bluuebunny/crossref_metadata_2025 huggingface dataset:
Induced Lactation with a Dopamine Antagonist in Mares: Different Responses between Ovariectomized and Intact Mares
Authors: Guillaume D , Chavatte‐Palmer P , Combarnous Y , Duchamp G , Martinat N , Nagy P , Daels PF
Published: August 2003

Contents

The aim of this study was to compare the effects of treatment with repeated injections of sulpiride (a dopamine D2antagonist) on prolactin secretion and induced lactation in ovariectomized and intact adult mares and to verify if this induction was possible at the beginning and at the end of the birth season. Two experiments were carried out in September [experiment (expt) 1], and in March (expt 2), in France (48°N). In expt 1, three groups of five mares were tested: intact‐control, intact‐treated and ovariectomized‐treated mares. In expt 2, mares previously subjected to artificial photoperiod were assigned in two groups: four intact‐control and five intact‐treated mares. The cyclicity of intact mares was previously synchronized with PGF2αinjections, then all the mares were in the follicular phase at the beginning of treatment. Sulpiride was intramuscularly injected (0.5 mg/kg of BW), twice a day. Mares were milked at 7:30, 11:45, 16:00 and 20:15 hours. Blood samples were collected every day during the treatment for progesterone, total oestrogen and prolactin assays. In the two experiments, only treated intact mares produced milk, with a large inter‐animal variability. Prolactin increase after sulpiride treatment was not so great in the ovariectomized‐treated mares as in the intact‐treated mares. The total correlations between prolactin, progesterone, oestrogen plasma concentrations and daily milk production were significant (0.57, 0.25, 0.17 respectively). This induction of lactation can be performed during the entire birth season in intact mares, but not in ovariectomized mares, indicating that steroids are necessary for this induction in mares treated by dopamine D2 antagonist.
Activation of Mouse Oocytes Following Intracytoplasmic Injection of Chicken Sperm Extract
Authors: Kim ST , Gye MC
Published: August 2003

Contents

The cytosolic factor from the sperm of a wide variety of species has been reported to induce [Ca2+]i increase and/or activation in oocytes. Although many species have been studied, there is no data available on the chicken sperm factor responsible for activation of oocytes. This study was aimed to verify the activation of mouse oocyte by intracytoplasmic injection of chicken sperm extract (CSE). Survival rate of oocytes without rupture or lytic degeneration following injection was greater than 80% regardless of the presence or absence of CSE. Among the intact oocytes, activation rates following injection were 27.5% (11 of 40) in the sham operation group. Injection of CSE resulted in significantly higher activation rates in the 1/10 dilution group (57.8%, 26 of 45) compared with the sham operation group (p = 0.0045). Calculated amount of injected sperm extract of 1/10 dilution of CSE was equivalent of 12 chicken sperm. When the 1/10 diluted mouse sperm extract (MSE) was injected, survival rate of injected oocytes and activation rate of the survived oocytes was 82% (41 of 50) and 78% (32 of 41), respectively. Activation rate of MSE‐injected oocytes was a little but significantly higher than that of CSE‐injected oocytes (p < 0.037). In conclusion, it suggests that CSE can activate the mouse oocyte and that oocyte activating sperm factor(s) may be common between avian and mammal.
Distribution of Cytochrome P450‐side Chain Cleavage in the Theca Interna Layers of Bovine Small Antral and Cystic Follicles
Authors: Isobe N , Nakao T , Yoshimura Y
Published: August 2003

Contents

Cystic follicle is anovulatory follicular structure that is caused by an endocrine imbalance. The activity of cytochrome P450‐side chain cleavage (P450scc) is essential for the initiation of steroidogenesis in the follicle. The present study was designed to compare the frequency of cells containing P450scc between healthy and atretic small antral follicles, and among several types (I, II and III, classified based on the presence of granulosa layer) of cystic follicles. Paraffin sections of healthy (2–5 mm in diameter), atretic (2–5 mm) and cystic follicles (>25 mm) were immunohistochemically stained with rabbit polyclonal antibody to bovine P450scc. The P450scc‐positive cells were counted in four different regions of the follicles from the apical to the basal side. In small antral follicles and cystic follicles, P450scc‐positive cells were localized in the theca interna layers but not granulosa layers. The P450scc‐positive cell populations decreased in the late atretic follicles compared with the early and advanced atretic follicles at all the regions of follicle. Type III cystic follicles showed significantly lower frequencies of P450scc‐positive cells than those in the types I and II cystic follicles. These results suggest that in both small and cystic follicles in cows, total loss of granulosa cells may be associated with the reduction of frequency of P450scc‐positive cells in theca interna layer.
Meiosis Resumption of Canine Oocytes Cultured in the Isolated Oviduct
Authors: Luvoni GC , Chigioni S , Allievi E , Macis D
Published: August 2003

Contents

The aim of this study was to investigate the effects of culture in isolated oviducts relative to meiotic maturation, the time required to resume meiosis and the viability of the canine oocytes. For this purpose, cumulus–oocyte complexes and isthmus–ampullar tracts of the oviducts were collected from bitches undergoing ovariohysterectomies and destined to two experiments of culture. In experiment 1, the oocytes were cultured for 24 or 30 h: (1) in 100 μl drops under oil; (2) on the mucosal epithelium of the open oviducts; (3) in the ligated oviducts. In experiment 2, oocytes were cultured in the ligated oviduct for 24, 30 and 48 h. A group of control oocytes was not cultured (0 h). The results showed that within 30 h of culture, a higher proportion of oocytes (p < 0.001) resumed meiosis in the ligated oviduct (63.8%) than in drop (20.4%) or in the open oviduct (27.1%). Moreover, 24 and 30 h of culture assured higher proportions of meiosis resumption than 48 h (69.2 and 59.1% vs 35.8%, p < 0.005). Oocyte resumption of meiosis was mainly determined by oocytes at meiotic stages preceding metaphase I, while stages between metaphase I and II in the ligated oviduct ranged between 12.5 and 31.9%. The extension of the culture time up to 48 h in the oviduct increased oocyte degeneration significantly (59.3%, p < 0.0001) compared with 24 and 30 h (18.7 and 27.3%, respectively) and the oviductal epithelium showed nuclear picnosis and degeneration following culture. The present study suggests that the close physical interaction between the canine oocytes and the oviductal tract positively affects oocyte maturation, and meiosis is resumed within 30 h of culture. Moreover, the oocyte survival is better preserved within 30 h in the ligated oviduct compared with the conventional culture in drop or to the culture in the open oviduct, but the ligated oviduct does not assure viability of the oocytes up to 48 h of culture.
Morphological Changes of the Endometrial Epithelium in the Bitch during Metoestrus and Anoestrus
Authors: Galabova G , Egerbacher M , Aurich JE , Leitner M , Walter I
Published: August 2003

Contents

Although cyclic changes of the endometrium in dogs involving both stromal and glandular compartments have been described, the fate of the surface epithelium after progressive growth and secretion is still unclear. In the present study, uteri of 43 healthy bitches in metoestrus and anoestrus were examined macroscopically and histologically. Tissue biopsies were taken from three different locations (cranial and middle parts of uterine horns and bifurcation). The stage of the oestrous cycle was determined by evaluation of progesterone and oestradiol levels in plasma hormone and was also confirmed clinically. Crypts formed in the luteal phase were covered with a columnar epithelium which gradually underwent fatty degeneration. In addition, the stromal part of the crypts disappeared and finally, in early anoestrus, epithelial sheaths desquamated and shed off into the uterine lumen. The surface epithelium was replaced by new cuboidal cells proliferating and migrating from the glandular openings. These findings were confirmed by oil red O staining and immunohistochemical detection of proliferation with Ki‐67 marker.
Therapy Groups for Trauma Experienced in Childhood
Authors: South Robyn , Wallis Denise
Published: August 2003

Objective: To describe a group programme for the treatment of patients suffering the sequelae of childhood trauma.

Conclusions: The programme evolved in response to treatment problems experienced by mental health professionals working with these patients. Patient and therapist experiences are reported and the program content described.
Use of the Strengths and Difficulties Questionnaire as an Outcome Measure in a Child and Adolescent Mental Health Service
Authors: Mathai John , Anderson Peter , Bourne Angela
Published: August 2003

Objective: To examine the usefulness of the Strengths and Difficulties Questionnaire (SDQ) as an outcome measure for patients referred to a child and adolescent mental health service (CAMHS).

Methods: This was a prospective study of new CAMHS attendees. Questionnaires were completed by clinicians, parents, teachers and children (if aged 11 years or older) at initial attendance and after approximately 6 months.

Results: At 6-month follow up, positive change was detected on the SDQ. There was a significant reduction in the ‘total difficulties’ score as rated by parents, teachers and children. This positive change corresponded to a significant reduction in the clinician-rated Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scores. Furthermore, there were lowered levels of perceived difficulties and burden on the SDQ impact supplement, and a decrease in the overall impact score.

Conclusion: The SDQ is a useful outcome measure. The HoNOSCA and SDQ complement each other because they provide measures of change from the clinician, the parent and the child.
Evaluation of a Multidisciplinary Inpatient Rehabilitation Programme for Adolescents With Chronic Fatigue Syndrome
Authors: Denborough Paul , Kinsella Simon , Stevens John , Lubitz Lionel
Published: August 2003

Objective: To examine the hypothesis that chronic fatigue syndrome (CFS) is associated with significant psychological and physical issues that can be improved by a multidisciplinary inpatient rehabilitation programme.

Methods: A battery of psychometric instruments was administered to 39 adolescents with CFS. These instruments were administered prior to a 4 week inpatient admission as well as on discharge. The instruments were also administered to 19 adolescents at 6 month follow up.

Results: The sample included 35 girls and four boys. The Beck Depression Inventory demonstrated high depression scores that improved after the 4 week programme (p < 0.001) and these improvements were maintained after 6 months (p < 0.038). Coopersmith self-esteem scores showed low self-esteem, which improved following the programme (p < 0.001) but there was some fall off at the 6 month follow up. Physical functioning scores improved significantly after the 4 week programme (p < 0.001) and were maintained at 6 months (p < 0.001); clinician ratings of functioning matched patient ratings. On Achenbach profiles the teenagers presented with internalizing problems, which significantly improved following admission (p < 0.001). Parents reported similar findings.

Conclusion: These findings confirm the effectiveness of a multidisciplinary approach to the management of adolescents with CFS with improvements in emotional and physical functioning. Most of the improvements were maintained at 6 months follow up.
Is the Content of Delusions and Hallucinations Important?
Authors: Aschebrock Yasmin , Gavey Nicola , McCreanor Tim , Tippett Lynette
Published: August 2003

Objective: To explore the level of interest among researchers and clinicians in the content of delusions and hallucinations.

Methods: A survey of 58 mental health practitioners and researchers was conducted. The questionnaire included closed and open-ended questions about participants' views concerning the value of attending to the content of delusions and hallucinations.

Results: Participants identified benefits (e.g. heightened understanding of clients' difficulties, enhanced therapeutic relationship, improved risk assessment) and drawbacks (e.g. waste of time, exacerbation of clients' distress, reinforcement of content, blurred distinction between reality and non-reality) associated with attending to content. Half of the participants suggested that their work would be enhanced, while approximately one-fifth felt that their work would be affected adversely, should they attend to content.

Conclusions: Taken together, the data suggest that there is ambivalence towards the practice of attending to content. Participants identified deterrents to this practice that were not only pragmatic but were also related to the customary way in which delusions and hallucinations are conceptualized in the mental health field.
Use of Antipsychotic Medications in Australian States and Territories Between July 1995 and December 2001
Authors: Mond Jonathan , Morice Rodney , Owen Cathy
Published: August 2003

Objective: To examine trends in the use of oral conventional, depot and atypical antipsychotic medications in Australian States and Territories between 1995 and 2001.

Methods: For each 6 month interval between July 1995 and December 2001, prescription data obtained were converted into a measure of drug utilization expressed as the number of defined daily doses per thousand population per day (DDDs/1000/day). Data concerning the major specialty of the prescriber were available for the period 1996–2000.

Results: In each State and Territory, use of atypical antipsychotic medications increased markedly while use of oral conventional and depot medications declined. Between July 2001 and December 2001, the proportion of total prescriptions for antipsychotic medications accounted for by prescriptions for atypical medications varied from 63.1% in South Australia to 76.1% in the Australian Capital Territory (ACT). Relative use of atypical medications was higher in the ACT than in other regions, while relative use of depot medications was higher in the Northern Territory than in other regions. During the year 2000, the proportion of prescriptions for oral conventional and depot medications written by general practitioners (GPs) exceeded 75% in all regions other than the ACT. Between 1996 and 2000, the proportion of prescriptions for atypical medications written by GPs increased markedly in all regions but remained lower than for oral conventional and depot medications.

Conclusions: Atypical antipsychotic medications have replaced conventional medications as the first-line pharmacological treatment for psychotic disorders in all regions of Australia. Continued expansion of programmes designed to foster collaboration between GPs and mental health services will be essential in achieving optimal prescribing of antipsychotic medications.
Psychiatric Services in Israel: Need for a Continuum of Care Model
Authors: Jaworowski Sol , Barel Yair , Gropp Cornelius
Published: August 2003

Objective: To highlight the need for a continuum of care model for the delivery of psychiatric services in Israel.

Conclusion: Crisis assessment teams working in the community in collaboration with community mental health clinics and inpatient psychiatric units are required. The community clinics should have the capacity for providing assertive outreach including home visits as required. General hospital psychiatric units that are able to treat both voluntary and involuntary patients are also needed. The psychiatric service needs to be responsive to special needs groups with high morbidity such as those persons suffering from first-presentation psychosis and post-partum psychiatric illness. Two case vignettes are discussed that demonstrate the need for a continuum of care model.
Kraepelin, Alzheimer and Munich
Authors: Gupta Ramesh
Published: August 2003

Objective: To provide a glimpse of psychiatry's past, which the author obtained during a recent sabbatical in Munich.

Conclusions: An examination of Kraepelin's memoirs, his first address to Munich's Ludwig-Maxmilians University and Alzheimer's notes from publications reveal that the two were dedicated and observant clinicians who contributed to the scientific foundations of modern psychiatry.
A New Measure of Consumer Expectations, Perceptions and Satisfaction for Patients and Carers of Older People With Mental Health Problems
Authors: Spear Jonathan
Published: August 2003

Objective: To describe the development and evaluation of the Consumer Expectations, Perceptions and Satisfaction Scale (CEPAS).

Methods: The content of CEPAS was developed from a focus group of patients and carers. A total of 115 consecutive patients discharged from a community mental health service for older people and their carers was asked to complete a postal survey.

Results: The CEPAS was appropriate for 49% of patients (56/115) and 51% of carers (59/115). The response rates were 69% (39/56) for patients and 76% (45/59) for carers. Overall satisfaction had a significant association with the Client Satisfaction Questionnaire (r = 0.67, p < 0.001) and the Clinical Global Impression Scale (r = 0.29, p < 0.01).

Conclusions: The CEPAS was an adequate measure of patient and carer satisfaction in this setting and for this population. More research is needed to evaluate CEPAS in other settings and with other populations.
Premorbid Functioning, Welfare Issues and Ethics in Chronic Fatigue Syndrome
Authors: Cantor Chris , Neulinger Kerryn
Published: August 2003

Objective: To assess former activity levels in chronic fatigue syndrome (CFS) subjects, identify differentiating variables and discuss ethical issues arising.

Method: File review of 91 CFS patients from a private psychiatric practice, presenting multiple case reports, with limited case comparison data.

Results: The CFS subjects appeared formerly more athletically inclined than controls. Other helpful differentiating variables included exercise intolerance, excessive need for sleep, hopefulness and subjective memory problems.

Conclusions: Former exercise and other achievement levels warrant systematic research study and consideration in the assessment of CFS patients. Omissions of consideration of premorbid functioning in medicolegal evaluations raise ethical concerns.
Historical Overview of a Psychiatric Clinical Information System: ‘Peninsula Pathways’
Authors: Reilly John , Greenwood Annette , Dowling Rosemary
Published: August 2003

Objective: To review the development of a psychiatric documentation suite and associated quality improvement processes, comparing suites historically with changes in service delivery and review.

Conclusions: Changes to service delivery principles and frameworks have influenced trends to more comprehensive and modular documentation forms. Documentation of quality improvement processes will help ensure that psychiatry-specific needs for information are met during the transition to a more integrated health system and associated electronic records.
Development and Implementation of the ‘Clinical Assessment Summary’ for Providing Continuous Clinical Information
Authors: Reilly John , Greenwood Annette , Margis Samuel , Rudolph Devapriya
Published: August 2003

Objective: To describe the development and implementation of a typed ‘continuous’ clinical summary, with a longitudinal formulation and modular episode-based summaries.

Methods: Outline of rationale for this form of summary and the implementation process.

Results: Despite identified technical and training difficulties, over 3000 clinical assessment summary documents have been created with successful implementation across a mental health service.

Conclusions: A typed continuous summary offers many advantages over a traditional discharge summary and can be implemented in routine clinical practice.
The Indigenous Mental Health Worker
Authors: Parker Robert
Published: August 2003

Objective: To provide background and context for the recent Royal Australian and New Zealand College of Psychiatrists (RANZCP) statement on indigenous mental health workers.

Conclusions: There are a number of difficulties facing indigenous mental health workers in Australia today. The RANZCP statement is one step in a move to increase recognition of these workers. National registration of Aboriginal mental health workers or the formation of a national association may further promote their identity.
Implementation and Effectiveness of Interpersonal Psychotherapy in a Community Mental Health Service
Authors: Reay Rebecca , Stuart Scott , Owen Cathy
Published: August 2003

Objective: Although the efficacy of a number of psychotherapeutic interventions has been well established in tightly controlled, randomized trials, there remains a paucity of literature examining the effectiveness of these interventions in community practice settings. In light of this, the Australian Capital Territory Mental Health Services (Canberra, ACT) set out to investigate the effectiveness of an empirically supported psychotherapeutic intervention, interpersonal psychotherapy (IPT). The present study describes a pilot evaluation of the training programme for health professionals and the IPT treatment programme.

Methods: Forty community mental health professionals participated in intensive IPT training. Clinicians who completed a course of supervision were asked to apply the treatment with non-psychotic acutely depressed patients. Measures of patients’ health outcomes were taken before and after treatment using a standardized outcome measure.

Results: A total of 17 out of 21 patients who were selected completed a course of 12–16 weeks of IPT. The majority of the patients had a depression originating in the post-partum period. A comparison of pre- and post-treatment scores of treatment completers revealed a significant decrease in mean depression scores. Clinicians who completed a course of training and supervision found that they were able to confidently apply IPT in a clinical setting.

Conclusions: Although there were a number of barriers and obstacles to the introduction of an evidenced-based treatment, the results are promising and demonstrate that IPT can be readily taught to experienced mental health professionals. Further study is required to determine the feasibility of IPT in other non-academic settings using larger sample sizes and homogenous groups of patients.
Psychotherapy in the Era of Evidence-Based Medicine
Authors: Starcevic Vladan
Published: August 2003

Objective: To examine the status of psychotherapy in an era when evidence-based medicine (EBM) largely determines what constitutes efficacious treatment, and to suggest how psychotherapy might respond to the expectations of EBM, while preserving its identity and role in psychiatry.

Conclusions: If EBM is espoused dogmatically it is likely that psychotherapy will never meet its requirements. Psychotherapy can survive in the climate of an ever-increasing pressure to demonstrate its usefulness by insisting on its own criteria for doing so. This is legitimate in view of the specific features of psychotherapy, which make the standard EBM procedures for assessing the usefulness of treatment largely inapplicable.
‘In-House’ Solutions for Major Ethical Breaches
Authors: Middleton Warwick
Published: August 2003

Objective: To evaluate ‘in-house’ decisions made in respect of major ethical breaches, whether occurring in psychiatry or within the hierarchy of major churches.

Conclusions: The closer professional bodies, churches and other related organizations that have high expectations of the duty of care of their professional members, get to practising democratic ideals and universal standards of human rights, the more such members become accountable, and the less there are special cases or exceptions to the law.
Initial Experience With Long-Acting Risperidone Microspheres Injection
Authors: Keks Nicholas , Been Cyril , D'Souza Russell , Thomas Rajan , Tune Philip , Babb Jenny , Brennan Edwina , Hope Judy
Published: August 2003

Objective: To report initial clinical experience with the injectable long-acting microspheres formulation of the atypical antipsychotic risperidone.

Methods: Case reports.

Results: The seven patients described have had good outcomes to date. A patient who has received the drug for 2 years has improved from a state of severe deterioration to full-time employment and participation in a relationship; he has reported mild erectile difficulties but is keen to continue. In all cases extrapyramidal side-effects have been uncommon and brief; weight gain or other physical adverse events have not been observed.

Conclusion: Initial use of long-acting injectable risperidone suggests that the first ‘atypical depot’ is a welcome therapeutic development likely to provide significant clinical benefits, particularly for patients who have previously had unsatisfactory experiences with conventional antipsychotics.
The NUCOG: Construction and Piloting of a Cognitive Screening Instrument in a Neuropsychiatric Unit
Authors: Walterfang Mark , Velakoulis Dennis , Gibbs Andrew , Lloyd John
Published: August 2003

Objective: To develop a cognitive screening instrument suitable for a neuropsychiatric inpatient, outpatient and consultation—liaison population.

Methods: A number of cognitive screening instruments used clinically and published in the literature were reviewed. A new tool, the Neuropsychiatry Unit Cognitive Screen (NUCOG), was developed on the basis of this review, and piloted in a diverse population of patients in the unit.

Conclusions: The NUCOG demonstrated a high degree of face validity, correlation with the Mini-Mental State Examination, and significant scoring differences between demented and non-demented patients.
Comorbidity in attention deficit–hyperactivity disorder
Authors: Ishii Takashi , Takahashi Osamu , Kawamura Yuuichi , Ohta Tatsuro
Published: August 2003

Attention deficit–hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age ≥ 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51–84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD.
Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school students
Authors: Honjo Shuji , Sasaki Yasuko , Kaneko Hitoshi , Tachibana Kota , Murase Satomi , Ishii Takashi , Nishide Yumie , Nishide Takanori
Published: August 2003

School refusal is a phenomenon that first drew attention in Japan around 1960 and it remains one of the major issues in child psychiatry today. Moreover, it is now said that there exists a large group of latent school refusers currently attending school but harboring feelings of school avoidance. To address this issue, a questionnaire survey was conducted on students enrolled in a junior high and high school affiliated with the Nagoya University School of Education. The questionnaire consisted of the Children's Depression Inventory (CDI), a scale for evaluating feelings of school avoidance (School Avoidance Scale), and a scale for assessment of personality characteristics associated with school refusal (School Refusal Personality Scale). The subjects were 425 first‐year junior high to second‐year high school students. Factor analysis of each scale revealed the CDI to consist of three factors: ‘core depression’, ‘feelings of interpersonal maladaptation’, and ‘self‐revulsion’, and the School Avoidance Scale to consist of two factors: ‘school dislike’, and ‘school avoidance’. The School Refusal Personality Scale consisted of three factors: ‘obsessive–compulsive’, ‘passive/unsocial’, and ‘socially introverted’. Mean CDI score and standard deviation (SD) was 19.44 ± 7.49, and that for ‘feelings of school avoidance’ was 20.18 ± 5.61. The two subordinate factors of the School Avoidance Scale were intimately associated with both ‘feelings of interpersonal maladaptation’ and ‘core depression’ of the CDI, and negatively correlated with the ‘obsessive–compulsive’ factor of the School Refusal Personality Scale.
Relationship between attention and arousal level in schizophrenia
Authors: Nakamura Mitsuru , Matsushima Eisuke , Ohta Katsuya , Ando Katsumi , Kojima Takuya
Published: August 2003

The purpose of the present paper was to clarify the link between the attention and arousal level that supports the basis of the cognitive dysfunction in schizophrenia, by investigating the relationship between the simple reaction time and the closed‐eye eye movements in 30 patients with schizophrenia and 20 healthy controls. In terms of closed‐eye eye movements during the simple reaction time test, healthy controls showed an increase of s‐type (small and slow) eye movements after the end of the preparatory interval (PI) in both regular and irregular series, while the patients with schizophrenia, particularly those in whom the cross‐over phenomenon was observed, showed no changes and maintained a hyperarousal level during the regular PI test. These results indicate that the patients with schizophrenia could not maintain appropriate attention during the burden tasks and their hyperarousal level persisted. It is therefore suggested that there is a close relationship between attentional deficit and hyperarousal among patients with schizophrenia.
Olanzapine in Chinese treatment‐resistant patients with schizophrenia: An open‐label, prospective trial
Authors: Chiu Nan Ying , Yang Yen Kuang , Chen Po See , Chang Cheng‐Chen , Lee I. Hui , Lee Jiunn‐Ren
Published: August 2003

The role of olanzapine in treatment‐resistant schizophrenia has still not been clearly resolved. In addressing this issue, the current report presents an open‐label, prospective, 13 week trial with olanzapine use in Chinese schizophrenic patients who were resistant to more than two different classes of antipsychotics during a minimal 4 week treatment period for each antipsychotic drug at adequate dosage. Fifty‐one inpatients were recruited after a cross‐titration period and given 10–25 mg of olanzapine daily, without any concomitant antipsychotic medication. Patients were evaluated with the Brief Psychotic Rating Scale (BPRS), the Positive and Negative Symptoms Scale, the Clinical Global Impression Scale (CGI), the Abnormal Involuntary Movement Scale, the Simpson–Angus scale, and the Barnes Akathisia Scale. The olanzapine‐treated patients showed significant improvement in both the positive and negative symptoms of schizophrenia by the end of the study. Overall, 20 of 51 (39.2%) responded to 10–25 mg of olanzapine per day as measured by the BPRS and CGI scores. Five patients dropped out due to the worsening of their psychotic symptoms, two patients discontinued owing to poor drug compliance, and the remaining patient complained of a lack of efficacy. Extrapyramidal side‐effects were mild, and anticholinergic medications required has decreased. The present open study suggests that olanzapine may be effective and well‐tolerated in Chinese treatment‐resistant schizophrenic patients. Further double‐blinded trials are needed to confirm this result.
An intervention to improve the interrater reliability of clinical EEG interpretations
Authors: Azuma Hideki , Hori Shiro , Nakanishi Masao , Fujimoto Shinji , Ichikawa Norimasa , Furukawa Toshiaki A.
Published: August 2003

Several studies have noted modest interrater reliability of clinical electroencephalogram (EEG) interpretations. Moreover, no study to date has investigated a means to improve the observed interrater agreement. The purpose of the present study was to examine (i) the interrater reliability of EEG interpretations among three raters (two psychiatrists and one pediatrician); and (ii) how to improve the reliability by establishing a consensus guideline for EEGinterpretation. Three raters, two psychiatrists and a pediatrician, interpreted 100 consecutive EEG recorded at Tajimi General Hospital. After discussing the results of the first trial, the raters established a consensus guideline for EEG interpretation. They then interpreted 50 consecutive EEG recorded at Nagoya City University Hospital following this guideline. Kappa for global judgment of EEG abnormality in three grades (abnormal/borderline/normal) was 0.42 on the first and 0.63 on the second trial. Kappa significantly improved by using the guideline (P = 0.004). It is suggested that discussing and establishing the consensus guideline among the raters offers a feasible method to improve interrater reliability in clinical EEG interpretations.
Cognitive deterioration and changes of P300 during total sleep deprivation
Authors: Lee Heon‐Jeong , Kim Leen , Suh Kwang‐Yoon
Published: August 2003

The study was conducted to evaluate the cognitive deteriorations induced by sleep deprivation with the computerized neurocognitive tests and the P300 event‐related potential. Thirty healthy college students (22 men, eight women) participated in the present study. Subjects remained awake for 38 h under continuous surveillance. In the morning and the evening of the two study days, the computerized neurocognitive tests and the P300 were performed. In vigilance test and reaction unit test, there were significant cognitive impairments during sleep deprivation. However, in the cognitrone test there was significant functional improvement, which might be due to the practice effect. The P300 latency was significantly prolonged and the amplitudes decreased during sleep deprivation. The cognitive impairment during 38 h of sleep deprivation was mainly in terms of vigilance and reaction time. In contrast, higher complex cognitive function such as fine perceptual analyses, visual discrimination and working memory might be not affected by 38 h of total sleep deprivation. The changes of P300 were significantly correlated with the results of vigilance and reaction unit tests but not with the cognitrone test. Taken together, these results suggest that the P300 changes that occur during sleep deprivation are a reflection of the decrement in vigilance, which prolongs reaction time.
Unipolar depression with bipolar family history: Links with the bipolar spectrum
Authors: Benazzi Franco
Published: August 2003

The aim of the present paper was to find if unipolar major depressive disorder (MDD) with bipolar family history could be included in the bipolar spectrum, by comparing it to unipolar MDD without bipolar family history, and to bipolar II disorder, on typical bipolar variables. A sample of 280 consecutive bipolar II outpatients, and a sample of 135 consecutive unipolar MDD outpatients, presenting for major depressive episode (MDE) treatment, were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn). Hypomanic symptoms during the MDE were systematically assessed. Clinical variables used to validate the inclusion of unipolar MDD with bipolar family history in the bipolar spectrum were young age of onset, many MDE recurrences, atypical features, and depressive mixed state (DMX; an MDE plus >2 concurrent hypomanic symptoms), following many previous studies reporting that these variables were typical features of bipolar disorders. Means were compared by t‐test and frequencies by χ2 test (stata 7). Two‐tailed P < 0.05 was chosen. Unipolar MDD with bipolar family history was present in 20% of MDD patients. Comparisons among unipolar MDD with bipolar family history (UP+BPFH), unipolar MDD without bipolar family history (UP–BPFH), and bipolar II (BPII), found that UP+BPFH versus UP–BPFH had a significantly lower age, lower age of onset, fewer recurrences, and more DMX; that UP+BPFH versus BPII had no significant differences (apart from recurrences); and that UP–BPFH versus BPII had significantly different age, age of onset, recurrences, atypical features, and DMX. Findings suggest that UP+BPFH shows many bipolar signs, and that it could therefore be included in the bipolar spectrum. Unipolar MDD with bipolar family history had a clinically significant 20.0% frequency in the unipolar MDD sample, supporting the clinical usefulness of this depression subtype. The subtyping of MDD based on bipolar family history could have treatment implications.
Mood stabilizers in hospitalized children with bipolar disorder: A retrospective review
Authors: Davanzo Pablo , Gunderson Brent , Belin Thomas , Mintz Jim , Pataki Caroly , Ott Derek , Emley‐Akanno Catherine , Montazeri Nazila , Oppenheimer Jami , Strober Michael
Published: August 2003

A paucity of naturalistic data supported a rationale for the present retrospective review of clinical changes during hospitalization in 44 bipolar pre‐adolescents, treated with monotherapy lithium, carbamazepine (CBZ) or divalproex sodium (DVP). Daily staff progress notes and discharge summaries on each patient were read by four trained clinicians blind to treatment group, and rated according to the Clinical Global Impression Improvement (CGI‐I) scale. Consensus rating was measured by kappa reliability. Data were analyzed using a general linear model (sas mixed) analysis of variance (anova) with repeated measures. The medication groups did not differ in length of hospitalization, overall severity of illness at the time of admission, or comorbidity. Prior treatment was considered as a covariate. Each group approached serum therapeutic levels at day 7 of the medication period. The estimated mean CGI‐I scores for CBZ were systematically higher (i.e. worse) than those for lithium and DVP, which overlapped and crossed over time. The difference became increasingly apparent and was statistically significant by week 2 (P = 0.036). The present study was limited in that the sample sizes, particularly in the case of CBZ, were small, commensurate with the low prevalence of the disorder. Lack of structured interviews, as an independent assessment of diagnoses was an intrinsic limitation of the study. Although constrained by its retrospective nature, our findings suggest that by week 2 of hospitalization both lithium and DVP may be more efficacious than CBZ in bipolar pre‐adolescents. Any significant finding must be viewed as tentative and subject to confirmation in other studies.
Japanese version of the Body Attitude Test: Its reliability and validity
Authors: Kashima Akiko , Yamashita Tatsuhisa , Okamoto Akiko , Nagoshi Yasuhide , Wada Yoshihisa , Tadai Toshiaki , Fukui Kenji
Published: August 2003

The Body Attitude Test (BAT) was developed by Probst et al. (1995) for female patients with eating disorders (ED). This test measures the subjective body experience and attitudes toward one's body. The present authors have developed the Japanese version of the BAT and the purpose of the present paper was to investigate its reliability and validity in control (CON, n = 599) and ED patients (n = 46). The ED patients consisted of 21 anorexia nervosa, restricting type (AN‐R) patients and 25 bulimia nervosa (BN) patients. Internal consistency was determined with Cronbach's α coefficient in CON. Factor analysis was conducted on BAT ratings given by CON. Factor analysis indicated that BAT was composed of two factors. These were body dissatisfaction (factor 1) and lack of familiarity with one's body (factor 2). A comparison was made among AN‐R, BN, and CON. Bulimia nervosa had a significantly higher score than the other two groups. The BAT scores of ED patients correlated significantly with the Self ‐rating Depression Scale, and State–Trait Anxiety Inventory. These results show that ED patients have negative feelings toward their own body, similar to the findings in the original report. On factor analysis, however, it was not possible to distinguish between negative appreciation of body size and general body dissatisfaction as described in the original report. The authors also examine influences on this difference from a cross‐cultural view point.
Role of coping strategies and attitudes in mediating distress due to hallucinations in schizophrenia
Authors: Singh Gagandeep , Sharan Pratap , Kulhara Parmanand
Published: August 2003

The purpose of the present study was to determine the role of coping strategies and attitudes in predicting distress due to hallucinations in schizophrenia. Seventy‐five chronic stable schizophrenia patients were assessed with respect to sociodemographic profile, clinical variables, general psychopathology, phenomenology (severity) of hallucinations, attitude towards hallucinations, distress due to hallucinations (determined by two measures) and coping strategies used to deal with hallucinations. On multiple stepwise regression analysis, ‘severity of hallucinations’ and ‘problem‐solving coping strategies’ contributed significantly to both measures of distress. It can be concluded that distress due to hallucinations in schizophrenia is determined by severity of hallucinations (stressor) and problem‐solving coping strategies. Attitudes do not seem to play any role in this respect.
Predictors of first‐onset major depressive episodes among white‐collar workers
Authors: Tokuyama Madoka , Nakao Kazuhisa , Seto Masako , Watanabe Akira , Takeda Masatoshi
Published: August 2003

Major depression is a multifactorial disorder. Previous studies have mainly evaluated work stress to determine the risk factors for depression among workers. The present study aimed to determine factors predictive of the first depressive episode 1 year later among white‐collar workers, and to examine whether work ‘stress’ is associated with an elevated risk of depression. A 5 year open‐cohort study was carried out in a Japanese company. The odds ratios (OR) of the development of depression 1 year later were calculated. Ninety‐eight first‐onset cases were compared with 1267 never‐ill cases. Forward stepwise multiple logistic regression indicated that the first onset of depression was associated with a past history of panic attack (OR: 5.14; 95% confidence interval (CI): 1.64–16.10), neuroticism (OR: 3.59; 95%CI: 2.06–6.26), perceived overprotection (OR: 2.75; 95%CI: 1.66–4.55), poor support (OR: 2.55; 95%CI: 1.58–4.10), and low care (OR: 2.23; 95%CI: 1.23–4.04). First‐onset cases were more likely to have had objective work events (OR: 1.50; 95%CI: 1.18–1.90) but they did not differ from never‐ill cases in subjective job stress. The development of major depression in white‐collar workers is associated with multiple factors, as is depression in the community.
Twelve month test–retest reliability of a Japanese version of the Structured Clinical Interview for DSM‐IV Personality Disorders
Authors: Osone Akira , Takahashi Saburo
Published: August 2003

The purpose of the present study was to examine the long‐interval test–retest reliability of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM‐IV) Axis II Personality Disorders (SCID‐II) Japanese version. One hundred and twenty outpatients with anxiety disorders completed the self‐report SCID‐II personality questionnaire (SCID‐II‐PQ) and structured interviews, and then again 12 months later. In the SCID‐II‐PQ, 70.8% and 71.7% of the patients had a personality disorder (PD) at the first evaluation and second evaluation 12 months later, respectively, and Cohen's kappas ranged from 0.29 for paranoid PD to 0.83 for histrionic PD, and overall kappa was 0.56. In the SCID‐II interviews, 47.5% and 41.7% of the patients fulfilled the criteria for PD at the first and the second evaluations, respectively. At least one PD was identified in 49 subjects (40.8%), of whom 65.3% had one PD, 30.6% had two PD, 2% had three PD, and 2% had four PD; the most frequently diagnosed PD were from cluster C (60.9%). The overall base rate of 12 PD was 7%, and overall kappa was 0.87. Cohen's kappas ranged from 0.86 for obsessive–compulsive PD to 0.93 for avoidant PD and schizoid PD, and were comparable with those in the previous interrater studies. The test–retest reliability of the SCID‐II‐PQ was moderately good, and after the SCID‐II interview the test–retest reliability of the SCID‐II appeared to be of almost perfect reliability. This first long‐interval, large‐sample, non‐Western‐language research on the test–retest reliability of the SCID‐II for DSM‐IV indicated its usefulness and excellent reliability.
Effects of circadian typology on sleep–wake behavior of air traffic controllers
Authors: Natale Vincenzo , Martoni Monica , Cicogna Piercarla
Published: August 2003

The effects of circadian typology on sleep–wake behavior in shiftworkers were investigated using wrist actigraph in 18 air traffic controllers (ATC), nine morning types and nine evening types, working in a backward 1‐1‐1 super rapid rotation shift schedule. The ATC wore a wrist actigraph continuously over 6 days (3 days on duty and 3 days off duty). Evening types presented more flexible sleep habits and slept significantly less than morning types. Regardless of circadian typology, the morning shift tended to reduce the amount of sleep whereas night shift produced a decrease in daily activity.
Open pilot study of gabapentin versus trazodone to treat insomnia in alcoholic outpatients
Authors: Karam‐Hage Maher , Brower Kirk J.
Published: August 2003

Alcohol‐dependent outpatients with persisting insomnia were treated with either gabapentin or trazodone. Patients were assessed at baseline and after 4–6 weeks on medication using the Sleep Problems Questionnaire (SPQ). Of 55 cases initially treated, 9% dropped out due to morning drowsiness. Of the remaining 50 cases, 34 were treated with gabapentin (mean dose ± SD = 888 ± 418 mg) at bedtime and 16 were treated with trazodone (105 ± 57 mg) at bedtime. Both groups improved significantly on the SPQ but the gabapentin group improved significantly more than the trazodone group. Controlled studies are warranted to replicate these findings.
Mutation and association analysis of the DAP‐1 gene with schizophrenia
Authors: Aoyama Shinsuke , Shirakawa Osamu , Ono Hisae , Hashimoto Takeshi , Kajimoto Yasuo , Maeda Kiyoshi
Published: August 2003

Glutamate dysfunction has been hypothesized to be involved in the pathophysiology of schizophrenia. The human homolog of Drosophila discs large protein (hDLG) and post‐synaptic density‐95‐associated protein‐1 (DAP‐1) is one of the major proteins that are involved in intracellular signal transduction via N‐methyl‐d‐aspartate receptors. In the present study 33 Japanese patients with schizophrenia were screened for mutations in the DAP‐1 gene. A single nucleotide polymorphism was identified in the DAP‐1 gene (1618A/G). A case–control study using a larger sample of unrelated patients and controls did not reveal a significant association between this polymorphism and schizophrenia. The results do not provide evidence that the DAP‐1 gene is involved in vulnerability to schizophrenia.