreover, the proportion of subjects of CATEGO class S+ was lower in our samples. With regard to onset, early manifestations and clinical subtypes of schizophrenia, our rural cohort deviated most from developed countries’ centres as a whole, with our urban sample falling in between, thus indicating the role of socio‐cultural factors in general, and urbanization in particular, in these variables in schizophrenia.
Psychoeducational psychotherapy for schizophrenic patients and their key relatives or care‐givers: results of a 2‐year follow‐up
Authors: Buchkremer G. , Klingberg S. , Holle R. , Mönking H. Schulze , Hornung W. P.
Published: November 2007

Psychoeducational medication management training (PMT), cognitive psychotherapy (CP) and key‐person counselling (KC) were carried out in various combinations in this randomized, controlled intervention study of schizophrenic out‐patients (according to DSM‐III‐R). Special design characteristics of the study were a control group consisting of non‐specifically treated patients and a 2‐year follow‐up after completion of treatment in order to evaluate medium‐term effects. A total of 132 patients underwent a follow‐up examination 2 years after completion of treatment and were evaluated with an intention‐to‐treat approach. In the second follow‐up year, all treatment groups had lower but not significantly different relapse rates compared to the control group. The most intensive treatment (PMT+CP+KC) produces a clinically relevant reduction in rehospitalization rate (a 26% reduction compared to the control group). In comparison with the non‐specifically treated control group, whose original effect decreased, at least a medium‐term therapeutic effect was recorded in the treatment groups.
How are nations trying to prevent suicide? An analysis of national suicide prevention strategies
Authors: Taylor S. J. , Kingdom D. , Jenkins R.
Published: November 2007

Recent increases in suicide rates internationally have focused attention on suicide as an important area of public health concern. In this review, strategies developed by various countries to halt this trend are compared. Nine out of 15 countries respond to enquiry about the state of development of suicide prevention strategies and programmes. Comprehensive strategies have been or are being developed by Finland, Norway, Australia, New Zealand and Sweden. The organization of these strategies differs between countries. The interventions have similar targets and are presented in detail. There are some similarities in strategy content but evident differences in organization. Further developments should not only be based on research, but also consider the diverse experiences of other countries, and they should incorporate appropriate structures for monitoring and evaluation.
Hospital vs. outreach treatment of patients with mental retardation and psychiatric disorders: a controlled study
Authors: van Minnen A. , Hoogduin C. A. L. , Broekman T. G.
Published: November 2007

The aim of this study was to investigate the effectiveness of specialized hospital treatment vs. outreach treatment of patients with mental retardation and serious mental illness. A total of 50 patients were randomly assigned to either the hospital treatment (n=25) or the outreach treatment group (n=25). The outcome measures included psychiatric symptoms, family burden, costs and hospital admissions. At most observation points (up to 28 weeks) and at all endpoints the two groups were equivalent with regard to psychiatric symptoms. The burden on carers did not increase significantly during the outreach treatment. Treatment costs were lower for the outreach treatment. Of the 25 patients who received outreach treatment, four had to be admitted to the specialized hospital. Aggressive behaviour, social competence and number of previous psychiatric hospitalizations were found to be predictors of treatment outcome. It is concluded that outreach treatment represents an effective and efficient alternative to hospital treatment for patients with mental retardation and psychiatric disorders.
Lifetime and 12‐month prevalence of DSM‐III‐R mental disorders among the homeless in Madrid: a European study using the CIDI
Authors: Vázquez C. , Muñoz M. , Sanz J.
Published: November 2007

The characteristics of homeless people in Europe are almost unknown. The aim of this study was to describe the lifetime and 12‐month prevalence of DSM‐III‐R/CIDI mental disorders among the homeless population of Madrid. A total of 261 homeless subjects, sampled from different sites, participated in the study. In terms of DSM‐III‐R lifetime rates, 50% of the sample had substance‐related disorders and 35% had non‐substance‐related disorders. In total, 67% of the study subjects had some type of disorder. The lifetime prevalence of schizophrenia (4%) was lower than reported in most previous studies. Although the mental illness pattern is similar to that observed in studies using the same diagnostic methods, the results reported here show a lower prevalence of drug abuse and schizophrenic disorders. The reasons for these cultural differences and their implications for international public health research are discussed.
An investigation into the psychobiology of social phobia: personality domains and serotonergic function
Authors: Chatterjee S. , Sunitha T. A. , Velayudhan A. , Khanna S.
Published: November 2007

The aim of the present study was to explore a psychobiological perspective in the aetiology of social phobia. The emphasis was on serotonergic function and personality. A total of 20 social phobics according to ICD‐10 DCR criteria were assessed with the Schedule for Clinical Assessment in Neuropsychiatry and the International Personality Disorder Examination. They were compared with an age‐matched normal population with regard to scores on the Fear of Negative Evaluation Scale, the Social Avoidance and Distress Scale, the Temperament and Character Inventory, and platelet 5HT2 receptor function. Other Axis‐I disorders and cluster C personality disorders were frequently encountered. The social phobia group was characterized by high levels of harm avoidance, and low levels of novelty seeking, co‐operativeness and self‐directedness. Platelet 5HT2 receptor density did not differentiate between the groups, but was associated with severity of social phobia. An integrated psychobiological model is presented.
MRI findings in patients with affective disorder: a meta‐analysis
Authors: Videbech P.
Published: November 2007

A review of the literature on primarily magnetic resonance imaging (MRI) scans of patients with affective disorders is presented. Several studies have indicated an increased ventricle/brain ratio and other signs of cerebral atrophy, as well as an increased frequency of lesions (so‐called signal hyperintensities) in the brains of unipolar and bipolar patients. This notion is strongly supported by two meta‐analyses performed in the present study. The lesions are often localized in the frontal lobes and the basal ganglia, indicating a defective basal ganglia/frontal circuit, and are correlated with the degree of cognitive impairment seen in these conditions. No studies have indicated that psychoactive drugs or electroconvulsive therapy (ECT) might cause the lesions, but on the other hand they can probably increase the risk of delirium complicating the treatment.
Coping strategies among the long‐term mentally ill: categorization and clinical determinants
Authors: Middelboe T. , Mortensen E. L.
Published: November 2007

The aim of this study was to explore strategies for coping with symptoms in 98 long‐term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non‐psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community‐care programmes.
Religiosity as a protective or prognostic factor of depression in later life; results from a community survey in The Netherlands
Authors: Braam A. W. , Beekman A. T. F. , Deeg D. J. H. , Smit J. H. , van Tilburg W.
Published: November 2007

This study examines the impact of religiosity on the incidence and course of depressive syndromes in a community‐based sample of elderly people in The Netherlands (n= 177). The course of depression was assessed in five waves of measurements, covering a period of 1 year. Religiosity was defined as salience of religion compared to the salience of other aspects of life. Religious salience was not associated with incidence of depression, but showed a relatively strong association with improvement of depression among the respondents who were depressed at the first measurement. This association was most prominent among subjects with poor physical health.
Psychosocial functioning in adolescent psychiatric patients: a prospective study on changes in psychosocial functioning among severely and moderately impaired adolescent out‐patients
Authors: Pelkonen M. , Marttunen M. , Laippala P. , Lönnqvist J. , Aro H.
Published: November 2007

Changes in psychosocial functioning during out‐patient treatment among 73 adolescent male and 100 female subjects, aged 12 to 19 years, were studied. The mean number of total treatment sessions was 15 sessions among the severely impaired and 14 sessions among the moderately impaired patients. The level of psychosocial functioning improved among the severely impaired (Global Assessment Scale (GAS) at treatment entry 3.9 vs. 4.7 at the last session, 95% CI, ‐1.085 to ‐0.577) and the moderately impaired patients (GAS 5.5 vs. 6.0, 95% CI, ‐0.682 to ‐0.355). The improvement was highly dependent on the psychiatric diagnosis. The level of psychosocial impairment improved in about two‐thirds of subjects with adjustment and non‐comorbid mood disorders, in about one‐third of those with non‐comorbid personality disorders, and in about a quarter of those with disruptive disorders. Careful diagnostic evaluation and assessment of psychosocial functioning are essential elements in the development of adolescent psychiatric services.
Fertility and schizophrenia: evidence for increased fertility in the relatives of schizophrenic patients
Authors: Srinivasan T. N. , Padmavati R.
Published: November 2007

Fertility has been observed to be reduced in patients with schizophrenia, although the disorder was seen to occur at a steady rate in the general population. The hypothesis of increased fertility in the healthy relatives of the patients, which maintained the genetic contribution to the disorder has been proposed but has not received much support. The present study reports the fertility rate in 100 schizophrenic patients and their relatives (grandparents, parents, uncles, aunts and siblings). The fertility of the different family members was compared, taking into account the completion of age of maximum reproductivity, i.e. up to 50 years of age. The trends in fertility rates over three generations of patients’families were compared with those in the general population of India over a corresponding period from 1950 to 2000 AD. The patients were observed to be hypofertile, but their parents showed a higher fertility than all other relatives, as well as the general population. The siblings of the patients also tended to have higher fertility rates than the general population. This increased fertility in parents and sibs, who are the probable carriers of the abnormal gene, could compensate for the reduction in genetic contribution to morbid risk for schizophrenia due to reduced reproductivity of the patients themselves.
A comparison of quetiapine and chlorpromazine in the treatment of schizophrenia
Authors: Peuskens J. , Link C. G. G.
Published: November 2007

A 6‐week, double‐blind, randomized, multicentre, parallel‐group study was conducted to compare the efficacy of quetiapine (“Seroquel”) (n=101) with that of chlorpromazine (n=100) in hospitalized patients with acute exacerbation of subchronic or chronic schizophrenia, or schizophreniform disorder. The tolerabilities of the two treatments were also compared. The mean daily doses of quetiapine and chlorpromazine at the end of the study were 407 mg and 384 mg, respectively. Both treatments were effective in the treatment of positive and negative symptoms, with a trend towards superior efficacy for quetiapine. The quetiapine group had a lower incidence of adverse events than the chlorpromazine group, and a low incidence of treatment‐emergent extrapyramidal symptoms. Quetiapine was not associated with a sustained increase in serum prolactin. These clinical data support the preclinical profile of quetiapine as an atypical antipsychotic agent.
Opponent processes and anxiety: toward a neurophysiological formulation
Authors: Vincent J. D. , Kukstas L. A.
Published: November 2007

As a general philosophical framework, the author presents a theoretical position according to which ‘opposition’ is at the heart of the workings of the living being and the very origins of life. He then deals with ‘opposing processes’ and neural mechanisms which appear to underlie them. The theory rests on the premise that a great number of our actions are derived from our emotions, and that the coupling of pleasure/suffering controls the expression of our desires. Developed in the 1970s, this theory is founded on the observation of dependence phenomena (addictions), but its value extends far beyond drugs, to all types of human conduct, including sexuality, play, alimentary behaviours, etc. Inconsistent with classical theories, it subordinates the act to an affective state. The author finally examines the phenomenon of anxiety in the light of these considerations.
Anxiety and increased aggression as pacemakers of depression
Authors: van Praag H. M.
Published: November 2007

The concept of a serotonin (5‐HT)‐related, anxiety and/or aggression‐driven, stressor‐precipitated depression is formulated and discussed. The serotonergic disturbances found in some depressed individuals, particularly those with lowered CSF 5‐HIAA, are linked to the anxiety and aggression components of the depressive sydrome. In this type of depression, called 5‐HT‐related depression, dysregulation of anxiety and/or aggression is hypothesized to be primordial and mood‐lowering is a derivative phenomenon. In other words, this is a group of anxiety/aggression‐driven depressions. The author submits that the serotonergic impairment in certain types of depression is a trait phenomenon, i.e. it persists during remission. This disturbance makes the individual susceptible to perturbation of anxiety and aggression regulation. Anxiety and (overt or suppressed) anger are core constituents of the stress syndrome. Thus the serotonergic disturbance will induce a heightened sensitivity to stressful events. i.e. the latter will induce stress phenomena, including anxiety and anger, more readily than normal. The latter psychological features induce lowering of mood, and thus ‘drive’ the patient into a full‐blown depression. Furthermore, it is predicted that anxiolytics and serenics (i.e. anti‐aggressive drugs) that act via normalization of serotonergic circuits will exert an antidepressant effect in 5‐HT related depression, in addition to their therapeutic actions in anxiety disorders and states of increased aggressiveness, respectively. The exact nature of the serotonergic impairment in 5‐HT‐related depression has yet to be elucidated.
Cognition and anxiety: the cognitive effects of anti‐anxiety medication
Authors: Hindmarch I.
Published: November 2007

There does not appear to be a single hypothesis or theory which can adequately explain the aetiology of anxiety, although there is no shortage of contenders. Neurochemical, existential, sociogenic, familial, pathological, psychodynamic and behavioural explanations have all been offered as putative reasons for the psychological disorder, which in its various representations (panic disorder, obsessive‐compulsive disorder, phobias, post‐traumatic stress disorder, generalized anxiety disorders, etc.) can affect up to 20% of the population on a lifetime basis (1). Notwithstanding the variety of theories and the diversity of presentation of anxiety disorders, it would appear that cognitive dysfunction of one sort or another is a characteristic feature of anxiety in all its manifestations. Indeed, it is possible to argue that a cognitive impairment is the primary presenting feature of pathological anxiety, with the characteristic syndrome of somatic symptoms as secondary or necessary consequences of such cognitive disorder.
Benzodiazepine dependence and withdrawal: a review of the syndrome and its clinical management
Authors: Schweizer E. , Rickels K.
Published: November 2007

The treatment of anxiety has evolved through various phases. Currently, there is a growing recognition that anxiety disorders are frequently chronic and/or recurrent. There is also less optimism than a decade ago that benzodiazepines will be replaced by alternative agents that are not active at the benzodiazepine receptor. Consequently. the understanding and management of benzodiazepine dependence and withdrawal continue to be of some clinical importance. This article briefly reviews the withdrawal syndrome and the pharmacological and patient variables that contribute to it. It then summarizes the various approaches to managing benzodiazepine dependence and withdrawal.
The nature and duration of treatment for GAD
Authors: Lader M. H.
Published: November 2007

It is becoming increasingly evident that GAD is a chronic condition with repeated acute‐on‐chronic episodes. Treatment in the short term relies on the benzodiazepines, which are rapid in action. providing substantial symptomatic relief with a low incidence of side‐effects and low toxicity in overdose. The risk of more serious unwanted effects in the long term, including some risk of physical dependence, has led to a move towards alternative treatments both pharmacological and psychotherapeutic. Antidepressants are being used on a long‐term basis, but data are sparse to confirm their efficacy in GAD. Anxiety management and cognitive‐behavioural techniques are rivalling pharmacotherapy in popularity. None the less, research seeking optimal ways of combining therapies remains an urgent priority.
Prevalence of winter depression in Denmark
Authors: Dam H. , Jakobsen K. , Mellerup E.
Published: November 2007

An unselected cohort of 3556 subjects in Copenhagen was asked to complete the Seasonal Pattern Assessment Questionnaire (SPAQ) for estimating the presence of seasonal affective disorders (SAD or winter depression). Completed questionnaires were received from 1794 subjects in total. About 12% of the respondents had a Global Seasonality Score (GSS) high enough to indicate the presence of SAD. Among those respondents without SAD, women and younger people were found to be much more sensitive to seasonal and weather changes than men and older people, respectively.
The familial aggregation of adolescent suicide attempts
Authors: Johnson B. A. , Brent D. A. , Bridge J. , Connolly J.
Published: November 2007

The objective of this study was to determine whether the familial aggregation of suicidal behaviour is explained by the familial aggregation of personality disorder and aggression. The relatives of 62 clinically referred adolescent suicide attempters were compared with 70 never‐suicidal psychiatric controls. The first‐degree relatives of the suicide attempters had a higher rate of suicide attempts/completion than those of the psychiatric controls. This rate remained significantly higher after controlling for Axis I and II differences in the probands and the relatives, but familial personality disorder was significantly associated with suicidal risk in probands. Among the adolescent attempters, high scores on a measure of assaultiveness were associated with significantly higher familial rates of suicide attempts/completion. Our results support the hypothesis that suicidal behaviour may be transmitted as a trait independent of Axis I and II psychopathology but that, in addition, personality disorder has a role in the transmission of suicidal behaviour. An interrelationship between proband assaultiveness and the familial aggregation of suicidality was noted.
Menstrual cycle and profiles of suicidal behaviour
Authors: Baca‐García E. , González A. Sánchez , Diaz‐Corralero P. González , García I. González , de Leon J.
Published: November 2007

The first (or menstrual) and fourth (or premenstrual) week of the menstrual cycle may be associated with many suicide attempts in women. The study sample included 113 Spanish women who attempted suicide and contacted an emergency service. Inclusion criteria were as follows: fertility; regular menstrual cycles; lack of oral contraceptives; and willingness to see a psychiatrist. The incidence of suicide attempts in the first week (36%) was significantly higher than that in the remaining weeks (second week, 19%; third week 16%; fourth week, 29%). A correspondence analysis suggested that suicide attempts were associated with differences in demographics and clinical profiles. In particular, suicide attempts in the third week were correlated with a severe history of psychiatric problems and a lower level of education. The limitations of this study are its exclusiveness to hospitalized cases and its use of patient reports to date menstruation.
Association of obsessive‐compulsive disorder and pathological gambling with Huntington's disease in an Italian pedigree: possible association with Huntington's disease mutation
Authors: de Marchi N. , Morris M. , Mennella R. , Pia S. La , Nestadt G.
Published: November 2007

This paper describes a pedigree with Huntington's disease (HD), in which three cases of obsessive‐compulsive disorder (OCD) and two cases of pathological gambling (PG) were identified. The mutation analysis of the HD gene was carried out in the examined individuals who were at risk for HD. In fact, OCD and PG only occurred in carriers of the HD expansion. The possible implications of this finding are discussed.
Early neuropsychological impairment in HIV‐seropositive intravenous drug users: evidence from the Italian Multicentre Neuropsychological HIV Study
Authors: Starace F. , Baldassarre C. , Biancolilli V. , Fea M. , Serpelloni G. , Bartoli L. , Maj M.
Published: November 2007

The aim of the Italian Multicentre Neuropsychological HIV Study is to assess the prevalence and natural history of cognitive deficit in intravenous drug users (IVDUS) during the asymptomatic phase of HIV infection. The study is currently being conducted in four centres (Napoli, Benevento, Verona and Pavia) whose catchment areas are characterized by different levels of prevalence of HIV infection. Cognitive evaluation is being performed by means of a standardized neuropsychological test battery. A total of 251 subjects (167 males and 84 females) have been recruited in the cross‐sectional phase of the study, including 75 asymptomatic HIV‐seropositive IVDUS (HIV+/IVDUS), 97 HIV‐seronegative IVDUS (HIV‐/IVDUS) and 79 non‐IVDU seronegative controls matched to IVDUS with regard to sex, age and educational level. The prevalence of global cognitive impairment (performance at least 1.5 standard deviations worse than the average of the control group, on at least two out of five tests) was significantly higher in HIV+/IVDUS than in either HIV‐/IVDUS (22.7% vs. 8.2%; P<0.01) or healthy controls (22.7% vs. 2.5%; P<0.001). The difference between HIV‐/IVDUS and healthy controls was not statistically significant (8.2% vs. 2.5%; P=0.19). The results of this study lend further support to the ‘cerebral reserve’ model. The cerebral reserve could indeed be reduced in IVDUS as a consequence of chronic exposure to the substance of abuse, so that these subjects become more vulnerable to direct and indirect neurotoxic effects of HIV.
Suicidality and aggressive behaviour
Authors: Castrogiovanni P. , Pieraccini F. , Muro A. Di
Published: November 2007

Psychiatrists have always maintained that there is a relationship between aggressive behaviour and suicide in depressed patients. However, this relationship is based on inconsistent and undocumented hypotheses, not on reliable clinical experimental data. The present study was designed to investigate the relationship between aggressive behaviour assessed by means of the Buss and Durkee Hostility Inventory (Bdhi), and suicide in a sample of 134 depressed out‐patients. The group with a higher level of suicidal behaviour was of younger age. The association between depressive subtypes (major depression, recurrent; major depression, single episode; bipolar disorder, depressive episode; dysthymia) and suicidality was found to be statistically significant. In contrast, there was no correlation between depressive subtypes and aggressive behaviour. The relationship between suicide and guilt as measured by the BDHI suggests that, in depression, suicidal behaviour becomes part of a symptom pattern in which aggression does not appear to be the main component. The suicide dimension arises when the cognitive sphere is involved. In fact, in depression, suicide is included among the cognitive disturbances, together with guilt, paranoid and obsessive‐compulsive symptoms, depersonalization/derealization and agitation.
Prevalence of mood disorders in the rural population of Udmurtia
Authors: Pakriev S. , Vasar V. , Aluoja A. , Saarma M. , Shlik J.
Published: November 2007

A sample of 855 rural adult inhabitants of Udmurtia was interviewed by means of the Composite International Diagnostic Interview (CIDI) in order to investigate the incidence and prevalence of mood disorders. Depression affected 30.5% of the population according to ICD‐10, and 22% according to DSM‐III‐R over a 12‐month period. Depressive disorders were more common in women (40.5%) than in men (17.4%), and in subjects who were widowed (68.8%), divorced (55.6%) or had poor family relationships. Depression was not related to ethnicity, educational level, income or living conditions. Depression showed a high level of comorbidity with social phobia in Udmurts and with persistent somatoform pain disorder in Russian women. The annual incidence of depressive episode was 7.5%, and the highest risk of depression was among younger women and older men.
Executive deficits in major depression
Authors: Degl'Innocenti A. , Ågren H. , Bäckman L.
Published: November 2007

Clinically depressed patients and control subjects were examined by means of different tests to assess executive functions (the Wisconsin Card Sorting Test, the Stroop Color Word Test and a test of verbal fluency). The results indicate that the depressed patients were generally slower than the controls, as reflected by longer retrieval times for both words and colours. Furthermore, the depressed patients showed impairment with regard to altering behaviour appropriately in response to feedback. However, there were no depression‐related increases in perseverative responses, and the ability to inhibit irrelevant information was unaffected by depression. No relationship was found between specific depressive symptoms or the severity of depression and cognitive performance. The overall pattern of results suggests that depression may affect various executive functions in a differentiated manner.
Collaboration with drug treatment by schizophrenic patients with and without psychoeducational training: results of a 1‐year follow‐up
Authors: Hornung W. P. , Klingberg S. , Feldmann R. , Schonauer K. , Mönking H. Schulze
Published: November 2007

Within a controlled prospective intervention study, schizophrenic outpatients randomly assigned to four treatment groups and one control group were assessed with regard to collaboration with drug treatment. In total, 39.3% of 84 regular attenders of the psychoeducational training programme and 26.6% of 64 control patients reported having persuaded their psychiatrists to modify their medication prescriptions. A total of 8.3% and 7.8%, respectively, modified their medication on their own initiative, although with subsequent approval by the psychiatrist, and 20.2% and 15.6%, respectively, modified their medication after consulting their psychiatrist. With regard to medication management, the groups did not differ either at post‐treatment or at follow‐up. At follow‐up, regular attenders showed a reduced fear of side‐effects, increased confidence in their medication and stable confidence in their physician. Among the control subjects, confidence in the medication and in their physician declined, and fear of side‐effects increased. Psychoeducational training therefore led to an optimization of patients' attitudes toward treatment, but not to changes in medication management.
Lack of continuity — a problem in the care of young suicides
Authors: Hultén A. , Wasserman D.
Published: November 2007

The course of the psychiatric in‐patient treatment received by 34 young people aged 15‐24 years before their deaths from suicide was studied retrospectively on the basis of medical records. The quality of the care that they were given was appraised in terms of continuity, an important aspect of the care of young individuals during a period of dynamic development. There were two suicides among patients in child psychiatric care and 32 suicides among those in adult psychiatric care. Continuity of child psychiatric care was satisfactory, while the striking discontinuity in adult psychiatric care, in terms of contacts with doctors, therapists and other staff, with from 3 to 30 different doctors being involved during the period of care, may have been a factor contributing to the suicidal outcome in these cases. In total, 20 of the 34 young people had reported previously known suicide attempts, and notes concerning suicidal communication were mentioned in all but three of the records, while in only three of the records had any form of suicide‐risk assessment been noted at the last care session before the suicide. Information about the suicidal process was thus available for most of these records but, as a rule, suicidal analyses were nevertheless lacking.
The dimensionality of schizophrenia concepts in first‐episode psychosis
Authors: Bell R. C. , Dudgeon P. , McGorry P. D. , Jackson H. J.
Published: November 2007

This study aimed to determine the dimensionality of concepts of schizophrenia using 11 different diagnostic systems, and then to identify the nature of these dimensions by their relationship to a range of signs and symptoms. The sample consisted of 479 patients admitted with a first episode of functional psychosis. The underlying structure of the 11 diagnostic systems was best represented by an oblique 3‐factor solution. Whereas the second and third factors could be meaningfully interpreted by their correlations with signs and symptoms, the first factor, anchored by‘modern’ nosologies such as DSM‐III‐R, was more clearly specified by what it is not (the absence of affective symptoms) rather than by what it is (the presence of characteristic psychotic symptoms). A logistic regression of DSM‐III‐R diagnosis on to separate diagnostic components supports the contention that duration of illness and affective exclusion criteria discriminate the presence of DSM‐III‐R schizophrenia much better than the three characteristic psychotic symptom groupings.
Are dysfunctional attitudes in depressive disorder trait or state dependent?
Authors: Ohrt T. , Thorell L.‐H. , Sjödin I. , D'Elia G.
Published: November 2007

The aim of this study was to investigate whether euthymic patients in remission on lithium prophylaxis score higher on the Dysfunctional Attitude Scale (DAS) than healthy subjects, thus indicating a trait quality of dysfunctional attitudes in unipolar depression. A total of 79 patients with recurrent unipolar depressive episodes and 79 individually matched healthy controls were compared using a Swedish version of the DAS. The results indicate that DAS score is a state‐dependent variable in depressive disorder.
Evolution of plasma homovanillic acid (HVA) in chronic schizophrenic patients treated with haloperidol
Authors: Galinowski A. , Poirier M. F. , Aymard N. , Leyris A. , Beauverie P. , Bourdel M. C. , Loo H.
Published: November 2007

In a 4‐week study of 14 drug‐free schizophrenic patients (according to DSM‐III‐R), free and conjugated fractions of plasma homovanillic acid (pHVA) were repeatedly measured. Free HVA levels decreased during the first 2 h of haloperidol intake (P<0.03). Conjugated HVA levels slowly decreased during the following weeks (P<0.05), while free HVA levels remained stable. After 4 weeks, free HVA levels remained unchanged 2 h after morning haloperidol intake, but conjugated HVA levels tended to increase. In haloperidol responders, at baseline the free/total HVA ratio was significantly higher than that in non‐responders (P<0.01). Tolerant patients, i.e. those whose post‐treatment free HVA levels decreased below pre‐treatment levels, were not found to respond better to haloperidol than non‐tolerant patients. The balance between free and conjugated pHVA may be a better reflection of the action of haloperidol than free pHVA levels and it may be of prognostic value in terms of drug response.
First‐incidence anxiety in the Lundby Study: course and predictors of outcome
Authors: Gräsbeck A. , Hansson F. , Rorsman B. , Sigfrid I. , Hagnell O.
Published: November 2007

The aim of the present study was to analyse first‐incidence anxiety in the Lundby Study with regard to course and predictors of outcome between 1947 and 1972. The Lundby concept of anxiety corresponds broadly to that of anxiety disorders in DSM‐III‐R. The Lundby Study is a prospective, psychiatric study of a geographically defined total population. The present study includes 124 subjects (46 men and 78 women) who between 1947 and 1972 developed anxiety as their first mental illness in life. The median total duration of illness was 1.6 years in men and 1.4 years in women. In both sexes episodes of mild impairment dominated. In total, 54% of the men and 71% of the women were mentally healthy at the follow‐up in 1972. A minority of the probands (27%) received psychiatric treatment. They significantly more often suffered from panic disorder with agoraphobia during their first episode, and from comorbidity of other mental illnesses, than did untreated subjects. They also had a significantly longer total duration of illness, a variable with a negative predictive influence on the probability of being mentally healthy in 1972. Men with anxiety showed a 55% increase in alcoholism compared to standard values. They also displayed an increased risk of relapsing into mental illness compared to female cases, a result which, in the light of earlier findings of increased mortality rates, suggests that further investigations of men with anxiety syndromes in the general population are warranted.
Suicide attempts among adolescents in Switzerland: prevalence, associated factors and comorbidity
Authors: Gex C. Rey , Narring F. , Ferron C. , Michaud P.‐A.
Published: November 2007

Switzerland has one of the highest rates of adolescent suicide in Europe, but the prevalence of suicidal thoughts and attempts is unknown. The objective of this paper is to assess the prevalence of suicidal ideation and behaviour among Swiss teenagers and to identify the factors associated with suicide attempts. A self‐administered anonymous questionnaire was distributed to a representative sample of 9268 15‐ to 20‐year‐old adolescents attending school or college. Six items focused on suicidal ideation and conduct. Multivariate analyses were performed to identify the health variables associated with suicide attempts. About 55% of the adolescents had no suicidal concerns; 26% reported suicidal thoughts, 15% reported suicidal plans and 3% reported suicide attempts. Suicide attempters reported significantly more problems in four areas, namely health behaviour, life events, social relationships and mental health. In conclusion, many factors associated with suicide attempts represent detectable behaviours. Thus health professionals could use this knowledge to be more effective in suicide prevention among adolescents.
Seasonal variation in suicide occurrence in Finland
Authors: Hakko H. , Räsänen P. , Tiihonen J.
Published: November 2007

The aim of this study was to investigate the age‐, gender‐ and suicide method‐related seasonality of suicide occurrence by using the largest database examined so far (n=21 279). The Chi‐square test for multinomials was used as the overall measure of deviation. The monthly observed and expected numbers of suicides were calculated and classified by year, month, gender, age groups and suicide methods. To identify the statistically significant peak and trough months, the ratio of observed numbers of suicides to expected numbers with 95% confidence intervals was calculated. For males, there was a suicide peak from April to July, while for females the distribution was bimodal (with peaks in May and October). In elderly people there was a significant excess in the number of suicides in autumn, and the troughs were deeper in winter. For violent suicides there was a unimodal spring peak, but for non‐violent suicides the distribution was bimodal. The results indicate that suicides among elderly subjects, as well as non‐violent suicides, occur significantly more often during autumn than would be expected.
The Nordic Comparative Study on Sectorized Psychiatry: patients who use only psychiatric in‐patient care in comprehensive community‐based services — a 1‐year follow‐up study
Authors: Saarento O. , Kastrup M. , Lönnerberg O. , Göstas G. , Muus S. , Sandlund M. , Öiesvold T. , Hansson L.
Published: November 2007

In the present paper a sample of patients using psychiatric in‐patient care only is characterized and analysed with regard to characteristics of the psychiatric services. This paper forms part of the Nordic Comparative Study on Sectorized Psychiatry, designed to investigate contact rates and use of psychiatric care by new patients in 7 catchment areas in 4 Nordic countries during a 1‐year follow‐up. One‐year treated incidence cohorts were used. The logistic regression analysis revealed that the variable ‘psychiatric service’ was one of the statistically significant determinants of using only in‐patient care during the follow‐up. The diagnostic groups with the highest probability of using only in‐patient care were dependencies and functional psychoses. The following factors were associated with a high risk of using only in‐patient care: older age, being referred by another psychiatrist, having received previous psychiatric in‐patient care, male sex, being retired, and not living with one's parents or a partner. Patients who used only inpatient care had fewer admissions and days in in‐patient care than others during the 1‐year follow‐up period. Lack of 24‐hour emergency services in out‐patient care correlated positively with the use of only in‐patient care.