bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying people with dementia on Twitter
Authors: Talbot Catherine , O’Dwyer Siobhan , Clare Linda , Heaton Janet , Anderson Joel
Published: August 2018

There is a growing body of research on the use of Twitter by people with health conditions, but it does not include people with dementia. In this brief report, we aim to: (1) determine whether people with dementia are using Twitter; (2) provide an estimate of the number of Twitter account holders who identify as having a diagnosis of dementia; and (3) examine the demographic characteristics of these account holders. Tweetcatcher was used to identify tweets containing the search terms ‘dementia’ or ‘Alzheimer’. These data were systematically searched to locate account holders who identified themselves as having a diagnosis of dementia, and a content analysis was conducted of these account holders’ profiles. Thirty account holders self-identified as having a diagnosis of dementia. The average age of account holders was 59 years and the majority were located in North America or the UK. Although the majority of account holders reported having Alzheimer’s disease or did not specify a type of dementia, some rare forms of dementia were also evident. The sample consisted of relatively young account holders and contained more men, which might suggest that other groups are under-represented on Twitter. The majority of account holders considered themselves a dementia activist or were affiliated with a dementia organisation. The findings suggest that people with dementia, with varying demographic characteristics and a range of diagnoses, are active on Twitter. These account holders are more frequently male, relatively young, and dementia activists.
Performance and predictors of recruitment success in National Heart, Lung, and Blood Institute’s cardiovascular clinical trials
Authors: Pemberton Victoria L , Evans Frank , Gulin Jamie , Rosenberg Ellen , Addou Ebyan , Burns Kristin M , Gordon David J , Pearson Gail D , Kaltman Jonathan R
Published: August 2018

Background/Aims

Identifying predictors of recruitment success in clinical trials, particularly prior to study launch, could contribute to higher study completion rates and improved scientific return on investment. This article evaluates the performance of clinical trials funded by the National Heart, Lung, and Blood Institute that began recruitment before and after implementation of National Heart, Lung, and Blood Institute’s 2009 Accrual Policy and identifies study-related factors that predict recruitment success.

Methods

A retrospective analysis of National Heart, Lung, and Blood Institute’s cardiovascular clinical trials with initial funding from 1996 to 2012 was performed to assess recruitment success. Success was defined as ≥100% enrollment of the proposed sample size within the duration initially proposed by investigators. Trials were assigned to categories (pre-policy vs post-policy) based on whether the first patient was enrolled before or after the 2009 Accrual Policy implementation. Potential determinants of successful recruitment were evaluated using multivariable logistic regression.

Results

Of 167 trials analyzed, 26.3% met the definition of success. Twenty-four trials (14.4%) were terminated early and 15 (62.5%) for insufficient recruitment. Trials failed due to <100% enrollment (22.8%), longer duration (19.8%), or both (31.1%). Trials testing behavioral interventions, those conducted within a National Heart, Lung, and Blood Institute–funded network, and those with normal controls were predictive of success. The proportion of successful clinical trials increased from 23% in the pre-policy era to 30% post-policy, although the difference was not statistically significant ( p = 0.29).

Conclusion

Enrollment success rates for National Heart, Lung, and Blood Institute’s clinical trials are concerning. The 2009 National Heart, Lung, and Blood Institute Accrual Policy did not significantly improve trial success. Clinical trials testing behavioral interventions, those conducted within networks, and those with normal controls were predictive of recruitment success. Components of networks may provide model practices to help other trials attain success, including close attention to oversight activities such as recruitment plans, real-time enrollment monitoring, corrective action plans to address shortfalls, and close sponsor-investigator collaborations.
Behavioural Observation Schedule (BOS), PIRS 2nd edition A revised edition of the PIRS (WHO, Geneva, March 1978)
Authors: Atakan Zerrin , Cooper John E.
Published: August 2018

The Psychological Impairments Rating Schedule (PIRS) was originally designed by the WHO (Jablensky, 1978; see also Biehl et al this volume) and was used as a supplement to the Present State Examination (PSE) (Wing et al, 1974) in a number of collaborative WHO studies. It was mainly designed for assessing selected areas of psychological and behavioural impairments (or deficits) in patients who have suffered, or are suffering, from functional psychotic disorders. It comprised items and scales for rating observed behaviour and was filled in immediately or soon after a psychiatric or PSE interview. Raters were encouraged to take note of a subject's current behaviour and function both before and after the interview proper. The first two sections of PIRS included all behavioural items of PSE (ninth edition). Sections 18–20 as well as a number of items taken from other psychopathological rating scales and items formulated de novo.
Introduction
Authors: Eccleston Donald
Published: August 2018

It is now over 30 years since Gaddum & Picarelli (1957) described and characterised tryptamine receptors in the periphery. The setting in which they were working was what to us now is an antique department of pharmacology whose most sophisticated equipment was a smoked drum to record the response of a variety of smooth muscle preparations to the extracts of tissue containing the sought after transmitters. Gaddum the Professor of Pharmacology was the ideas man, Crawford a brilliant though highly obsessional methodologist, and Amin an indefatigable Indian PhD student. That group (Amin et al, 1954) described the presence of 5-HT in brain. They had been looking for substance P but the contractile response of the preparations to the extracts of brain did not resemble that peptide but serotonin. In many ways that was an initiator of psychopharmacology which has progressed exponentially to the present day.
Magnetic Resonance Imaging and Its Applications in Neuropsychiatry
Authors: Besson J. A. O.
Published: August 2018

The ability to measure the behaviour of protons when influenced by a magnetic field has been known to scientists since the early work of Purcell et al (1946) and Bloch (1946). The application of this technique to man, with the ability to reconstruct the data to create an image, is however a more recent innovation. Early work in this area was carried out by Damadian (1977) and Lautebur (1979) in New York, Mansfield & Maudsley (1977) in Nottingham, and Mallard et al (1979) in Aberdeen. The general principles of all these systems are similar, although the technical approaches have differed.
Magnetic Resonance Imaging and Spectroscopy in Schizophrenia
Authors: Waddington John L. , O'Callaghan Eadbhard , Larkin Conall , Redmond Oonagh , Stack John , Ennis Joseph T.
Published: August 2018

In this new era of structural and functional neuroimaging technologies, it is the unsurpassed anatomical resolution of magnetic resonance imaging (MRI) (Andreasen, 1989; and Besson, this supplement) that has resulted in a new generation of studies on cerebral morphology in schizophrenia. With the recent development of whole-body magnets of very high (⩾ 1.5T) and uniform field strength, it has become possible to extend the scope of this approach to include measurement of certain fundamental neurochemical processes, via magnetic resonance spectroscopy (MRS: Hubeschet al, 1989; Locket al, this supplement). The purpose of this article is to introduce and review critically the existing literature on the application of MRI and MRS to schizophrenia, and to give a preliminary account of some of our own recent studies in these areas.
Psychotropic-Drug Prescribing for Women
Authors: Ashton Heather
Published: August 2018

The reasons for women in Europe and North America being prescribed over twice as many psychotropic drugs as men are complex. Psychiatric disorders such as depression and anxiety appear to be more common in women than in men, and women more commonly complain of psychological symptoms. There may be a gender bias in medical diagnosis and choice of medication. Sociological factors may also be involved, including the likelihood that women have fewer outlets than men for symptom control by activities outside the home (e.g. the social use of alcohol). Women also have special problems including pregnancy, lactation, child rearing and pre-menstrual tension. Probably, much use of psychotropic-drug use for women (and men) is inappropriate and not closely related to the symptoms or conditions for which they are prescribed. Furthermore, the chronic use of some psychotropic drugs, especially benzodiazepines, may compound the problem by inducing dependence and withdrawal symptoms.
Adult Sequelae of Child Sexual Abuse
Authors: Sheldrick Carol
Published: August 2018

At present there is no consensus of opinion about the short-term or long-term effects of child sexual abuse, although there is a growing body of literature on the subject. Definitions of what constitutes child sexual abuse vary enormously and, even where agreed, include a wide range of behaviours. Most clinical reports are retrospective in nature and based on self-report. Many authors agree that effects can be classified into four general areas, however, emotional/psychological; sexual adjustment; interpersonal relationships; and social functioning. There are considerable implications for treatment of those who have been abused and for the protection of their children.
Theory of Schizophrenia: Comments
Authors: Kringlen Einar
Published: August 2018

Since Gregory Bateson and his co-workers presented their double-blind theory of the aetiology of schizophrenia in the 1950s, no grand comprehensive theory of the disorder has appeared. The double-blind theory was never accepted by the worldwide psychiatric community, and empirical research during the 1970s gave no support to it. In recent years, psychiatrists have focused attention on limited aspects of the illness, and mini-theories have flourished, but this tendency has been typical for the social sciences in general. Therefore, it is refreshing to have two attempts to integrate biological, psychological, and social viewpoints. But have these succeeded?
Need-Adapted Treatment of Schizophrenia: Family Interventions
Authors: Lehtinen Klaus
Published: August 2018

Need-adapted treatment of schizophrenia is an integrative treatment model developed in the Turku Schizophrenia Project. It is based on the interactional viewpoint and understanding on the interactional level. Experience of family and network therapy has shown that immediate interactions-oriented intervention is an essential starting-point for the treatment. It creates the possibility for the treatment as a whole to become a therapeutic process. For clinical purposes, it has seemed logical to divide the patients into three groups; the methods and focus of the family-oriented work differ somewhat between the groups. The main separator between these is the level of social functioning before the psychosis.
The Shared Image Guiding the Treatment Process
Authors: Aaltonen Jukka , Räkköläinen Viljo
Published: August 2018

The aim of the study reported here was to develop psychotherapeutic in-patient treatment for acute schizophrenia, following the principles of a need-adapted approach. To improve the integration of experiences which hospital staff have with acutely psychotic patients and their families, systematic supervision sessions were organised. In these sessions, it was possible to achieve shared psychological images through which the whole staff could integrate patients' behaviour and symptoms, both symbolic and non-symbolic. Such an image was called ‘the shared image guiding the treatment process’ (SIGTP). The process of achieving the SIGTP was interpreted through Peircean semiotics, especially the concepts of indexical, iconic, and symbolical signs. An SIGTP was considered to have been achieved in the early phase of the supervision process in 32 of the 54 cases. For the patients, SIGTP and the need-adaptation connected with it meant achieving a more realistic and more functional ordering of their experiences.
Community Care and Need for Treatment of Schizophrenic Patients in Finland
Authors: Salokangas Raimo K. R.
Published: August 2018

In recent years, the use of hospital care in Finland has decreased, while out-patient care has expanded; a psychotherapeutic approach and rehabilitative measures have been widely adopted. For schizophrenic patients, these changes may also have improved outcome, which is better than 30 years ago. However, their need for treatment and care has not been reduced to the extent that was hoped; in line with the decrease in use of hospital services, the need for alternative services for the socially disabled has increased. There is an urgent need to develop crisis-intervention. Male schizophrenic patients require special attention from the community care system and possibly a new kind of service which would meet their needs better. The need for care, support and education of patients' families is also increasing.
The Social Context of Psychiatric Rehabilitation in China
Authors: Pearson Veronica , Phillips Michael R.
Published: August 2018

A Western psychiatrist visiting a ward, out-patient department, or sheltered workshop in China would find much that was familiar, not only in terms of clinical syndromes and medication usage but also in the paucity of resources, problems with administrative hierarchies, and lack of status accorded by medical colleagues to psychiatry. Chinese psychiatric patients able to converse with their Western counterparts would discover that they shared much of the experience in common: stigma, problems with employment, and difficulties in finding a marital partner. Patients' relatives from East and West, likewise, would be able to recite a litany of similar concerns and complaints: the need for guidance and advice in handling disturbed behaviour at home, the gossip of neighbours, and the fear of another relapse.
Future Opportunities and Challenges for the Development of Psychiatric Rehabilitation in China
Authors: Phillips Michael R. , Pearson Veronica
Published: August 2018

The models of psychiatric rehabilitation described in this supplement evolved in response to a change in the official attitude to the disabled and to the provision of welfare services that has arisen since the start of China's reform era in 1978. The traditional ‘residual’ welfare that provided the minimum services needed to prevent social unrest (Chan & Chow, 1992) has been transformed into a pro-active form of welfare that identifies disadvantaged and disabled persons in the community and provides them with support and rehabilitation. Perhaps the most dramatic indication of the new status of the disabled in China is that the opening ceremony of the Second National Congress of the China Disabled Persons' Federation on 6 October 1993 was held in Beijing's Great Hall of the People, and President Jiang Zemin, Premier Li Peng and “all China's top Party and government leaders” were in attendance (Liang, 1993).
Neurodevelopmental Schizophrenia: The Rediscovery of Dementia Praecox
Authors: Murray Robin M.
Published: August 2018

Many people with severe schizophrenia have increased cerebral ventricular size and diffuse reduction in cortical volume; recent attention has focused on subtle malformations of the cytoarchitecture in the hippocampus and parahippocampal cortex. Sufferers also show an excess of dermatoglyphic and minor physical abnormalities, and a significant proportion had psychomotor deficits, cognitive or behavioural problems as children. Such findings suggest that the form of schizophrenia most akin to Kraepelin's original description of dementia praecox results from neurodevelopmental impairment. This may have its origin in genetic defects in the control of early brain growth, or in early environmental hazards such as prenatal exposure to maternal influenza or perinatal complications. How foetal or neonatal lesions produce hallucinations and delusions two or three decades later remains a mystery, but maturational changes in the brain may be important.
CNS drug discovery in the 21st century
Authors: Paul Steven
Published: August 2018

The discovery of new drugs for psychiatric and neurological disorders has been greatly facilitated by advances in molecular biology, genetics and chemistry. Several examples are given of how these revolutionary advances have been applied to the discovery of new drugs that selectively modify serotonergic neurotransmission, including compounds which may prove to be more effective antidepressants.
Olanzapine: a basic science update
Authors: Bymaster Franklin , Perry Kenneth W. , Nelson David L. , Wong David T. , Rasmussen Kurt , Moore Nick A. , Calligaro David O.
Published: August 2018

Olanzapine, an atypical antipsychotic, has a broad receptor binding profile, which may account for its pharmacological effects in schizophrenia. In vitro receptor binding studies showed a high affinity for dopamine D2, D3, and D4 receptors; all 5-HT2 receptor subtypes and the 5-HT6 receptor; muscarinic receptors, especially the M1 subtype; and α1-adrenergic receptors. In vivo studies showed that olanzapine had potent activity at D2 and 5 -HT2A receptors, but much less activity at D1 and muscarinic receptors, and that it inhibited dopaminergic neurons in the A10 but not the A9 tract, suggesting that this agent will not cause extrapyramidal side-effects (EPS). Microdialysis studies showed that olanzapine increased the extracellular levels of norepinephrine and dopamine, but not 5-HT, in the prefrontal cortex, and increased extracellular dopamine levels in the neostriatum and nucleus accumbens, areas ofthe brain associated with schizophrenia. Studies of gene expression showed that olanzapine 10 mg/kg also increased Fos expression in the prefrontal cortex, the dorsolateral striatum, and the nucleus accumbens. These findings are consistent with the effectiveness of olanzapine on both negative and positive symptoms and suggest that, with careful dosing, olanzapine should not cause EPS.
Introduction
Authors: Sartorius N. , Jablensky A. , Cooper J. E. , Burke J. D.
Published: August 2018

The purpose of this collection of papers is to describe the present state of development of Chapter V (F) of the Tenth Revision of the International Classification of Diseases (ICD-10) (to be published by the World Health Organization, Geneva), and to discuss some related issues concerning psychiatric classification in an international setting.
International Perspectives of Psychiatric Classification
Authors: Sartorius N.
Published: August 2018

When Renaudin, aghast at the situation in 1856 wrote, “We now see anarchy in the field of classification threatening to split our ranks and robbing us of the victories of our predecessors”, he was not only providing an argument for adhering to a common system of communication in psychiatry, he was also stating why classifications are such an enchanting conundrum attracting attention, arousing emotion and giving rise to thought.
The Structure and Presentation of Contemporary Psychiatric Classifications with Special Reference to ICD-9 and 10
Authors: Cooper J. E.
Published: August 2018

The discussion here is largely concerned with the purposes and structure of classifications of clinical concepts, variously called diseases, illnesses, disorders and syndromes, which are the main reasons why patients go to see doctors. Multiaspect (or multiaxial) classification has deservedly come to the fore in recent years, and seems likely to increase in importance for purposes of education, communication and research in the near future, but it is mentioned only briefly in the following discussion. The main focus of attention for the moment is the clinical descriptions of disorders; this is, of course, usually the first aspect in a multiaspect system, and the one around which the other aspects tend to be organised.
Vocal Acoustic Correlates of Flat Affect in Schizophrenia
Authors: Alpert M. , Rosen A. , Welkowitz J. , Sobin C. , Borod J. C.
Published: August 2018

In a survey of authoritative psychiatric texts, inconsistent, sometimes contradictory use can be found of the terms ‘affect’, ‘mood’, and ‘emotion’. There is some consensus that these terms deal with subsets of the larger domain of feelings, but many authorities, explicitly or implicitly, treat them as at least partially interchangeable. Others see the terms as referring to different phenomena, but disagree on how they differ. In lay usage, feelings are primarily subjective experiences, but the term is used here in a more encompassing, generic sense. In the psychiatric texts, some attributes are frequently used to distinguish among feelings. These include the duration of the phenomena; whether they are subjective, objective or both; the relative involvement of cognition; and whether they are clinically observable or rather reflect the patient's potential for response. Some examples of current usage will be considered before alternative formulations are suggested.
Dopaminergic Balance and Subtypes of Schizophrenia
Authors: Dávila R. , Zumárraga M. , Andia I. , Manero E. , Retuerto F. , Bárcena B. , Guimón J.
Published: August 2018

Several attempts have been made to relate subtypes of schizophrenia to dopaminergic status. For example, Crow's hypothesis states that Type I schizophrenia is characterised by positive symptoms, increased activity of the dopaminergic system, good response to neuroleptics, and no brain structural changes; and Type II by negative symptoms, reduced dopaminergic activity, poor response to neuroleptics, and brain structural changes. Testing of this hypothesis has, however, been inconclusive, and it seems more likely that both types are inter-related.
International Diagnostic Systems and Latin-American Contributions and Issues
Authors: Mezzich Juan E.
Published: August 2018

The complex socio-cultural features of Latin peoples throughout the Americas represent a potent challenge to health care planning. Attempting to meet this challenge requires consideration of the suitability of diagnostic systems as key clinical and public health tools, as well as exploration of promising ways for improving them.
A Three-Component-System Hypothesis of Psychosis
Authors: Emrich Hinderk M.
Published: August 2018

Hypotheses as to the pathogenesis of schizophrenia can be discussed at different levels of a possible manifestation of the causative factor: the macroscopic-morphological, the microscopic-morphological, and the molecular. Some abnormalities have been observed on all of them: e.g. increased ventricular-brain ratios in CT, hypofrontality in SPECT and in glucographic PET-scans, and other macromorphological abnormalities (for reviews cf. Bogerts 1984; Mundt, 1986; Bogerts et al, 1987), gliosis on a microscopic level (Stevens, 1982), and an increased dopamine-binding in in vivo receptor studies (PET as well as in post-mortem studies; Cazzullo, 1988). However, the diversity and variability of these findings point to the view that rather than there being a single distinct pathogenetic factor responsible for the pathogenesis of schizophrenic psychoses, a constitutional disposition exists, which can be described as a functional dysequilibrium within the human brain. From this point of view, schizophrenia would not appear as an inherited disorder of metabolism, but as a weakness of a neurobiological ‘system’, i.e. as an interactional disorder of a complex of networks, in which the interaction between different substructures is labile in such a way that under special conditions (e.g. ‘stress’), a decompensation (functional breakdown) results. In this sense, ‘vulnerability’ to schizophrenia may be interpreted as a consequence of a constitutional deficiency of the brain which results in an inability to stabilise, under specially challenging conditions, the interaction between different substructures of the human brain. Before this ‘functional dysequilibrium-hypothesis’ (which is a special form of a constitutional structural deficiency-hypothesis) is discussed, and before the question is raised as to which are the relevant dysequilibrated components, some indication will be given as to why such an hypothesis appears plausible.
Relationship of Schizophrenia to the Environment
Authors: Freeman Hugh
Published: August 2018

Attention was first drawn to the importance of this topic by Schneider (1957) when he proposed that some of his first-rank symptoms could be grouped together under the concept of ‘permeability’ of the barrier between the individual and his/her environment — the ‘loss of ego boundaries’. Similarly, in a recent series of papers (Strauss et al, 1987), the essence of schizophrenia was conceptualised in the processes of interaction between biology, behaviour, and environment. The two main syndromes — acute and chronic — can each be precipitated or made worse by environmental factors, and although most patients with the negative syndrome appear to show some irreducible impairment, poverty of the social environment has been found to worsen their condition, while on the other hand, a moderate degree of social stimulation promotes relative improvement (Wing, 1987).
The Rating and Self-rating of Anxiety
Authors: Kellner Robert , Uhlenhuth Eberhard H.
Published: August 2018

The principles of measuring anxiety are reviewed. Scales of anxiety differ in their time focus: state-anxiety scales measure the present or recent past, whereas trait-anxiety scales measure the ways the subject generally feels. Commonly used scales have adequate validity, but there is incomplete agreement on the boundaries of the construct of anxiety. There are consistent differences in sensitivity among anxiety scales, and they vary greatly in the number of items, number of cues and in the method of scoring. For self-rating scales a large number of items with only two cues (e.g. ‘yes’ and ‘no’), or only two scores for each item, increases the sensitivity of the scale for screening as well as for detecting differences between drug and placebo. A large number of cues decreases the sensitivity of a self-rating scale; it is unknown whether a large number of cues is advantageous in group research, but a small number of items is adequate both for rating and self-rating scales.
I. Background, Method, and General Description of the Sample
Authors: Johnstone Eve C. , Frith C. D. , Leary J. , Owens D. G. C. , Wilkins Soraya , Hershon H. I.
Published: August 2018

The aims of this study were to identify and trace all schizophrenic patients discharged from in-patient and day-patient psychiatric services in Harrow between 1 January 1975 and 1 January 1985, to examine the patients in terms of their mental state, cognitive functioning, extrapyramidal function and social disability, and to relate their current status in those terms to demographic, historical and treatment variables. The data collection was conducted between 1 February 1987 and 1 January 1990. The project was devised against the background of developing community care policies for psychiatric patients. In the UK, policies of closure of the mental hospitals have been advocated for a considerable time (Tooth & Brooke, 1961). In the US the plan of closing the mental hospitals and replacing in-patient care with care in the community was partially adopted (Scharfstein, 1978; Fink & Weinstein, 1979; Winslow, 1979). In Italy it was carried out in a much more complete way, at least in some areas (Jones & Poletti, 1985, 1986), but problems appear to have arisen in both of these countries (Donovan, 1982; Papeschi, 1985).
PET Analysis Indicates Atypical Central Dopamine Receptor Occupancy in Clozapine-Treated Patients
Authors: Farde Lars , Nordstrom A-L
Published: August 2018

D1 and D2 dopamine (DA) receptor occupancy was determined by PET in the basal ganglia of drug-treated schizophrenic patients. In 22 patients treated with classical neuroleptics at conventional doses, the average D2 occupancy was 78% (s.d. 6%). In five patients treated with the prototype atypical antipsychotic drug clozapine, a lower D2 occupancy of 48% (s.d. 11%, P<0.01) was found. Accordingly, clozapine is ‘atypical’ with respect to the striatal D2 DA receptor occupancy induced in patients. No obvious D1 DA receptor occupancy was induced by the classical neuroleptics haloperidol or sulpiride. The thioxanthene flupenthixol induced a 36-44% D1 occupancy in individual patients. In four patients treated with clozapine the D1 occupancy was 38-52%.
The Benefits and Risks of 5-HT Uptake Inhibitors in Depression: Chairman's Introduction
Authors: Montgomery Stuart A.
Published: August 2018

Depression is unfortunately a very common illness; it is extremely unpleasant for sufferers and for their relatives and friends, and is associated with a substantial morbidity and mortality. The lifetime risk of developing depression was estimated by Boyd & Weissman (1981) as between 8% and 12% for men and between 20% and 26% for women. Estimates of point-prevalence vary, but a review of published studies suggests a level of 8.4% for men and 14.8% for women. A difference in prevalence of depression between men and women, with a twofold increase in women, appears to be well established. Recent evidence suggests, however, that the incidence of depression in men is rather more common than was previously thought: some apparent sex differences in frequency may be accounted for by a difference in coping with, and expression of, depressive symptoms (Angst & Dobler-Mikola, 1984). What is clear from the epidemiological studies in ‘normal’ populations is that much depressive illness remains untreated.

All existing treatments for depression, in particular the tricyclic antidepressants (TCAs), have drawbacks. Since the TCAs, for example, are associated with rather unpleasant and sometimes dangerous side-effects, which reduce compliance and compromise treatment, the search for new antidepressants with less unwanted effects and if possible greater efficacy remains an important goal. A recent trend in antidepressant research has been to develop compounds with specific pharmacological actions, which are selective for one of the amine systems. Currently, a number of specific 5-HT reuptake inhibitors are being developed, and some of these are now in clinical use.
Editor's Preface: Antidepressants of the Future
Authors: Priest R.G.
Published: August 2018

Existing antidepressants are unsatisfactory: they have limited efficacy, side-effects are a problem, and there is an appreciable degree of toxicity. However, nonpharmacological, psychological approaches to the treatment of depression also have their own drawbacks, so that the search for better antidepressant compounds continues.
Tyramine and New Monoamine Oxidase Inhibitor Drugs
Authors: Simpson G.M. , de Leon J.
Published: August 2018

The hypertensive crisis induced by the ingestion of cheese in subjects undergoing treatment with monoamine oxidase inhibitors (MAOIs) led to their virtual disappearance in many parts of the world. Three strategies to try and diminish the risk of this reaction have been developed: the combination of current (irreversible and non-selective) MAOIs with tricyclic antidepressants, the use of new selective MAOIs, and the use of new reversible MAOIs. The relative effectiveness of these different approaches can be assessed by the tyramine pressor test. The introduction of reversible and selective monoamine oxidase-A (MAO-A) inhibitors looks especially promising clinically.
School teacher ratings predictive of psychiatric outcome 25 years later
Authors: Olin Su-Chin Serene , Mednick Sarnoff A. , Cannon Tyrone , Jacobsen Bjorn , Parnas Josef , Schulsinger Fini , Schulsinger Hanne
Published: August 2018

Background The current study examines teacher ratings as a tool for identifying students at risk of developing psychosis. Follow-up and follow-back studies have shown that teachers are capable of identifying individuals who later develop serious mental illness.

Method We examine the long-term outcomes for individuals at genetic risk who were identified as showing markedly deviant behaviour and those identified who did not show markedly deviant behaviour.

Results Teachers were able to correctly anticipate 35% of students who developed schizophrenia. Furthermore, those identified as showing markedly deviant behaviour had poorer clinical and psychiatric outcomes 10 and 25 years later than those identified as not behaving with marked deviance. Their ratings also differentiated, within the group of people with schizophrenia, which individuals would show evidence of poorer functioning 25 years later. These results were replicated in a group of students not at genetic risk of schizophrenia. Within this low-risk group, teachers were able to predict which students would develop psychotic disorders.

Conclusions Teacher ratings were particularly useful in predicting clinical and psychiatric outcomes 10 and 25 years later. The applicability of these findings in early intervention and treatment research is discussed.
Cognitively-oriented psychotherapy for early psychosis (COPE): Preliminary results
Authors: Jackson H. , McGorry P. , Edwards J. , Hulbert C. , Henry L. , Francey S. , Maude D. , Cocks J. , Power P. , Harrigan S. , Dudgeon P.
Published: August 2018

Background The present study describes the results of the pilottesting of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.

Method Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL–90–R, and Beck Depression Inventory measures.

Results People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P<0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure.

Conclusions There seems to be a place for psychological therapy in this group of people butour results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.
Epidemiology of obsessive-compulsive disorder
Authors: Bebbington P. E.
Published: August 2018

Background Although the concept of obsessive-compulsive disorder (OCD) has long been established, research diagnostic criteria are relatively recent developments. This is partly because the symptoms of OCD occur in the context of other disorders and it is arguable to what extent they are relatively discrete phenomena.

Method Review of the existing epidemiological surveys based on standardised instruments.

Results Nine population surveys using the Diagnostic Interview Schedule have given data on OCD, with six-month prevalences ranging from 0.7 to 2.1%. The British National Survey of Psychiatric Morbidity based on the CIS – R gave a one-month prevalence of 1% in males and 1.5% in females. Community surveys show an excess of females and emphasise the early age of onset. Minor obsessional symptoms are considerably more common than OCD itself.

Conclusions OCD is fairly rare in the general population, but causes considerable distress to those who suffer from it.
Treatment of obsessive-compulsive spectrum disorders with SSRIs
Authors: Hollander E.
Published: August 2018

Background Obsessive-compulsive spectrum disorders (OCSDs) are now recognised as distinct diagnostic entities related to obsessive-compulsive disorder (OCD). The features of OCSDs and OCD overlap in many respects including demographics, repetitive intrusive thoughts or behaviours, comorbidity, aetiology and preferential response to anti-obsessional drugs such as the selective serotonin reuptake inhibitors (SSRIs).

Method Literature was reviewed and preliminary data from various studies were re-examined to assess the relationship between compulsivity and impulsivity, and between OCD and OCSDs.

Results OCSDs include both compulsive and impulsive disorders and these can be viewed as lying at opposite ends of the dimension of risk avoidance. Compulsiveness is associated with increased frontal lobe activity and increased serotonergic activity, while impulsiveness is associated with reduced activity of these variables. Neural circuits affected by serotonergic pathways have been identified and pharmacological challenge of OCSD patients with serotonin receptor agonists have supported the involvement of serotonergic processes.

Conclusions SSRIs such as fluvoxamine have established efficacy in OCD and preliminary studies indicate that they are also effective in OCSDs. The features of three specimen OCSDs –body dysmorphic disorder, pathological gambling and autism – and their treatment with SSRIs are reviewed.
Neurochemical alterations in schizophrenia affecting the putative receptor targets of atypical antipsychotics
Authors: Harrison P. J.
Published: August 2018

What mechanisms make an antipsychotic atypical? A common view is that the different therapeutic and side-effect profile of atypical compared to typical antipsychotics is due to their high affinity for specific dopamine and/or 5-HT (serotonin) receptors. Dopamine D4and 5-HT2areceptors are particularly implicated, though many others have been proposed as well, including dopamine D1and D3, 5-HT1a, 5-HT2c, 5-HT6, 5-HT7and α2adrenergic receptors (for review, see Deutchet al,1991; Ashby & Wang, 1996; Kinon & Lieberman, 1996).
Change in Care Staff's Attitudes Towards People with Learning Disabilities Following Intervention at the Leros PIKPA Asylum
Authors: Kordoutis P. , Kolaitis G. , Perakis A. , Papanikolopoulou P. , Tsiantis J.
Published: August 2018

The pilot intervention project at Leros PIKPA asylum sought to change the management of residents by decreasing care staff's tendency to view people with learning disabilities with attitudes of custodial segregation (e.g. “they should all live in institutions”) and categorisation (e.g. “they are all alike”). To that end, staff were trained on the job in resident management and participated in seminars, sensitisation groups, clinical case presentations and visits to model rehabilitation units. To investigate whether staff attitudes towards people with learning disabilities had been influenced, staff members responded to a questionnaire of such attitudes, in March 1991 (initial assessment) and a year later (reassessment). Factor analyses of attitude ratings at initial assessment revealed a strong negative attitudinal construct, “Rejective and custodial segregation – Categorisation”, according to which institutionalisation was the only appropriate type of care for people with learning disabilities, regardless of individual differences. At reassessment, however, this factor had split into two independent ones, “Rejective and custodial segregation” and “Categorisation”, suggesting that the staff had understood that custodial care did not apply to all persons with learning disabilities indiscriminately. Reassessment factors further indicated that staff had comprehended the appropriateness of alternative care forms – community and home care. Analysis of Categorisation and Custodial segregation attitude ratings showed that only staff's tendency to view the disabled as “all alike” (Categorisation) had decreased at reassessment. The latter change and the structural change revealed by the factor analyses imply that staff's attitudes underwent a small but significant modification.
Mortality among Institutionalised People with Learning Disabilities in Greece: A 30-Year Survey at the Leros PIKPA Asylum
Authors: Perakis A. , Kolaitis G. , Kordoutis P. , Kranidioti M. , Tsiantis J.
Published: August 2018

The life expectancy of institutionalised people with learning disabilities is shorter than that of the general population. Data on population dynamics in institutions for such people are vital for planning purposes. Mortality can be considered a crude measure of quality of health care. Mortality data on the 914 admissions to the Leros PIKPA asylum for children and young adults with learning disabilities and associated problems in the years 1961–91 were reviewed. The overall crude mortality rate was 59.2 deaths per 1000 person-years. Twenty-two per cent of the deaths occurred within a year after admission. Age-specific mortality rates were particularly high for those aged one to four years, and declined thereafter. Male residents had lower mortality than female residents in almost all of the age groups. Compared with sex- and age-specific mortality data for the general population of Greece, the observed rates were 20–150 times higher but still comparable to those reported for people with more severe learning disabilities in institutions in other countries. Lifetable analysis by length of stay showed that male residents had a statistically significant higher probability of survival than female residents, which could not be attributed to age-related differential mortality. Culture-specific differential admission criteria may account for the observed sex difference.
Depression and Endocrine Disorders: Focus on the Thyroid and Adrenal System
Authors: Musselman Dominique L. , Nemeroff Charles B.
Published: August 2018

Of the various hypothalamic–pituitary–end organ axes, the thyroid and adrenal systems have been implicated most often in affective disorders. Patients with primary thyroid disease have high rates of depression, and patients with Addison's disease or Cushing's syndrome have relatively high rates of affective and anxiety symptoms. However, the major support for these endocrine axes in the pathophysiology of mood disorders comes from studies in which alterations in components of the hypothalamic–pituitary–thyroid (HPT) and the hypothalamic–pituitary–adrenal (HPA) axes have been documented in patients with primary depression. Concerning the HPT axis, depressed patients have been reported to have: (a) alterations in thyroid-stimulating hormone response to thyrotropin-releasing hormone (TRH); (b) an abnormally high rate of antithyroid antibodies; and (c) elevated cerebrospinal fluid (CSF) TRH concentrations. Moreover, tri-iodothyronine has been shown conclusively to augment the efficacy of various antidepressants. Concerning the HPA axis, depressed patients have been reported to exhibit: (a) adrenocorticoid hypersecretion; (b) enlarged pituitary and adrenal gland size; and (c) elevated CSF corticotropin-releasing factor concentrations. All of the HPA axis alterations in depression studied thus far are state-dependent, whereas the HPT axis alterations may be partially trait and partially state markers.
Risk assessment and clinical risk management: the lessons from recent inquiries
Authors: Reed John
Published: August 2018

Recent inquiries show that there is a need for a better understanding of the relationship between mental disorder and risk, about what is involved in risk assessment and risk management, and for better training for all involved, whether in health and social care services or in the criminal justice system. This paper sets out the basis for this conclusion and describes some recent central initiatives to promote better understanding of risk and risk assessment and management.
Study of the Awareness of Adoption as a Family-Building Option Among Oncofertility Stakeholders in Japan
Authors: Shiraishi Eriko , Sugimoto Kouhei , Shapiro Jason Solomon , Ito Yuki , Kamoshita Keiko , Kusuhara Atsuko , Haino Takayuki , Koizumi Tomoe , Okamoto Aikou , Suzuki Nao
Published: August 2018

Purpose

The oncofertility decision tree was developed by the oncofertility consortium as a tool to support healthcare professionals and patients through the complicated process of deciding the most appropriate fertility preservation strategy for patients with cancer. Various strategies include oocyte retrieval, oocyte donation, use of a gestational carrier and adoption. However, differences in the cultural and legal landscape present serious barriers to utilizing some of these strategies in Japan.

Patients and Methods

We surveyed Japanese oncofertility stakeholders including 60 cancer survivors, 27 oncology facilities, 78 reproductive medicine facilities and 15 adoption agencies by a questionnaire to characterize awareness among oncofertility stakeholders in Japan about parenting options including adoption to inform work to establish guidelines for decision-making by cancer survivors in an oncofertility.

Results

Our results indicate that oncologists and reproductive endocrinologists in Japan have an insufficient understanding of adoption that prevents them from adequately informing their patients. Japanese cancer survivors self-describe a lack in confidence in finding a suitable partner and raising a child. Contrastingly, of the 9 adoption agencies which responded, no agency included being a cancer survivor as a criterion for disqualification and 4 of 9 (44%) adoption agencies reported at least 1 adoption to a cancer survivor in the last year.

Conclusion

Our work demonstrates that a cancer survivor’s medical history itself is not a hurdle to adoption and investment in patient-provider education could be a viable strategy to improve the utilization of adoption as a fertility preservation strategy in Japan.
BgeeDB, an R package for retrieval of curated expression datasets and for gene list expression localization enrichment tests
Authors: Komljenovic Andrea , Roux Julien , Wollbrett Julien , Robinson-Rechavi Marc , Bastian Frederic B.
Published: August 2018

BgeeDB is a collection of functions to import into R re-annotated, quality-controlled and re-processed expression data available in the Bgee database. This includes data from thousands of wild-type healthy samples of multiple animal species, generated with different gene expression technologies (RNA-seq, Affymetrix microarrays, expressed sequence tags, and in situ hybridizations). BgeeDB facilitates downstream analyses, such as gene expression analyses with other Bioconductor packages. Moreover, BgeeDB includes a new gene set enrichment test for preferred localization of expression of genes in anatomical structures (“TopAnat”). Along with the classical Gene Ontology enrichment test, this test provides a complementary way to interpret gene lists.

Availability: https://www.bioconductor.org/packages/BgeeDB/