bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuation therapy in endogenous depression controlled by changes in the TRH stimulation test
Authors: Kirkegaard C. , Smith Eli
Published: July 2009

Synopsis

Thyrotropin response to thyrotropin-releasing hormone is impaired during endogenous depression and normalized between the depressive periods. Changes in the thyrotropin response to thyrotropin-releasing hormone were shown to be of predictive value and might be useful in the control of continuation therapy with antidepressants in patients with endogenous depression.
Ernst Kretschmer 1888–1964
Authors: Häfner Heinz
Published: July 2009

Synopsis

Until his retirement in 1959 Ernst Kretschmer was Professor of Psychiatry at the University of Tübingen. He published eight monographs, five of which were of eminent importance and at least two exerted considerable influence on European psychiatry for several decades, namely Der sensitive Beziehungswahn (1918) and Körperbau und Charakter (1921). His theory on constitutional body types and character became an integral part of German schoolbooks.
Cerebrospinal fluid somatostatin in delirium. II Changes at the acute stage and at one year follow-up
Authors: Koponen Hannu , Reinikainen Kari , Riekkinen Paavo J.
Published: July 2009

Synopsis

Cerebrospinal fluid somatostatin-like immunoreactivity (CSF SLI) was determined for elderly delirious patients during the acute stage and after one-year follow-up. The SLI levels were compared with age-equivalent controls. For the group as a whole, and also when the group was subdivided according to the severity of cognitive decline at the acute stage, type of delirium, or the central nervous system disease, delirious patients showed significant reduction of SLI as compared with the controls. In the follow-up, we observed a further reduction of CSF SLI together with significant correlations in the second and third samples between SLI levels and Mini-Mental State Examination score. Our results suggest a role for somatostatinergic dysfunction in the genesis of some symptoms of delirium. This dysfunction may be a common phenomenon in various forms of delirium and dementia.
Neuropsychological deficits and CT scan changes in elderly depressives
Authors: Abas Melanie A. , Sahakian Barbara J. , Levy Raymond
Published: July 2009

Synopsis

A number of computerized tests were used to study visual attention, memory and learning in elderly depressed patients. Impairment was found in approximately 70% of depressed patients and was seen particularly in memory and in measures of latency. Depressed patients showed equivalent impairment in short-term memory but less impairment in conditional associative learning compared to a group of patients with early dementia of the Alzheimer-type (DAT), matched for age and pre-morbid IQ. With respect to qualitative differences between depression and DAT, depressed patients showed a different pattern of errors and a consistently prolonged latency of response which was independent of delay in a delayed matching-to-sample test. On recovery from depression, although improvement was seen in most test scores, performance in measures of latency and in a number of tests of memory and learning failed to reach the level seen in a group of matched control subjects and approximately 35% of patients continued to show impairment. For the depressed patients, ventricular brain ratio (VBR) correlated with measures of slowing. In addition, in the ‘recovered-depressives’, VBR correlated with poor performance at high levels of task difficulty. These findings are discussed with respect to previous literature on the pattern of cognitive impairment and CT scan findings in depression.
Sampling strategy in linkage studies of affective disorders
Authors: Leboyer M. , Babron M. C. , Clerget-Darpoux F.
Published: July 2009

Synopsis

Evidence of linkage in families of bipolar patients has so far been identified with genetic markers on chromosome X and 11. However, replications of these data have not consistently been reported in either case, which favours the hypothesis of genetic heterogeneity. Therefore, we have tried to outline a sampling strategy for linkage replication in affective disorders. We estimated the average number of nuclear families required to replicate X or 11 linkage as a function of the degree of heterogeneity as well as the number to prove heterogeneity given that linkage exists. The results are presented and discussed.
A contribution of fluorescent lighting to agoraphobia
Authors: Hazell Jane , Wilkins Arnold J.
Published: July 2009

Synopsis

Under three types of artificial lighting 24 women with chronic agoraphobia and 24 female control subjects assessed their mood and bodily symptoms, and their heart rate was measured. One of the three types of lighting was incandescent. The other two were fluorescent, one pulsating in the conventional manner 100 times per second and the other relatively steady. Both were provided by a single fluorescent lamp controlled from one of two circuits. When exposed to the conventional pulsating fluorescent light under double-blind conditions the agoraphobic group showed a higher heart rate and reported more anomalous visual effects in response to an epileptogenic pattern. Control subjects reported more bodily symptoms under the conventional fluorescent light than under the two other lighting conditions.
Psychological treatment for atypical non-cardiac chest pain: a controlled evaluation
Authors: Klimes I. , Mayou R. A. , Pearce M. J. , Coles L. , Fagg J. R.
Published: July 2009

Synopsis

Thirty-one patients with atypical non-cardiac chest pain which had persisted despite negative medical investigation were treated in a controlled trial of cognitive-behavioural therapy. The average duration of pain was 4·7 years. Patients were randomized to either immediate treatment or as a control to assessment only. Treatment involved teaching patients how to anticipate and control symptoms, and modification of inappropriate health beliefs. The average number of sessions given was 7·2. There were significant reductions in chest pain, limitations and disruption of daily life, autonomic symptoms, distress and psychological morbidity in the treated group as compared with the control group who were unchanged. The assessment-only group were treated subsequently and showed comparable changes. Improvements were fully maintained by both treated groups at four to six-months follow-up.
Perceived parental rearing style, parental divorce and transsexualism: a controlled study
Authors: Cohen-Kettenis Peggy T. , Arrindell Willem A.
Published: July 2009

Synopsis

The parental representations of male-to-female and female-to-male transsexuals were rated using the EMBU inventory. Scores on the measure were compared against ratings returned by controls of similar biological sex, matched on age, educational level and number of female siblings in an ANCOVA design. In line with previous findings by Parker & Barr (1982), who studied male-to-female transsexuals only, these patients were found not to differ from the male controls in their scoring of their mothers, but did score their fathers as less emotionally warm, more rejecting and more protective. Extending the findings by Parker & Barr (1982), female-to-male transsexuals rated both parents as more rejecting and less emotionally warm, but only their mothers as more protective than their female control equivalents rated theirs. Parental divorce distinguished both patient groups from controls, although further analyses revealed this not to imply more parental absence in patients than in controls. Male and female transsexuals differed from each other in some respects (e.g. lower scores on parental emotional warmth and higher scores on maternal rejection for the female patients), while being comparable in other respects (e.g. parental divorce).
Lycanthropy and demonomania: some psychopathological issues
Authors: Koehler K. , Ebel H. , Vartzopoulos D.
Published: July 2009

Synopsis

Modern reports on lycanthropy mainly concentrate on the content of patients' beliefs in being transformed into an animal. By contrast, an interest in the form of the symptomatology is usually minimal. This paper draws on Karl Jaspers' phenomenological views and focuses on some important albeit neglected psychopathological issues related to form which are relevant to any comprehensive consideration of lycanthropic phenomena.
Hypertension labelling, life events and psychological well-being
Authors: Moum Torbjørn , Næss Siri , Sørensen Tom , Tambs Kristian , Holmen Jostein
Published: July 2009

Synopsis

Almost all previous studies of the psychological sequelae of hypertension labelling have lacked a prospective, longitudinal design which could allow for causal interpretations. The present study relies on questionnaire data from a hypertension screening carried out on the entire adult population of a medium-sized, Norwegian county (total number of participants = 74977). ‘Labelled’ individuals, i.e. previously unaware hypertensives (N = 173), false positives (N = 233), and patients in need of continued BP control (N = 474) have been followed up after 1–3 years, and comparisons are made with aware hypertensives (N = 206), patients previously treated for hypertension (N = 118), and a random sample of normotensives (N = 2326). ‘Pre-labelling’, baseline measures of subjective well-being had been carried out on all comparison groups in connection with the screening. Changes in psychological well-being are not significantly related to labelling or BP-status. However, there is a deterioration in psychological well-being among participants who have been subjected to one or more negative life events/stresses (other than labelling) in the preceding 12 months.
Prevalence of three bulimia syndromes in the general population
Authors: Bushnell John A. , Wells J. Elisabeth , Hornblow Andrew R. , Oakley-Browne Mark A. , Joyce Peter
Published: July 2009

Synopsis

Prevalence of bulimia was estimated from a cross-sectional general population survey of 1498 adults, using the Diagnostic Interview Schedule (DIS) administered by trained lay interviewers. Lifetime prevalence of the DSM-III syndrome in adults aged 18–64 was 1·0% and this was concentrated in young women: in women aged 18–44 lifetime prevalence was 2·6%, and 1·0% currently had the disorder. Based on clinicians' reinterviews of random respondents and identified and marginal cases, the prevalence of current disorder using criteria for draft DSM-III-R bulimia was 0·5%, for DSM-III it was 0·2%, and for Russell's Criteria bulimia nervosa 0·0%. A strong cohort effect was found, with higher lifetime prevalence among younger women, which is consistent with a growing incidence of the disorder among young women in recent years. Although elements of the syndromes were so common as to suggest that dysfunctional attitudes to eating and disturbed behaviour surrounding eating are widespread, there was little evidence of the bulimia syndrome having become an epidemic on the scale suggested by early reports.
Patterns of neuropsychological deficit in alcoholic Korsakoff's Syndrome
Authors: Jacobson R. R. , Acker C. F. , Lishman W. A.
Published: July 2009

Synopsis

Twenty-five male and 13 female patients with alcoholic Korsakoff's syndrome (AKS) were compared with age- and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers in a neuropsychological study, which included computer-administered tests of cognitive function. The performance of male Korsakoff patients was significantly inferior to that of healthy male controls, not only in tests of memory, but also in visuo-perceptual tasks with a speed or motor component, and on category sorting and verbal fluency measures. Compared with male alcoholics, the performance of male Korsakoff patients was again inferior on similar tests. Female Korsakoff patients showed more extensive deficits compared with female controls, but differed less from matched female alcoholics.

The results suggest that, in addition to their amnesia, many Korsakoff patients have sustained widespread cognitive deficits, affecting particularly visuo-perceptual and abstracting functions, which are sensitive to cortical lesions. The range of deficits falls short of what may be regarded as ‘global’ in male, but probably not in female, Korsakoffs. The implications for a dual aetiology of AKS involving thiamine deficiency and other features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.
Whakama: culturally determined behaviour in the New Zealand Maori
Authors: Sachdev Perminder S.
Published: July 2009

Synopsis

Whakama is a psychosocial and behavioural construct in the New Zealand Maori which does not have any exact equivalent in Western societies although shame, self-abasement, feeling inferior, inadequate and with self-doubt, shyness, excessive modesty and withdrawal describe some aspects of the concept. It is an important construct in order to understand the interaction of the Maori with each other and with the Caucasian New Zealander, the behaviour of the Maori in cross-cultural settings, and the clinical presentations of some Maori patients. This paper examines some of the meanings of Whakama, its various behavioural manifestations and its possible causes. The clinical relevance to psychiatry is emphasized.

Waiho ma te whakama e patu!

‘ Leave him alone he is punished by whakama ’ (Maori saying)
General practice aspects of self-poisoning and self-injury
Authors: Hawton Keith , Blackstock Eileen
Published: July 2009

Synopsis

A sample of individuals who had carried out acts of self-poisoning or self-injury were interviewed and information was also obtained from their general practitioners. More of both the men and the women had visited their general practitioners in the year before the acts than would have been predicted from national statistics, although this was not found to the same extent for persons aged 16–24. Thirty-six per cent of the sample had contacted their general practitioners during the week before the act and over 60% in the month beforehand. Sixty-three per cent had visited them for a variety of psychiatric and social reasons during the preceding year and had nearly all been prescribed psychotropic drugs, usually tranquillizers or sedatives. These were commonly the drugs taken in acts of self-poisoning. Methods of prevention are discussed.
Systematic self-assessment by P.Q.R.S.T.
Authors: Mulhall David J.
Published: July 2009

Synopsis

This paper presents a Personal Questionnaire which is sufficiently simple for use in most clinical settings. Following a brief description of Personal Questionnaires, their origin and background are discussed and some subsequent developments delineated. The method involves the use of a general set of adjectives which can be used to qualify the symptoms experienced by any given patient. Successive measurements of the symptoms can be made so that changes in their subjective intensity can be monitored. The internal consistency of ratings of each symptom on each occasion is used as a measure of reliability. As with all previous Personal Questionnaires the symptoms which are measured are unique to the individual, but unlike other methods the format of this Questionnaire is predetermined, which ensures its simplicity and ease of use.
Comparative trial of L-tryptophan and amitriptyline in depressive illness
Authors: Herrington R. N. , Bruce A. , Johnstone E. C. , Lader M. H.
Published: July 2009

Synopsis

Depressed patients who were suitable for drug treatment were allocated randomly to treatment for four weeks with either amitriptyline in doses reaching 150 mg daily or with l-tryptophan in a maximal dose of 8 G daily. Both in-patients and out-patients were included. The trial was double-blind and ratings were made at the start of treatment and weekly for the subsequent four weeks: the patients were then followed for a further six months. Both groups of patients improved steadily over the course of four weeks and there were no marked differences between the treatment groups though there was some tendency for the improvement of the tryptophan-treated patients to fade between the third and fourth weeks. Within the tryptophan group anxious patients improved least. It is concluded that L-tryptophan probably has some antidepressive action in patients with depressive illness of moderate severity.
Drug response and psychiatric nosology
Authors: Murray Robin M. , Murphy Dennis L.
Published: July 2009

Synopsis

The possibility that pharmacological response might help to refine psychiatric nosology has been the subject of recurrent speculation, but few clear-cut results have been obtained. Only bipolar depressives and several other minor patient subgroups manifest consistent drug responses in association with characteristic psychobiological features. The presence of multiple intervening variables, such as individual differences in drug metabolism, drug-taking behaviour and biological sensitivity to drugs, may mitigate against the reliable identification of clinically distinguishable drugresponding subgroups. Furthermore, the majority of available psychoactive drugs have either multiple or broad spectrum effects inconsistent with hypotheses utilizing the mechanism or site of drug action to argue for a diagnosis-specific biological disorder at such sites.

Nonetheless the successful use of drug-response models in other areas of medicine suggests a rationale for continued exploration in this area, and a number of recent advances make this approach potentially more productive. Pharmacological developments have rendered it possible to assess the biological availability of drugs in potential responders, thus eliminating some of the confounding intervening variables. Further consideration should also be given to the use of drugs with more specific neurochemical effects, even when they themselves are not necessarily therapeutic. The comparison of drug responder and non-responder groups has also been made more meaningful by the availability of more reliable methods of assessing clinical phenomena, more sophisticated diagnostic models and the introduction of other biological measures. Combining several of these approaches may allow the use of one to validate the other.
Physical ill-health and psychotropic drug prescription – a review
Authors: Williams Paul
Published: July 2009

Synopsis

This review collates evidence of substantial physical morbidity in patients who receive psychotropic drugs, and evidence that these drugs are not infrequently prescribed for patients with known physical illness. Minor tranquillizers are the psychotropic drugs most commonly prescribed, and the category of physical illness most likely to be associated with psychotropic medication is cardiovascular disease.
Previous induced abortion and ante-natal depression in primiparae: preliminary report of a survey of mental health in pregnancy
Authors: Kumar R. , Robson Kay
Published: July 2009

Synopsis

One hundred and nineteen primiparae, who were routinely attending ante-natal clinics, were interviewed repeatedly between the 12th and 36th weeks of their pregnancies. The incidence of depression was highest in the first trimester and, overall, about a fifth of the sample was found to be suffering from clinically significant neurotic disturbances. In a proportion of these expectant mothers there was an association between depression and anxiety early in pregnancy and a previous history of induced abortion; this phenomenon may reflect a reactivation of mourning which was previously suppressed.
The changing profile of a nineteenth-century asylum: the York Retreat
Authors: Digby Anne
Published: July 2009

Synopsis

This paper focuses on the later history of the York Retreat after the initial period for which it is best known. It discusses the marked changes which occurred in the social composition of its patients and the way in which these changes modified the asylum's management and therapy. It argues that the conventional image of the Retreat, based as it is on the institution's earliest years, needs considerable revision.
Endocrine changes and clinical profiles in depression: I. The dexamethasone suppression test
Authors: Calloway S. P. , Dolan R. J. , Fonagy P. , De Souza V. F. A. , Wakeling A.
Published: July 2009

Synopsis

Hypothalamic–pituitary–adrenal axis function was investigated in 72 patients with primary depression. Forty-four per cent of the patients demonstrated abnormal suppression of their cortisol levels after a 1 mg overnight dexamethasone suppression test. Patients with abnormal suppression (‘non-suppressors’) were not clearly distinguished from ‘suppressors’ by the commonly used diagnostic classifications. They did not appear to be more severely depressed, but they were more likely than the ‘suppressors’ to be in-patients. Multivariate analysis of the data suggested that two clinical features were independently associated with non-suppression: the PSE syndromes of Slowness and General Anxiety. However, the association of these syndromes with non-suppression was relatively weak, indicating that the clinical significance of the dexamethasone suppression test is, as yet, unclear. The results raise doubts about the validity of using the dexamethasone suppression test as a diagnostic marker for a specific depressive syndrome.
Genetic and environmental influences on obsessional traits and symptoms
Authors: Clifford C. A. , Murray R. M. , Fulker D. W.
Published: July 2009

Synopsis

A biometrical genetic analysis was carried out on the response of 419 pairs of twins to the 42-item version of the Leyton Obsessional Inventory. Just under half the variation in both the Obsessional Trait and Symptom Scales was due to heredity. Multivariate analysis revealed a genetic effect on the development of obsessional personality and also the transmission of a general tendency predisposing to neurotic breakdown. Although the influence of heredity was outweighed by that of the environment, the latter effect showed an absence of general factors and, in particular, of any noticeable effect from the common home environment.
Bronchial asthma: lack of relationships between allergic factors, illness severity and psychosocial variables in adult patients attending an asthma clinic
Authors: Spittle Bruce J. , Sears Malcolm R.
Published: July 2009

Synopsis

The relationships between illness severity, allergy as indicated by serum total immunoglobulin E, and various psychological and social factors were studied in 66 adult asthmatics. No substantial relationships were found between these factors. An earlier onset of illness before 3 years was associated with a higher serum IgE. These results do not support the commonly held concept that asthma is a ‘psychosomatic’ disorder.
Blunting of neuroendocrine responses to infusion of L-tryptophan in women with perimenstrual mood change
Authors: Bancroft John , Cook Ann , Davidson David , Bennie John , Goodwin Guy
Published: July 2009

SYNOPSIS

The neuroendocrine response to L-tryptophan infusion was measured at two stages of the menstrual cycle, premenstrually and postmenstrually, in 13 women with and 13 women without premenstrual depression (the MC and NMC groups respectively). Previous studies have shown that in non-depressed women, this challenge test results in an increase in circulating prolactin and growth hormone. In depressed women both responses are blunted. In this study the growth hormone and cortisol responses were smaller in the MC group than the NMC group on both occasions. The prolactin response was blunted premenstrually compared with postmenstrually in both groups. These findings suggest that women who experience premenstrual depression may have neuroendocrine abnormalities throughout the cycle. The neurotransmitter abnormalities reflected in these altered endocrine responses appear to interact with neuroendocrine changes that normally occur premenstrually resulting in a vulnerability to depression at that phase of the cycle.
A further exploration of the relationships between immune parameters and the HPA-axis activity in depressed patients
Authors: Maes M. , Bosmans E. , Suy E. , Minner B. , Raus J.
Published: July 2009

SYNOPSIS

In order to investigate the relationship between the immune apparatus and the hypothalamic–pituitary–adrenal (HPA)-axis activity in depressed patients, we measuredin vitrolymphocyte responses to the mitogens Phytohaemagglutinin (PHA), Pokeweed (PWM) and Concanavalin A (Con A) and 8 a.m. baseline cortisol values in plasma, free cortisol excretion in 24 h urine (UFC), basal and post-dexamethasone βendorphin values. Major depressed patients with melancholia/psychotic features exhibited a significantly lower mitogen-induced blast transformation as compared to minor and simple major depressed patients. The lymphocyte responses to the three mitogens were significantly inversely related to baseline cortisol values and postdexamethasone β-endorphin values. The proliferative capacity of lymphocytes to stimulation with PHA and PWM was significantly and positively related to UFC excretion. Up to 45% of the variance in the immune responses to the mitogens was explained by the baseline cortisol, post-dexamethasone β-endorphin and UFC values.
Coping: a genetic epidemiological investigation
Authors: Kendler Kenneth S. , Kessler Ronald C. , Heath Andrew C. , Neale Michael C. , Eaves Lindon J.
Published: July 2009

SYNOPSIS

This study examines data on self-report coping behaviour, life events and symptoms of anxiety and depression in a general population sample of 827 female twin pairs. Factor analysis identified three almost uncorrelated coping factors: turning to others; problem solving; and denial. Turning to others and problem solving were negatively and denial was positively related to levels of anxiety and depression. Turning to others and problem solving buffered the depressogenic and anxiogenic effects of stressful life events, while denial exacerbated the anxiogenic effects of life events. Structural equation model-fitting indicated that twin resemblance in turning to others and problem solving could be explained entirely by genetic factors with an estimated heritability of 30 and 31%, respectively. For denial, twin resemblance could be best explained by familial–environmental factors accounting for 19% of the total variation. Genes may affect the vulnerability to psychiatric disorders in part by influencing coping behaviour.
Psychosocial family intervention in schizophrenia: a review of empirical studies
Authors: Lam Dominic H.
Published: July 2009

SYNOPSIS

This paper reviews the recent empirical studies on psychosocial family intervention in schizophrenia. Six family educational intervention studies and five more intensive family work studies with 2-year follow-up have been included. A series of questions is asked relating to the effects of such interventions, the efficacy of the different educational models, the active ingredients of these multi-component treatment packages, and the contribution of this new generation of studies to our understanding of the mechanisms through which these interventions work. Suggestions for further research are made. Finally, from the published manuals, the common components of these diverse, multi-component treatment packages of different family-intervention studies are identified.
Assay-guided isolation of naturally-occurring neuroactive substances
Authors: McIlwain Henry
Published: July 2009

Synopsis

Ways in which chemical techniques could be applied to the understanding of neural systems, their functioning and their disorders were devised only gradually during the present century. In a particularly successful procedure, now termed assay-guided isolation, neural defects were made good by means of tissue-extracts and the restoration of function was established as an assay-system to guide the chemical separation and identification of the active tissue constituent. Thiamin was so isolated, using an experimental polyneuritis assay; subsequent instances among other metabolites, hormones, neurotransmitters and nerve growth factors are recounted. Procedures of assay-guided characterization ensured that links were retained between specific, sparsely-occurring substances and chosen aspects of their biological roles while their chemical nature was first explored and then established. The procedures discouraged the too-facile postulating of hypothetical molecules and contributed to the distinctiveness of neurochemistry as a subject within the neurosciences.
Clinical correlates of septum pellucidum cavities: an unusual association with psychosis
Authors: Lewis Shôn W. , Mezey Gillian C.
Published: July 2009

Synopsis

Cavities in the septum pellucidum are widely regarded as incidental findings of little clinical importance. The prevalence of such cava on computerized tomography in a mixed sample of 22000 neurological and psychiatric patients is found to be 0·15%. A statistical association between this anomaly and a referral diagnosis of functional psychosis is reported, and 6 cases are described. These cases were male and characterized by an early history of developmental delay, with lifelong disturbances of emotion and behaviour prior to the onset in early adulthood of an atypical schizophrenia-like psychosis with disorders of speech and movement. It is suggested that septal cavities may signal an underlying abnormality of function relevant to the pathogenesis of these illnesses.
Positive symptoms and the organization within and between ideas in schizophrenic speech
Authors: Allen Heidelinde A. , Allen Derek S.
Published: July 2009

Synopsis

The study examined the performance of positive symptom schizophrenics vis à vis that of demographically well-matched negative symptom schizophrenics and normals in organizing words into ideas and ideas into integrated spoken discourse. This involved applying a series of analyses to speech produced when describing pictures in an unconstrained way. The results showed that, for the most part, positive symptom schizophrenics organized their speech, both within and between ideas, as well as negative symptom schizophrenics and normals. The results did, however, show an increased tendency by the positive speech disordered schizophrenics to omit referents for noun phrases requiring referents. This constitutes a specific failure to connect ideas and does, at least in part, explain what makes positive speech disorder (incoherence of speech) unintelligible. However, taken altogether, the results do not support the extant view that positive symptom schizophrenics suffer from a general loss of control in producing speech.
A test of the repression hypothesis in agoraphobics
Authors: Arrindell Willem A. , Emmelkamp Paul M. G.
Published: July 2009

Synopsis

In a recent study Turner et al. (1983) employed Bell & Byrne's (1978) Repression-Sensitization (R–S) scale to test the hypothesis that agoraphobics utilize repression as a method of avoiding anxiety-arousing forms of cognition. However, no support was found for this view. Rather, the R–S scores indicated general sensitization and attention to negative affect. In this paper it is argued that, on both theoretical and psychometric grounds, the R–S scale cannot be considered a suitable measure of the repression–sensitization process. A study was carried out in which a number of other defensivity measures were used in addition to the R–S scale. Weak support was found for Goldstein & Chambless’ (1978) view that a defensive cognitive style is characteristic of agoraphobic patients when compared with non-phobic psychiatric controls.
Mental illness: a conceptual analysis
Authors: Farrell B. A.
Published: July 2009

SYNOPSIS

The concept of mental illness is explored by noting its connections with other concepts, such as deviance, social maladjustment and morbidity. It is fitted to patients from some of the chief categories into which they are classified by psychiatrists. The objection that the concept is one of value is examined and deflated.
A scaled version of the General Health Questionnaire
Authors: Goldberg D. P. , Hillier V. F.
Published: July 2009

SYNOPSIS

This study reports the factor structure of the symptoms comprising the General Health Questionnaire when it is completed in a primary care setting. A shorter, 28-item GHQ is proposed consisting of 4 subscales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Preliminary data concerning the validity of these scales are presented, and the performance of the whole 28-item questionnaire as a screening test is evaluated. The factor structure of the symptomatology is found to be very similar for 3 independent sets of data.
The clinical evaluation of obsessionality: a development of the Leyton Obsessional Inventory
Authors: Robertson John R. , Mulhall David J.
Published: July 2009

SYNOPSIS

The Leyton Obsessional Inventory gives both an indication of the range of obsessional symptoms present and the degree of resistance and interference associated with each symptom. A new method is described in which the covariation of resistance and interference is represented in the form of a matrix. The results, using this method, can give a unique picture of the quality of the patient's symptoms from the clinical standpoint and provide useful guidelines for treatment and follow up. Automatic data-processing is offered for the convenience of clinicians and researchers wishing to utilize the test in this form.
The use of the Visual Analogue Mood and Alert Scales in diagnosing hospitalized affective psychoses
Authors: Luria Richard E.
Published: July 2009

SYNOPSIS

A consecutive series of 90 admissions of functional patients was examined with thePresent State Examination(PSE). Based primarily on PSE findings together with previously published diagnostic criteria, we identified 11 clear or index cases of schizophrenia, 12 of affective psychoses, and 12 of neurotic/personality disorders. All patients were given daily 2 analogue scales, one measuring mood and the other alertness. Among the index cases, the depressives were distinguished by low scores on both scales and the manics by high scores. There was little overlap in the distribution of the scores among the diagnostic groups, suggesting that these scales might be effective psychological markers of clear affectiveversusclear non-affective functional disorders.

Among the undiagnosed cases, those with low or high scores on both scales resembled index affectives phenomenologically, clinically, and demographically. The scores of the ‘affective-like’ patients overlapped little with those of the ‘non-affective-like’ patients. The scales therefore might be practical diagnostic aids.
Psychiatrists' models of mental illness and their personal backgrounds
Authors: Toone B. K. , Murray R. , Clare A. , Creed F. , Smith A.
Published: July 2009

SYNOPSIS

Seventy-nine junior psychiatrists at the Maudsley Hospital answered 16 biographical questions and a 68-item questionnaire measuring attitudes to the psychoanalytical, biological, social, behavioural, and anti-medical models of mental illness. The psychoanalytical model was the most clearly defined and its adherents the most dogmatic, while those supporting the social model were the most eclectic. Sex, social class, education and political sympathy proved a poor guide to the orientation of the respondent. Individuals who had decided on a career in psychiatry before entering medical school were the most critical of the biological model. Biologically minded psychiatrists were older and, in contrast to Kreitman's findings, there was a shift from a psychoanalytical to a biological preference with increasing psychiatric experience. The importance of scientific attitudes in psychiatry was endorsed by biologically and behaviourally inclined psychiatrists but denigrated by supporters of the analytical approach. Adherents of the psychoanalytical model had as many academic qualifications as the biologically inclined, but had fewer publications and were less active in research. It appears that interest in psychoanalysis is antipathetic to the development of scientific attitudes conducive to research.
The question of hormonal influences on intellectual development: growth hormone
Authors: Meyer-Bahlburg H. F. L. , Feinman J. A. , MacGillivray M. H. , Aceto T. A.
Published: July 2009

SYNOPSIS

Contrary to expectations based on findings of enhanced brain development and learning in rats after prenatal growth-hormone administration, a sample of patients with growthhormone deficiency of early onset did not show impairment of mental abilities when tested with standard intelligence tests. We conclude from our findings, as well as from other clinical reports, that growth-hormone deficiency of early onset does probably not interfere with normal human brain development.
MRI in schizophrenia: basal ganglia and white matter T1 times
Authors: Harvey I. , Ron M. A. , Murray R. , Lewis S. , Barker G. , McManus D.
Published: July 2009

SYNOPSIS

The T1 relaxation time of the basal ganglia (putamen, globus pallidus and head of caudate) and of the frontoparietal centrum semiovale was compared between 49 schizophrenic patients and 36 healthy controls. Previous reports of increased T1 time in the basal ganglia were not confirmed, and group differences were not detected within the white matter. Within patients T1 values could not be related to tardive dyskinesia or other clinical features. Normal variation seen in basal ganglia T1 times is described for the first time: lowest values occur in the globus pallidus and highest in the caudate, and values within the putamen increase rostrally.
Expressed emotion and early onset schizophrenia: a one year follow-up
Authors: Stirling John , Tantam Digby , Thomas Philip , Newby David , Montague Linda , Ring Noreen , Rowe Steven
Published: July 2009

SYNOPSIS

Key relatives of 33 first or early admission psychotic patients (mainly schizophrenics) were interviewed to determine household levels of expressed emotion (EE). The patients were followed up for 12 months from index admission, during which time 13 (39%) experienced psychotic relapse. There was no association between relapse rate and household EE, but correlations between individual components of EE and pre-morbid measures suggest that level of criticism may be related to less acute onset of index episode, greater elapsed time since first signs of illness, and poor adjustment in the realm of work/study. The results are discussed in the context of continuing uncertainties about the precise nature of the relationship between EE and relapse.
The pattern of cerebral activity underlying verbal fluency shown by split-dose single photon emission tomography (SPET or SPECT) in normal volunteers
Authors: Shedlack K. J. , Hunter R. , Wyper D. , McLuskie R. , Fink G. , Goodwin G. M.
Published: July 2009

SYNOPSIS

Uptake of 99mTc-Exametazime, a marker of relative regional cerebral blood flow has been determined with Single Photon Emission Tomography (SPET or SPECT) in 20 healthy, elderly female subjects during neuropsychological challenge. Each subject was studied under basal conditions after injection of 125 MBq 99mTc-Exametazime. Without moving the head of the subject, they were scanned again after injection of 375 MBq 99mTc-Exametazime. The second injection was made in 10 subjects during a test of verbal fluency, usually regarded as a test of the integrity of function of the left frontal cortex. In the other 10 subjects the second injection was made during simple verbalization (counting). This method of splitting the normal full dose of 99mTc-Exametazime allows a novel comparison between basal and active conditions for different brain regions. Verbal fluency was associated with reduced uptake bilaterally in the region of the basal ganglia and in left temporal (peri-sylvian) cortex when compared with calcarine cortex, an unstimulated reference sensory area. By contrast, counting produced relative activation, greatest in frontal and parietal areas. Thus, a clinically relevant neuropsychological test can be characterized metabolically by a pattern of regional brain activity, whose localization cannot readily be predicted from classical studies of brain lesions. Reduction of regional uptake may suggest an important role for de-activation or inhibition of function in human cognition. The involvement of basal ganglia and temporal areas is of particular interest in relation to the investigation of functional psychiatric illness.
The pathways to psychiatric care: a cross-cultural study
Authors: Gater R. , Almeida E. Sousa De B. , Barrientos G. , Caraveo J. , Chandrashekar C. R. , Dhadphale M. , Goldberg D. , Al Kathiri A. H. , Mubbashar M. , Silhan K. , Thong D. , Torres-Gonzales F. , Sartorius N.
Published: July 2009

SYNOPSIS

This paper describes the referral pathways taken by 1554 patients newly referred to the mental health services in 11 countries, and documents factors associated with delays in referral. The pathways in centres relatively well provided with psychiatric staff were dominated by general practitioners and to a lesser extent hospital doctors: the relatively less well resourced centres showed a variety of pathways with native healers often playing an important part. Delays were remarkably short in all centres regardless of psychiatric resources, but in some centres we found longer delays on pathways involving native healers. Somatic problems were a common presentation in all centres, and in some centres there was a tendency for patients presenting with somatic problems to have longer delays than those with symptoms of depression or anxiety. The implications of these findings are discussed in the context of an ongoing programme of WHO research activities aimed at improving the quality of mental illness care available in community settings.
The effects of social changes in chronic schizophrenia: a study of forty patients transferred from hospital to residential home
Authors: Pryce I. G.
Published: July 2009

Synopsis

Various clinical and social measures were applied to forty long-stay schizophrenic patients before and after transfer from hospital to a residential home and similarly to twenty-five patients retained in hospital. The results are used to test specific hypotheses concerning the relationship between social changes and clinical state in chronic schizophrenia.
The relation of deviant symptoms and behaviour in a normal population to subsequent delinquency and maladjustment
Authors: Watt David C. , Taylor Terence
Published: July 2009

Synopsis

A survey of more than 6000 school children in 1961 established norms for symptomatology and behaviour at ages 5–15. A follow-up to 1968 identified all children from the survey attending a child guidance clinic or appearing in court within that time. Those thus identified contained a significantly high proportion of boys who were reported as having more than 3 deviant items (i.e. occurring in approximately 10% of subjects in 1961). Specific health and behavioural items were found to have been reported in 1961 in proportions which were significantly different for children later appearing in child guidance clinic from those appearing in court. The amount of concern expressed by their parents over psychological and behavioural items distinguished court from clinic boys, while the concern shown by parents over items of physical health showed little difference in these 2 groups.
Personality traits and platelet monoamine oxidase in tobacco smokers
Authors: Von Knorring Lars , Oreland Lars
Published: July 2009

Synopsis

A study was made of the smoking habits of an unselected series of 1129 18-year-old men from the general population. Their smoking habits were related to personality traits, intellectual level and platelet monoamine oxidase (MAO). Regular smokers were found to be extraverts, sensation seekers who were easily bored and with a strong tendency to avoid monotony. They also had a lower than average intellectual level, and were more prone to the abuse of alcohol, glue, cannabis, amphetamine and morphine. Furthermore, they had a low platelet MAO.

The results are discussed in relation to the pharmacological reasons for smoking and favour the hypothesis that tobacco smoking is related to arousal-seeking behaviour. Ex-smokers had personality traits, intellectual levels and platelet MAO of the same magnitude as non-smokers: this may be the reason why they were able to give up smoking.
Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation
Authors: Birchwood Max , Smith Jo , Macmillan Fiona , Hogg Bridget , Prasad Rekha , Harvey Cathy , Bering Sandy
Published: July 2009

Synopsis

Recognition of prodromal symptoms of schizophrenia offers the potential of early intervention to avert relapse and re-hospitalization (Carpenter & Heinrichs, 1983). The present study investigated how a strategy to detect prodromal signs might be effectively applied in the clinical setting. A standard monitoring system was developed involving completion of a new early signs scale (ESS) measuring changes in key symptoms phenomenologically (self-report) and behaviourally (observer report). The ESS was subject to rigorous psychometric evaluation and tested in a prospective pilot investigation. The ESS reliably identified early signs and predicted relapse with an overall accuracy of 79%. Several different patterns of relapse were identified. Observer reports compensated for loss of insight in some patients. In two cases where early signs indices were detected, prompt increases in medication appeared to arrest relapse and avert readmission. The ESS offers itself as a reliable, valid and administratively feasible measure and demonstrates considerable potential as a cost-effective procedure for secondary prevention.
The ‘well control’ artefact in case/control studies of specific psychiatric disorders
Authors: Schwartz Sharon , Link Bruce G.
Published: July 2009

Synopsis

An appropriate choice of controls in case/control studies of specific psychiatric disorders is crucial for valid risk-factor assessment. One suggested approach to control-group selection, the use of a well control group, is the focus of this paper. While using well controls has intuitive appeal, this paper shows that such a procedure can lead to ambiguous and biased results.
Exposure to recurrent combat stress: combat stress reactions among Israeli soldiers in the Lebanon War
Authors: Solomon Zahava , Mikulincer Mario , Jakob Beni R.
Published: July 2009

Synopsis

This study examined the impact of repeated exposure to combat on combat stress reaction (CSR). Sodliers diagnosed with CSR during the Lebanon War (N = 382) were compared with a matched control group of soldiers who fought in the same units but did not manifest symptoms of CSR (N = 334). CSR in the Lebanon War was found to be related to the psychological outcome the soldier experienced in previous wars. The CSR rate in the Lebanon War was higher in soldiers who had experienced an episode of CSR in a previous war than in soldiers with no past combat experience. However, CSR rates were lower among soldiers who had not had an episode of CSR in a previous war than among soldiers with no prior combat experience. High intensity of combat in Lebanon was found to increase both the detrimental and favourable effects of prior combat experience.
A modern melancholia: Van Gogh's portrait of Dr Gachet
Authors: Starobinski Jean
Published: July 2009

It would be unwise to hazard a diagnosis for those attacks of illness to which Van Gogh was subject and which he dreaded. Karl Jaspers (1922) believed it might be possible to speak of schizophrenia, but few people today would retain this diagnosis as there is no indication of it in either the paintings or in the copious writings. Psychomotor epilepsy has, more recently and with greater plausibility, been proposed while certain symptoms are suggestive of attacks of vertigo of labyrinthine origin. The outbursts of anger, the anxiety attacks contribute to a clinical picture indisputably exacerbated by absinthe abuse. And there were frequent periods of dysphoria and depression. But who would dare to pin any of the classical labels of melancholia on Van Gogh?