bluuebunny/crossref_metadata_2025 huggingface dataset:
Anorexia nervosa: change over time in age of onset, presentation and duration of illness
Authors: Hindler C. G. , Crisp A. H. , McGuigan S. , Joughin N.
Published: July 2009

Synopsis

The question as to whether anorexia nervosa as an illness has transformed itself was partially addressed in an investigation into the possible change over time in age of onset, age of presentation and the derived variable, delay between onset and presentation. These three variables were examined in 827 patients diagnosed as suffering with anorexia nervosa, who had attended the Eating Disorders Unit at the Middlesex and St George's Hospitals from 1960 to 1990. This analysis revealed a stable age of onset but a lengthening in duration of illness and associated increase of age at presentation. However, investigation of data obtained from two other tertiary referral centres revealed stability of all three variables over time.

The overall conclusion was that there has been no change in the age of onset of anorexia nervosa during the past 30 years. The increasing delay in presentation to the eating disorders clinic is most likely attributable to a change in the practice of patient referrals to a national tertiary referral centre.
Self-monitoring in speech production: effects of verbal hallucinations and negative symptoms
Authors: Leudar I. , Thomas P. , Johnston M.
Published: July 2009

Synopsis

This paper reports results of a study on self-monitoring in speech production. Thirty schizophrenics, varying in verbal hallucination and in negative symptoms status, and 17 controls were tested on the reporter test. The position of interruptions of the speech-flow to repair errors was used to indicate whether the detection of the errors was through monitoring of internal phonetic plans or through external acoustic feedback. We have found that the internal error detection was twice as frequent in controls as in schizophrenics. The relevance of this finding to Frith's (1992) model of schizophrenia is discussed. Our conclusion is that the problem with internal monitoring of phonetic plans is common to all schizophrenics, and not just to those with verbal hallucinations.
Assessing cognitive abilities and dementia in a predominantly illiterate population of older individuals in Kinmen
Authors: Liu H. C. , Chou P. , Lin K. N. , Wang S. J. , Fuh J. L. , Lin H. C. , Liu C. Y. , Wu G. S. , Larson E. B. , White L. R. , Graves A. B. , Teng E. L.
Published: July 2009

Synopsis

A community survey of dementia was conducted on a Chinese islet. A total of 221 men and 234 women in the age range of 50–92 were assessed. The Cognitive Abilities Screening Instrument (CASI), a 100-point cognitive test designed for cross-cultural studies and adapted in Chinese for individuals with little or no formal education, was administered twice by trained field workers with a retest interval of 3 to 4 weeks. In addition, all participants were assessed by physicians who did not know the CASI scores. The physicians' assessment included a complete neurological examination, plus semi-structured tests and interviews covering cognitive abilities, daily activities, depression, cerebrovascular disease, and Parkinson's disease. Dementia was diagnosed by consensus among the physicians according to the DSM-III-R criteria. Among the 455 participants, 16 cases of dementia were identified, including 13 with probable Alzheimer's disease and 1 each with vascular dementia, Parkinson's disease, and alcoholism. The rates of dementia were 0, 3·9 and 11·5% for the age groups of 50–69, 70–79 and 80–92; and 4·4, 2·0 and 0% for the education groups of 0–1, 2–6 and 7–15 years of schooling. No sex difference was found after controlling for education. The Chinese version of the CASI had an intraclass retest reliability of 0·90. Using a cut-off score of ≤ 50 for dementia, the sensitivity was 0·88 and the specificity was 0·94. The preliminary study suggests that the CASI can be used in Chinese populations with generally low education levels and that Alzheimer's disease was the most common type of dementia in this population.
Personality characteristics of the parents of autistic individuals
Authors: Piven J. , Wzorek M. , Landa R. , Lainhart J. , Bolton P. , Chase G. A. , Folstein S.
Published: July 2009

Synopsis

Personality characteristics of 87 parents of autistic probands and 38 parents of Down's syndrome probands were examined using a standardized personality interview. Using best-estimate ratings derived from subject and informant interviews, parents of autistic individuals were rated significantly higher than controls on three characteristics: aloof, untactful and undemonstrative. When ratings were based on interviews with subjects only, parents of autistic probands were rated as significantly more aloof, untactful and unresponsive. There were no significant differences between parent groups on ratings based on informant interviews only. The implications of these findings for future family studies of autism are discussed.
Loss, humiliation and entrapment among women developing depression: a patient and non-patient comparison
Authors: Brown G. W. , Harris T. O. , Hepworth C.
Published: July 2009

Synopsis

This paper is part of a series dealing with the role of life events in the onset of depressive disorders. Women who developed depression in a general population sample in Islington in North London are contrasted with a National Health Service-treated series of depressed patients in the same area. Findings among the latter confirm the importance of a severely threatening provoking event for onset among the majority of depressed women patients. The results for the two series are similar except for a small subgroup of patients characterized by a melancholic/psychotic condition with a prior episode.

The severe events of importance have been recognized for some time by the traditional ratings of the Life Events and Difficulty Schedule (LEDS). However, the full descriptive material collected by the LEDS has been used to develop a new refined measure reflecting the likelihood of feelings of humiliation and being trapped following a severely threatening event, in addition to existing measures of loss or danger. The experience of humiliation and entrapment was important in provoking depression in both the patient and non-patient series. It proved to be associated with a far greater risk of depression than the experience of loss or danger without humiliation or entrapment.
Positive and negative symptoms/syndromes in schizophrenia: reliability and validity of different diagnostic systems
Authors: Peralta V. , Cuesta M. J. , De Leon J.
Published: July 2009

Synopsis

The paper explores the reliability, concurrent validity and overlap of some positive/negative symptom rating scales and typological criteria in 100 schizophrenic patients. Rating scales include Andreasen's Scales for the Assessment of Positive and Negative Symptoms, Abrams and Taylor's Scale for Emotional Blunting, and Kay's Positive and Negative Syndrome Scale. Criteria for categorizing individual patients include Andreasen's and Kay's criteria for positive and negative types of schizophrenia as well as Carpenter's criteria for the deficit syndrome. The correlations among positive as well as among negative scales were high. The agreement among criteria tended to be lower. Both positive scales showed low internal consistency. Kay's negative scale had the greatest internal consistency, which suggests that it is measuring a homogeneous syndrome. All negative symptom scales and categorical syndromes identified a group of patients who were single and exhibited schizoid or schizotypal pre-morbid personality disorders, poor premorbid sexual/social adjustment, poor response to neuroleptics and poor prognosis.
Differing patterns of electrodermal and finger pulse responsivity in schizophrenia and depression
Authors: Bernstein A. S. , Schnur D. B. , Bernstein P. , Yeager A. , Wrable J. , Smith S.
Published: July 2009

Synopsis

Non-response of the autonomic orienting response (OR), as indexed jointly by deficient skin conductance (SCR) and finger pulse amplitude responding (FPAR), has been shown to occur with excessive frequency in the schizophrenic population. The present study is an attempt to replicate earlier evidence that SCR-OR and FPAR-OR, when measured in concert, could distinguish schizophrenic from depressed patients (Bernstein et al. 1988). This issue is critical of the question of diagnostic specificity of OR non-responding, since reduced SCR has been found repeatedly in depression as well as in schizophrenia. We examined SCR and FPAR concurrently in 69 schizophrenic, 45 depressed, and 67 normal subjects. SCR non-responding was more frequent in both schizophrenics and depressives than in normal controls, while only the schizophrenics displayed excessive FPAR non-responding. Moreover, among SCR non-responders, concordant OR non-responding — defined as non-responding indexed simultaneously in both the SCR and FPAR components — was most common in the schizophrenic sample. These findings support our previous conclusion that OR non-responding in depression, may have distinct peripheral origins. Our results also suggest that measuring multiple biochemically distinct components of the OR may be more sound methodologically than obtaining a single channel recording.
Time course of prefrontal lobe dysfunction in severely depressed in-patients: a longitudinal neuropsychological study
Authors: Trichard C. , Martinot J. L. , Alagille M. , Masure M. C. , Hardy P. , Ginestet D. , Féline A.
Published: July 2009

Synopsis

The Stroop Colour-Word Test (SCWT) and the Verbal Fluency Test (VFT), two tests that have been suggested to be particularly sensitive to prefrontal dysfunction, were administered to 23 severely depressed in-patients. Both tests were impaired in patients at inclusion, but only verbal fluency normalized with successful treatment of depression. VFT impairment is consistent with the hypothesis of a left prefrontal cortex dysfunction in depression. Moreover, the persistence of an impaired performance on SCWT in patients at discharge suggests that a selective attention deficit may persist in patients beyond a clear clinical improvement.
Reduced total complement haemolytic activity in schizophrenic patients
Authors: Spivak Baruch , Radwan Marguerite , Brandon Jonathan , Baruch Yehuda , Stawski Mike , Tyano Sam , Weizman Abraham
Published: July 2009

Synopsis

Serum concentrations of the third and fourth components of the complement system and total complement haemolytic activity were measured in 167 psychiatric patients. Total complement haemolytic activity was decreased in chronic schizophrenic patients as compared to healthy controls and bipolar patients. The relatively diminished total haemolytic activity was not attributable to drug treatment. It is not clear if the reduced total haemolytic activity is an epiphenomenon or related to the involvement of an autoimmune process in the pathophysiology of schizophrenia.
Cavum septum pellucidum in schizophrenia, affective disorder and healthy controls: a magnetic resonance imaging study
Authors: Jurjus George J. , Nasrallah Henry A. , Olson Stephen C. , Schwarzkopf Steven B.
Published: July 2009

Synopsis

Many structural brain abnormalities have been described in schizophrenia, consistent with a neurodevelopmental model for this disease. We report here a study of the cavum septum pellucidum (CSP) in schizophrenia compared to control groups, as well as the clinical correlates of this congenital anomaly in schizophrenia. We conducted a magnetic resonance imaging (MRI) study to compare rates of CSP in schizophrenia (N = 67) v. psychiatric controls (bipolar and schizoaffective, N = 60) and healthy controls (N = 37). Of the controls 18·9 %, and of all psychotic subjects 18·1 % had a CSP of any size and there was no difference in the frequency of large CSP among the groups. Males had higher rates of CSP than females (25% v. 9·7%, P = 0·01) in all groups. Schizophrenics had higher CSP rates than affective patients (25%, v. 10%, P = 0·02). No clinical difference was found between schizophrenics with or without CSP.
Therapeutic advantage of bifrontal electrode placement in ECT
Authors: Letemendia F. J. J. , Delva N. J. , Rodenburg M. , Lawson J. S. , Inglis J. , Waldron J. J. , Lywood D. W.
Published: July 2009

Synopsis

Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery–Åsberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.
Major depression and phobias: the genetic and environmental sources of comorbidity
Authors: Kendler Kenneth S. , Neale Michael C. , Kessler Ronald C. , Heath Andrew C. , Eaves Lindon J.
Published: July 2009

Synopsis

In a population based sample of 2163 personally interviewed female twins, substantial comorbidity was observed between DSM-III-R defined major depression (MD) and 4 subtypes of phobia: agoraphobia, social phobia, animal phobia and situational phobia. However, the level of comorbidity of MD with agoraphobia was much greater than that found with the other phobic subtypes. We conducted bivariate twin analyses to decompose the genetic and environmental sources of comorbidity between MD and the phobias. Our results suggest that a modest proportion of the genetic vulnerability to MD also influences the risk for all phobic subtypes, with the possible exception of situational phobias. Furthermore, the magnitude of comorbidity resulting from this shared genetic vulnerability is similar across the phobic subtypes. By contrast, the non-familial environmental experiences which predispose to depression substantially increase the vulnerability to agoraphobia, have a modest impact on the risk for social and situational phobias and no effect on the risk for animal phobias. The increased comorbidity between MD and agoraphobia results, nearly entirely, from individual-specific environmental risk factors for MD which also increase the risk for agoraphobia but not for other phobias.
Psychiatric outcome of termination of pregnancy for foetal abnormality
Authors: Iles Susan , Gath Dennis
Published: July 2009

Synopsis

Termination of pregnancy for foetal abnormality has become frequent with the increasing sophistication of techniques of antenatal diagnosis. The aim of this study was to obtain quantitative and qualitative information about psychiatric morbidity in women after termination of pregnancy for foetal abnormality.

Two samples of women were compared. The first consisted of 71 women who had had a termination of pregnancy for foetal abnormality (FA group). The second consisted of 26 women who had experienced so-called missed abortion (MA group). Both groups had lost a pregnancy in the mid-trimester of pregnancy, but the MA group had no element of choice.

Standardized psychiatric and social measures were used to assess both groups on three occasions after the termination. In both groups, 4 weeks after the termination psychiatric morbidity was high (four to five times higher than in the general population of women), and social adjustement was impaired. Six months and 12 months after the abortion, levels of psychiatric morbidity were near normal.

Semi-structured interviewing was used to obtain information about the experience of grief after mid-trimester termination. For many women, symptoms of grief persisted throughout the year. These symptoms included typical features of grief as well as grief symptoms specific to pregnancy loss. The findings have implications for the counselling of women after termination for foetal abnormality or after missed abortion.
How abnormal is the desire for slimness? A survey of eating attitudes and behaviour among Chinese undergraduates in Hong Kong
Authors: Lee Sing
Published: July 2009

Synopsis

Using the 40-item Eating Attitudes Test and other self-report questions, a two-stage screening survey of 1020 (F 646, M 374) Chinese bilingual university students in Hong Kong showed that although female students were ‘underweight’ by Western standard, the majority of them and nearly all female students above a body mass index of 20·5 kg/m2were cognitively inclined to diet and weigh less, albeit without being driven to actual weight control behaviour. In contrast, most male students and a minority of constitutionally thin female students clearly wished to gain weight. While a number of items were culturally inappropriate, factor analysis supported the overall cross-cultural conceptual validity of the EAT. The principal factor, reflecting dieting concerns, correlated positively with the current body mass index. Among the high scorers, only three female students with partial syndrome bulimia nervosa were identified, yielding a low prevalence of 0·46% for the spectrum of eating disorders. It is argued that the desire for slimness is widespread but its intensity and pathogenic potentiality vary across cultures. In the relative absence of obesity, it may not lead to more eating disorder.
A study of the validity of the scaled version of the General Health Questionnaire in paralysed spinally injured out-patients
Authors: Griffiths T. C. , Myers D. H. , Talbot A. W.
Published: July 2009

Synopsis

This study validates the GHQ-28 on a sample of paralysed, spinally injured outpatients under the care of the West Midlands Spinal Injuries Unit. The validity of the GHQ-28 was 0·83 (95% confidence interval: 0·70 to 0·93) using the Clinical Interview Schedule (CIS) as the validating criterion. The effectiveness of the GHQ-28 as a screening instrument using CIS 11/12 as case criterion, and thus a prevalence rate of 0·18, was judged by relative operating characteristic (ROC) analysis. The area under the ROC curve was 0·91±0·03. “Optimum’ discrimination occurred near GHQ 3/4 (0011 scoring scheme) giving a sensitivity of 0·81, a specificity of 0·82 and a misclassification rate of 18%.
A new interview for the multiaxial assessment of psychiatric morbidity in medical settings
Authors: Lobo Antonio , Campos Ricardo , Pérez-Echeverría M.-Jesús , Izuzquiza Julián , García-Campayo Javier , Saz Pedro , Marcos Guillermo
Published: July 2009

Synopsis

A new semistructured instrument, the Standardized Polyvalent Psychiatric Interview or SPPI has been developed primarily for assessing medical patients. It has been built on the Clinical Interview Schedule and is intended to evaluate individuals in a multiaxial schema: psychopathology, including duration and severity of disorder; somatic disturbance; social problems and social supports: and pre-morbid personality, with especial emphasis on ‘neuroticism’. The SPPI generates enough information to allow the use of different research diagnostic criteria, including DSM-III-R, ICD-10 and Goldberg's criteria of ‘attribution’ of somatic symptoms and ‘relationships between psychiatric and physical disorder’. It also includes a section related to recommended treatment. The new interview fulfils standards of feasibility, face and content validity. An incomplete block design, inter-rater reliability study was carried out with a consecutive sample of 48 out-patients referred to the Psychosomatic-Liaison Service of the University Hospital of Zaragoza. A broad range of agreement coefficients were calculated, the results being quite acceptable (most kappas are in the range from 0·7 to 0·9) and tending to support the procedural validity of the interview.
The development and use of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals
Authors: Ruggeri Mirella , Dall'Agnola Rosa
Published: July 2009

Synopsis

In this paper the global design of a research project aiming at measuring expectations and satisfaction of patients, relatives, and professionals with community-based psychiatric services (CPS) in a multidimensional, sensitive, valid and reliable way is described. Some psychometric properties of two newly developed instruments, partly adapted from the Service Satisfaction Scale (SSS), the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS), are discussed. Three groups were selected for inclusion in the study: all patients living with their families who had more than 18 contacts in the last three years, according to the South-Verona Psychiatric Case Register; the relative who had been mainly caring for the patient; and all professionals working in the South-Verona CPS for at least one year. Data on 75 patients and 76 relatives are presented and show that VECS and VSSS have good content validity and test–retest reliability in both groups. Notwithstanding some differences, patients and relatives expressed similar expectations and were mostly satisfied. The current study is the first to provide a parallel measurement of expectations and satisfaction in all three above-mentioned groups; moreover, it is the first to investigate consumers' satisfaction with a CPS organized according to the principles of the Italian Psychiatric Reform.
Neuropsychological dysfunction in depression: the relationship to regional cerebral blood flow
Authors: Dolan R. J. , Bench C. J. , Brown R. G. , Scott L. C. , Frackowiak R. S. J.
Published: July 2009

Synopsis

The relationship between neuropsychological test performance and regional cerebral blood flow (rCBF) was examined in 29 patients meeting Research Diagnostic Criteria (RDC) for major depression. Following a comprehensive neuropsychological assessment two subsets of tests, comprising tests that discriminated between patients and controls or between patients with varying degrees of global cognitive impairment, were selected. These subtests were entered into a principal components analysis (PCA) which generated a two-factor solution, accounting for 50% of the overall variance in test scores. Individual patient loadings on each of these factors were subsequently correlated with regional cerebral blood flow (rCBF), as measured by positron emission tomography (PET). Both factors demonstrated significant correlations with rCBF in the medial prefrontal cortex and frontal polar cortex while for each factor there were also unique patterns of correlations with posterior brain regions. The findings provide additional evidence that neuropsychological deficits in depression are associated with abnormalities in regional brain function and in particular with the function of the medial prefrontal cortex.
A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II Psychological and health status at baseline and at 12-month follow-up
Authors: Pugh K. , Riccio M. , Jadresic D. , Burgess A. P. , Baldeweg T. , Catalan J. , Lovett E. , Hawkins D. A. , Gruzelier J. , Thompson C.
Published: July 2009

Synopsis

The aim of this study was to determine whether HIV infection is associated with increased psychosocial distress in the asymptomatic and early symptomatic stages of disease and to determine the factors associated with reporting health symptoms. Subjects included 61 gay men (41 HIV −, 20 HIV +) who were assessed at the time of requesting their first HIV test and again 12 months later. Measures included a detailed standardized psychiatric interview (Present State Examination, PSE), a range of psychosocial self-report measures and a physical symptom checklist. There were no differences between the HIV + and HIV − groups in terms of self-reported symptoms. Multiple regression analysis showed that the symptom reporting was not associated with clinical or immunological markers of disease progression but was associated with measures of psychosocial distress. Although both groups showed elevated levels of psychosocial distress at the time of HIV testing, there were no differences between serostatus groups at follow-up. Multiple regression analysis indicated that the best predictors of PSE scores at follow-up were baseline PSE score and a history of psychiatric illness. Early HIV disease is not associated with increased psychosocial distress and symptom reporting is more closely related to psychological measures than to clinical or immunological markers of disease.
Psychosocial predictors of vulnerability to distress in the year following heart transplantation
Authors: Dew M. A. , Simmons R. G. , Roth L. H. , Schulberg H. C. , Thompson M. E. , Armitage J. M. , Griffith B. P.
Published: July 2009

Synopsis

This study examines psychological symptomatology in a cohort of 72 heart transplant recipients followed longitudinally during their first year post-transplant. In keeping with research on other domains of life stressors and illnesses, a central study goal was to identify pre-transplant and perioperative psychosocial factors associated with increased vulnerability to, and maintenance of, elevated psychological distress levels post-transplant. Average anxiety and depression levels, but not anger–hostility symptoms, were substantially elevated in the early post-transplant period, relative to normative data. Average symptom levels improved significantly over time, although one-third of the sample continued to have high distress levels at all follow-up assessments. Recipients with any of seven psychosocial characteristics at initial interview were particularly susceptible to continued high average distress levels over time: a personal history of psychiatric disorder prior to transplant; younger age; lower social support from their primary family caregiver; exposure to recent major life events involving loss; poor self-esteem; a poor sense of mastery; and use of avoidance coping strategies to manage health problems. Recipients without such factors showed improvement in average distress levels across the assessment period. These effects were stronger for anxiety than depressive symptoms, with the exception of a sizeable relationship between loss events and subsequent depression. The findings suggest that clinical interventions designed to minimize prolonged emotional distress post-transplant need to be closely tailored to heart recipients' initial psychosocial assets and liabilities.
The role of physical activity in the development and maintenance of eating disorders
Authors: Davis C. , Kennedy S. H. , Ravelski E. , Dionne M.
Published: July 2009

Synopsis

This study was intended to establish the pathogenic significance of sport and exercise in the development of eating disorders. Hospitalized eating disordered patients and an age-matched control group were assessed. Historical and current physical activity data were collected. An in-depth interview was also conducted to ascertain the age of onset of the diagnostic symptoms for eating disorders, and to determine whether: (i) exercising predated dieting; (ii) patients had been involved in competitive athletics; (iii) exercise was excessive; and (iv) weight loss was inversely related to level of exercise. The results indicated that patients were more physically active than controls from adolescence onwards,andprior to the onset of the primary diagnostic criteria for anorexia nervosa. A content analysis of the interview data indicated that 78% of patients engaged in excessive exercise, 60% were competitive athletes prior to the onset of their disorder, 60% reported that sport or exercise pre-dated dieting, and 75% claimed that physical activity levels steadily increased during the period when food intake and weight loss decreased the most. Together our results suggest that overactivity should not be routinely viewed as a secondary symptom in anorexia nervosa, equivalent to other behaviours. For a number of anorexic women, sport/exercise is an integral part of the pathogenesis and progression of self-starvation.
Priming deficits in patients with dementia of the Alzheimer type
Authors: Burke J. , Knight R. G. , Partridge F. M.
Published: July 2009

Synopsis

In a study that replicated the procedures used by Salmon et al. (1988), the effect on stem completion performance of two different semantic orientation tasks has been assessed in patients with Alzheimer's disease. Previously reported findings of impairment in repetition priming in Alzheimer patients were confirmed. Performance was not affected by the nature of the orientation task. No significant correlations were found between explicit and implicit memory tests. The results are discussed in the context of a hypothesized parallel decline in explicit and implicit memory systems.
Diagnosis and length of psychiatric in-patient stay
Authors: McCrone Paul , Phelan Michael
Published: July 2009

Synopsis

This paper examines the link between diagnosis and length of psychiatric in-patient stay. Up to now the main method of predicting the use of in-patient services has been to use diagnosis-related groups (DRGs), primarily in the USA. Previous findings have revealed that DRGs generally predict less than 10% of variation in hospital stay. Psychiatric DRGs are considered to lack homogeneity and are too broad. Nevertheless, diagnosis, as an indicator of resource utilization, is now on the agenda in the UK and a study which examines the link between service use and diagnosis per se is called for. Altogether 5482 patients were allocated to 43 diagnostic categories (DCs). These DCs covered mental disorders, drug and alcohol-related problems, diseases of the nervous system and sense organs, and other related illnesses. Age was used in an attempt to refine the model further. Coefficients of variation were calculated for the DCs, and multivariate regression analysis was performed to gauge predictiveness. The results reveal that DCs contain extremely limited homogeneity and only predict 3% of variation in length of stay. When age group is included the results are only marginally improved, although the numbers contained in some DCs are low. Diagnosis, even when clearly defined, is a poor indicator of resource utilization.
The case of the amnesic intelligence officer
Authors: Kopelman M. D. , Green R. E. A. , Green E. M. , Lewis P. D. R. , Stanhope N.
Published: July 2009

Synopsis

This paper describes a patient whose amnesia for an offence (fraud) and two fugue episodes occurred against the background of an underlying organic amnesia. The fugue states conformed in their duration and precipitating factors to previous accounts in the literature. The organic, anterograde memory impairment was attributed to multiple small infarcts and a larger infarction in the left medial temporal lobe, which were evident on MRI and PET scans after the patient had developed transient neurological signs. At follow-up, the anterograde amnesia had persisted, and the patient also showed some difficulty in retrieving autobiographical memories of past incidents or events, although other aspects of his retrograde memory were intact (including his knowledge of facts about his past life and his general knowledge of public events). The difficulty in retrieving autobiographical incidents may have resulted from the presence of a moderate degree of frontal lobe dysfunction or, just possibly, from ischaemia in the left anterior temporal lobe. The persistence of the organic memory impairment and the importance of both the clinical history and neuropsychological testing in assessment are discussed, as well as the need to examine for possible organic factors in patients who may initially appear to manifest purely ‘psychogenic’ memory loss.
The illness of Ludwig II of Bavaria
Authors: Hay G. G.
Published: July 2009

synopsis

It has been argued by many biographers of King Ludwig II that he was not mentally ill but simply labelled mad as part of a conspiracy to remove him from the throne. The evidence for his mental disorder is reviewed and the conclusion drawn that he was probably suffering from a schizophrenic illness of some twenty years duration prior to his suicide in 1886.
Some factors influencing the effects of temporary mother-infant separation: some experiments with rhesus monkeys
Authors: Hinde R. A. , McGinnis Lynda
Published: July 2009

synopsis

Some experiments, reported in detail elsewhere, on the effects of mother–infant separation in rhesus monkeys are here reviewed and compared. They involved 4 groups – one in which mothers were removed for 13 days leaving the infant in the social group; one in which infants were removed; one in which mothers and infants were removed and separated; and one in which mothers and infants were removed but not separated. The nature of the separation experience had a profound effect on the infant's response: infants left in a familiar environment while their mothers were removed showed marked but brief ‘protest’ and then profound ‘despair’, whilst infants removed to a strange cage showed more prolonged ‘protest’. A major factor determining the effects of the separation experience in the weeks following reunion is the degree to which the mother–infant relationship has been disturbed by it. The multiplicity of factors affecting the outcome of a separation experience are discussed.
Lithium and erythrocyte membrane cation carrier studies in normal and manic depressive subjects
Authors: Naylor G. J. , Smith A. , Boardman L. J. , Dick D. A. T. , Dick E. G. , Dick P.
Published: July 2009

synopsis

Changes in the erythrocyte membrane cation carrier following lithium ingestion in normal human subjects were studied; ouabain sensitive potassium influx fell significantly during the lithium treated phase. Lithium was fed to rats and no change in erythrocyte Na-K ATPase was shown. These findings contrast with studies of lithium in manic depressive psychosis. The fluctuations in the erythrocyte membrane cation carrier were studied in 5 normal subjects over 12 weeks and the correlations between the parameters calculated. The erythrocyte sodium concentration correlated positively with the ouabain sensitive potassium influx. This too contrasts with findings in manic depressive psychosis.
A reappraisal of body perception disturbance in anorexia nervosa
Authors: Button E. J. , Fransella F. , Slade P. D.
Published: July 2009

synopsis

Previous research has suggested that patients suffering from anorexia nervosa tend to overestimate their body size, whereas normal females tend to be very accurate in this respect. This paper presents the results of further investigations of body perception amongst anorexic and normal females. The results, in contrast to earlier findings, indicate no such difference between groups. Detailed analysis of the data, however, points to the likelihood of certain differences between the present group of anorexic patients and previous groups. Moreover, it seems that body perception disturbance is not a consistent feature of anorexia nervosa and is only present amongst some patients at certain stages during their illness. On subdividing the anorexic group it was demonstrated that patients who vomit tend to overestimate their size more than do non-vomiters. It also seems likely that normal females are far from homogeneous in terms of body perception. In line with previous findings, a direct relationship was found between marked overestimation of body size and an early relapse. Evidence is also discussed which suggests that body perception disturbance is not specific to anorexia nervosa and may reflect an abnormal sensitivity about body size associated with such factors as the anticipation of an undesired change in weight, extreme concern about slimness and anxiety about putting on weight.
Awareness of body dimensions during pregnancy: an analogue study
Authors: Slade P. D.
Published: July 2009

synopsis

Two alternative explanations of the body-image abnormality in anorexia nervosa patients are outlined: namely, the ‘abnormal sensitivity’ and ‘adaptational failure’ hypotheses. Evidence relating to these 2 conflicting hypotheses was obtained from body-perception measurements carried out on groups of pregnant women.

In the first study 40 pregnant women, at approximately 4 months' duration, were found to overestimate their bodily dimensions, albeit to a lesser extent than the previously tested group of anorexia nervosa patients (Slade & Russell, 1973a). When they were subdivided on the basis of a history of weight change over the previous 12 months, the ‘stable weight’ subgroup was found to overestimate significantly more than the ‘weight gain’ and ‘weight loss’ subgroups.

In a second study 16 of the original group of pregnant women were retested at approximately 8 months' duration. Although their weight and bodily dimensions had increased on retesting, their tendency to overestimate was found to be significantly reduced.

It was concluded that the phenomenon of body-image disorder is not specific to anorexia nervosa, extending not only to patients with obesity and to some normal women, but also to women during pregnancy. Moreover, the ‘abnormal sensitivity’ hypothesis was considered to fit these and other recently accumulated data better than the alternative ‘adaptational failure’ hypothesis. Some of the theoretical and clinical implications of these findings are discussed.
Schizophrenia and coeliac disease – the nature of the relationship
Authors: Stevens F. M. , Lloyd R. S. , Geraghty S. M. J. , Reynolds M. T. G. , Sarsfield M. J. , McNicholl B. , Fottrell P. F. , Wright R. , McCarthy C. F.
Published: July 2009

synopsis

To test the hypothesis of an association between schizophrenia and coeliac disease, the sera of 380 chronic schizophrenic in-patients in two mental hospitals in the West of Ireland have been screened for the presence of reticulin antibodies. Antibodies were found in 26 patients. Twenty-one of these patients were further studied by proximal duodenal mucosal biopsy. None of the biopsies showed the morphological and histological features found in untreated coeliac disease. The incidence of reticulin antibodies in schizophrenic patients and controls is similar. The findings of this study lead to the rejection of the hypothesis of a positive genetic relationship between schizophrenia and coeliac disease.
Analysis of dream contents by scaled and rated measurements
Authors: Gaillard Jean-Michel , Phelippeau Marc
Published: July 2009

synopsis

The study was undertaken in order to test a dream-rating scale and to propose some modifications, especially for use in laboratory situations, where the effect of a given experimental factor is to be assessed on mental activity in sleep. Dreams collected from normal subjects under EEG monitoring were analysed in detail in order to establish definitions for each rating point of each dimension of the rating scale. The scoring of a second set of dreams by two judges using this scale resulted in an inter-rater agreement significantly above the level of chance agreement.
People who deliberately poison or injure themselves: their problems and their contacts with helping agencies
Authors: Bancroft John , Skrimshire Angela , Casson Jeannette , Harvard-Watts Olivia , Reynolds Frances
Published: July 2009

synopsis

A representative sample of 130 people was interviewed shortly following self-poisoning or self-injury. The interview method is described. Events in the week prior to the attempt, and the incidence of various kinds of chronic problems are reported. Events involving key relationships were much more common than other kinds. The most important event was a quarrel, particularly in the 48 hours prior to the attempts and more common with female than with male attempters. The possible relevance of quarrels to understanding overdose behaviour is discussed.

Nearly a third were receiving non-psychiatric treatment at the time of the ‘attempt’ Approximately one quarter were currently receiving psychiatric treatment and a half had received it at some time. A substantial proportion had been admitted to either psychiatric or non-psychiatric hospitals within the past year.

The proportions indicating the need for various kinds of help are reported. Most people said they needed ‘someone to talk to’. More than half had been in contact with some form of helping agency during the week prior to the attempt. The possible significance of these findings is discussed.

An attempt was made to look for ‘syndromes’ or groupings of problems. The resulting analysis, whilst of interest, did not lead to a satisfactory method for classifying individuals. It was concluded that a more satisfactory typology of ‘attempters’ is likely if types of relationship problems are investigated in more detail.
Psychiatric morbidity among West Africans and West Indians living in London
Authors: Rwegellera G. G. C.
Published: July 2009

synopsis

All West Africans and West Indians living in Camberwell who made a psychiatric contact between 1 January 1965 and 31 December 1968 were selected using the Camberwell Psychiatric Register as a sampling frame. Inception rates of psychiatric illness were then calculated using the 1966 10% census figures for West Africans and West Indians in Camberwell. The rates found were compared to those among the British living in Camberwell. For each major diagnostic category, with the exception of reactive depression and paranoid states, the inception rates are significantly higher among West Africans than West Indians. They are also significantly higher among West Indians than the British. However, the differences in inception rates are generally greater between West Africans and West Indians than between the latter and the British.
Regional and neuronal reductions of polyadenylated messenger RNA in Alzheimer's disease
Authors: Harrison Paul J. , Barton Amanda J. L. , Najlerahim Abdolrahman , McDonald Brendan , Pearson R. Carl A.
Published: July 2009

SYNOPSIS

Messenger RNA (mRNA) is the key intermediate in the gene expression pathway. The amount of mRNA in Alzheimer's disease (AD) brains has been determined using in situ hybridization histochemistry (ISHH) to detect the poly(A) tails of polyadenylated mRNA (poly(A) + mRNA). On a regional basis, AD cases had significantly less poly(A) + mRNA than controls in hippocampus (field CA3) and cerebellum (granule cell layer). Analysis of constituent pyramidal neurons showed mean reductions per cell within AD hippocampus (field CA3) and temporal cortex, but not in visual cortex. Similar changes were seen in a small group of non-AD dementias. The finding of reduced poly(A) + mRNA content is another indication of the altered brain gene expression occurring in AD. It is proposed that measurement of poly(A) + mRNA may be valuable in identifying functionally impaired neuronal populations. The methodology also provides a means by which changes in the quantitative distribution of individual mRNAs can be determined relative to that of poly(A) + mRNA as a whole.
Psychiatric, neurological and medical aspects of misidentification syndromes: a review of 260 cases
Authors: Förstl Hans , Almeida Osvaldo P. , Owen Adrian M. , Burns Alistair , Howard Robert
Published: July 2009

SYNOPSIS

Two hundred and sixty case reports of misidentification syndromes were evaluated. One hundred and seventy-four patients had a Capgras syndrome misidentifying other persons, 18 a Fregoli syndrome, 11 intermetamorphosis, 17 reduplicative paramnesia and the rest had other forms or combinations of mistaken identification. Schizophrenia (127 cases), mostly of paranoid type, affective disorder (29), and organic mental syndromes including dementia (46) were the most common diagnoses in patients who misidentified others or themselves. The patients with reduplicative paramnesia more frequently suffered from head trauma or cerebral infarction and showed more features of right hemisphere lesions on neuropsychological testing or CT scan than the patients with other misidentification syndromes. Forty-one case-reports implicated underlying medical conditions. Forty-six of the patients were reported to show violent behavioaur.

The misidentification of persons can be a manifestation of any organic or functional psychosis, but the misidentification of place is frequently associated with neurological diseases, predominantly of the right hemisphere. Misidentification syndromes show a great degree of overlap and do not represent distinctive syndromes nor can they be regarded as an expression of a particular disorder. These patients deserve special diagnostic and therapeutic attention because of the possible underlying disorders and their potentially dangerous behavioura.
Cognitive impairment and dementia in Parkinson's disease: a controlled study
Authors: Boyd J. L. , Cruickshank C. A. , Kenn C. W. , Madeley P. , Mindham R. H. S. , Oswald A. G. , Smith R. J. , Spokes E. G. S.
Published: July 2009

SYNOPSIS

The performance of 47 patients with Parkinson's disease on a battery of tests of cognition, motor function, disability and mood was compared with the performance of 47 healthy control subjects who were matched to the patients on the basis of age, sex and pre-morbid IQ. An increased prevalence of impairment over a range of cognitive functions was observed in the Parkinson's disease patients as compared with their matched controls. The differences between the Parkinson's disease patients and controls could not be accounted for by factors such as depressed mood, effects of medication or motor impairment. Our findings are discussed in relation to the methodology of previous studies in this area and to the need for a comprehensive clinico-pathological longitudinal study.
Psychophysiological anomalies in children with emotional and conduct disorders
Authors: Garralda M. Elena , Connell John , Taylor David C.
Published: July 2009

SYNOPSIS

We studied patterns of psychophysiological (skin conductance, heart rate) reactivity to sounds and to situations with varying emotional and alerting connotations in child psychiatric out-patients and in healthy controls. Children with emotional disorders were particularly reactive to situations with aversive components, while conduct disorder subjects showed increased reactivity to pleasant situations and decreased responses to neutral but high-intensity stimulation and to withdrawal of stimulation in silence periods. The results indicate patterns of biological reactivity which may underlie different psychiatric disturbances in children.
Meta-analysis of double-blind placebo-controlled trials of antidepressants and benzodiazepines for patients with panic disorders
Authors: Wilkinson Greg , Balestrieri Matteo , Ruggeri Mirella , Bellantuono Cesario
Published: July 2009

SYNOPSIS

Meta-analysis of 19 double-blind placebo-controlled trials of antidepressants (N = 13) and benzodiazepines (N = 6) for patients with panic disorders showed that active treatment had 25% greater success rate than placebo over a mean duration of 14 weeks. There were no statistically significant differences observed between treatment sub-groups (antidepressants – mean duration 16 weeks; and benzodiazepines – mean duration 7 weeks). On this basis antidepressants and benzodiazepines prescribed in clinical settings are likely to be equally effective in the short-term treatment of people with panic disorders.
Attributions of common somatic symptoms
Authors: Robbins James M. , Kirmayer Laurence J.
Published: July 2009

SYNOPSIS

Three studies explored the causal attributions of common somatic symptoms. The first two studies established the reliability and validity of a measure of attributional style, the Symptom Interpretation Questionnaire (SIQ). Three dimensions of causal attribution were confirmed: psychological, somatic and normalizing. The third study examined the antecedents and consequences of attributional style in a sample of family medicine patients. Medical and psychiatric history differentially influenced attributional style. Past history and attributional style independently influenced clinical presentations over the subsequent 6 months. Symptom attributional style may contribute to the somatization and psychologization of distress in primary care.