bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in a proposed new neuroendocrine marker of oestrogen receptor function in postpartum women
Authors: Bearn J. A. , Fairhall K. M. , Robinson I. C. A. F. , Lightman S. L. , Checkley S. A.
Published: July 2009

Synopsis

We describe a novel neuroendocrine test which reflects a central response to activation of oestrogen receptors. This is achieved by measurement of plasma levels of oestrogen-stimulated neurophysin (ESN) following an oestrogen challenge. In normal women the ESN response to ethinyl oestradiol is dose-dependent. This response is attenuated in normal women during the first postpartum month, although it is unchanged in patients with anorexia nervosa, in spite of their similar concurrent hypo-estrogenic state. The altered puerperal response may result from the acute oestrogen withdrawal which occurs at delivery. The time course of the altered ESN response coincides with the period of maximum risk for puerperal psychosis. The ESN response to oestrogen provides a novel neuroendocrine measure to test the relevance of changes in central oestrogen receptor responsiveness in the pathogenesis of puerperal psychosis.
Psychosis associated with demonstrable brain disease
Authors: Feinstein Anthony , Ron Maria A.
Published: July 2009

Synopsis

Sixty-five psychotic patients with unequivocal evidence of brain pathology and a variety of neurological disorders were assessed with respect to phenomenology and outcome. No relationship was found between site of brain pathology and type of psychotic disorder. A majority of patients had a syndrome indistinguishable from schizophrenia without coarse brain involvement and shared similar variables predicting outcome of psychosis, thus raising important issues concerning their nosological status.
Physical disorders associated with mental illness. A register investigation
Authors: Fink Per
Published: July 2009

Synopsis

On the basis of nationwide patient register data the diagnostic pattern of the medical admissions of a general population (17–49 year-olds; N = 30427) during an 8-year period was studied by comparing those individuals who had been admitted to the psychiatric department (i.e. psychiatric patients) with those individuals who had not. The results suggest that the high utilization of medical admissions by psychiatric patients could not be explained simply by coincident chronic physical illness or particular types of physical disease including the somatic complications of mental disorders. It is more likely to be attributable to other factors such as an increased general susceptibility to physical illness, different forms of illness behaviour, and the process of somatization.
The epidemiology of fatigue and depression: a French primary-care study
Authors: Fuhrer Rebecca , Wessely Simon
Published: July 2009

SYNOPSIS

The prevalence of fatigue as a presenting complaint and as a symptom is evaluated in French general practice patients. The data for a sample of 3784 persons 18–64 years-of-age who were seen by 367 general practitioners were examined for fatigue as a presenting complaint, diagnosis, and reported symptoms of persistent fatigue. Gender, age, and socio-professional category were considered as potential risk correlates. At least one of the symptoms of persistent fatigue was reported by 41·2% of the patients, but only 7·6% had presented with fatigue to the doctor. Women reported more symptoms of fatigue than men, but they were only slightly more likely to present with, or be diagnosed with fatigue; women were more frequently diagnosed with depression. There was a strong relationship between the symptoms of depression as measured by the Center for Epidemiologic Studies – Depression Scale (CES-D) and fatigue, but fatigue was neither sensitive nor specific for the diagnosis of depression. Age and fatigue as a presenting complaint and diagnosis were strongly associated for men. After adjusting for sex and age, we found that lower social classes were less likely to be diagnosed as fatigued, though they were more likely to report symptoms of fatigue.
The existence of a fatigue syndrome after glandular fever
Authors: White P. D. , Thomas J. M. , Amess J. , Grover S. A. , Kangro H. O. , Clare A. W.
Published: July 2009

SYNOPSIS

This prospective cohort study was designed to test whether a distinct fatigue syndrome existed after the onset of glandular fever. Two hundred and fifty primary care patients, with either glandular fever or an ordinary upper respiratory tract infection (URTI) were interviewed three times in the 6 months after the clinical onset of their infection. At each interview a standardized psychiatric interview was given and physical symptoms were assessed.

There were 108 subjects with an Epstein-Barr virus (EBV) infection; 83 subjects had glandular fever not caused by EBV and 54 subjects had an ordinary URTI. Five subjects were excluded because they had no evidence of an infection. Principal components analyses of symptoms supported the existence of a fatigue syndrome, particularly in the two glandular fever groups. The addition of symptoms not elicited by the standard interviews gave the full syndrome. This included physical and mental fatigue, excessive sleep, psychomotor retardation, poor concentration, anhedonia, irritability, social withdrawal, emotional lability, and transient sore throat and neck gland swelling with pain. A fatigue syndrome probably exists after glandular fever.
Can the chronic fatigue syndrome be defined by distinct clinical features?
Authors: Hickie I. , Lloyd A. , Hadzi-Pavlovic D. , Parker G. , Bird K. , Wakefield D.
Published: July 2009

SYNOPSIS

To determine whether patients diagnosed as having chronic fatigue syndrome (CFS) constitute a clinically homogeneous class, multivariate statistical analyses were used to derive symptom patterns and potential patient subclasses in 565 patients. The notion that patients currently diagnosed as having CFS constitute a single homogeneous class was rejected. An alternative set of clinical subgroups was derived. The validity of these subgroups was assessed by sociodemographic, psychiatric, immunological and illness behaviour variables. A two-class statistical solution was considered most coherent, with patients from the smaller class (27% of the sample) having clinical characteristics suggestive of somatoform disorders. The larger class (73% of sample) presented a more limited combination of fatigue and neuropsychological symptoms, and only moderate disability but remained heterogeneous clinically. The two patient groups differed with regard to duration of illness, spontaneous recovery, severity of current psychological morbidity, utilization of medical services and CD8 T cell subset counts. The distribution of symptoms among patients was not unimodal, supporting the notion that differences between the proposed subclasses were not due simply to differences in symptom severity. This study demonstrated clinical heterogeneity among patients currently diagnosed as CFS, suggesting aetiological heterogeneity. In the absence of discriminative clinical features, current consensus criteria do not necessarily reduce the heterogeneity of patients recruited to CFS research studies.
Bulimia nervosa in Rochester, Minnesota from 1980 to 1990
Authors: Soundy T. J. , Lucas A. R. , Suman V. J. , Melton L. J.
Published: July 2009

SYNOPSIS

Numerous studies have estimated the frequency of bulimia nervosa among high school girls and college women, but population-based trends in incidence in a community have not been reported.

In this study we determined the incidence of bulimia nervosa by identifying persons residing in the community of Rochester, Minnesota, who had the disorder initially diagnosed during the 11-year period from 1980 to 1990. Using our comprehensive population-based data resource (the Rochester Epidemiology Project), we identified cases by screening 777 medical records with diagnoses of bulimia; feeding disturbance; rumination syndrome; adverse effects of cathartics, emetics, or diuretics; polyphagia; sialosis; or vomiting.

We identified 103 Rochester residents (100 female and 3 male) who fulfilled DSM-III-R diagnostic criteria for bulimia nervosa during the 11-year study period. Mean ± S.D. age for females at the time of diagnosis was 23·0 ± 6·1 years (range, 14·4 to 40·2 years). Yearly incidence in females rose sharply from 7·4 per 100000 population in 1980 to 49·7 in 1983, and then remained relatively constant around 30 per 100000 population. The annual age-adjusted incidence rates were 26·5 per 100000 population for females and 0·8 per 100000 population for males. The overall age-and sex-adjusted annual incidence was 13·5 per 100000 population.

Bulimia nervosa is a common disorder in adolescent girls and young women from 15 to 24 years of age. Histories of alcohol or drug abuse, depression, or anorexia nervosa were higher than expected in the general population.
Predicting the long-term outcome of schizophrenia
Authors: Harrison G. , Croudace T. , Mason P. , Glazebrook C. , Medley I.
Published: July 2009

Synopsis

Predictors of long-term (13 year) outcome of schizophrenia are reported for a representative cohort of ‘treated incidence’ patients ascertained on their first contact with Nottingham psychiatric services between 1978–80. An initial (baseline) model including previously reported predictors of 2-year outcome (age, gender, ever married, acuteness of onset) and length of untreated illness was used to predict a range of outcome measures covering the domains of disability, psychopathology, hospitalization, employment, social activity, and global outcome. This model demonstrated significant prognostic ability across all non-hospitalization outcomes under both ICD-10 and ICD-9 diagnoses of schizophrenia, but was attenuated under broad (ICD-9 and CATEGO S, P or O) and restrictive (S+) diagnostic classifications. Female gender predicted more favourable outcome under all diagnostic classifications except S+. In an extended analysis, the addition of initial 2-year course type substantially increased the prognostic ability of the model under all diagnostic classifications and enabled over 30% of the variance in global ratings of disability and symptoms to be predicted. In this extended model female gender predicted more favourable outcome over and above the effect of course type, across most domains under ICD-10, and for disability and psychopathology under other diagnostic classifications. The inclusion of measures of psychopathology at the time of first assessment, pre-morbid functioning, and duration of index admission conferred only marginal additional predictive ability for respective outcomes in the domains of psychopathology, social activity, employment and hospitalization. Hospitalization during the past year was the most difficult outcome to predict under any model suggesting that resource utilization represents the ‘administrative outcome’ of schizophrenia and serves as a poor proxy for broader concerns in the era of community care. These data demonstrate that key demographic variables and the mode of onset influence the long-term course of schizophrenia, but that early course type is a particularly strong predictor.
The changing mental health of children and adolescents: evidence for a deterioration?
Authors: Prosser Jonathan , McArdle Paul
Published: July 2009

Synopsis

This paper reviews the evidence for changing patterns of mental health over time in childhood and youth in Western societies. The evidence suggests that the prevalence of major depression, substance abuse and offending behaviour, as well as the incidence of suicide, is increasing in adolescent populations, particularly among males. There are also indications that problem behaviours among younger children are becoming more common. There is no evidence of a deterioration in the adjustment of the pre-school population.
The cost of treatment of psychiatric emergencies: a comparison of hospital and community services
Authors: Merson S. , Tyrer P. , Carlen D. , Johnson T.
Published: July 2009

Synopsis

This study aimed to compare the costs of treatment by community-based and hospitalbased psychiatric services. The design entailed random allocation of patients presenting with psychiatric emergencies over a subsequent 3-month period to one of two services, followed by retrospective quantification of service use and its cost for each group. One hundred patients with emergency presentations to the psychiatric service via the Accident and Emergency Department, liaison psychiatrist and approved social worker were included in the study. Their use of a range of items of service was recorded and disaggregated costings of these items of service was calculated. The use of non-psychiatric services was similar for both groups, but the use of psychiatric services differed, with the hospital group making greater use of in-patient beds and the community group employing more frequent home-based interventions. The total cost of treatment for the community group (£56000) was much lower than for the hospital group (£130000), although the median patient cost was 50% higher in the community group (£938 v. £610), and a greater proportion of the community service expenditure (10% v. 2%) was due to failed contacts. Taken together with clinical outcome, which showed no advantages for the hospital-based service over the community-based service, our findings suggest that this form of community psychiatric service is a cost-efficient alternative to hospital-based care for this group of patients.
Pseudohallucinations: a conceptual history
Authors: Berrios G. E. , Dening T. R.
Published: July 2009

Synopsis

The term ‘pseudohallucination’ is currently used to name imaginal experiences whose relationship to one another and to hallucinations ‘proper’ remains obscure. Clinicians, including specialists in psychopathology, disagree on how pseudohallucination must be defined and on its diagnostic role. Empirical research is unlikely to help as the term does not have a stable referent. Historical and conceptual analyses, on the other hand, are of great use to show how this untidy state of affairs has obtained. This paper includes a full account of the history of pseudohallucination and concludes that: (a) the problem has resulted from the fact that the history of theword, concept(s) and putativebehaviour(s) failed to ‘converge’ (i.e. there never has been a time when the three components have formed a stable complex); (b) failure to converge has been caused by the fact that the concept of pseudohallucination is parasitical upon that of hallucination, and that the latter has proved to be far more unstable than what is usually recognized; (c) hence, pseudohallucination is a vicarious construct (i.e. one created by a temporary conceptual need, and which is not associated with a biological invariant); (d) pseudohallucination is used as the ‘joker’ in a poker game (i.e. made to take diagnostic values according to clinical need) – this has led to diagnostic complacency and retarded important decisions as to the nature and definition of hallucinations; and (e) the language of current descriptive psychopathology is not fine-grained enough to generate a stable frame for pseudohallucination. This suggests that its boundaries and usage will remain fuzzy and unbridled.
Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview
Authors: Bentsen H. , Boye B. , Munkvold O. G. , Uren G. , Lersbryggen A. B. , Oskarsson K. H. , Berg-Larsen R. , Lingjærde O. , Malt U. F.
Published: July 2009

Synopsis

High expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2–3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3–4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.
Increased plasma kynurenine and its relationship to neopterin and tryptophan in Tourette's syndrome
Authors: Rickards H. , Dursun S. M. , Farrar G. , Betts T. , Corbett J. A. , Handley S. L.
Published: July 2009

Synopsis

Fasting plasma levels of tryptophan, kynurenine and the pteridines, neopterin and tetrahydrobiopterin were measured in seven patients with Gilles de la Tourette syndrome (GTS) and 10 healthy controls. Plasma kynurenine was significantly elevated in the GTS patients. The lowest patient value was higher than the highest control value. Values for tryptophan, neopterin and tetrahydrobiopterin were similar in TS patients and controls. However, in TS patients only, there was a significant negative correlation between tryptophan and neopterin and a significant positive correlation between kynurenine and neopterin when controlling for tryptophan. This finding indicates that activation of cellular immune processes is a possible explanation for the rise in plasma kynurenine.
Pagophagia, or compulsive ice consumption: a historical perspective
Authors: Parry-Jones Brenda
Published: July 2009

Synopsis

Pagophagia, or the excessive consumption of ice or iced drinks, is popularly regarded as a novel manifestation of pica, which has emerged, predominantly in the USA, over the last 30 years. However, a sampling of historical sources reveals that not only are there warnings in the writings of both Hippocrates and Aristotle concerning the dangers of excessive intake of cold or iced water, but a series of medical works, from the sixteenth century on, incorporate discussion and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of disordered eating.
Early onset bulimia nervosa: who is at risk? A retrospective case–control study
Authors: Schmidt Ulrike , Hodes Matthew , Treasure Janet
Published: July 2009

Synopsis

The aim of the study was to compare the clinical features and predisposing characteristics of patients with an early onset of bulimia nervosa with those with a more typical onset. Twenty-three cases of early onset bulimia nervosa (onset age 15 or below) were compared with 23 sex- and class-matched cases of typical onset (onset age 17 to 21) using a retrospective case–control design. No difference was found in eating symptomatology between the two groups. Deliberate self-harm was more frequent in the early onset group, and there was a trend towards more depression among their relatives. Inadequate parental control occurred more often in the early onset group, but other indicators of intrafamilial disturbance did not differ in the two groups. There was also a trend for the early onset group to be exposed to more cultural stress as a result of family migration. Early onset patients were found to have a higher loading on risk factors than typical onset patients.
Coping subtypes for men with coronary heart disease: relationship to well-being, stress and Type-A behaviour
Authors: Denollet Johan , De Potter Bea
Published: July 2009

Synopsis

We used cluster analysis to delineate coping subtypes in a sample of 166 men with coronary heart disease who completed the Antwerp out-patient rehabilitation programme. These subtypes were identified on the basis of three well-defined superordinate traits that were selected from a comprehensive taxonomy: negative affectivity, social inhibition, and self-deception. Using Ward's minimum variance method and the cubic clustering criterion, we identified four coping subtypes; low-negative affectivity (N = 48), high-negative affectivity (N = 30), inhibited (N = 62), and repressive (N = 26) individuals. The accuracy of the resulting classification was demonstrated across parallel data sets and was further validated against external, health-related correlates that were not included in the clustering. The identified coping subtypes were significantly related to self-reports of subjective distress/perceived stress, ratings of Type A behaviour and anger-in, return to work, prevalence of chest-pain complaints, and use of minor tranquillizers and sleeping pills. The major findings of this study suggest that (a) male coronary patients represent a heterogeneous population with distinctly different coping subtypes, and that (b) a relatively small number of homogeneous subtypes can account for a substantial amount of variance in subjective well-being, coronary-prone behaviour, and return to work. These findings indicate that psychosomatic research should focus on how superordinate traits interact within individuals and corroborate the appropriateness of a class model to describe coping styles of male coronary patients. It is argued that discrepant findings across studies of Type-A behaviour and hostility may be related to the coping subtypes of the subject sample. Further attempts to cross-validate this classification scheme and to examine its health-related correlates are needed.
QALYs in mental health: a case study
Authors: Wilkinson Greg , Williams Brian , Krekorian H. , McLees S. , Falloon I.
Published: July 2009

Synopsis

The applicability of the Charing Cross health indicator (CH-X) to the field of mental health was investigated in a community setting using descriptive statistics and principal components analysis. The CH-X is based on assessments of (i) distress and (ii) disability. Our results suggest that with respect to quality of life in mental health settings measurements of distress may be of greater importance than disability. In addition, the CH-X may be insensitive to variations in the severity of mental disorder and may primarily reflect physical disability as opposed to social disability. QALYs methodology may require the adoption of a multidimensional measure of health in order to fulfil its proposed role in comparing medical and mental health programmes.
A two-year prospective study of treatment compliance in patients with schizophrenia
Authors: Buchanan Alec
Published: July 2009

Synopsis

The study is a prospective investigation of the factors associated with treatment compliance in 61 patients discharged from hospital with a ward diagnosis of schizophrenia. All cases were classified using reliable diagnostic criteria and all were followed up for two years. Compliance was assessed by inspection of records and by analysis of urine. Sociodemographic factors and illness variables were unrelated to compliance. Some aspects of a patient's insight and attitude, namely, a belief that medication had helped during the admission, a stated willingness to take treatment after discharge and a generally optimistic outlook, were associated with improved compliance. Other variables which showed such an association were the absence of the drug side-effect akinesia, good previous compliance and voluntary, as opposed to compulsory, admission to hospital.
A cancellation test: its reliability in assessing attentional deficits in Alzheimer's disease
Authors: Sala Sergio Della , Laiacona Marcella , Spinnler Hans , Ubezio Chiara
Published: July 2009

Synopsis

The aim of the study is to provide (i) a standardized procedure for a Cancellation Test of Digits, designed to assess in the visual modality selective attention deficits in patients with Alzheimer's disease, and (ii) a detailed analysis of how patients cope with it.

Age-, education-, and sex-adjusted normative scores earned by 352 healthy controls are set forth, as well as data yielded by the Digit Cancellation Test in 74 Alzheimer patients, in 26 patients with a CT-assessed frontal lobe lesion and in a group of 24 healthy subjects urged to perform the task with a shortened time-constraint. Findings include discriminant power of Alzheimer patients versus healthy controls, sensitivity to cognitive evolution of the dementing process and analysis of errors. Attention data failed to supply psychometric support for the posterior-to-anterior algorithm of progressive cortical encroachment of Alzheimer's disease suggested by PET-findings.

Emphasis is put on methodological aspects of neuropsychological research on Alzheimer patients and on the analysis of processing components of the tests employed. Results are discussed in the light of the relationships between psychometric assessments and related functions, and underlying neuronal degeneration.
Estimating pre-morbid intellectual ability in the Alcoholic Korsakoff Syndrome
Authors: O'Carroll R. E. , Moffoot A. , Ebmeier K. P. , Goodwin G. M.
Published: July 2009

Synopsis

The National Adult Reading Test (NART) is widely used in clinical and research settings to estimate pre-morbid intellectual levels. The validity of the NART in estimating pre-morbid ability in Alcoholic Korsakoff Syndrome (AKS) is examined in the present study. Twenty AKS subjects were compared with 40 healthy controls. The validity of the NART as a pre-morbid measure in AKS was examined using four methods. AKS subjects made more NART errors than controls, had lower NART predicted IQ than demographically predicted IQ, made more NART errors than predicted by demographic variables and demonstrated NART performance which correlated with degree of memory impairment. It is concluded that NART performance is detrimentally affected by the AKS and that estimating pre-morbid intellectual level in Korsakoff's psychosis using the NART may be invalid. Furthermore, it is postulated that the impaired ability to pronounce correctly irregular words in AKS may reflect a failure in cognitive ‘error checking’ which may represent a consequence of frontal lobe dysfunction.
A population survey of ischaemic heart disease and minor psychiatric disorder in men
Authors: Stansfeld S. A. , Sharp D. S. , Gallacher J. E. J. , Yarnell J. W. G.
Published: July 2009

Synopsis

Associations between ischaemic heart disease and psychiatric morbidity in hospital recruited samples may be confounded by differential referral of patients with co-morbidity. Associations of angina, past history of myocardial infarction, blood pressure, and electrocardiographic evidence of ischaemia with psychiatric disorder can best be examined in community samples as reported here in 2204 middle-aged men from the Caerphilly Collaborative Study. There was a strong association between past history of myocardial infarction, non-specific chest pain, Angina Grade II and psychiatric disorder measured by the 30-item General Health Questionnaire. Electrocardiographic evidence of ischaemia alone was not significantly associated with psychiatric disorder. It is suggested that non-specific chest pain is a symptom of psychiatric disorder; conversely in severe angina psychiatric disorder is secondary to the pain, restricted activity and threat to life which angina implies.
Can we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless
Authors: Hogg Lorna I. , Marshall Max
Published: July 2009

Synopsis

Hostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.
A linkage study of schizophrenia with DNA markers from the long arm of chromosome 11
Authors: Gill M. , McGuffin P. , Parfitt E. , Mant R. , Asherson P. , Collier D. , Vallada H. , Powell J. , Shaikh S. , Taylor C. , Sargeant M. , Clements A. , Nanko S. , Takazawa N. , Llewellyn D. , Williams J. , Whatley S. , Murray R. , Owen M.
Published: July 2009

Synopsis

We report the results of a collaborative linkage study using 12 polymorphic markers (9 loci) from the long arm of chromosome 11, and 24 families multiply affected with schizophrenia and other closely related disorders. This region is of interest because several families have been reported in which balanced translocations involving 11q apparently co-segregate with psychotic illness. In addition, the dopamine D2 receptor, porphobilinogen deaminase, and tyrosinase genes map within the region studied and may be aetiologically involved in schizophrenia. We have primarily analysed genotypic data by the LOD score method using a range of single gene models. In order to minimize error due to mis-specification of genetic parameters we have analysed data from markers at candidate gene loci by the non-parametric extended sib-pair method in addition to the LOD score method. Our results suggest that most of the region can be excluded from containing a gene of major effect in the aetiology of this disease.
Working memory in clinical depression: an experimental study
Authors: Channon Shelley , Baker Jane E. , Robertson Mary M.
Published: July 2009

Synopsis

This study compared clinically depressed subjects with normal controls on a range of working memory tasks. The findings suggested the articulatory loop and visuospatial sketch pad components of working memory to be unimpaired in depression. On a range of clinical tasks likely to involve central executive function, depressed subjects showed impairment only on some tasks.
Acting on delusion: a review
Authors: Buchanan Alec
Published: July 2009

Synopsis

The paper reviews the link between delusional beliefs and behaviour. The literature pertaining to the link between normal beliefs and behaviour is briefly examined, emphasizing the predominance of psychological and philosophical contributions to the topic. The psychiatric literature describing actions consequent upon delusional beliefs is then reviewed. In conclusion, those aspects of psychosis, distinct from delusional beliefs themselves, which may affect the likelihood of a given belief being acted upon, are discussed.
Detection of eating disorders in a small rural town: an epidemiological study
Authors: Rathner Günther , Messner Klara
Published: July 2009

Synopsis

The occurrence of eating disorders among 517 school girls (11 to 20 years of age) in a small rural Italian town was studied using a three-stage prospective procedure. The screening stage was aimed at defining risk and sub-risk groups. One year later, the risk group (N = 44) and a random sample of the sub-risk (N = 25) and of the screen-negative group (N = 32) were interviewed to detect cases of anorexia/bulimia nervosa. The case registers of four hospitals over a period of 3 years were investigated to detect any additional cases that may have been overlooked in the survey. A minimum point prevalence rate of 1·30% clinical anorexia nervosa, 1·30 % sub-clinical anorexia nervosa and 0·87 % sub-clinical bulimia nervosa was found for age 15 and above. No case of clinical bulimia nervosa was detected. For age 15 and below no clinical or sub-clinical cases were found. All cases of (sub-)clinical eating disorder initially belonged to the predefined sub-risk and risk groups. Because of the low positive predictive value of any single risk factor, this study shows that early case detection can be improved by using multiple risk indices. In this rural area the prevalence was as high as in metropolitan or urban areas. Urban–rural differences should be assessed in further studies.
The ability of trainee general practitioners to identify psychological distress among their patients
Authors: Goldberg D. P. , Jenkins L. , Millar T. , Faragher E. B.
Published: July 2009

Synopsis

It is argued that a general practitioner's ability to make accurate ratings of psychological distress is partly determined by the rate at which patients emit cues that are indicative of such distress. This study addresses the behaviours of doctors which influence the rates at which patients emit such cues. Consultations were videotaped involving six General Practice Vocational Trainees, three of them poor, and three of them able identifiers of emotional illness. Consultations were selected so that each trainee was rated interviewing 4 patients with low GHQ scores, and 4 patients with high scores. Behaviours are described which lead to increased cue emission and which are also practised more frequently by able identifiers, while other behaviours reduce cue emission and are practised less frequently by them. Another set of behaviours is no more frequent among the able identifiers, but when practised by able identifiers is associated with increased cue emission by the patients, and when practised by poor identifiers with unaltered or decreased cue emission. Interviews that are ‘patient-led’ are associated with increased rates of cue emission, while those that are ‘doctor-led’ are associated with lower rates. The implications of these findings for training doctors working in general medical settings are discussed.
Rehabilitation and staffing levels in a ‘new look’ hospital-hostel
Authors: Allen Heidi , Baigent Barbara , Kent Andy , Bolton Jeremy
Published: July 2009

Synopsis

The present study examined the utility of a new hospital-hostel with low staffing levels. Results showed that the hostel was able to maintain 9 of the 10 initially transferred patients and has been able to provide some improvements in their quality of life. However, unlike highly staffed hospital-hostels, it was not able to decrease patients' disabilities. Implications of this are discussed in relation to staffing levels and practices.
Locus of control and adjustment to chronic haemodialysis
Authors: Poll Ira B. , De-Nour A. Kaplan
Published: July 2009

SYNOPSIS

Forty patients on chronic haemodialysis were studied in order to gather information about the relationship of locus of control and adjustment. Negative correlations of high statistical significance were found between locus of control and compliance with the diet, and locus of control and vocational rehabilitation, as well as between locus of control and acceptance of disability. All the findings indicate that patients with internal locus of control adjust and adapt better than those with external locus of control. The number of years on dialysis did not correlate with locus of control. It might be suggested that the shift from internal to external locus of control occurs prior to dialysis in the stage of chronic kidney disease.
Alcoholism among prisoners
Authors: Gibbens T. C. N. , Silberman M.
Published: July 2009

A stratified sample of 404 prisoners and ex-prisoners from three contrasted London prisons were interviewed: 40% were found to be excessive drinkers, although drunken offenders with very short sentences were excluded. The significant differences between heavy drinkers and the rest are considered in relation to history and social status.
Prognosis of depression and the endogenous-neurotic distinction
Authors: Paykel E. S. , Klerman G. L. , Prusoff B. A.
Published: July 2009

SYNOPSIS

Depressed patients were followed-up after 10 months, and factor scores reflecting respectively general severity, the endogenous-neurotic distinction, and an admixture of anxiety versus depression were used as predictors. The main prognostic relationships were with the endogenous-neurotic distinction and provided validating evidence for it. Endogenous depressives showed generally better prognoses. Individual rating variables used to derive the factors showed little relationship to outcome and prediction appeared to derive from a summation of elements relevant to the endogenous-neurotic distinction across many variables.
Psychomotor performance in presenile dementia
Authors: Miller Edgar
Published: July 2009

SYNOPSIS

The psychomotor performance of patients with presenile dementia was investigated in two experiments. It was found that motor retardation in dementia was due more to impaired effector processes rather than slowness in deciding when and where to move.
Institute of Psychiatry Clinical Psychopharmacology Research Team
Authors: Lader Malcolm
Published: July 2009

SYNOPSIS

In 1960, the National Institute of Mental Health of the U.S.A. provided research support to Professor H. O. Schild of the Department of Pharmacology, University College London (U.C.L.) and to Dr. (now Professor) Michael Shepherd of the Department of Psychiatry, Institute of Psychiatry, University of London, for studies in human psychopharmacology. The research assistants initially employed were Dr. Lorna Wing, Dr. J. D. Montagu, and Dr. Malcolm Lader and work was carried out at U.C.L., the Institute of Psychiatry, and Runwell Hospital, Essex. In 1966, the Medical Research Council assumed responsibility by appointing Dr. Lader to their External Scientific Staff. Other support has come from the Bethlem Research Fund and from the pharmaceutical industry, in particular Roche (U.K.) Ltd. and May and Baker, Ltd. A group of six to eight workers has thus been built up based mainly in the Institute of Psychiatry but with continuing links to U.C.L. At present our team comprises pharmacologists, psychiatrists, psychologists, a physiologist, a chemist, and a mathematician. Several workers from abroad on British Council or Commonwealth Fellowships have been attached to the team at various times, and students for higher degrees such as PhD and MD have been welcomed.
Binge-eating and vomiting: a survey of a college population
Authors: Halmi Katherine A. , Falk James R. , Schwartz Estelle
Published: July 2009

Synopsis

A survey of 355 college students was carried out to determine the prevalence of the psychiatric disorder bulimia (the binge-eating syndrome). Results of the survey indicate that, within the normal college population, 13% experienced all of the major symptoms of bulimia as outlined in the DSM-III. Within the bulimic population, 87% were females (19% of the female population) and 13% were males (5% of the male population). Although self-induced vomiting may accompany other symptoms of bulimia, the results suggest that self-induced vomiting is not a necessary symptom for diagnosis. A significant relationship between laxative use and self-induced vomiting was detected. These forms of behaviour, termed purging behaviour, occurred in an average of 10% of the students. Individuals who experienced the symptoms of bulimia had a history of being overweight or tended to be in the upper portion of their normal weight range (age, sex, and weight corrected) when compared with those individuals who had not experienced the symptoms of bulimia. No significant weight history differences were detected between vomiters and non-vomiters.
Genetic factors in the response to neuroleptics in schizophrenia: a psychopharmacogenetic study
Authors: Galdi Joe , Rieder Ronald O. , Silber David , Bonato Roland R.
Published: July 2009

Synopsis

A psychopharmacogenetic strategy was used to investigate a genetic heterogeneity model of schizophrenia. This model consisted of various genetic subtypes represented by patients classified hypothetically according to the types and genealogical (Mendelian) patterns of illnesses in first-degree relatives. The effect of neuroleptics on these subtypes (drug x genetic subtype interactions) were tested for evidence of post-treatment responses which discriminated between them. The findings revealed that schizophrenics who had depressed relatives tended to exhibit (1) depression and more severe pseudoparkinsonism irrespective of types of neuroleptics, and (2) greater remission of paranoid-hostility symptoms when treated with neuroleptics of the aliphatic-piperadine type. Schizophrenics who had schizophrenic relatives failed to show these responses.

Interpretation of these findings emphasized the recognition of these responses as arising from neuroleptic-induced alterations of defective neurologic-neurochemical systems underlying this subtype and as ‘pharmacogenetic criteria’ by which it can be discriminated.
Hierarchical patterns in the distribution of psychiatric symptoms
Authors: Sturt Elizabeth
Published: July 2009

Synopsis

The occurrence of hierarchical patterns in the incidence of psychiatric symptoms in individual patients and community subjects is investigated. Data obtained from interviewing a sample of people from the population of Camberwell, south-east London, using the Present State Examination (PSE), were analysed as were similar data concerning three series of patients referred to different kinds of psychiatric service.

The population series showed that each of the common PSE symptoms tends to occur in association with other symptoms. Symptoms that are rarer in the general population are associated with the presence of many other symptoms or with other symptoms present to a severe degree. The rarer the symptom, the higher is the total symptom score indicated by its presence. The more indicative symptoms are also associated with a measure of social disability derived from the MRC Social Performance Schedule, which asks about serious problems in functioning in each of 8 role areas.

The implication of this study is that total symptom score is a valid measure of the current severity of the disorder. The hierarchy model of Foulds & Bedford (1975) is discussed and is shown to be a more specific formulation of the same idea.

Investigation of the referred series confirmed these conclusions. When compared with community subjects, patients tend to have a much higher total PSE score; they display symptoms which are very rare in the community; they tend to be disabled socially. However, they are less likely to fulfil the requirements of a specific formulation for the presence of minor symptoms. In particular, only about half of psychotic subjects display specific neurotic symptoms, although virtually every subject with ‘specific’ symptoms of some sort displayed non-specific neurotic symptoms.
Long-term psychotropic drug-taking and the process of withdrawal
Authors: Murray Joanna
Published: July 2009

Synopsis

Perceived efficacy and reliance on psychotropic drugs is explored in a sample of mainly long-term consumers. A comparison of past and present users elucidates some of the factors involved in prolonged usage and the experiences of those who withdraw from the medication.
Aspects of personality and depression
Authors: Snaith R. P. , McGuire R. J. , Fox K.
Published: July 2009

SYNOPSIS

Fifty consecutive patients suffering from primary depressiv illness, but excluding those who had a distinct episode of mania, were rated for the presence and degree of certain symptomatology, especially agitation and retardation. They were also divided into two groups (‘early’ and ‘late’ onset), according to whether their first-ever attack of depressive illness had occurred before the age of 45. After they had recovered from their illness, aspects of personality were assessed on a battery of self-rating personality tests. There was no evidence from this study that any of the personality traits measured was in any way significantly related to any of the clinical features of the illness.
The speed of recall of pleasant and unpleasant experiences
Authors: Lishman W. A.
Published: July 2009

SYSNOPSIS

A method is described for comparing the speed of recall of pleasant and unpleasant experiences. Pleasant experiences have proved to be recalled significantly more quickly than unpleasant experiences in healthy volunteer subjects, and especially in those scoring low on neuroticism or high on extraversion as measured by the Eysenck Personality Inventory. The overall pleasant/unpleasant differential was found to persist on re-testing some months later with an alternative form of the test. The technique appears to be a valid and simple means for exploring hedonic selectivity in memory.
Familial differences in schizophrenia with good and poor prognosis
Authors: McCabe Michael S. , Fowler Richard C. , Cadoret Remi J. , Winokur George
Published: July 2009

SYNOPSIS

Probands with schizophrenia of good and poor prognosis were selected according to defined criteria. Families were investigated blindly. The families with poor prognosis contained significantly more schizophrenia, neurosis, and overall illness, but less affective disorder than the families with good prognosis.
Preliminary Communication: 2: The Highlands Dependency Questionnaire (HDQ): An administered version for use with mothers of school children
Authors: Berg Ian , McGuire Ralph , Whelan Edward
Published: July 2009

SYNOPSIS

A questionnaire concerned with dependency, mainly in the mother–child relationship, and intended for use in child psychiatry, is described. It was administered to the mothers of 116 randomly selected junior and secondary school children in the general population, stratified into age, sex, social class, and school groupings. Two meaningful dimensions were revealed by principal component factor analyses: one concerned with reliance on mother and the other reflecting sociability. Reliability and validity were found to be satisfactory.
The Hamilton Rating Scale for depression: a factor analysis
Authors: Mowbray R. M.
Published: July 2009

Synopsis

A factor analysis was carried out of ratings on the Hamilton Scale on a group of 134 male and 213 female depressed patients. The original data covered a wide range of severity of illness and the distribution of severity scores was not biased from normal. Hamilton's general factor was confirmed but his bipolarity between agitated and retarded depression did not emerge. Sex differences in factor patterns were found and a preliminary experiment showed that factor scores could isolate anxiety features and personality factors.
A controlled evaluation of lithium prophylaxis in affective disorders
Authors: Cundall R. L. , Brooks P. W. , Murray L. G.
Published: July 2009

Synopsis

In a double-blind crossover trial lithium carbonate was found to be significantly superior to placebo in the prophylaxis of manic-depressive (bipolar) psychosis. A striking feature was the high incidence of manic or hypomanic attacks in patients who relapsed on placebo. Patients participated in the trial with their full knowledge and consent.
The long-term course of the schizophrenic psychoses
Authors: Bleule Manfred
Published: July 2009

SYSNOPSIS

Results of studies of a large number of long-standing schizophrenic illnesses are discussed. On an average, schizophrenia showed no further change for the worse after a duration of five years, but rather a tendency to improve. The success and limitations of modern therapy were statistically determined. Many recovered schizophrenics continued to do well even without medication and social care. As a rule, schizophrenics had no endocrine pathology and endocrine patients were not schizophrenic. Neither a broken home in childhood nor an upbringing by a schizophrenic parent resulted in any important association with schizophrenia. However, a disturbed relationship with relatives and loved persons was more frequent in the anamnesis of schizophrenic women than of schizophrenic men. Most schizophrenics who had been schizoid before their psychosis had lived in miserable familial conditions.