bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of long‐term lithium treatment on the mortality of patients with manic‐depressive and schizoaffective illness*
Authors: Müller‐Oerlinghausen B. , Ahrens B. , Grof E. , Grof P. , Lenz G. , Schou M. , Simhandl C. , Thau K. , Volk J. , Wolf R. , Wolf T.
Published: August 2007

Clinical research centers in Aarhus, Berlin, Hamilton and Vienna collected mortality data for 827 manic‐depressive and schizoaffective patients given lithium treatment for more than 6 months. The average duration of the treatment was 81 months and the total time on lithium 5600 patient‐years. For each patient, the mortality risk was calculated by entering the appropriate national life tables for the general population. The number of observed deaths was 44; the number of expected deaths was 49.7. The standardized mortality ratio, 0.89, did not differ significantly from 1.0. The mortality of manic‐depressive patients is 2–3 times that of the general population. Our data show that the mortality of manic‐depressive and schizoaffective patients given long‐term lithium treatment does not differ significantly from that of the general population.
Somatization in primary care: pattern and correlates in a clinic in Nigeria
Authors: Gureje O. , Obikoya B.
Published: August 2007

During a study of mental disorder in a primary care clinic in Nigeria, 214 patients, selected on the basis of their scores on the General Health Questionnaire, were interviewed with the Composite International Diagnostic Interview, a structured clinical interview that allows for a systematic assessment of somatization symptoms. Only 1.1% of this clinical sample fulfilled the DSM‐III‐R criteria for somatization disorder, but 4.7% and 10.8% met the criteria for somatoform pain disorder and undifferentiated somatoform disorder, respectively. Age, gender and the presence of a DSM‐III‐R diagnosis of depression or dysthymia accounted for significant variability in the number of reported somatization symptoms. On factor analysis, a factor with close similarity to DSM‐III‐R somatization disorder was obtained. This factor is associated with the demographic features commonly found among patients with DSM‐III‐R somatization disorder.
Does an attempted suicide actually have a cathartic effect?
Authors: Bronisch T.
Published: August 2007

It has been suggested in empirical studies that an attempted suicide has a cathartic effect. However, only one study used a control group of depressives who had not attempted suicide. A replication of these results using more strictly defined patient groups and a more comprehensive assessment of the psychopathology during index treatment was not possible. Major depressives with and without suicide attempts before index admission displayed similar courses of their depressive symptoms and somatic complaints during index treatment. The cathartic effect of a suicide attempt may be restricted to a severe major depression or to a violent suicide attempt.
Noradrenergic neuronal dysregulation in panic disorder: the effects of intravenous yohimbine and clonidine in panic disorder patients
Authors: Charney D. S. , Woods S. W. , Krystal J. H. , Nagy L. M. , Heninger G. R.
Published: August 2007

In order to evaluate possible abnormal noradrenergic neuronal functional regulation in patients with panic disorder, the behavioral, biochemical and cardiovascular effects of intravenous yohimbine (0.4 mg/kg) and clonidine (2 μg/kg) were determined in 15 healthy subjects and 38 patients with panic disorder. A subgroup of 24 panic disorder patients were observed to experience yohimbine‐induced panic attacks and had larger yohimbine‐induced increases in plasma 3‐methoxy‐4‐hydroxyphenylglycol (MHPG) than healthy subjects and other panic disorder patients. A blunted growth hormone response to clonidine and a significant clonidine‐induced decrease in plasma MHPG was also observed in this subgroup of panic disorder patients. These data replicate and extend previous investigations, which are consistent with a large body of preclinical and human data relating increased noradrenergic neuronal function to human anxiety and fear states.
Factor study of the Geriatric Depression Scale
Authors: Salamero M. , Marcos T.
Published: August 2007

A sample of 234 people between the ages of 60 and 95 was studied using the Brink‐Yesavage Geriatric Depression Scale (GDS). The GDS has good concurrent validity with the Hamilton Rating Scale for Depression with the Melancholia Scale (r= 0.77), which confirms the clinical utility of this scale. A factor analysis of principal components with an oblimin rotation was performed. The results obtained imply that structural validation cannot be made in relation to Beck's cognitive model of depression. It can be concluded that the elimination of the somatic items does not add any theoretical correspondence with the model, as the factors tend to group the various items into one dimension.
Multidimensional ordering of psychopathology
Authors: Goekoop J. G. , Hoeksema T. , Van der Klein E. A. M. Knoppert , Klinkhamer R. A. , Van Gaalen H. A. E. , Van Londen L. , De Weme R. , Zwinderman A. H.
Published: August 2007

The aim of the study was to search for a multidimensional order in the psychopathology of the functional mental disorders in general. A heterogeneous group of 192 patients was investigated by means of a semistructured interview based on the Comprehensive Psychopathological Rating Scale. Principal component factor analysis revealed 5 clinically meaningful dimensions interpretable as representing dysregulation of emotion and motivation, perceptual and behavioural disintegration and dysregulation of autonomic functions.
Postimperative negative variation and skin conductance response in chronic DSM‐III‐R schizophrenia
Authors: Eikmeier G. , Lodemann E. , Olbrich H. M. , Pach J. , Zerbin D. , Gastpar M.
Published: August 2007

The hypothesis was tested that there are relationships between schizophrenic negative or deficit symptoms, the skin conductance nonresponding and an elevated amplitude of the postimperative negative variation (PINV). These variables were recorded in 16 chronic schizophrenics and 10 healthy controls. Clinical symptoms were assessed by the Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, Frankfurt Complaint Questionnaire 3 and Chapman Questionnaire. In the patient group we found a significantly elevated PINV at Fz. Surprisingly, only one patient was a skin conductance nonresponder. PINV amplitude at Fz and the number of skin conductance responses to habituation were not correlated with negative or deficit symptoms including anhedonia. The hypothesis thus had to be rejected.
The desipramine‐induced growth hormone response and the dexamethasone suppression test in obsessive‐compulsive disorder
Authors: Lucey J. V. , Barry S. , Webb M. G. T. , Dinan T. G.
Published: August 2007

Ten patients with DSM‐III‐R obsessive‐compulsive disorder (OCD) underwent the desipramine (DMI) growth hormone (GH) stimulation test as well as the dexamethasone suppression test (DST). The results were compared with the responses in a group of matched healthy controls. The GH response to DMI did not differ between patients and controls and 9 of 10 patients showed cortisol suppression in response to dexamethasone. The data suggest that neither alpha2 adrenergic dysfunction nor DST non‐suppression are features of primary OCD.
Familial influences on the clinical characteristics of major depression: a twin study
Authors: Kendler K. S. , Neale M. C. , Kessler R. C. , Heath A. C. , Eaves L. J.
Published: August 2007

We sought in this study to clarify the role that familial factors play in influencing the clinical presentation of major depression (MD). We examined the similarity of the historical and symptomatic features of MD in 176 pairs of female‐female monozygotic (MZ) and dizygotic (DZ) twins from a population‐based registry, where both members reported a history of MD defined by DSM‐III‐R criteria. The age at onset and treatment‐seeking were significantly correlated in all twin pairs and the correlation in concordant DZ pairs was actually somewhat higher than in concordant MZ twins. The degree of impairment was modestly correlated in all twin pairs with substantially higher correlations in MZ vs DZ twins. No twin resemblance was observed for number of episodes or longest duration of an episode. Twin resemblance for the clinical features of MD was modest, but so was their consistency for the same individual over successive 1‐year periods. However, in 5 of the 6 neurovegetative symptoms involving changes in appetite, weight and sleep, MZ twins were significantly correlated and correlations were significantly greater in concordant MZ vs DZ twins. Although the familial factors that cause twin resemblance for the age at onset and treatment seeking appear to be largely environmental, twin resemblance for the degree of impairment and neurovegetative symptoms are probably due largely to genetic factors. Our results suggest that familial factors influence the predisposition to some clinical features of MD.
Plasma homocysteine in vascular disease and in nonvascular dementia of depressed elderly people
Authors: Bell I. R. , Edman J. S. , Selhub J. , Morrow F. D. , Marby D. W. , Kayne H. L. , Cole J. O.
Published: August 2007

Depression among elderly people with reversible cognitive loss often manifests with concomitant vascular disease and can also precede the development of nonvascular degenerative dementia. Little is known about etiological factors for reversible or irreversible dementias in older depressed people. The amino acid homocysteine (HC), which is both a vascular disease risk factor and a precursor of the excitotoxic amino acids cysteine and homocysteic acid, could play a role in the pathophysiology of such individuals. Twenty‐seven depressed elderly acute inpatients by DSM‐III‐R criteria had significantly higher plasma homocysteine levels and lower cognitive screening test scores than did 15 depressed young adult inpatients. HC was highest in the older patients who had concomitant vascular diseases (n= 14). HC was lowest in the older depressives who had neither vascular illnesses nor dementia (n= 8), comparable to the young adult depressives. Higher HC correlated significantly with poorer cognition only in the nonvascular geriatric patients (rs= ‐0.53). The findings extend earlier work showing higher HC in vascular patients from general medical populations, and also suggest a possible metabolic factor in certain dementias associated with late‐life depression.
Associations between self‐induced vomiting and personality disorder in patients with a history of anorexia nervosa
Authors: Dowson J. H.
Published: August 2007

Fifty‐five patients of an eating disorders service with a history of anorexia nervosa (AN), defined by a history of refusal to maintain body weight above a level of 15% below that expected, completed a modified version of the revised Personality Diagnostic Questionnaire (PDQ‐R) based on DSM‐III‐R personality disorders (PD). The subjects were divided into 2 groups based on AN subtypes: vomiters, defined by a history of self‐induced vomiting, and non‐vomiters, who had maintained low weight mainly or only by diet ± excessive exercise. Vomiters showed significantly higher scores on self‐report measures of borderline and antisocial PD criteria. Discriminant analysis based on PD scores for all 13 DSM‐III‐R PD categories correctly predicted AN subtype membership based on vomiting history in 85.5% of patients. The implications of PD comorbidity for the development and management of eating disorders are discussed.
Are siblings of schizophrenic individuals psychologically disturbed? A perceptgenetic inquiry
Authors: Titelman D. , Nilsson A.
Published: August 2007

Questions about psychopathology among siblings of schizophrenic individuals were addressed by means of a projective test, the Perceptgenetic Object‐Relation Test (PORT), which uses tachistoscopic presentations of 3 object‐relation themes: attachment, separation and oedipal. Twenty‐two siblings of schizophrenic individuals ‐ 10 siblings of patients with recent onset, and 12 siblings of chronic patients ‐ were compared with normal controls and with siblings of mentally handicapped people. Earlier observations of unstable defensive organizations among the siblings of chronic schizophrenic patients were corroborated, particularly in response to the attachment theme. The schizophrenia siblings fell within the narcissistic‐borderline spectrum of PORT. The 50% drop‐out rate was discussed as reflecting anxiety and evasiveness, and the results were seen as substantiating that siblings of schizophrenic people are structurally if not clinically affected by their sibship.
Aldosterone responses to angiotensin II in anorexia nervosa
Authors: Mizuno O. , Tamai H. , Fujita M. , Kobayashi N. , Komaki G. , Matsubayashi S. , Nakagawa T.
Published: August 2007

Patients with anorexia nervosa (AN) tend to have renin‐angiotensin‐aldosterone (RAA) abnormalities caused by abnormal behaviors such as strict dieting, fasting, vigorous exercise, self‐induced vomiting and abuse of laxatives and/or diuretics. Adrenal responsiveness to angiotensin II (A II) was studied in 13 AN patients before and after therapy and in 6 normal sex‐ and age‐matched controls: adrenal responses to postural change (1 h of walking following 1 h in a supine position) and to exogenous A II injection (A II: 10 ng/kg/min intravenous infusion for 30 min). The 24‐h urine sodium concentration was significantly lower in AN patients before therapy than after therapy. Plasma aldosterone secretory response to A II was significantly higher in AN patients before therapy in both postural change and exogenous A II injection tests compared with after therapy response and that of controls. On the other hand, there was no significant difference in adrenal response to postural change or to exogenous A II between AN patients after therapy and controls. In conclusion, increased A II sensitivity caused by chronic sodium deficiency in AN patients normalized over time as the patients recovered.
The pharmacology and toxicology of disulfiram and its metabolites
Authors: Petersen E. N.
Published: August 2007

Disulfiram (Antabuse®) is one of several aldehyde dehydrogenase (ALDH) inhibitors that raise the plasma level of acetaldehyde following ethanol ingestion. The usually pleasant reaction to ethanol is thereby changed to an unpleasant one, owing to a number of bodily reactions to acetaldehyde. Populations showing genetic polymorphism with a lack of some isozymes of ALDH have exhibited an intolerance to ethanol similar to that seen with disulfiram. A normal isozyme pattern seems to be a prerequisite for the development of alcoholism, which supports the principle of disulfiram treatment. Disulfiram is an irreversible ALDH inhibitor when administered in vivo. Diethylthiomethylcarbamate (Me‐DTC) is formed from disulfiram in three metabolic steps. This compound and two further oxidized metabolites appear to be active metabolites of disulfiram. Measurements of plasma Me‐DTC or the reduction of leucocyte ALDH 1 activity may be valuable markers for the proper dose titration of disulfiram and the rational use of this drug. Some toxicological points are discussed.
Lack of bioequivalence between disulfiram formulations
Authors: Andersen M. P.
Published: August 2007

A comparison of the bioavailability of disulfiram (DSF) after administration of non‐effervescent Antabuse® tablets (CP Pharmaceuticals, UK) and Antabuse® effervescent tablets Antabus® (A/S Dumex, DK) has been made in two cross‐over studies.

The first study included 6 volunteers who were given 400 mg DSF after an overnight fast. The bioavailability of DSF after administration of non‐effervescent was found to be only 27 ff/o of that achieved with effervescent tablets.

The second study included 24 volunteers who were given 800 mg DSF after a light standardized meal. The relative bioavailability of DSF after administration of non‐effervescent compared with effervescent tablets was found to be only 34%.

In addition to the difference in bioavailability of DSF after administration of the two preparations, a considerable difference was seen between the two studies. A light meal seems both to increase the bioavailability of DSF and to reduce the interindividual variation. A two to threefold increase in the bioavailability of DSF was found.

Thus, the bioavailability of DSF appears to depend on both the formulation (preparation) and the mode of administration. A lack of bioequivalence between the two investigated DSF preparations was found.
Disulfiram therapy –adverse drug reactions and interactions
Authors: Poulsen H. Enghusen , Loft S. , Andersen J. R. , Andersen M.
Published: August 2007

Adverse drug reactions (ADR) to disulfiram treatment have been reported as single cases, but few systematic investigations exist. In this study we analysed the spontaneous ADR reports to the Danish Committee on Adverse Drug Reactions during 1968–1991. In that period 154 ADRs to disulfiram were reported, mainly of hepatic, neurological, skin, and psychiatric reactions, in decreasing order of frequency. The safety of disulfiram, estimated on the amount produced and the number of reactions reported, corresponds to an intermediate rate of adverse reactions (1 per 200–2000 treatment year). Over the 23‐year period, 14 deaths were reported in Denmark and this corresponds to a rate of 1 per 25,000 treatment year; the chief cause was liver toxicity. Reports to the WHO collaborating Centre for International Drug Monitoring in Uppsala, Sweden, showed the same ADR profile, although with a higher rate of neurological and psychiatric and a lower rate of hepatic reactions.

The latency time from the start of treatment to the manifestion of the ADR differed according to organ. Hepatitis occurred with a distinct peak after 2 months of treatment, skin reactions peaked after 2 weeks, and the rate of neurological ADR increased with duration of therapy. The relation of skin reactions and hepatitis to nickel allergy is discussed, as is the dose‐dependency of neuropathy.

Concomitant disulfiram treatment affects the metabolism of several drugs and the dynamics of others, leading to a number of clinically important drug interactions. The disulfiram drug interactions are reviewed.
Beta‐endorphin, vasoactive intestinal peptide and cholecystokinin in peripheral blood mononuclear cells from healthy subjects and from drug‐free and haloperidol‐treated schizophrenic patients
Authors: Panza G. , Monzani E. , Sacerdote P. , Penati G. , Panerai A. E.
Published: August 2007

Beta‐endorphin, cholecystokinin and vasoactive intestinal peptide were measured in peripheral blood mononuclear cells of healthy controls, and schizophrenic patients at the first diagnosis before any treatment and after 2 or 15 d of treatment with haloperidol. Beta‐endorphin concentrations were similar in controls and untreated patients, and increased with treatment. Cholecystokinin concentrations were higher in patients than in controls, and decreased during treatment. Vasoactive intestinal peptide was lower in patients and did not change with treatment. These observations are consistent with measurements of the same peptides in autopsy samples or cerebrospinal fluid. Peripheral blood mononuclear cells might be an useful tool for the study of some neuropeptides in brain.
Differences between adolescent suicide attempters and depressed adolescents
Authors: Kienhorst C. W. M. , de Wilde E. J. , Diekstra R. F. W. , Wolters W. H. G.
Published: August 2007

Most of the characteristics differentiating between adolescent attempters and nonattempters do not have discriminative power in comparing 48 adolescents who recently attempted suicide with 66 depressed adolescents. These characteristics may probably be attributed to an affective disorder that is present in most of the suicide attempters. However, suicide attempters, compared with the depressed group, live in more problematic circumstances (such as family disruption or sexual abuse) and have a cognitive style that promotes a more negative evaluation of events and situations. Their depressive symptoms are distinguished from the depressed group by withdrawal and isolation, besides maintaining a hopeless and negative expectation of the future. Furthermore, there are reasons to accept the idea that suicidal behavior is a serious alternative within their behavioral repertoire. Based on these findings, a psychological interpretation is given concerning the dynamics leading to a suicide attempt. Also, intervention strategies are discussed.
Is levomepromazine a useful drug in treatment‐resistant schizophrenia?
Authors: Lal S. , Nair N. P. V.
Published: August 2007

Levomepromazine (LMP) unexpectedly improved 16 of 23 chronic treatment‐resistant schizophrenic patients who were hospitalized in most cases for at least 2 years and who manifested positive symptoms, irritability and, in many cases, restlessness, hostility, uncooperativeness, poor concentration and aggressive behavior. Improvement led to discharge in 7 (6 to a foster home), placement on a waiting list for a foster home in 4 and improved behavior and autonomy in 5 patients. Five subjects developed seizures and 1 agranulocytosis. Whether improvement with LMP is caused by unique antischizophrenic properties or by diminished liability to induce side effects such as akathisia, a formal controlled study of LMP in treatment‐resistant schizophrenia is merited.
Polyneuropathy caused by chlorprothixene
Authors: Luisto M.
Published: August 2007

Seven chronic psychiatric patients developed signs of polyneuropathy mainly in the lower limbs after receiving chlorprothixene (500‐1800 mg/d) from 3 to more than 24 months. The most prominent electroneuromyographic findings were decreased or not measurable motor conduction velocities of the peroneal nerves. Electromyography showed signs of denervation in the leg muscles in all the patients, and also in the upper limbs in 4 of them. The signs of polyneuropathy gradually subsided after withdrawal of chlorprothixene. Thus, chlorprothixene may cause a toxic, dose‐dependent, reversible polyneuropathy.
Course of schizoaffective psychosis: further data from a retrospective study
Authors: del Rio Vega J. M. , Ayuso‐Gutierrez J. L.
Published: August 2007

This study investigated the clinical course and outcome of 72 patients, diagnosed as suffering from schizoaffective psychosis (according to ICD‐9 criteria) who also satisfied Research Diagnostic Criteria for schizoaffective disorder. The current overall functioning of these patients was related to the number and frequency of episodes, regardless of the duration of the illness: the lesser the number or frequency of relapses, the better the overall functioning. In addition, there were no statistically significant differences in psychosocial impairment between bipolar and unipolar schizoaffective disorder.
Cause of death in reactive psychosis
Authors: Jørgensen P. , Mortensen P. B.
Published: August 2007

Patients admitted for the first time with reactive psychosis have a greater mortality risk than the general population. This is caused by an increased risk of almost every cause of death, even cancer. However, the suicidal risk is increased considerably and suicide is the most frequent cause of death among men and women. Postpsychotic treatment that includes careful examination for somatic illness is recommended, and it is questioned whether the time has come to resolve reactive psychosis as a diagnostic term.
Relationship between parameters of serotonin transport and antidepressant plasma levels or therapeutic response in depressive patients treated with paroxetine and amitriptyline
Authors: Kuhs H. , Schlake H.‐P. , Rolf L. H. , Rudolf G. A. E.
Published: August 2007

In a double‐blind clinical study, antidepressant plasma levels, parameters of platelet serotonin (5‐HT) transport (Km, Vmax and basal platelet 5‐HT content) and therapeutic response were measured in depressive patients treated with either paroxetine (30 mg/day) or amitriptyline (150 mg/day) for 6 weeks. No correlation could be found between paroxetine plasma levels and therapeutic outcome after 2, 4 and 6 weeks of treatment. In contrast to the amitriptyline group, a marked increase in Km from baseline to week 2 was determined in paroxetine‐treated patients, with Km increase being correlated with paroxetine plasma levels at week 2. However, no significant relationship could be found between 5‐HT transport parameters and any of the outcome measures in either treatment group.
Housing conditions and residential needs of psychiatric patients in Copenhagen
Authors: Nordentoft M. , Knudsen H. C. , Schulsinger F.
Published: August 2007

A study of the extent of homelessness among 1581 psychiatric patients in Copenhagen found that 342 patients (22%) in contact with the psychiatric services had serious housing problems. A total of 112 (7%) were long‐stay patients without a home address, 134 (8%) were in an unstable housing situation and 96 (6%) were actually homeless. The homeless among the psychiatric patients were characteristically single, on disability pension or general public assistance, most often under 45 years of age, often schizophrenic and, among the men, almost one third were alcohol abusers. The majority of the homeless preferred separate apartments, and the psychiatrists also considered this form of housing to be the most appropriate for them. Approximately one fifth were estimated to need staff‐supported housing, and the number of places in psychiatric group homes or halfway houses should therefore be increased.
Assessing psychopathology in Chinese psychiatric patients in Hong Kong using the Brief Psychiatric Rating Scale
Authors: Chan D. W. , Lai B.
Published: August 2007

This study investigated the use of the Brief Psychiatric Rating Scale (BPRS) in a sample of 155 Chinese psychiatric patients in Hong Kong. The commonly rated symptoms were those related to the spectrum of anxiety‐depression, and the symptom dimensions differed only slightly from those symptom clusters reported in past studies with the BPRS. Although symptoms were rated regardless of psychiatric diagnoses, the BPRS profiles of these patients were sensitive to diagnostic distinctions. In addition, these patients were also classifiable into the 8 phenomenological types. However, the less elevated BPRS profiles across types raised the question of whether there was a tendency to under‐present symptoms on the part of the patients or to under‐rate symptoms on the part of the clinicians. These results were discussed in terms of the use of the BPRS for descriptive and classification studies in the Chinese setting as well as for cross‐cultural research.
Gender role in adolescent suicidal behavior: observations and therapeutic implications
Authors: Gasquet I. , Choquet M.
Published: August 2007

We analyzed the relative seriousness of suicide attempts by boys based on 430 hospitalized suicide attempters ages 13 to 19 years. A comparison by sex of adolescent suicide attempters with a school population of non‐suicidal adolescents of the same age group shows greater differences in the areas of school failure, psychosomatic and distress‐related symptoms and substance abuse between suicidal and non‐suicidal boys than between suicidal and non‐suicidal girls. These findings suggest that compared with non‐suicidal boys and girls, suicidal boys show more deviant behavior than girls. The question then arises as to whether there are differences in the treatment received by male and female suicide attempters. On hospital admission, more boys than girls are sent to psychiatric wards, and boys are proposed follow‐up care more frequently than girls. On the other hand, boys and girls are not treated differently with respect to psychiatric consultations during hospitalization or coordination with outside physicians (family doctor, school doctor, other physicians) and the social services. These findings could serve as the basis for the development of specific treatment plans to meet the needs of suicidal boys.
A long‐term study of remoxipride in chronic schizophrenic patients
Authors: Vartiainen H. , Leinonen E. , Putkonen A. , Lang S. , Hagert U. , Tolvanen U.
Published: August 2007

The purpose of this study was to assess the tolerability and efficacy of 150–600 mg remoxipride (predominantly a DA2 receptor antagonist) in an open long‐term (1 year) multicentre trial in chronic schizophrenic patients. The mean duration of illness before entering the study was 21 years and the pre‐study neuroleptic dosage in chlorpromazine equivalents was 930 mg/day. The clinical efficacy was measured with the Brief Psychiatric Rating Scale and the Clinical Global Impression scale. The adverse events were recorded by a 26‐item Adverse Symptom Checklist and by the Abnormal Involuntary Movements Scale. Forty‐five patients were included in the study. The mean daily dose of remoxipride during the last week of treatment was 378 mg. Eighty percent (36 patients) withdrew prematurely (< 1 year). The main reasons for withdrawal were: ineffectiveness (n= 15), treatment refusal (n= 12) and adverse events (n= 8). The most frequently reported adverse events were insomnia (n= 20) and tiredness (n= 7), whereas only a few (n= 6) extrapyramidal symptoms were reported. There was no relationship between remoxipride plasma concentrations and clinical efficacy nor was any relationship found between the ratio of pretrial chlorpromazine equivalent to last remoxipride dose and the therapeutic effect. Remoxipride alone seemed to have an insufficient neuroleptic efficacy in these chronic and treatment‐resistant schizophrenic patients but was well tolerated.
The validity of diagnoses obtained through the psychological autopsy procedure in adolescent suicide victims: use of family history
Authors: Brent D.A. , Perper J.A. , Moritz G. , Allman C.J. , Roth C. , Schweers J. , Balach L.
Published: August 2007

A test of validity of the psychiatric diagnoses obtained by the psychological autopsy procedure is described in a consecutive series of 67 adolescent suicide victims. Family history of mental illness in first‐degree relatives of subjects was obtained blind to subject diagnosis using the family history method. It was hypothesized that subjects with a given diagnosis, compared with subjects without this diagnosis, would show an increased rate of this disorder among first‐degree relatives. This hypothesis was supported insofar as specific associations between subject diagnosis and familial rates of illness were demonstrated for major depression, bipolar illness, conduct and antisocial disorder and substance abuse. These results provide further support for the validity of diagnoses obtained through the psychological autopsy procedure.
Agreement in psychiatric assessment
Authors: Andersen J. , Kørner A. , Larsen J.K. , Schultz V. , Nielsen B.M. , Behnke K. , Munk‐Andersen E. , Bjørum N.
Published: August 2007

In 103 schizophrenic patients we investigated the extent of practice needed in the use of the Brief Psychiatric Rating Scale (BPRS) to enable its reliability to be assessed. The agreement level of the 7 raters was analysed. Generally, the lowest mean agreement found was for the negative symptoms of the BPRS schizophrenia subscale. A high degree of agreement was attained both for the positive symptoms of the BPRS schizophrenia subscale and for the symptoms of the depression – and of the mania subscale. The degree of disagreement observed was due to both individual differences in assessment ability and the rating procedure. These results indicate that it is necessary to state the degree of agreement achieved in studies in which several raters are taking part.
A double‐blind, comparative, multicentre study comparing paroxetine with fluoxetine in depressed patients
Authors: De Wilde J. , Spiers R. , Mertens C. , Bartholomé F. , Schotte G. , Leyman S.
Published: August 2007

A randomized, double‐blind, parallel‐group, 6‐week study was undertaken to compare the efficacy and tolerability of once or twice daily administration of the selective serotonin reuptake inhibitors paroxetine and fluoxetine. After a 1‐week placebo wash‐out, patients suffering from DSM‐III major depression and with a score of 18 or more on the 21‐item Hamilton Rating Scale for Depression (HRSD) received either paroxetine or fluoxetine. The patients were assessed for efficacy using the HRSD, Montgomery‐Åsberg Depression Rating Scale and Clinical Global Impression; for tolerability, adverse events were elicited by the use of a non‐leading question and a side effects checklist. The groups of patients were comparable on entry to the study. One hundred patients were recruited into the study, of whom 78 were evaluable for the efficacy analysis. Paroxetine and fluoxetine showed comparable efficacy at the end of the 6‐week treatment period, but a statistically significant difference in the number of responders at week 3 in favour of paroxetine was observed. This could suggest an earlier onset of action with paroxetine. Also, associated anxiety symptoms were significantly reduced on paroxetine compared with fluoxetine at week 3. Patients on paroxetine reported fewer adverse events than those on fluoxetine. The most commonly reported adverse events were nausea and vomiting in both groups.
Life events and depression in Japan
Authors: Nanko S. , Demura S.
Published: August 2007

The relationship of life events to the onset of depression as well as the relationship between positive family history and reactivity to stress were investigated. Our results indicated that life stress in general plays an important role for women in the onset of depression and that undesirable events and problems of work specifically play a role in the onset of depression. The dichotomy of reactive and endogenous depression was not supported based on our result that no relationship was observed between the presence of familial loading and reactivity to stress.
The prevalence of mental disorders in school‐age children attending a general paediatric department in southern India
Authors: Chandra R. , Srinivasan S. , Chandrasekaran R. , Mahadevan S.
Published: August 2007

This study was conducted over a period of 18 months in a medical college hospital in southern India. Of 313 children of age 5 and above referred for detailed psychiatric evaluation, 101 were found to have a mental disorder according to DSM‐III‐R criteria; the remaining had organic disorders. Children above 8 years (74%) registered higher morbidity. There was no sex difference in overall morbidity. Precipitating factors were discernible in half of these cases, of which school‐related problems were found in the majority. Almost two‐thirds had multiple stressors, of which chronic family and social adversity (39%) and learning disabilities (28%) were common. Mental disorders were significantly related to urban background, middle‐class socioeconomic status and literate parents compared with age‐ and sex‐matched controls. There was no significant relationship with the type of family and number of siblings. Conversion disorder (31%) was the commonest, followed by conduct disorders (16%). The symptoms, stressors, response to treatment and the transcultural aspects are also discussed.
Ethnicity as a risk factor for mental illness
Authors: Sundquist J.
Published: August 2007

This article shows the influence of ethnicity on mental health compared with material factors and lifestyle, which are well‐known risk factors for mental illness. The study was designed as a case‐control study, with 338 Latin American refugees aged 16–74 years (response rate = 81.8%) in Lund, and a random sample of 996 age‐, sex‐ and education‐matched Swedish controls. The data were analysed unmatched with logistic regression in main effect models. The strongest independent risk mediator for mental illness was ethnicity, with an estimated odds ratio of 4.11 (2.31–6.92). Low material standard was associated with mental illness, with an odds ratio of 2.13 (1.07–4.11). Individuals who did not feel secure in daily life were at risk of mental illness, as were those with poor leisure opportunities. The combination of ethnicity, age over 44, and not feeling secure in daily life increased the odds ratio of mental illness to 26.62. Ethnicity, a low material standard, not feeling secure in daily life and poor leisure opportunities were significant risk factors for mental illness. Dalby, Sweden
A comparison of fluoxetine and imipramine in the treatment of outpatients with major depressive disorder
Authors: Nielsen B.M. , Behnke K. , Arup P. , Christiansen P.E. , Geisler A. , Ipsen E. , Maach‐Møller B. , Øhrberg S.C.
Published: August 2007

A double‐blind clinical trial was undertaken to evaluate the clinical efficacy and safety of fluoxetine compared with imipramine in the treatment of 59 outpatients suffering from major depressive disorder. The mean scores of all depression rating scales showed that the drugs had comparable efficacy. The side effect profile of imipramine was found to be mainly anticholinergic, which was not the case for fluoxetine, where it was mainly found to be gastrointestinal, such as nausea and diarrhoea. In both groups the total number of adverse events reported were the same. Fluoxetine treatment resulted in weight loss, whereas imipramine treatment resulted in a slight but significant weight increase.
The distinction of bipolar II disorder from bipolar I and recurrent unipolar depression: results of a controlled family study
Authors: Heun R. , Maier W.
Published: August 2007

The aim of the study was to differentiate bipolar II, bipolar I and recurrent unipolar depression by their familial load for affective disorders. Eighty bipolar, 108 unipolar, 80 control subjects and interviewed first‐degree relatives were diagnosed according to Research Diagnostic Criteria using the Schedule for Affective Disorders and Schizophrenia – lifetime version. The morbid risks for bipolar I disorder were equivalent in relatives of bipolar I (3.6%) and bipolar II (3.5%) subjects and lower in relatives of unipolar subjects (1.0%). The morbid risks of relatives for bipolar II disorder distinguished bipolar II subjects (6.1%) from bipolar I subjects (1.8%), from unipolar depressives (0.3%) and from controls (0.5%). To promote further evaluation, bipolar II disorder should be included in DSM‐IV as a distinct diagnostic category.
Mortality in major affective disorder: relationship to subtype of depression
Authors: Buchholtz‐Hansen P. E. , Wang A. G. , Kragh‐Sørensen P. ,   the Danish University Antidepressant Group
Published: August 2007

A total of 219 inpatients with a DSM‐III diagnosis of major depression, 150 women and 69 men, were followed prospectively for 3–10 years and mortality was recorded. The patients were previous participants in psychopharmacological multicenter trials, which were carried out for the purpose of comparing the antidepressant effect of newer 5‐HT reuptake inhibitors with that of the tricyclic antidepressant drug, clomipramine. The study comprised patients with a total Hamilton Rating Scale for Depression score of ≥ 18 and/or a Hamilton subscale score of ≥ 9. Diagnostic classification according to the Newcastle I Scale in endogenous and nonendogenous depression was performed. The observed mortality was significantly greater than that expected. The increased mortality was essentially due to suicides and mainly found among women. Patients scored as nonendogenously depressed had a significantly higher suicide rate than endogenously depressed patients. The excess number of suicides in the nonendogenous group largely occurred within the first year of observation. No association was found between response to the antidepressant treatment in the trial and the suicide risk in the first 3 years of observation.
Standardization of a psychiatric screening test for use by general practitioners in Sardinia. Preliminary results
Authors: Carta M. G. , Carpiniello B. , Cicone V. , Sannais C. , Paulis M. , Rudas N.
Published: August 2007

The use of screening test for case‐finding studies was introduced only a few years ago in Italy. This study aimed to define the degree of accuracy of the Italian version of the 24‐item Self Reporting Questionnaire (SRQ‐24) applied by general practitioners to their patients. The latter was carried out by comparing results with those obtained by means of the Present State Examination performed by a qualified psychiatrist. About 37% of patients interviewed could be considered as cases. In particular, 23% were affected by anxiety disorder and 14% by a depressive disorder. The receiver operating characteristic analysis showed a fairly good degree of accuracy of SRQ‐24 for cut‐off points between 7 and 8.
Lack of association between schizophrenia and alleles in the dopamine D3 receptor gene
Authors: Jönsson E. , Lannfelt L. , Sokoloff P. , Schwartz J.‐C. , Sedvall G.
Published: August 2007

Dopamine receptor dysfunction has been implicated in the pathophysiology of schizophrenia. Schizophrenic patients (n= 76) and control subjects (n= 53) were examined for allele frequencies in a 2‐allele BalI polymorphism, causing a serine → glycine amino acid substitution in the coding sequence of the dopamine D3 receptor gene. No statistical significant differences of allele frequencies or genotype frequencies could be found between the two groups. Neither were there any significant relationships between allele frequencies and a number of clinical variables within the schizophrenic subsample. However, if not corrected for multiple testing, an association was found between homozygosity and positive response to neuroleptic drugs. The present study does not provide evidence that the BalI polymorphism in the dopamine D3 receptor gene is involved in the pathophysiology of schizophrenia. Further investigations with an increased number and variety of patients concerning response to neuroleptic drugs and expression of the receptor in human brain should be performed to definitively exclude this hypothesis.
Parental divorce and neuroendocrine changes in adolescents
Authors: Gerra G. , Caccavari R. , Delsignore R. , Passeri M. , Affini G. Fertonani , Maestri D. , Monica C. , Brambilla F.
Published: August 2007

Plasma noradrenaline (NE), adrenocorticotrophic hormone (ACTH), growth hormone (GH), prolactin (PRL) and luteinizing hormone (LH) concentrations were examined in basal conditions and after stimulation by the step test in two groups of psychophysically healthy adolescent girls, 18 from divorced families and 16 from non‐divorced families. Basal NE, ACTH, GH, PRL values did not differ in the two groups, whereas those of LH were significantly lower in the adolescents from divorced parents than in those from non‐divorced families. Responses of NE and ACTH to the stimulus were normal, of GH and PRL were weaker, and of LH slightly weaker in children of divorced parents. An impaired catecholaminergic and serotoninergic tonus in children of disrupted families might underly the hormonal alterations.
Reproductive rates in schizophrenic outpatients
Authors: Nanko S. , Moridaira J.
Published: August 2007

We investigated the marriage rates, the reproductive rates and the marital reproductivity of schizophrenic outpatients in Japan. A total of 553 patients with DSM‐III‐R‐diagnosed schizophrenia at the Teikyo University Hospital, Tokyo, Japan were compared with age‐ and sex‐matched outpatients at surgical clinics of the same hospital. Our findings indicate that the reproductivity of schizophrenics is reduced, even though the sample consists of outpatient population and modern operational diagnostic criteria have been used. The marriage rate and reproductive rate of the schizophrenics were reduced, especially in men. The number of married men was significantly less than that of married women and the reduced marital reproductivity was found in women but not men. These findings indicate that the reduced reproductivity of men is accounted for largely by a reduced rate of marriage, and that in women is accounted for partly by lower rate of reproductivity within marriage.
Clinical significance of outcome in long‐term follow‐up of borderline patients at a day hospital
Authors: Sandell R. , Alfredsson E. , Berg M. , Crafoord K. , Lagerlöf A. , Arkel I. , Cohn T. , Rasch B. , Rugolska A.
Published: August 2007

All borderline patients admitted at a day hospital during a 6‐year period were followed up with a postal questionnaire after 3–10 years. Patients who had chosen to leave the treatment within 4 months were analyzed as a separate group, and these drop‐outs and the remaining patients were compared with a group of well‐adjusted people who were assumed to represent the functional norm. The patients who remained in treatment were clearly posited at a level of functioning between the norm and the drop‐outs, although the variation among them was quite large. Depending on the stringency and content of the criterion of clinical significance, 25–75% of the patients remaining in treatment fell within the range of the norm group versus 20–50% of the drop‐outs. The patients who had benefited most since termination had differed favorably from the other patients already at admission to treatment, but not as much as had the drop‐outs. The drop‐outs, however, at admission also had more ambivalent or negative attitudes towards treatment.
Prospective data on the prevalence of abnormal involuntary movements among elderly people living in the community
Authors: Green B. H. , Dewey M. E. , Copeland J. R. M. , Saunders P. A. , Sharma V. , Larkin B. , Davidson I. A. , Scott A.
Published: August 2007

Trained raters from the Liverpool Continuing Health in the Community study interviewed 1070 people over the age of 65 in 1982–1983 using the Geriatric Mental State (GMS) examination. Three years later the cohort was re‐interviewed, this time by psychiatrists trained in the GMS, who used the GMS and the History and Aetiology Schedule (HAS). The cohort had fallen in size to 875, because of mortality; 701 were re‐interviewed. The cohort was followed up again 6 years after the first interview by trained nurse raters using the GMS (A3) and the Mini‐Mental State Examination. Cases of mental disorder identified by the computer diagnostic program AGECAT were re‐interviewed by psychiatrists along with a number of controls using the GMS and the HAS on the remaining 450 individuals. Observational behavioural ratings from the GMS and summary sheets were analysed along with AGECAT diagnoses and data on medication gained at the 3 assessments. The community prevalence of tardive dyskinesia and other movement disorders in elderly people over a 6‐year follow‐up appears to be very low (the community prevalence of tardive dyskinesia being 0.22% and akathisia 1.57%). is usually associated with organic mental disorder (and consequently higher mortality) and is furthermore not usually associated with antipsychotic medication.
The relative efficacy of high‐dose buspirone and alprazolam in the treatment of panic disorder: a double‐blind placebo‐controlled study
Authors: Sheehan D. V. , Raj A. B. , Harnett‐Sheehan K. , Soto S. , Knapp E.
Published: August 2007

This 8‐week double‐blind placebo‐controlled trial investigated the relative efficacy and safety of alprazolam and buspirone in the treatment of panic disorder. Alprazolam (mean ± SD dose 5.2 ± 2.6 mg) produced a rapid and sustained improvement in panic attacks, anxiety, phobias, and disability and was superior to buspirone (mean ± SD dose 61 ± 26.5 mg) and placebo on all of these measures on completer (n= 85) and endpoint analysis (n= 92). Although higher doses of buspirone were used in this study than in previous trials, buspirone was not superior to placebo on any of the outcome measures. The results were disappointing in light of buspirone's benign side effect profile and low abuse potential.