bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Secondary’ affective disorder: a study of 95 cases
Authors: Guze Samuel B. , Woodruff Robert A. , Clayton Paula J.
Published: July 2009

SYNOPSIS

Patients with ‘secondary’ affective disorder differ from those with ‘primary’ affective disorder in that there are additional symptoms of their pre-existing illness among the former. Hysteria, anxiety neurosis, antisocial personality, alcoholism, and drug dependency are the psychiatric conditions most frequently associated with ‘secondary’ affective disorders. There are other differences which may also be related to the presence of pre-existing illness. These differences include the findings that patients with ‘secondary’ affective disorder are younger, more often male, and are rarely manic; they suggest that it is appropriate to distinguish between ‘primary’ and ‘secondary’ affective disorder for research purposes.
Freud and medicine in Vienna: Some scientific and medical sources of his thought
Authors: Rosen George
Published: July 2009

Synopsis

Freud as a medical student accepted the role of a man of science as defined by the medical milieu of Vienna, as well as the accompanying philosophy and methodology of clinical and scientific research. These forms became a part of his thought and into them he fitted his psychological discoveries as well as his view of himself. Without the medical Vienna in which he developed, Freud would not have been what he was.
A feasibility study for a controlled trial of formal psychotherapy
Authors: Candy J. , Balfour F. H. G. , Cawley R. H. , Hildebrand H. P. , Malan D. H. , Marks I. M. , Wilson J.
Published: July 2009

Synopsis

A feasibility study for a controlled trial of a certain type of formal psychotherapy is described. Patients referred by consultant psychiatrists in the Inner London Area were carefully selected and fully assessed before random allocation to one of three treatment procedures. The results indicate that the trial as initially envisaged is not feasible. The reasons for this conclusion are discussed.
Metabolism, anticholinergic effects, and therapeutic outcome of desmethylimipramine in depressive illness
Authors: Watt D. C. , Crammer J. L. , Elkes A.
Published: July 2009

Synopsis

In order to test two theories of the mode of action of imipramine 58 depressive patients were treated at two dosage levels with desmethylimipramine (DMI), its active metabolite. Clinical judgments were used to distinguish therapeutic responders from non-responders, who showed clear differences in depressive rating scales and body weight changes. Measurements of urinary output of DMI, of salivation, and of the incidence of side-effects were compared in responders and non-responders: no differences appeared between the two groups. It is concluded that the therapeutic effect of imipramine does not depend on either its anticholinergic or other action revealed by the common side-effects, and that variability of response cannot be accounted for by differences in the rate of metabolism of DMI.
Catecholamine-containing neurones and electrical self-stimulation: 1. a review of some data
Authors: Crow T. J.
Published: July 2009

Synopsis

SYNOPSIS Experimental data on the location in the brain of electrode sites supporting electrical self-stimulation are reviewed. All previous studies are in agreement that the behaviour is most easily elicited from lateral hypothalamic sites corresponding approximately to the fibre pathways known as the ‘medial forebrain bundle’. Some brainstem electrode sites will support self-stimulation. Experiments are summarized which indicate that there is a correlation between the sites of electrode tips positive for self-stimulation and the location of catecholamine-containing neurones in two regions: (1) in the region of the dopamine-containing cells in the ventral mesencephalon (cell-body groups A9 and AIO of Dahlstr¨m and Fuxe, 1964), and (2) in the region of the noradrenaline-containing cells of the locus coeruleus (A6 group). These two cell-body groups give rise to axons which pass through the medial forebrain bundle to form terminal systems with a widespread distribution in the prosencephalon. The hypothesis is advanced that electrical self-stimulation results in the majority of cases from activation of one or both of these catecholamine-containing systems.
Cross-national (Anglo—Irish) differences in obsessional symptoms and traits of personality
Authors: Kelleher M. J.
Published: July 2009

SYNOPSIS

The Leyton Obsessional Inventory, together with 46 questions taken from Sections M–R of the Cornell Medical Index and the short version of the Maudsley Personality Inventory were administered to a group of orthopaedic patients made up of Irish, English, and Irish immigrants. The results indicated that the Irish subjects had more obsessional symptoms and traits and also that they appeared to be more disturbed by the possession of such attributes than did the English. Among the various cultural factors considered, the bachelor state, in the case of the Irish males, and rural dwelling, in the case of Irish females, were associated with the highest obsessional scores. Ways in which the cultural background may be related to the development of obsessional symptoms and traits are discussed and suggestions are made as to the further epidemiological implications of these findings.
Physiological and psychological measures in anxious patients
Authors: Bond Alyson J. , James D. Colin , Lader Malcolm H.
Published: July 2009

SYSNOPSIS

Thirty drug-free patients suffering from chronic anxiety states were compared with 30 normal controls matched for age, sex, and social class on a variety of physiological and psychological measures. The tests included the electroencephalogram, the auditory evoked response, and skin conductance recorded during a passive and an active condition and auditory reaction time, the digit symbol substitution test, and arithmetic. The patients showed increased EEG voltage, shorter latencies of the evoked response, higher skin conductance levels, higher pulse rate and less pupillary constriction, and they responded less to the increase in activation. They also showed impairment on complex psychological tests. It is concluded that pathological anxiety involves an increase in arousal irrelevant to the task and has a disorganizing rather than a facilitating effect on performance.
A cluster analysis of the behavioural items in the pre-school child
Authors: Wolkind S. N. , Everitt B.
Published: July 2009

SYSNOPSIS

The difficulties of developing a classification of the non-psychotic disorders of early childhood are discussed. A cluster analysis technique is described for determining whether the pattern of behavioural items in 3 year olds could be used as a basis for such a classification. Among the clusters found were two suggesting conduct and neurotic disorders. Two pieces of evidence suggest that the clusters produced are clinically meaningful and have prognostic significance: (1) a group of children with a high risk for later psychiatrie disorder (children in local authority care) are over-represented in the ‘pathological’ clusters, and (2) the mothers of the children in these latter ‘clusters’ have significantly higher scores than mothers of children in the remaining clusters on an index of mental health one year later. It is suggested that evidence for the psychiatrie syndromes of early life is sufficiently strong to warrant further investigation.
School phobia and agoraphobia
Authors: Berg Ian , Marks Isaac , McGuire Ralph , Lipsedge Maurice
Published: July 2009

SYSNOPSIS

The incidence of past school phobia was surveyed by questionnaire in 786 women under 60 years of age who were members of an agoraphobia correspondence club. Twenty-two per cent admitted to previous school phobia, a proportion similar to that found in 57 non-agoraphobic neurotic controls. Past school phobia predicted an earlier onset of subsequent agoraphobia and a more severe psychiatric state as far as symptoms not specifically agoraphobic were concerned. Adolescent agoraphobic difficulties were more associated with school phobia than with agoraphobia in adult life. It was concluded that school phobia leads to agoraphobia in only a small proportion of cases. Although school phobia may predispose to later agoraphobia, it seems more likely that both conditions reflect a lasting tendency to neurotic illness.
Social skills training and psychotherapy: a comparative study
Authors: Argyle Michael , Bryant Bridget , Trower Peter
Published: July 2009

SYSNOPSIS

A comparison is made between two forms of treatment for patients with interpersonal difficulties—one, an established treatment in the form of brief psychotherapy, and the other, social skills training, a form of behaviour modification designed to provide or improve the social skills necessary for successful social interaction. In a pilot study using social skills training, six out of seven patients showed marked clinical and social improvement. In the controlled trial, there was evidence that both types of treatment improved behaviour, but that social skills training tended to maintain its effect for longer, even though psychotherapy patients had more than twice the number of therapy hours.
An evaluation of continuation therapy with tricyclic antidepressants in depressive illness
Authors: Mindham R. H. S. , Howland C. , Shepherd Michael
Published: July 2009

Synopsis

A double-blind clinical trial has been carried out to ascertain whether patients making a good recovery from depressive illness with tricyclic antidepressant medication derive any benefit from continuation of therapy with the same drug at a lower dose level. Of the 92 patients who entered the trial significantly fewer on active treatment relapsed during the six-month trial period: 22% as compared with 50% of patients receiving placebo. Patients with residual symptoms on entry to the trial derived more benefit from continuation therapy than patients who had made a complete recovery. The findings relate to a six-month trial period only, and any possible advantage of continuation therapy over a longer period remains uncertain.
Catecholamine-containing neurones and electrical self-stimulation: 2. A theoretical interpretation and some psychiatric implications
Authors: Crow T. J.
Published: July 2009

Synopsis

A theory is proposed which relates the learning theory concepts of reinforcement and incentive motivation to visceral afferent pathways in the central nervous System. Herrick's hypothesis of the functional significance of the difference between olfactory and gustatory connexions is used to demonstrate a parallel between olfactory and ‘drive inducing’ stimuli in their role in energizing and directing behaviour; and a somewhat similar parallel between the roles of gustatory and ‘reinforcing’ stimuli. This theory is used to explain recent evidence that there is a relationship between catecholamine-containing neurones and electrical self-stimulation behaviour. It is proposed that self-stimulation can be understood as resulting in most instances from activation of one or both of two ascending Systems: (1) a ‘reinforcement System’ (which may be phylogenetically related to gustation), arising from cell-bodies in the locus coeruleus and releasing noradrenaline as a neurohumour from terminals distributed to the neocortex; and (2) an ‘incentive motivational’ System (which may be a phylogenetic derivative of olfactory pathways), arising from cell bodies in the ventral mesencephalon and releasing dopamine from terminals distributed to the corpus striatum and related nuclei. Some implications of this theory for the action of certain psychotropic drugs and the ‘catecholamine hypothesis’ of affective disorders are discussed.
A self-rating scale of distress
Authors: Kellner Robert , Sheffield Brian F.
Published: July 2009

Synopsis

Results of studies with various versions of the Symptom Rating Test are described. The test was designed to measure changes in the symptoms of neurotic patients participating in experiments in therapeutics such as drug trials. In all studies the test scores discriminated significantly between psychiatric patients and normals. In drug trials the test was found to be effective in discriminating between the responses to psychotropic drugs and to placebo. The findings suggest that the test is a valid and reliable measure of distress.
Influence of psychiatric training in the use of descriptive terms among psychiatrists in the British Isles
Authors: Copeland J. R. M. , Gourlay A. J.
Published: July 2009

Synopsis

Three videotapes of diagnostic interviews were rated by psychiatrists at several different centres in the British Isles. Audiences were asked to use a number of rating schedules including a list of 116 technical psychiatric terms. They were also asked to make a provisional diagnosis. The influence of the psychiatrists' concepts of normality and the type of training and other factors such as age on the perception and quantitative assessment of psychiatric symptoms and the use of technical terms is discussed. Maudsley-trained raters tended to see fewer symptoms of all kinds in all three patients, while Glasgow psychiatrists made more ratings of affective symptoms–both manic and depressive—on two of the three tapes. Dublin raters use more ‘dynamic’ terms in their daily routine than do raters from the United Kingdom. Raters over 40 years of age tended to use ‘dynamic’ terms more often than raters under 40 years. Raters trained in university departments differed only slightly in the terms they used from those trained in area mental hospitals. This study points to the problems of psychiatric communication within one culture.
Drug defaulting by patients on long-acting phenothiazines
Authors: Johnson D. A. W. , Freeman Hugh
Published: July 2009

Synopsis

This survey investigates drug defaulting by schizophrenic patients on a regime of long-term medication with injections of long-acting phenothiazines (LAP). Although the frequency of discontinuing LAP was appreciably less than reported in most surveys on oral medication, it remained a problem. An analysis of the reasons for patients discontinuing LAP identified several causes: patient-refusal, side-effects, failure of administration of the regime, and patients losing contact with the medical services by moving to other districts.
Phenelzine in phobic anxiety: a controlled trial
Authors: Tyrer Peter , Candy Julian , Kelly Desmond
Published: July 2009

Synopsis

A double-blind trial of phenelzine versus placebo in psychiatric outpatients with long-standing phobic anxiety is described. Forty patients with agoraphobia or social phobias entered the trial and 32 of these completed treatment with either phenelzine or placebo (with appropriate dietary restrictions) in flexible dosage for two months. Fourteen pairs of patients were prospectively matched, and analysis of the score differences between these pairs showed a significant improvement for patients on phenelzine compared with placebo on overall assessment (P<0·01) and secondary phobias (P<0·05). These differences were not shown at assessment after one month's treatment, but became marked after two months. The improvement on phenelzine, which was maintained at follow-up, was not related to initial depressive symptoms in the patients. It is suggested that phenelzine is an effective agent in the treatment of phobic anxiety but that treatment needs to be continued for at least two months before full benefit is achieved.
Are we entering an age of melancholy? Depressive illnesses in a prospective epidemiological study over 25 years: the Lundby Study, Sweden
Authors: Hagnell Olle , Lanke Jan , Rorsman Birgitta , Öjesjö Leif
Published: July 2009

Synopsis

The Lundby cohort consists of all inhabitants in a delimited area in Sweden studied in 1947 by Essen-Möller, then by Hagnell in 1957, and by Hagnell & Öjesjöin 1975. It has been claimed that depressive disorders have increased during the sixties and seventies. In order to examine this hypothesis on a normal population (the Lundby Study), comparisons were made of the incidence figures for depression during the periods 1947–57 and 1957–72, and during the five 5-year intervals within the period.
The effect of pilgrimage on anxiety, depression and religious attitude
Authors: Morris P. A.
Published: July 2009

Synopsis

This investigation aimed to ascertain the levels of anxiety, depression and religious attitude, by means of rating scales, in a group of physically sick men and women planning to go on a pilgrimage to Lourdes. These levels were reassessed one month and ten months after the pilgrims had returned. There was a statistically significant decrease in anxiety and depression which was sustained. The possible reasons for these findings are discussed.
Health beliefs and health care behaviour in pregnancy
Authors: Reading Anthony E. , Campbell Stuart , Cox David N. , Sledmere Caroline M.
Published: July 2009

Synopsis

Primiparae were randomly assigned to two conditions of routine ultrasound examination at their first antenatal clinic visit: (a) high feedback ultrasound where the monitor screen was visible and the patient was shown the foetal size, shape and movement (N = 67); (b) low feedback ultrasound where the screen was not seen and specific verbal feedback was denied (N = 62). Women were interviewed at 16 weeks gestation. Those receiving high feedback were more likely to report that they had acted on health advice given at the first antenatal visit to reduce their smoking and drinking.
The concept of coping
Authors: Ray C. , Lindop J. , Gibson S.
Published: July 2009

Synopsis

Coping is action directed at the resolution or mitigation of a problematic situation. There are a number of ways in which this may be attempted, and a number of ways of classifying coping strategies. This paper presents a simple schema of six coping themes, ordered in terms of their defensiveness and the degree of attempted personal control which they imply. They comprise rejection, control, resignation, dependency, avoidance and minimization, and characterize the meaning or qualitative ‘style’ of the individual's response, rather than the formal characteristics of the strategies employed. Data from studies of breast cancer and surgical patients are cited to illustrate the substance of the themes.
The concepts of disease: a response
Authors: Scadding J. G.
Published: July 2009

I am grateful for the opportunity to comment on Dr Kräupl Taylor's paper. I agree with much of what he says and think that he agrees with some of what I have said. We both disapprove of Platonic realism, for which the term ‘essentialism’ used by Popper (1945) seems to me preferable, since it avoids the danger of confusion with the very different meaning of ‘realism’ in the later idealism–realism opposition. But he has misunderstood my position in the nominalist-essentialist argument; and he seems to think that my statement about the meaning of the names of diseases in medical discourse and the application of ‘modern systems of class logic’ in medicine are in some way incompatible or discordant, whereas I think they are complementary to each other.
The lifetime prevalence of mental disorders: estimation, uses and limitations
Authors: Kramer Morton , Von Korff Michael , Kessler Larry
Published: July 2009

SYNOPSIS

The age-specific lifetime prevalence rate of a disease is the proportion of persons surviving to a given age who have experienced the disease at any time during their lives. This measure of morbidity has been used to report findings in many of the epidemiological surveys of mental disorders of the last 30 years. This paper presents a life-table method for estimating age-specific lifetime prevalence rates from incidence and mortality data. The method is applied to Monroe County, New York, case register data on the incidence of schizophrenia. Using this method, we estimate that at least 3% of the White population surviving to age 55 have experienced an episode of schizophrenia at some time during their lives. The difficulties of producing valid estimates of lifetime prevalence and the difficulties in interpreting differences reported in such rates make this morbidity measure of secondary importance to incidence and point-prevalence data.
Depression and anxiety in the community: replicating the diagnosis of a case
Authors: Jones-Finlay Robert , Brown George W. , Duncan-Jones Paul , Harris Tirril , Murphy Elaine , Prudo Ray
Published: July 2009

SYNOPSIS

The diagnoses were reviewed of 866 women interviewed in 5 community surveys carried out by the Bedford College team. The diagnoses matched commonly held conceptions of who is a case in terms of both severity and type of syndrome. Two methods of replicating the diagnoses are presented, one based on discriminant function analysis and the other based on a simple checklist.
Comparison of doctors and nurses in the assessment of deliberate self-poisoning patients
Authors: Catalan J. , Marsack P. , Hawton K. E. , Whitwell D. , Fagg J. , Bancroft J. H. J.
Published: July 2009

SYNOPSIS

The assessments of deliberate self-poisoning patients carried out by 8 doctors and 8 nurses were compared. Both groups of staff had undergone special training in the assessment procedure. The adequacy of the assessments was determined by blind judges' ratings of transcripts of assessment interviews, comparisons of the types of treatment offered and repetition of self-poisoning. The attitudes of the patients and their general practitioners were also investigated.

No major differences were found between the assessments of the 2 groups of subjects. It is concluded that nurses under supervision of a senior psychiatrist can safely carry out the assessment of self-poisoning patients, provided they have received appropriate training. The findings suggest that services in which nurses assess most self-poisoning patients could be established in district general hospitals. This would reduce the demands currently placed on psychiatrists and physicians.
On establishing the validity of ‘objective’ data: can we rely on cross-interview agreement?
Authors: Platt Stephen
Published: July 2009

SYNOPSIS

It has been proposed that a high level of agreement between informants‘ reports about events and happenings (‘objective’ data) is a sound basis for establishing (a) the validity of the measure which is based on the reports, and (b) the nature of objective reality. In this paper it is argued that such agreement may not be an adequate basis for validation since the accounts may not be independent. Likewise, low across-interview agreement may not signify the inaccuracy of either report because of the phenomenon of ‘object-variation’. It is concluded that, although this method of validation can be significantly improved, it should be supplemented, wherever possible, by other approaches.
Memory functions and prophylactic treatment with lithium
Authors: Smigan L. , Perris C.
Published: July 2009

Synopsis

Memory functions were examined in a group of 53 patients with affective disorders before commencing prophylactic lithium therapy and then after 4 and 12 months of lithium treatment. The memory tests administered were the 30 Figure Test, the 30 Word-Pair Test, the 30 Person-Data Test (these tests are included in the Cronhoim–Molander test battery) and the 30 Face Test. Three scores were obtained: immediate memory score, delayed memory score and forgetting score. There were no statistical significant differences between these scores before lithium therapy or after 4 and 12 months, except for immediate and delayed memory on the Person-Data Test and the 30 Face Test which showed an increased score of memory functions. The results of this study support the view that long-term lithium treatment with serum levels of about 0·6 mmol/1 does not induce memory disturbances.
The association of affective disorder with Huntington's Disease in a case series and in families
Authors: Folstein Susan E. , Abbott Margaret H. , Chase Gary A. , Jensen Barbara A. , Folstein Marshal F.
Published: July 2009

Synopsis

Major affective disorder clinically similar to the disorder found in conditions other than Huntington's Disease (HD) was found in 41% of patients with HD in a consecutive case series ascertained through multiple sources in a defined geographical area. The association appears to be confined to certain families, and affective disorder may appear as long as 20 years before the onset of chorea and dementia. The association may represent genetic heterogeneity in HD.
A record-linkage study of mortality and general hospital discharge in patients diagnosed as schizophrenic
Authors: Herrman H. E. , Baldwin J. A. , Christie David
Published: July 2009

Synopsis

Six hundred people diagnosed as schizophrenic by the specialist psychiatric services in Oxfordshire, between 1971 and 1973, were identified from the Oxford Psychiatric Case Register (OPCR). The person records of deaths and hospital discharges held by the Oxford Record Linkage Study (ORLS) were used to examine the following items of information for members of this group: details of discharges from and surgical operations performed in Oxfordshire non-psychiatric hospitals in a 6-year period before and a 4-year period after the date of first inclusion in the OPCR, and details of deaths in a 4-year period after the date of first inclusion in the OPCR.

The numbers of deaths, discharges and operations so observed in the study group were compared in age, sex and major diagnostic groups with the expected numbers derived from rates prevailing in the Oxfordshire population over the same periods. Observed deaths were twice as numerous as expected in both sexes, and the numbers of general hospital discharges were also higher than expected. Ischaemic heart disease was the commonest cause of death in both sexes, but did not account for the excessive numbers of hospital discharges. Trauma and poisoning accounted for the excess both of deaths in younger members of the study group and of general hospital discharges overall. Social and environmental difficulties associated with the diagnosis schizophrenia are likely to have contributed more than any inherent biological disadvantage to this excess.
The Brief Symptom Inventory: an introductory report
Authors: Derogatis Leonard R. , Melisaratos Nick
Published: July 2009

Synopsis

This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test-retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument
Factors influencing the duration of treatment with psychotropic drugs in general practice: a survival analysis approach
Authors: Williams Paul
Published: July 2009

Synopsis

There have been few previous attempts to study factors which affect the duration of treatment with psychiatric drugs in general practice. In the present study ‘duration of treatment’ was regarded as analogous to ‘survival time’, and techniques of survival analysis were applied to data from a previously published study of psychotropic drug use in general practice (Williams et al. 1982). Methods of logistic modelling were used in an attempt to construct a comprehensive and parsimonious model to describe and predict the duration of psychotropic use. Such a model was found to include the effects of previous psychotropic treatment, social problems, duration of treatment and general practitioner behaviour. The implications of the findings, vis à vis the prevention of unnecessary long-term psychotropic drug use, are discussed.
Erotomania in males
Authors: Taylor Pamela , Mahendra B. , Gunn John
Published: July 2009

Synopsis

In anglophonic countries erotomania has traditionally been regarded as a female disorder of little more than curiosity value. The French literature recognizes the disorder in males, but as a rarity. In a recently collected group of violent male offenders the syndrome proved to be fairly common. The offending behaviour was invariably triggered by the core symptom. A description is provided of four cases whose level of aggression was low but appeared to be directly related to the firmness with which the delusion of being loved was held. The disorder of these men can be regarded as a variant of one of the major functional psychoses, but for the purposes of predicting behaviour and management there may be advantages in treating it as a syndrome in a similar taxonomic category as that of morbid jealousy.
The Doppelgänger, disintegration and death: a case report
Authors: Maack Lara H. , Mullen Paul E.
Published: July 2009

Synopsis

The phenomenon of a Doppelgänger (the double autoscopy; heautoscopy) and its resolution in a psychotic patient is presented. A comparison is made between this experience and the phenomenon as it is described and defined in the literature. The themes of death and disintegration so commonly associated with the Doppelgänger in folklore and literature are highlighted by this patient's experience.
Cognitive functions in tardive dyskinesia
Authors: Wolf Marion E. , Ryan Joseph J. , Mosnaim Aron D.
Published: July 2009

Synopsis

Cognitive functions of psychiatric patients with and without tardive dyskinesia were evaluated using the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Rey Auditory Verbal Learning Test. Schizophrenic patients with and without tardive dyskinesia did not differ in their performance on the administered psychological tests. However, affective disorder patients with tardive dyskinesia showed significantly more impairment on the Wechsler Memory Scale and Rey Auditory Verbal Learning Test than affective disorder patients without tardive dyskinesia. These findings suggest that affective disorder patients who develop tardive dyskinesia may have some predisposing brain damage or that tardive dyskinesia in these patients represents both a motor and a dementing disorder.
The epidemiology of anorexia nervosa
Authors: Kendell R. E. , Hall D. J. , Hailey Anthea , Babigian H. M.
Published: July 2009

Synopsis

All patients with anorexia nervosa were extracted from three psychiatric case registers— North-East Scotland, Camberwell, and Monroe County. The average incidence varied from 0·37 per 100,000 population per year in Monroe County to 1·6 per 100,000 in North-East Scotland, in all three areas the number of cases reported per year was increasing, and in Camberwell, but not in Monroe County or North-East Scotland, there was a significant excess of patients from middle-class backgrounds.
Morphine dependent behaviour in rats: some clinical implications
Authors: Kumar R. , Stolerman I. P.
Published: July 2009

Synopsis

An animal model of morphine dependence is described, in which rats learned to overcome their aversion to solutions of morphine and eventually drank such solutions in preference to water on choice trials. Selected aspects of the acquisition, maintenance, and elimination of this type of morphine dependent behaviour were studied and the findings are discussed in terms of their relevance to man.
The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline, and a combination of L-tryptophan and amitriptyline with placebo
Authors: Thomson Joan , Rankin H. , Ashcroft G. W. , Yates Celia M. , McQueen Judith K. , Cummings S. W.
Published: July 2009

Synopsis

One hundred and fifteen patients from 5 general practices participated in a 12-week, double-blind study comparing L-tryptophan, amitriptyline, L-tryptophan–amitriptyline combination and placebo in the treatment of depression. Analysis of total score on the Hamilton Depression Scale and a global rating of depression showed that all 3 active treatments were more effective than placebo. Significantly more patients were withdrawn as treatment failures in the placebo group compared with the active treatment groups. Side-effects necessitated withdrawal of more patients from the amitriptyline group than from the other active tratment groups, but this difference was not significant. Plasma amitriptyline and nortriptyline levels were similar in the difference was not significant. Plasma amitriptyline and nortriptyline and biochemical profiles did not alter significantly in any group, but mean heart rate was significantly increased in patients receiving amitriptyline. There was no change in free or total plasma tryptophan concentration with treatment or on remission of symptoms.
Correlates of enduring distress patterns following bereavement: social network, life situation and personality
Authors: Vachon M. L. S. , Sheldon A. R. , Lancee W. J. , Lyall W. A. L. , Rogers J. , Freeman S. J. J.
Published: July 2009

Synopsis

In a 2-year study of conjugal bereavement, 26 of 99 women remained highly distressed throughout the course of the study. Of the remaining 73 women, 30 never gave evidence of ‘high distress’. Deficits in social support, health and financial problems correlate with enduring ‘high distress’. Personality traits consonant with a socially acceptable and expected ‘widow role’ were found to differentiate the women with enduring ‘low distress’.
Self-reports of emotional distress in a sample of urban black high school students
Authors: Freeman Ellen W. , Rickels Karl , Mudd Emily B. H. , Huggins George R. , Garcia Celso-Ramon
Published: July 2009

Synopsis

Emotional distress as assessed by the self-report Hopkins Symptom Checklist (HSCL) was examined in a sample of 607 urban black high school students aged 15–18. These adolescents reported high distress primarily about feelings of disadvantage, volatile anger, interpersonal sensitivity and loneliness. Females were significantly more likely than males to indicate emotional distress, although several of the leading distress items were endorsed equally by both groups. Male and female scores across the HSCL factors differed in degree rather than form. The great majority of these adolescents didnotreport significant emotional distress. These data provide a base from a non-clinical sample for comparison with other adolescent groups where emotional distress may play a role.
Psychopathology and seizure type in children with epilepsy
Authors: Whitman Steven , Hermann Bruce P. , Black Rita B. , Chhabria Shaku
Published: July 2009

Synopsis

Previous investigations have reported an increased rate of behavioural disorder in children with epilepsy. The role, if any, played by temporal lobe epilepsy (TLE) in predisposing to psychopathology is unclear. In order to evaluate the relationship between seizure type and psychopathology, 35 children with TLE were compared with 48 children with primary generalized epilepsies (GE) on standardized measures of social competence, aggression and overall behavioural disorder via analyses of covariance. Additionally, Pearson correlations were computed in order to evaluate the relationships between psychopathology and several seizure and subject variables. It was found that the presence of TLE per se bore no relationship to aggression, social competence or overall behavioural disorder. Some specific subject- and seizure-related variables were found to be associated with increased aggression and behavioural dysfunction in children with TLE and the interpretation of these findings are related to the larger epilepsy/psychopathology literature. Finally, an alternative approach for studying the precursors of behavioural disorder in epilepsy is suggested.
Validity of the Diagnostic Interview Schedule, Version II: DSM-III diagnoses
Authors: Robins Lee N. , Helzer John E. , Ratcliff Kathryn S. , Seyfried Warren
Published: July 2009

Synopsis

A new diagnostic instrument, The Diagnostic Interview Schedule, was evaluated for use by lay interviewers by comparing its DSM-III diagnoses when given by lay interviewers with results obtained through an independent interview by a psychiatrist using the same schedule, his clinical judgement after the interview, his clinical judgement after both the interview and a free question period, and with diagnoses on the medical chart.
The Eating Attitudes Test: psychometric features and clinical correlates
Authors: Garner David M. , Olmsted Marion P. , Bohr Yvonne , Garfinkel Paul E.
Published: July 2009

Synopsis

Psychometric and clinical correlates of the Eating Attitudes Test (EAT) are described for a large sample of female anorexia nervosa (N = 160) and female comparison (N = 140) subjects. An abbreviated 26-item version of the EAT (EAT-26) is proposed, based on a factor analysis of the original scale (EAT-40). The EAT-26 is highly correlated with the EAT-40 (r = 0·98) and three factors form subscales which are meaningfully related to bulimia, weight, body-image variables and psychological symptoms. Whereas there are no differces between bulimic and restricter anorexia nervosa patients on the total EAT-26 and EAT-40 scores, these groups do indicate significant differences on EAT-26 fractors. Norms for the anorexia nervosa and female comparison subjects are presented for the EAT-26, EAT-40 and the EAT-26 factors. It is concluded that the EAT-26 is a reliable, valid and economical instrument which may be useful as an objective measure of the symptoms of anorexia nervosa.
Who receives the aftercare? Utilization of services by discharged in-patients
Authors: Keane Petrina , Fahy T. J.
Published: July 2009

Synopsis

A prospective one-year follow-up of 216 in-patients showed that utilization of aftercare was significantly associated with certain clinical and social factors in the year after discharge from hospital. Rural domicile, a diagnosis of schizophrenia, long dependence on services, and ease of access to care comprised an aftercare dependency syndrome with substantial predictive power. Alcoholic and personality disordered patients were light users of services. Staff—patient relationships and attitudes of staff and patients to the need for aftercare were important. Depot neuroleptics were associated with high levels of aftercare for patients with chronic schizophrenia. The findings reveal the steady silting up of a new area service for the adult mentally ill by patients with a combination of social disadvantage and severe chronic psychosis. Family doctors played very little part in the delivery of aftercare. Some implications of the findings for the future development of community-based psychiatric services are discussed.
The aftermath of boxing
Authors: Corsellis J. A. N. , Bruton C. J. , Freeman-Browne Dorothy
Published: July 2009

SYNOPSIS

The brains of 15 retired boxers have been studied and the lives of the men concerned have been investigated in retrospect. A characteristic pattern of cerebral change has been identified which appears not only to be a result of the boxing but also to underlie many features of the punch-drunk syndrome.
5-Hydroxytryptamine metabolism in affective illness: the effect of tryptophan administration
Authors: Ashcroft G. W. , Crawford T. B. B. , Cundall R. L. , Davidson D. L. , Dobson Janet , Dow R. C. , Eccleston D. , Loose R. W. , Pullar I. A.
Published: July 2009

SYNOPSIS

L-tryptophan 50 mg/kg was administered orally to patients suffering from either unipolar or bipolar affective illness, and the concentration of 5-hydroxyindol-acetic acid estimated in their cerebrospinal fluid eight hours later. There was no significant difference between the patient groups or between these and patients with neurological disease. These findings suggest a reduced neuronal activity in the 5-hydroxytryptaminergic system in some depressed patients rather than an absolute deficiency of tryptophan-5-hydroxylase. The synthesis of 5-HIAA in response to tryptophan varied with age.
3-Methoxy-4-hydroxyphenylglycol in depression
Authors: Shaw D. M. , O'Keeffe R. , Macsweeney D. A. , Brooksbank B. W. L. , Noguera R. , Coppen A.
Published: July 2009

SYNOPSIS

The concentration of 3-methoxy-4-hydroxyphenylglycol (MHPG) in the cerebrospinal fluid of patients suffering from unipolar depressive illness did not differ significantly from the concentration in a neurological control group. After recovery there was a small but significant decrease in the concentration of MHPG and there was positive correlation between the concentration of MHPG and severity of depression as measured by the Beck Inventory. There was no correlation between urinary excretion of MHPG and the concentration of MHPG in cerebrospinal fluid. In contrast with the findings in cerebrospinal fluid there was a significant increase in the urinary excretion of MHPG after recovery.
Hypothyroidism in patients treated with lithium: a review and two case reports
Authors: Crowe M. J. , Lloyd G. G. , Bloch S. , Rosser R. M.
Published: July 2009

SYNOPSIS

Two different types of hypothyroidism can occur during lithium administration, one with evidence of underlying thyroiditis, the other without. Two cases are reported, one of type 1, the other of type 2, and 17 other cases of lithium-induced hypothyroidism in the literature are reviewed. The literature on the occurrence of goitre during lithium treatment, and that on the alteration of thyroid function tests are also reviewed. Possible mechanisms for the disturbance of thyroid function are discussed and recommendations for managing this complication of lithium therapy are made.
Suicide in England and Wales 1959–63 Part 1. The county boroughs
Authors: Whitlock F. A.
Published: July 2009

SYNOPSIS

A five-year sample of suicide deaths in 82 county boroughs in England and Wales has been examined according to the age and sex of the victims. A number of demographic and other factors were chosen to test out the hypothesis that male suicides were more likely to be associated with other forms of violent death in the community and that female suicides would correlate with a number of variables measuring aspects of sociosexual life. In old age it was postulated that mental and physical illness would outweigh any environmental factors—apart from social isolation—as contributory causes to suicide by both sexes. The fmdings give limited support to the original hypothesis which needs to be checked by a sociomedical investigation of as many suicides as possible in a large number of towns.
Medical Research Council Unit for Metabolic Studies in Psychiatry, Sheffield
Authors: Jenner F. A.
Published: July 2009

The Medical Research Council Unit for Metabolic Studies in Psychiatry was set up at Middle-wood Hospital, Sheffield, in 1967. It was to a considerable extent a continuation of the Medical Research Council Unit for the Chemical Pathology of Mental Disorders which had been associated with the Department of Physiology in the University of Birmingham under the direction of Professor I. E. Bush. The latter unit had in its turn largely corne from a group headed by Sir George Pickering at Oxford.
Conduct disorder and affective disorder among the offspring of patients with Huntington's Disease
Authors: Folstein Susan E. , Franz Mary Lousie , Jensen Barbara A. , Chase Gary A. , Folstein Marshal F.
Published: July 2009

Synopsis

The rate of occurrence of conduct disorder and affective illness was studied for a sample of 112 offspring of 34 Huntington's Disease (HD) patients. Psychiatric disorder in the offspring was assessed as a function of: (1) age of the parent at the onset of symptoms of HD; (2) family disorganization; and (3) psychiatric disorder in either parent. The findings indicated an increased frequency of conduct disorder in disrupted families, most especially in those where the HD parent had an early onset of symptoms and the non-HD parent showed psychiatric disorder. Affective disorder in the offspring was most strongly associated with the presence of similar symptoms in the HD parent. Affective disorder, but not conduct disorder, may be an early manifestation of the HD gene. The implication of these findings for genetic counselling is discussed.
The influence of age on lithium efficacy and side-effects in out-patients
Authors: Murray N. , Hopwood S. , Balfour D. J. K. , Ogston S. , Hewick D. S.
Published: July 2009

Synopsis

One hundred and sixty-six unipolar and bipolar out-patients (21–78 years) on long-term lithium treatment were studied on a prospective basis. Although there was a possible tendency for manic attacks to increase in prevalence and severity with age, it was difficult to demonstrate a general age-related decline in lithium efficacy. There was a tendency for the prevalence and severity of fine hand tremor to increase with age. This was not seen with polydipsia/polyuria, the other typical lithium side-effect.
Tardive dyskinesia: a 3-year follow-up study
Authors: Barnes T. R. E. , Kidger T. , Gore S. M.
Published: July 2009

Synopsis

A prospective study of tardive dyskinesia was carried out to gain information regarding the natural history of the condition and to identify risk factors. Out of an original cohort of 182 psychiatric patients receiving maintenance antipsychotic drugs 99 were available for reassessment after 3 years. In this follow-up group the point prevalence of oro-facial dyskinesia increased from 39% to 47% over the 3-year period. Twenty-two patients developed the disorder, while remission occurred in 14 others. Risk factors predicting the presence of oro-facial dyskinesia at follow-up included being over 50 years of age and the presence of akathisia. There was no convincing association between the duration of antipsychotic drug treatment and the presence or severity of oro-facial dyskinesia. Patients receiving over 1000mg chlorpromazine equivalents of antipsychotic drug per day were unlikely to have the condition. The amount of purposeless trunk and limb movement present proved to be a relatively stable phenomenon, showing only a slight increase with age and no change over the follow-up period. The implications of these findings are discussed, with particular consideration being given to the effects of loss of patients to follow-up.
Nosology of atypical depression
Authors: Paykel E. S. , Parker R. R. , Rowan P. R. , Rao B. M. , Taylor C. N.
Published: July 2009

Synopsis

A review of the literature on atypical depression indicated three relatively separate usages for the term: anxiety or phobic symptoms additional to depression, reversed functional shift, and non-endogenous depression. A sample of 160 out-patient depressives was rated on a variety of diagnostic systems measuring these concepts. Inter-relationships between groups selected by the three definitions were found to be low. In addition, although there was moderate consistency within different definitions of endogenous depression and of additional anxiety, reversed functional shift symptoms did not correlate well with each other. These findings suggest that atypical depression may be of limited value as a specific diagnosis within non-psychotic depression.
Can a computer take a psychiatric history?
Authors: Carr A. C. , Ghosh A. , Ancill R. J.
Published: July 2009

Synopsis

A program on an inexpensive microcomputer was designed to elicit personal histories from patients in a general psychiatric ward. Their answers were compared with the information recorded by the responsible psychiatric team. Where answers disagreed with the clinicians' records, the patient was interviewed to investigate the discrepancy. In the computer-elicited case-histories 90% of items were correct; a further 3% of items were considered correct by the patient. Most patients' computer histories revealed several items unknown to the clinicians and of importance in the management of the patient. Most patients (88%) found that the computer interrogation was as easy as a clinical interview. Computer assessment is proposed as a useful technique for the routine assessment of patients to augment the clinician's findings and to allow him to concentrate on the most relevant areas.