bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of Puerperal Psychoses
Authors: Kendell R. E. , Chalmers J. C. , Platz C.
Published: August 2008

Computer linkage of an obstetric register and a psychiatric case register made it possible to investigate the temporal relationship between childbirth and psychiatric contact in a population of 470 000 people over a 12-year period resulted in 54 087 births: 120 psychiatric admissions within 90 days of parturition. The ‘relative risk’ of admission to a psychiatric hospital with a psychotic illness was extremely high in the first 30 days after childbirth, particularly in primiparae, suggesting that metabolic factors are involved in the genesis of puerperal psychoses. However, being unmarried, having a first baby, Caesarian section and perinatal death were all associated with an increased risk of psychiatric admission or contact, or both, suggesting that psychological stresses also contribute to this high psychiatric morbidity. Women with a history of manic depressive illness, manic or depressive, had a much higher risk of psychiatric admission in the puerperium than those with a history of schizophrenia or depressive neuroses, and the majority of puerperal admissions met Research Diagnostic Criteria for manic or depressive disorder. Probably, therefore, puerperal psychoses are manic depressive illnesses and unrelated to schizophrenia.
Mania Following Head Injury
Authors: Bracken Patrick
Published: August 2008

A case of mania subsequent to head injury is presented. The literature reporting cases of mania after head injury is reviewed. It is suggested that the concept of Secondary Mania be broadened to include cases occurring after head injury. It is also suggested that a true bipolar illness can be secondary.
Communicating with Cancer Patients
Authors: Gautam S. , Nijhawan M.
Published: August 2008

In a prospective study, 100 cancer patients and their relatives were separately interviewed using a structured interview to examine whether the diagnosis of cancer should be communicated to patients and relatives; the reasons for doing so or not, the emotional reactions of patients and families; any change in the attitude of relatives; behaviour of patients and patient's expectation, on diagnosis, of the course of their illness. The majority of patients, who knew their diagnosis (71 %), wanted to be told the truth. The majority of relatives wanted to know the truth themselves (81 %) without the patients being told (77%). Patients did show immediate emotional reactions like anxiety and dejection, however they appeared to accept the diagnosis. Findings suggest that in an Indian setting the attitude of family members is more positive. The role played by sociocultural factors in the acceptance of the truth is discussed.
Patterns of use and Related Harm with Toluene-based Adhesives and Butane Gas
Authors: Evans A. C. , Raistrick D.
Published: August 2008

The patterns of use and related harm of solvent inhalation were investigated in a group of young people who misused toluene (n= 31) and a group misusing butane (n= 12). The two groups were similar in terms of patterns of use and solvent related harm. The toluene users were more likely to sniff only in a group setting, probably because of the long duration of intoxication. The toluene group were more approving in their attitudes towards taking other drugs.
Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home
Authors: Little A. , Hemsley D. , Bergmann K. , Volans J. , Levy R.
Published: August 2008

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS)) were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.
Abnormal Intestinal Permeability
Authors: Wood N. C. , Hamilton I. , Axon A. T. R. , Khan S. A. , Quirke P. , Mindham R. H. S. , McGuigan K.
Published: August 2008

Abnormal intestinal absorption has been suggested as an aetiological factor in schizophrenia. A procedure for investigating intestinal permeability was carried out in a group of chronic psychiatric in-patients. A proportion of the subjects studied showed abnormal intestinal permeability which could not be attributed to established bowel disease. Patients who were receiving neuroleptic but not anticholinergic drugs were those most often showing abnormal intestinal permeability. This work is at an early stage of development but preliminary findings suggest that further investigations should be carried out to establish the circumstances in which changes in intestinal permeability may be associated with mental illness.
Schizophreniform Episode Following Measles Infection
Authors: Stoler M. , Meshulam B. , Zoldan J. , Sirota P.
Published: August 2008

A case of schizophreniform episode following measles infection in a 27-year-old woman is presented. The possibility that the clinical picture is a first description in the literature of an association between a schizophreniform episode and possible measles-induced allergic encephalitis is discussed. Other possible connections between measles infection and schizophreniform episode are also mentioned.
Bipolar Affective Disorder in Down's Syndrome
Authors: McLaughlin Martin
Published: August 2008

Recent literature reports suggest that the presence of Down's syndrome precludes the development of mania. A case of bipolar affective illness in a man with Down's syndrome is presented.
Monitoring the Occurrence and Duration of Electroconvulsive Fits
Authors: Barrington Patrick , Lambourn John
Published: August 2008

During 100 routine psychiatric hospital electroconvulsive treatments the medical staff administering treatment experienced little difficulty in deciding that a fit had occurred. The judgement was based on simple clinical observation of a succession of clonic bodily movements, and high inter-rater agreement was found for the measurement of fit duration. The cuff technique was also used, but it tended to underestimate fit duration and is not recommended for routine ECT practice.
Seasonality, Birth Complications and Schizophrenia in a High Risk Sample
Authors: Machón R. A. , Mednick S. A. , Schulsinger F.
Published: August 2008

It has been suggested that viral infections, more prevalent in the winter months, might increase pregnancy and birth complications, which might in turn be responsible for the excess of winter-born patients with schizophrenia. In this study it was found that the rate of schizophrenia among high risk winter-urban births who had suffered a perinatal complication was significantly greater than that for those who had not thus supporting the hypothesis.
Family-Genetic Studies and Identification of Valid Diagnostic Categories in Adult and Child Psychiatry
Authors: Leckman James F. , Weissman Myrna M. , Pauls David L , Kidd Kenneth K.
Published: August 2008

Family-genetic studies of child and adult psychiatric disorders have become increasingly fashionable over the past decade. The development of structured diagnostic interview schedules, the emergence of uniform diagnostic criteria such as DSM-III, and the use of refined design and analytic techniques from the field of chronic disease epidemiology have made substantial contributions to the methodology of such studies. Advances in molecular genetics, particularly our emerging capacity to perform chromosomal linkage studies throughout the human genome, have renewed hope that the constitutional underpinnings of some psychiatric disorders can be identified and that the pathophysiology of these disorders can be elucidated. Family-genetic techniques in child and adult psychiatry are discussed with a particular focus on their potential value in validating diagnostic categories spanning developmental epochs.
The Outcome of Neurotic Disorders After Out-patient and Day Hospital Care
Authors: Tyrer P. , Remington M. , Alexander J.
Published: August 2008

New psychiatric out-patients with depressive, phobic, and anxiety neurosis were randomly allocated to out-patient care or to one of two types of day hospital treatment one specialising in psychotherapy and the other offering all forms of day care. Of 106 patients who entered the study, 78 had assessments of psychiatric symptomatology and social adjustment both before treatment and after 4, 8 and 24 months. There was no significant difference in outcome between depressive, phobic, and anxiety neurosis, and no overall difference in response to treatment between the three types of care. Suicidal symptoms were significantly less common in out-patients. In many respects, neurotic disorder can be regarded as a single syndrome.
In-Patient Treatment for Drug Abuse
Authors: Ghodse A. H. , London M. , Bewley T. H. , Bhat A. V.
Published: August 2008

During 1984 there were 253 admissions to the in-patient drug dependence treatment unit at Tooting Bec Hospital. Of the 198 patients responsible for these admissions, 60% were male and 43% were over the age of 30 years. There were 151 patients admitted for opiate detoxification, and 75% completed the withdrawal schedule. However, only 15 out of 25 patients admitted for benzodiazepine withdrawals were found to be physically dependent. Other reasons for admission included stabilisation of the dose of opiate (24%) and the treatment of physical complications of addiction.
The Efficacy of Electroconvulsive Therapy in the Treatment of Schizophrenia
Authors: Abraham K. R. , Kulhara P.
Published: August 2008

The efficacy of ECT was investigated in a double-blind trial. Twenty-two patients with schizophrenia received trifluoperazine and were randomly allocated to receive eight real or eight simulated ECTs. In the first eight weeks, the group receiving real ECTs showed significantly more improvement as measured on the Brief Psychiatric Rating Scale. However, the groups showed no significant differences from the twelfth week onwards. The superiority of real ECT was not confirmed at the end of six months.
Expressed Emotion and Schizophrenia in North India
Authors: Wig N. N. , Menon D. K. , Bedi H. , Ghosh A. , Kuipers L. , Leff J. , Korten A. , Day R. , Sartorius N. , Ernberg G. , Jablensky A.
Published: August 2008

A bilingual rater was trained in English in a technique of assessing relatives emotional attitudes to patients, and was then required to rate material in Hindi without any further experience. This strategy revealed that the rating of critical comments, hostility and positive remarks could be transferred from English to Hindi without distortion. There were problems with the remaining two scales, over-involvement and warmth, but these were due to technical issues connected with rating and not to cross-cultural distortion.
Expressed Emotion and Schizophrenia in North India
Authors: Wig N. N. , Menon D. K. , Bedi H. , Leff J. , Kuipers L. , Ghosh A. , Day R. , Korten A. , Ernberg G. , Sartorius N. , Jablensky A.
Published: August 2008

We measured the components of expressed emotion among two samples of relatives of first-contact patients from Aarhus (Denmark) and Chandigarh (India). The Danes were very similar in most respects to samples of British relatives, whereas the Indian relatives expressed significantly fewer critical comments, fewer positive remarks, and less over-involvement. Within the Chandigarh sample, city-dwellers were significantly more expressive than villagers of all EE components except over-involvement.
Expressed Emotion and Schizophrenia in North India
Authors: Leff J. , Wig N. N. , Menon D. K. , Bedi H. , Kuipers L. , Ghosh A. , Bedi H. , Menon D. K. , Kuipers L. , Korten A. , Ernberg G. , Day R. , Sartorius N. , Jablensky A.
Published: August 2008

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo American studies for ‘high EE’, we found a significant relationship between high EE and relapse. This relationship was not explained by other factors often associated with higher relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.
Correlation between the 37-Item Mental Test Score and Abbreviated 10-Item Mental Test Score by Psychogeriatric Day Patients
Authors: Thompson P. , Blessed G.
Published: August 2008

Groups of organically and functionally mentally ill psychogeriatric day patients were assessed by the 37-item Roth-Hopkins test and the abbreviated ten-item Roth-Hopkins test. The scores correlated highly, correlation being equally good for both diagnostic groups. Among the functionally ill and the mild organically ill, scores improved between first and second test. The quicker, better tolerated ten-item test is a useful test of mental impairment for psychogeriatric patients in the community, as well as in institutional care.
The Phenomenology of Acute Organic Psychosis
Authors: Cutting J.
Published: August 2008

The psychopathology of acute organic psychosis was investigated by interviewing 74 patients using the Present State Examination (PSE). Their delusions, perceptual disturbance, thought disorder, and emotional disorder were categorised and then compared with those seen in 74 acute schizophrenics. In acute organic psychosis there was a particular pattern to the delusions, perceptual disturbance, and thought disorder, which was quite unlike that seen in acute schizophrenia. These results have implications for theories claiming that schizophrenia is an organic psychosis. It is suggested that the psychopathology in acute organic psychosis has very different origins from that seen in schizophrenia.
The Social Breakdown Syndrome in the Elderly Population Living in the Community: the Helping Study
Authors: Radebaugh T. S. , Hooper F. J. , Gruenberg E. M.
Published: August 2008

A representative sample of elderly people residing in the community was examined to establish their psychiatric status. An interview with a close friend or relative, focusing on a one-week period in 1981, was used to investigate each subject's functional limitations and troublesome behaviour, these being the two components of the Social Breakdown Syndrome. The data from the sample were weighted to allow estimates of the characteristics of the general population. No cases of SBS at its most extreme were identified, and almost the entire population was found to be functioning at an adequate or near-adequate level: all cases of severe SBS were attributable to troublesome behaviour. Severe SBS was shown to increase with age and to be most common in non-white males. Persons with dementing disorders were more likely than their non-demented counterparts to show severe/moderate SBS, but in the majority of cases of SBS there was no mental disorder.
Can Categorical and Dimensional Views of Psychiatric Illness be Distinguished?
Authors: Grayson D. A.
Published: August 2008

Bimodality in a distribution of symptoms is often claimed to be convincing evidence that a disorder is categorical, a discrete disease entity, rather than the extreme on a continuous dimension. However, using concepts from contemporary psychometric theory it is shown that bimodality can arise from the dimensional viewpoint. In fact, contrary to the usual belief, bimodality would be expected to occur in many research contexts if the dimensional alternative were correct.
The General Health Questionnaire and the Detection of Emotional Disorder by General Practitioners
Authors: Boardman A. P.
Published: August 2008

This paper reports on a study of psychiatric morbidity in 920 patients attending 18 General Practitioners in Lewisham, South East London. Two indices of morbidity were computed on the basis of the patients responses to the General Health Questionnaire (GHQ) and the GPs' own estimates. Indices of the GPs' detection ability were found by comparing questionnaire and GP rating. The results are compared to those obtained by other workers in a sample of Manchester GPs. The GHQ gave a prevalence estimate of 42.9% which is comparable to that of 39.6% obtained in the Manchester study. In addition, the variation in caseness across sociodemographic groups was consistent with the Manchester findings. The GPs' estimates of morbidity, while much lower than those obtained in Manchester, have similar sociodemographic profiles. The results support the use of the GHQ as a screening device in epidemiological studies, and suggest the need for further investigation of the individual GP's performance as a case detector.
Ageing and Recovery from Alcoholism
Authors: Nordström G. , Berglund M.
Published: August 2008

Fifty-five dependent (DSM-III) male alcoholics, chosen for good social adjustment, were personally followed up about 20 years after their first admission to hospital. The conditions of all the alcoholics were evaluated with a multidimensional diagnostic schedule when first admitted. At the follow-up, 11 were abstainers, 11 reported a change to social drinking via abstinence, and 10 reported a change to social drinking by gradual stages. Improvement after the age of 45 was mainly due to gradual change to social drinking. This type of improvement was in half of the cases attributed to a decreased tolerance for alcohol. In the present sample, there were no indications of any relationship between premature ageing and gradual change to social drinking. It is hypothesised that physiological processes of normal ageing with concomitant changes in reactions to alcohol may be of importance for remission from alcoholism in middle-aged and older alcoholics. The relationships of personality, social factors and the degree of alcohol-dependence to patterns of successful long-term adjustment are discussed.
Alcohol, Other Drugs and Tobacco use and Anxiolytic Effectiveness
Authors: Tilley S.
Published: August 2008

Recent studies raise questions regarding use or abuse of alcohol by phobics, and about compatibility of behaviour therapy and benzodiazepine use. In this study 40 patients, referred with mainly anxiety-related problems to a nurse behaviour therapist, and a comparison group of 40 psychiatric nurses completed a self-administered questionnaire assessing use of alcohol, sedative drugs and tobacco, and their perceived anxiolytic effectiveness. The paper confirms earlier findings that the patients, in general, drank less than the general public. They also drank less than the nurses, but used more sedative drugs and were heavier smokers. Alcohol was an unreliable anxiolytic. A few patients, including two agoraphobics, drank heavily and did not enter treatment made conditional on stopping drinking. Implications for case management are discussed.
Anthropology and Psychiatry
Authors: Kleinman Arthur
Published: August 2008

To illustrate the contribution anthropology can make to cross-cultural and international research in psychiatry, four questions have been put to the cross-cultural research literature and discussed from an anthropological point of view: ‘To what extent do psychiatric disorders differ in different societies?’ ‘Does the tacit model of pathogenicity/pathoplasticity exaggerate the biological aspects of cross-cultural findings and blur their cultural dimensions?’ ‘What is the place of translation in cross-cultural studies?’ and ‘Does the standard format for conducting cross-cultural studies in psychiatry create a category fallacy?’ Anthropology contributes to each of these concerns an insistence that the problem of cross-cultural validity be given the same attention as the question of reliability, that the concept of culture be operationalised as a research variable, and that cultural analysis be applied to psychiatry's own taxonomies and methods rather than just to indigenous illness beliefs of native populations.
Detention of ‘Psychopathic Disorder’ Patients in Special Hospitals Critical Issues
Authors: Grounds A. T.
Published: August 2008

The detention of offenders in the legal category ‘psychopathic disorder’ in special hospitals for treatment raises a number of critical issues. There are doubts about the nature of the disorder; what constitutes treatment; who is ‘treatable’; the effectiveness of treatment; and whether evidence of psychological change implies reduced risk of reoffending. In view of these uncertainties, it is argued that indeterminate hospital orders may provide an unrealistic and unjust legal framework for treating ‘psychopaths' in special hospitals, and the use of powers under the Mental Health Act to transfer such patients to hospital during the course of prison sentences is a more appropriate alternative. This provision could be used more frequently, subject to improved safeguards of the right of release at the expiry of sentence.
The Dismantling of the Mental Hospital?
Authors: Ford M. , Goddard C. , Lansdall-Welfare R.
Published: August 2008

Results of the sixth quinquennial survey of the resident population of Glenside Hospital, Bristol, are reported. The total population continues to fall, but the rate of decline has slowed; the implications of this are discussed. Many patients live in an emotionally impoverished state, friendless and rarely leaving the hospital. Few in-patients are employed, even within the hospital. Considerable provision is made, however, for the employment of day-patients. To effectively resettle and support in the community those currently remaining in hospital will require increasingly extensive provision.
The Extent and Nature of Depressive Phenomena in Primary Health Care
Authors: Sen Biswajit , Williams Paul
Published: August 2008

The extent and factor structure of depressive phenomena were investigated in three primary health care clinics in the city of Calcutta. The Self-Reporting Questionnaire and the Screening for Depression Questionnaire were used as the first-stage instruments, and the Clinical Interview Schedule and the Hamilton Rating Scale for Depression as the second-stage instruments. The implications of the findings are discussed.
Winter-Born v Summer-Born Schizophrenics
Authors: Kendell R. E. , Kemp I. W.
Published: August 2008

Data from two sources-the Edinburgh Psychiatric Case Register and the psychiatric inpatient records of the Scottish Health Service-were used to compare large populations of first-admission schizophrenics born in winter (January to March) and in summer (June to October). Parallel comparisons were carried out for affective psychoses. Comparison of the months of birth of the Scottish patients with those of the general population indicated that there was a 9% excess of schizophrenic births and a 3% excess of affective births in the first 3 months of the year. In the Edinburgh material, winter-born schizophrenics were more likely than the summer-born to receive a diagnosis of paranoid or schizoaffective schizophrenia and less likely to receive diagnoses other than schizophrenia on readmission, but neither of these differences emerged in the much larger Scottish material. There were no differences between winter-and summer-born schizophrenics in age of onset, sex ratio, or prognosis in either data set, nor were any significant differences found between winter- and summer-born affectives. We have therefore failed to demonstrate any convincing differences between winter-and summer-born schizophrenics.
A Comparison of Scales for Assessing Rehabilitation Patients
Authors: McCreadie Robin G. , Affleck James W. , McKenzie Yvonne , Robinson Andrew D. T.
Published: August 2008

Twenty-four chronic schizophrenic patients were assessed by the Morningside Rehabilitation Status Scale, the Krawiecka Scale, and the Social Adjustment Scale by Self-Report. Inter-rater correlations suggest that the MRSS can be used by a rater with little previous knowledge of the patient. Between-scale correlations suggest the three scales assess somewhat different dimensions. A standard approach to rehabilitation assessment is suggested.
Extent, Timing and Persistence of Emotional Disorders following Childbirth
Authors: Nott P. N.
Published: August 2008

A three-stage community survey of a representative group of Southampton mothers was carried out. A semi-structured psychiatric interview was administered at 3, 9 and 15 months post-partum. The results of these interviews are presented and used to assess the extent and timing of psychiatric disorders arising in this period. In contrast to previous studies, it was found that the highest incidence ofnew cases, variously defined, occurred between the third and ninth month post-partum and not immediately following childbirth. These results are discussed in the context of previous studies using the same definition of caseness.
Short-Cycle Manic-Depressive Psychosis in a Mentally Handicapped Child without Family History
Authors: Linter C. M.
Published: August 2008

Diagnosis of classic psychiatric illness in mentally handicapped individuals remains difficult. Manic-depressive illness has previously been reported in both pre-pubertal and pubertal children with a mental handicap and with a family history. This paper reports a case of manic-depressive psychosis in childhood, with no family history, short-cycle mood swings and good response to lithium therapy.
AIDS-Related Psychiatric Disorder
Authors: Fenton Thomas W.
Published: August 2008

The background to HIV infection, its mode of transmission, and its neurological and psychiatric complications are described. The management of AIDS-related psychiatric disorder and problems encountered among staff involved in the management of patients suffering from AIDS are considered. There is a need for appropriate educational programmes. Although the incidence of AIDS in the UK has been appreciably lower than in many other countries, there are no grounds for complacency; psychiatric disorder associated with HIV infection will be encountered much more frequently in the future. Psychiatric staff are urged to inform and prepare themselves in anticipation of this development.
Double-Blind Comparison of Half-Dose and Standard-Dose Flupenthixol Decanoate in the Maintenance Treatment of Stabilised Out-Patients with Schizophrenia
Authors: Johnson D. A. W. , Ludlow J. M. , Street K. , Taylor R. D. W.
Published: August 2008

A double-blind controlled trial of 50% dose reduction in maintenance treatment in stable out-patients with low BPRS scores and good social function shows a significantly higher relapse rate in the low-dose group at 12 months (P < 0.05). After an interval of 24–36 months from dose reduction, 56–76% had experienced a relapse and 76–79% had resumed their former dosage. No clear advantage was shown for the lower dose in either a reduction of side-effects or improved social function, but a reduced prevalence or lower rate of symptom emergence for tardive dyskinesia was suggested.
Neural Substrates of Violent Behaviour a Preliminary Study with Positron Emission Tomography
Authors: Volkow Nora D. , Tancredi Laurence
Published: August 2008

Brain function was evaluated in four psychiatric patients with a history of repetitive purposeless violent behaviour, using EEG, CT scan, and positron emission tomography (PET). Three patients showed spiking activity in left temporal regions, and two showed CT scan abnormalities characterised by generalised cortical atrophy. The PET scans for the four cases showed evidence of blood flow and metabolic abnormalities in the left temporal lobe. Two patients also had derangement in the frontal cortex. The patients showing the largest defects with the PET scans were those whose CT scans were reported as normal. This paper shows the utility of PET in investigating possible brain derangements that could lead to violent behaviour.
Paranoid Psychosis as the First Presentation of a Fulminating Lethal Case of AIDS
Authors: Thomas Christopher S. , Szabadi E.
Published: August 2008

A 34-year-old heterosexual intravenous drug abuser presented with a paranoid psychosis and was subsequently found to have the Acquired Immune Deficiency Syndrome (AIDS). The patient died 14 days later of generalised septicaemia. The case is reported and the aetiology and pathogenesis of the organic psychosis are discussed. It is anticipated that similar psychiatric manifestations will occur as the AIDS epidemic increases.
The Place of Benzodiazepines in Psychiatric Practice
Authors: Tyrer Peter , Murphy Siobhan
Published: August 2008

For the past 20 years, benzodiazepines have been the most commonly prescribed psychotropic drugs. It is now difficult to imagine the excitement produced by this new class of compounds. Existing anti-anxiety drugs, mainly the barbiturates, were known to be dangerous in overdosage, tend to cause addiction, and have many side-effects. Previous compounds, including opium, alcohol, chloral, and bromides, were similarly burdened. The benzodiazepine era began almost 30 years ago, in style. “Four hours after being given chlordiazepoxide on New Year's day 1958, one of 12 chronically anxious but therapeutically recalcitrant patients previously studied by Tobin and N. D. C. Lewis telephoned that for the first time in many years he was totally free from symptoms” (Hordern, 1968). The early studies were all enthusiastic and confirmed the therapeutic potential of the drug (Tobin et al, 1960; Jenner et al, 1961). In the ‘tranquilliser decade’ of the 1970s, prescriptions of benzodiazepines increased at a rate that was perceived as alarming, ‘the relentless march of the psychotropic drug juggernaut’ (Trethowan, 1975). This concern was related more to the inappropriate use of these drugs for treating personal problems than to the demonstration of dangers with these compounds. The dangers, however, appeared to be remarkably few; the drugs were safe in overdose, had greater efficacy than the barbiturates (Lader et al, 1974), and had virtually no unwanted effects, apart from sedation when given in excessive dosage. It was therefore hardly surprising that they proved so popular with clinicians. As Priest (1980) commented when benzodiazepine prescription was at its peak: “it is a tremendous boon to the medical profession to have active weapons in the fight against misery that are not only effective but are relatively safe when abused by despairing and desperate patients”.
Post-mortem Study of Chronic Schizophrenic Brains
Authors: Pakkenberg Bente
Published: August 2008

Volume measurements were carried out on 29 brains from institutionalised, chronic schizophrenic patients and 30 age and sex-matched controls using a stereological method. The volumes of the total fixated brain, the hemispheres, the cortex, and the central grey matter of the schizophrenic brains were significantly reduced while the volumes of the ventricles were significantly enlarged compared with the control group. The patients had been diagnosed by a psychiatrist on the basis of their case records as having either a Type I or Type II syndrome according to the symptoms they presented in the first years of their disease. The Type II patients were found to have significantly enlarged ventricles compared with the Type I patients.
A Long-term Follow-up Study of Schizophrenia in Japan -with Special Reference to the Course of Social Adjustment
Authors: Ogawa Kazuo , Miya Mahito , Wataral Akio , Nakazawa Masao , Yuasa Shuichi , Utena Hiroshi
Published: August 2008

A 21–27-year follow-up was conducted on 140 schizophrenic patients consecutively discharged from the Department of Neuropsychiatry, Gunma University Hospital, between 1958 and 1962, and 130 patients (93%) were successfully evaluated. Of these patients, 105 were still living, and the longitudinal courses could be fully observed in 98. With regard to the social outcome of the 105 patients, 47% were assessed as 'self-supportive’ whereas 31% were ‘hospitalised‘. As for psychopathological outcome, 31% were ‘recovered’, 46% were ‘improvead’, and 23% were ‘unimproved‘. In the studies of the longitudinal courses of the 98 patients, fluctuating courses of social adjustment were the most numerous in the early stages, whereas in the later stages many of the patients showed differentiation in one of two directions, namely the 'stable self-supportive’ state and the ‘chronic institutionalised’ state. However, this form of differentiation was not revealed in the distribution of psychopathological ‘end states'.
Prediction of Outcome in Depressed Patients by Weekly Monitoring with the Dexamethasone Suppression Test
Authors: Schweitzer I. , Maguire K. P. , Gee A. H. , Tiller J. W. G. , Biddle N. , Davies B.
Published: August 2008

Forty-three depressed patients in hospital were studied with weekly dexamethasone suppression tests (DSTs) and were followed as out-patients for at least three months after discharge. The detection rate of patients with LHPA axis dysfunction increased from 41% with a single DST to 59% with serial DSTs. There was a poor correlation between weekly post-dexamethasone cortisol levels and Hamilton depression rating scores. In patients with evidence of LHPA axis dysfunction, a DST at discharge discriminated effectively between a good and a poor outcome group; persistent non-suppression was strongly linked with a relapse of depression in the first three months after discharge. In general, our results support previous claims that the DST is a state marker for depressive illness.
Major Affective Disorder in Anorexia Nervosa and Bulimia
Authors: Laessle Reinhold G. , Kittl Susanne , Fichter Manfred M. , Wittchen Hans-Ulrich , Pirke Karl M.
Published: August 2008

DSM-III lifetime diagnoses were assessed in 52 patients with a lifetime history of anorexia nervosa or bulimia by means of a standardised diagnostic interview. It was found that 44.2% had a lifetime diagnosis of DSM-III major affective disorder, with abstaining anorectics having a lower rate of depression than those with bulimic symptoms. In the great majority of cases, the on set of affective disorder post-dated the onset of the eating disorder by at least one year. In patients whose eating disorder was in remission, the rate of depressive symptoms was lower than in those in the acute stage of their illness. These findings, combined with recent studies on biological changes in eating disorders, and psychological theories of depression, suggest that in most cases in which the two conditions are associated, the depression is secondary to the eating disorder.
The Evaluation of a Hostel Ward
Authors: Hyde C. , Bridges K. , Goldberg D. , Lowson K. , Sterling C. , Faragher B.
Published: August 2008

A controlled modified cost-benefit evaluation of a hostel ward caring for new long-stay patients is described and results are presented for the first two years. In some respects the residents of the hostel ward had fewer psychotic impairments than those remaining on the wards of the district general hospital, mainly because the latter seem to continue to acquire such defects, while the former have remained relatively unchanged. The hostel ward residents also develop superior domestic skills, use more facilities in the community, and are more likely to be engaged in constructive activities than controls. These advantages were not purchased at a price, since the cost of providing this form of care for these patients has cost less than care provided by the district general hospital.
Substance-Use Disorders in DSM-III-R
Authors: Kosten Thomas R. , Rounsaville Bruce J. , Babor Thomas F. , Spitzer Robert L. , Williams Janet B. W.
Published: August 2008

Using the newly revised DSM-III-R criteria for substance-abuse diagnoses, we examined dependence syndrome elements among 83 psychiatric patients. The sample included 14 with no history of substance abuse. The remainder abused alcohol (52), sedatives (31), hallucinogens (12), stimulants (33), cannabis (44), cocaine (52), or opiates (47). Many patients (52) had abused more than one type of drug. Ten items assessing the proposed dependence symptoms for each type of drug were factor-analysed. The dependence syndrome items formed a single factor for opiates, cocaine, and alcohol, but not for other drugs. When the items were combined into cumulative scales, they had excellent internal consistency. Furthermore, they formed good approximations of unidimensional Guttman scales on which higher scores indicated greater syndrome severity. The items associated with higher scores differed across drugs, with opiates having the most striking differences from the other substances. Medical-psychosocial consequences were relatively independent of the dependence syndrome, although alcohol and cocaine dependence had some association with other problem areas. These findings support the utility of a common dependence syndrome concept for drugs of abuse as well as alcohol, and provide empirical support for the current revision of the DSM-III diagnostic criteria.
Conversive Hallucinations
Authors: Sirota P. , Spivac B. , Meshulam B.
Published: August 2008

Conversive hallucinations are rare in the psychiatric literature. The authors present a case which demonstrates the psychogenesis and phenomenology of conversive hallucinations in a young female patient.
Lithium Toxicity and Mefenamic Acid
Authors: Shelley R. K.
Published: August 2008

An elderly patient with bipolar manic-depressive psychosis, stabilised satisfactorily on lithium carbonate, developed acute symptoms of lithium toxicity shortly after commencing mefenamic acid. Vulnerability factors for the interaction may have included age, history of cardiac failure, and impaired glomerular function. It is hypothesised that the interaction may have been mediated by inhibition of prostaglandin activity.
The Effect of Maternal Psychotic Illness on a Child
Authors: Mander Anthony J. , Norton Beverley , Hoare Peter
Published: August 2008

We report the case of an 11-year-old girl who had been living with only her mother, a woman with chronic schizophrenia. The girl had been caught shoplifting with her mother, and had a long history of non-attendance at school. The case emphasises that adult psychiatrists should always consider the impact of chronic parental psychiatric disorder on children, particularly in one-parent families.
Early-onset Huntington's Chorea
Authors: Brooks D. S. , Murphy D. , Janota I. , Lishman W. A.
Published: August 2008

A patient with early-onset Huntington's chorea is described. The diagnosis had been overlooked during previous contacts with psychiatric services because there was no family history, and features typical of the adult disease were absent. Distinctive findings on CT scan and electroencephalography were observed.
Two Cases of Erotomania (de Clérambault's Syndrome) in Bipolar Affective Disorder
Authors: Signer Stephen F. , Swinson Richard P.
Published: August 2008

Two female patients with longstanding bipolar affective disorder demonstrated de Clérambault's paradigm of erotomania during the euthymic phase of their illness. Although a diagnosis of schizophrenia or paranoid disorder is often given, a review of the literature shows that many cases have features of a major affective disorder, probably bipolar affective disorder and its spectrum.
Community Care
Authors: Turner T.
Published: August 2008

Community care has lost its innocence. Critics and evangelists vie for television space and newspaper headlines. The Chief Medical Officer had to beg for clarification of a term that had developed too many meanings and an “ethos of virtue” (Acheson, 1985). How should it be defined? Can a hospital be part of the community? Does it mean care ‘in’ ‘by’ the community? The Department of Health and Social Security (DHSS) definition seems to be “the provision of alternatives to long-term institutional care for the chronically sick or those suffering from long-term handicaps or disabilities” (Hunt, 1985). Lord Trefgarne (1984) put the policy aim, more simply, as “to move out of hospital those people who do not really need to be there”.
Childhood Sexual Abuse in Adult Female Psychotherapy Referrals
Authors: Sheldon Helen
Published: August 2008

Among 115 women referred to a regional psychotherapy unit, childhood sexual abuse was reported at the referral or assessment stage by 19, and referred to covertly by 5. A significant number of cases must remain undetected. For the purpose of this study, sexual abuse includes any form of sexual activity between a female child and a familiar adult or young person older than her, which was perceived by the subject to be of a sexual nature and distressing to her. The symptoms in adulthood have been described as similar to those of Borderline Personality Disorder. Development, treatment and implications are discussed.
Mental Disorders among Yugoslav Medical Students
Authors: Erić Ljubomir , Radovanović Zoran , Jevremović Ivana
Published: August 2008

The mental health of 523 medical students was examined one month after enrolment and two years later. The point prevalence rates of all mental disorders were 16.1% and 17.5% respectively. The incidence rate was 5.3% per year, with neuroses being the most frequent diagnoses (3.5%).
Hypomania Following Complex Partial Seizures
Authors: Barczak P. , Edmunds E. , Betts T.
Published: August 2008

Depressive disorders are commonly found among selected groups of patients with epilepsy, but hypomania is seldom seen. Three cases of hypomania seen at a unit specialising in epilepsy are presented. The cases are of interest because of their association with recent seizures, and location in the non-dominant temporal lobe.
Neurotic Depression: Delineation of Symptom Profiles and Their Relation to Outcome
Authors: Parker Gordon , Blignault Ilse , Manicavasagar Vijaya
Published: August 2008

Ninety-one subjects diagnosed clinically as having a ‘neurotic depression’ were interviewed and then re-assessed at 6 weeks and 20 weeks. Four symptom profiles of clinical features were derived: ‘negative cognition’, ‘lack of drive’, ‘anxiety’, and ‘arousal’, the last being independent of the other three dimensions and of the severity of depression. Symptom profile scores were then examined against antecedent risk variables and outcome. Links between profile scores and personality variables suggest that personality may colour the clinical presentation of neurotic/reactive depressions, and challenge the assumption that a typology of these depressive disorders based on clinical features is achievable. The break-up of an intimate relationship in the preceding 12 months was a strong predictor of a good outcome. Further analyses suggested, firstly, that there was a distinct subgroup delineated by this life event, with features weighted to the ‘arousal’ symptom profile, including many symptoms often associated with diagnosis of ‘endogenous depression’; and, secondly, that this life event and a good outcome were directly linked, being uninfluenced by personality or other mediating variables.
Growth Hormone Response to Clonidine After Recovery in Patients with Endogenous Depression
Authors: Mitchell P. B. , Bearn J. A. , Corn T. H. , Checkley S. A.
Published: August 2008

The growth hormone response to clonidine was measured in ten drug-free recovered patients, seven of whom had previously been tested when endogenously depressed, and compared with the response in ten individually matched controls. In eight of the patients there was an impairment of the growth hormone response, despite clinical recovery, although the hypotensive effect of clonidine in these patients was normal. This is suggestive of a persisting abnormal alpha2-adrenoceptor function in forebrain regions after recovery from an episode of endogenous depression, and may represent a trait marker for this condition.
Delusional and Non-delusional Depression in Late Life
Authors: Baldwin Robert C.
Published: August 2008

The study tests the hypothesis that delusional and non-delusional depressive illnesses are distinct entities in late life. Two groups of 24 patients with late-onset depression, one with and one without delusions, were compared retrospectively. At the index admission, deluded patients were significantly more depressed, were in hospital for longer, responded poorly to antidepressants alone and required more physical treatments, especially ECT and major tranquillisers. Although illness severity was a major factor accounting for these differences, the finding that only the deluded group experienced delusional relapses suggests an underlying intrinsic susceptibility. The discharge status was similar for both groups, as were relapse rates over 48 months and the clinical course of depressive symptoms over 42–104 months. The findings are consistent with studies of younger patients which point to a distinction between these two types of depression, but not with recent work suggesting a very poor prognosis for delusional depression in late life.
Psychiatric Liaison Referrals of Elderly In-patients in a Teaching Hospital
Authors: Poynton Amanda M.
Published: August 2008

A retrospective review of 131 psychiatric referrals of hospital in-patients aged 65 years and older was made to examine the referral rate, the characteristics of referred patients, and the pattern of diagnoses and recommendations made by the psychiatrist. The referral rate was much less than the estimated prevalence of psychiatric morbidity in similar populations. The majority of referrals received a psychiatric diagnosis, most commonly an organic psychiatric syndrome (37%) or depression (23%). Comparison of various aspects of referral for the periods before and after the introduction of a specific psychiatric liaison service for the elderly showed little change apart from a small increase in referral rate.
Measuring the Course of Alzheimer's Disease
Authors: St Clair David , Blackburn Ivy , Blackwood Douglas , Tyrer Gillian
Published: August 2008

On two occasions one year apart, the cognitive performance of 12 patients with presenile dementia Alzheimer type (ATD) and 14 with alcoholic Korsakoff syndrome (KS) was assessed both psychologically using the Christensen version of Luria's neuropsychological investigation and physiologically by measuring P300 (P3) and other long-latency auditory event-related potentials. All patients with ATD showed evidence of psychological deterioration and most also showed changes in auditory P3, whereas on all measures the KS group remained essentially unchanged. The extent of the changes in the ATD group varied, but in general those patients with most psychological deterioration also displayed the biggest changes in P3 wave form. There were two patterns of decline: a majority followed the traditional progressive course associated with Alzheimer disease; and in a minority, decline was slower. Methods for determining the rate of decline in individual patients with ATD, together with the prognostic implications, are discussed.
Dangerous Delusions
Authors: de Pauw Karel W. , Szulecka T. Krystyna
Published: August 2008

Among the mentally ill, those with well-developed delusions are more likely to commit violent crimes against persons than those with chronic, undifferentiated psychoses. Reports of violence associated with delusional misidentification are reviewed and four patients described who were either perpetrators or victims of assaults as a consequence of the syndromes of Frégoli, lntermetamorphosis, Subjective Doubles and Capgras. The cases illustrate the multiplicity of factors which have to be taken into consideration in order to predict whether an individual will act in a violent manner on these delusions.