bluuebunny/crossref_metadata_2025 huggingface dataset:
Wilson's Disease and Catatonia
Authors: Davis Elizabeth J. B. , Borde Milind
Published: October 2008

A 12-year-old Indian boy presented to a psychiatric unit with catatonia. He was subsequently diagnosed to have Wilson's disease. Symptoms improved on treatment with penicillamine, zinc sulphate, and benzodiazepines.
Diversion from Custody. I: Psychiatric Assessment at the Magistrates' Court
Authors: Joseph Philip L. A. , Potter Mark
Published: October 2008

The homeless mentally disordered defendant facing minor charges poses considerable problems regarding appropriate disposal. Psychiatric assessment may be required in order to facilitate the court's decision, but this is often available only after remand in custody. A psychiatric assessment service based at two inner-London magistrates' courts is described. Over 18 months, 201 defendants were referred. They were predominantly male, single, and of no fixed abode, suffering from serious psychiatric disorder; these defendants had often received previous in-patient treatment, frequently as detained patients. They typically were recidivists charged with minor offences. Following initial assessment, 25% were admitted to hospital, 50% were released, and 25% returned to custody. The Crown Prosecution Service discontinued 29% of cases. For those admitted directly to hospital, the mean (s.d.) time from arrest to hospital admission was 5.8 (6.8) days, significantly quicker than with prison-based assessments.
Does Recollection of Exposure to Poor Maternal Care in Childhood Affect Later Ability to Relate?
Authors: Birtchnell John
Published: October 2008

The study tested Bowlby's hypothesis that experiencing the poor relating of parents in childhood predisposes the individual to poor relating in adult life. Data were drawn from two community samples: a younger sample of 25–34-year-old married women, and an older one of 40–49-year-old women. Data were also drawn from the husbands of the women in the younger sample. It focused on the single childhood variable of the recollection of poor maternal care. To avoid the effect of this on depression or other psychopathology, groups who were depressed and not depressed, or who were at different levels of psychopathology, were examined separately. Recollection of poor early care was associated with poor relating, lower age at marriage, poor-quality marriage and divorce from first marriage. There was a suggestion that the effects of the recollection of poor early care of marital partners summate.
‘Neurosis' and the Personal Social Environment
Authors: Sims A. C. P. , Heard D. H. , Rowe C. E. , Gill M. M. P. , Maddock V.
Published: October 2008

The Interview Schedule for Social Interactions (ISSI) was used to assess the social environment of 65 British inner-city patients suffering from severe neurotic disorder; all patients were offered a 12-week course of intensive day treatment with an educational and psychodynamic basis. Compared with a general population in Canberra, the neurosis sufferers had lower (morbid) scores on the ISSI for the extent and quality of their social relationships. Of the 34 subjects who completed treatment and attended for the post-treatment investigation, 21 attained a PSE score below the level for ‘caseness'. Twenty-five subjects who attended for follow-up at 18–24 months had improved significantly on all four of the standard ISSI measures, although they had not done so immediately after treatment. This suggests that although symptoms may improve at the time of treatment, social relationships improve only over several months.
A New Community Mental Health Team Based in Primary Care
Authors: Jackson Gayle , Gater Richard , Goldberg David , Tantam Digby , Loftus Linda , Taylor Helen
Published: October 2008

A new community multidisciplinary team based in primary care is described and the experience of the first year discussed. The effect the team has had on the use of psychiatric services in its first year was studied. There was a threefold increase in the rate of inception to care, leading to a doubling in the prevalence of treated psychiatric disorder. There has been a reduction in the demands made on the hospital out-patient services, but no change in the use of in-patient resources or emergency contacts.
Gastric Emptying, Body Weight and Symptoms in Primary Anorexia Nervosa
Authors: Stacher Georg , Abatzi-Wenzel Thalia-Anthi , Wiesnagrotzki Stefan , Bergmann Helmar , Schneider Christa , Gaupmann Gabriele
Published: October 2008

In a double-blind trial, 12 out-patients with primary anorexia nervosa received, for six weeks, either 10 mg cisapride or placebo, three times a day. Cisapride accelerated gastric emptying of a radiolabelled semisolid meal in all six patients; five gained weight and symptoms of gastric retention ameliorated in four. With placebo, three of six had emptying enhanced, four gained weight, and one's symptoms improved. For another six weeks, all patients received cisapride. In five of the patients who had received cisapride, emptying further accelerated or remained stable; in one it slowed. Of the six patients who received placebo, four had emptying accelerated, five gained weight, and symptoms improved in four. Longer administration of cisapride may, by enhancing gastric motor activity, alleviate symptoms of retention and thus help to change eating behaviour.
Alcoholics with Eating Disorders: Prevalence and Clinical Course
Authors: Higuchi Susumu , Suzuki Kenji , Yamada Koichi , Parrish Kiyoko , Kono Hiroaki
Published: October 2008

Investigation of the prevalence of eating disorders among a large sample of Japanese alcoholics admitted for hospital treatment revealed a strong association between eating disorders and alcohol abuse and alcohol dependence among young women. That association was not apparent in young men. The results of this study of the clinical courses of eating disorders and alcohol abuse and alcohol dependence suggest that women with eating disorders, especially bulimia nervosa, are at high risk of becoming alcoholic.
The Essential Psychotherapies
Authors: Andrews Gavin
Published: October 2008

Psychiatry is becoming increasingly confident about defining the benefits to be expected from each treatment (World Health Organization, 1991). The World Health Organization has published a list of essential drug treatments, but neither it nor any national regulatory body has ever examined non-drug treatments. This article examines the utility of the psychotherapies as treatments for persons with psychiatric disorders, and within a health service, whether supported by private insurance or by public taxation. It is not about the utility of psychotherapy paid for by an individual, for what people do with their own money is their own business. However, when deciding how to apportion a limited health budget, one should choose treatments that are more effective, safer, and cheaper than competing alternatives. Precisely how effectiveness, safety, and cost efficiency should be traded off against each other is a moot point, but there is agreement that treatments that are ineffective, harmful, and costly should not be used.
Delusions in Children and Teenagers Admitted to Bethlem Royal Hospital in the 19th Century
Authors: Wilkins Robert
Published: October 2008

The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital (‘Bedlam’) in the 19th century were analysed with particular reference to the frequency and types of delusions. Delusions were present in 700 (65%), among whom there were significantly more boys than girls. There was a statistically significant rise in the frequency of delusions from 1830 to the end of the century. Sixty-six per cent of the patients were discharged cured and, taken overall, the presence of delusions did not affect the prognosis: specifically, delusions did not worsen the prognosis in those diagnosed as suffering from mania or melancholia. Nevertheless, the prognosis was worse in boys with single paranoid delusions, or paranoid delusions in combination with auditory hallucinations of people, and worse for girls with delusions of exaltation in combination with other types of delusions.
Institutionalisation and the Long-Term Course of Schizophrenia
Authors: Abrahamson David
Published: October 2008

It is ironic, in a field with many other ironies, that a number of studies (Johnstone et al, 1981; Mathai & Gopinath, 1985; Curson et al, 1992) have questioned what Mathai & Gopinath call “the hitherto inviolate (and ingenious) concept of institutionalisation”, at a time when massive deinstitutionalisation is casting into relief some of the practices to which it refers (Team for the Assessment of Psychiatric Services, 1990; Murphy, 1991; Abrahamson, 1993). However, the gap that this creates between theory and practice may be risky for the future. It would certainly be a major failure if the institutional era with which psychiatry's early professional identity was so intimately bound up were to end in unresolved contradictions. With this background, it will be argued here that re-examination of institutionalisation in the context of the longitudinal course of schizophrenic disorders both confirms the validity of the concept and sets a demanding agenda for alternative care in the community.
Behavioural Sensitisation and Steroid-Induced Psychosis
Authors: Mullen Richard S. , Romans-Clarkson Sarah E.
Published: October 2008

As yet, there is no satisfactory model with which to understand steroid-induced mental disorder. It is suggested that a case of prednisone-induced psychosis in an adolescent female with Chrohn's disease can be best understood in terms of behavioural sensitisation to steroid therapy.
Concurrent Agranulocytosis and Hepatitis Secondary to Clomipramine Therapy
Authors: Alderman Christopher P. , Atchison Michelle M. , McNeece Janet I.
Published: October 2008

A 67-year-old man developed concurrent severe agranulocytosis and elevation of hepatic transaminases as a result of treatment with clomipramine. Although such adverse drug reactions can be considered rare events, the potentially serious nature of these reactions vindicate the routine monitoring of blood picture, and liver function tests, after initiation of treatment with tricyclic antidepressants.
Face-Processing Impairments and the Capgras Delusion
Authors: Young Andrew W. , Reid Ian , Wright Simon , Hellawell Deborah J.
Published: October 2008

Investigations of two cases of the Capgras delusion found that both patients showed face-processing impairments encompassing identification of familiar faces, recognition of emotional facial expressions, and matching of unfamiliar faces. In neither case was there any impairment of recognition memory for words. These findings are consistent with the idea that the basis of the Capgras delusion lies in damage to neuro-anatomical pathways responsible for appropriate emotional reactions to familiar visual stimuli. The delusion would then represent the patient's attempt to make sense of the fact that these visual stimuli no longer have appropriate affective significance.
Shifts of Dependency in the Resolution of Folie à Deux
Authors: Porter Taylor L. , Levine John , Dinneen Michael
Published: October 2008

We have presented a case of folie à deux in which the wife was the primary (dominant) partner and the husband the secondary (submissive) partner. The husband's symptoms seemed to have resolved as his dependency shifted from his wife back to his mother. Treatment is recommended by deliberately shifting dependencies only when there is advantage in doing so. For most patients, the aim should be independence.
Catatonia: the Tension Insanity
Authors: Johnson John
Published: October 2008

A historical review of Kahlbaum'sCatatoniais presented. He attributed the condition to organic cerebral disease. It is now best considered as a neuropsychiatric syndrome due to a wide variety of organic disease processes, manifest in catelepsy in a setting of an abnormal mental state, most commonly an affective disorder. Chronic catatonic states were common sequelae of encephalitis lethargica; this disease has now disappeared in epidemic form with a resulting fall in the incidence of catatonia in psychiatric hospitals. Acute catatonia, due to medical and particularly pharmacogenic causes, continues to occur in current psychiatric practice.
Sexual Abuse and Eating Disorders
Authors: Waller Glenn
Published: October 2008

Sexual abuse appears to be causally linked to eating disorders, particularly those involving bulimic features. However, the psychological factors that mediate between these two phenomena are not understood. Recent findings suggest that borderline personality disorder may explain some of the association. The present research investigates the potential links between reported sexual abuse, borderline personality disorder, and eating psychopathology in a case series of 100 women with eating disorders. The results suggest that borderline personality disorder is a psychological factor that explains a small part of the causal link between sexual abuse and bulimic behaviour - especially frequency of bingeing. However, other factors are likely to be involved, and further research is suggested to investigate these.
Clinical and Polygraphic Characteristics of Patients with Respiratory Dyskinesia
Authors: Chiu Helen F. K. , Lam Linda C. W. , Chan Christopher H. S. , Ho Crover K. W. , Shum Patrick P. S.
Published: October 2008

Respiratory dyskinesia is characterised by irregularity in rate, rhythm and depth of breathing. This study reports on the clinical features of 11 patients with respiratory dyskinesia identified from a mental hospital in Hong Kong, together with the results of the 24-hour polygraphic recording of seven patients. Virtually all patients with respiratory dyskinesia had tardive dyskinesia. However, the condition was missed or misdiagnosed in all cases by the case psychiatrists. The respiratory irregularity persisted for most of the day and only disappeared when patients took a prolonged rest or fell asleep. A standardised clinical examination for respiratory dyskinesia is proposed.
Polycythaemia, Delirium and Mania
Authors: Chawla Mohan , Lindesay James
Published: October 2008

The case is described of a 65-year-old woman who initially presented with delirium caused by polycythaemia rubra vera. Following venesection she was discharged home recovered, but presented again shortly after with an episode of mania associated with relapse of her polycythaemia.
Media Influences on Body Size Estimation in Anorexia and Bulimia
Authors: Hamilton Kate , Waller Glenn
Published: October 2008

Anorexic end bulimic women overestimate their body sizes substantially more than comparison women, but little is known about the factors that influence this overestimation. This study examined the influence of media portrayal of idealised female bodies in women's fashion magazines. Comparison women were not affected by the nature of the photographs that they saw, but eating-disordered women were - they overestimated more when they had seen the pictures of women than when they saw photographs of neutral objects.
Psychometric Assessment of Diabetic Impotence
Authors: Watkins S. E. , Williams P. , Ryder R. E. J. , Bowshier W.
Published: October 2008

In a study of 23 diabetic men complaining of impotence, completion of physical tests, self-report psychometric testing, a rating of marital intimacy, and a semistructured interview revealed that, of ten patients found to be at risk of psychogenic impotence secondary to marital or psychiatric morbidity, five were thought to have adequate erectile response and to have a psychogenic component to their problem. This seems to show high sensitivity, if not specificity, of the selfreport questionnaires.
Psychological Treatment of Generalised Anxiety Disorder
Authors: Durham Robert C. , Allan Thérèse
Published: October 2008

Comparative outcome studies of generalised anxiety disorder suggest that psychological therapy is a potentially valuable alternative to anxiolytic medication. However, on average psychological therapy results in modest improvements in symptoms, with about 50% of patients achieving normal functioning. Limited follow-up data indicate that these changes are maintained over six months. Cognitive therapy appears to be most effective, although comparisons with other therapies are limited and non-specific factors are clearly important. There is also evidence of considerable variability in outcome between studies, with the best results obtained with patients who are free of anxiolytic medication and recruited directly from primary care or other non-psychiatric settings. The effects on outcome of patient characteristics known to be associated with more severe illness and complexity of clinical presentation have yet to be explored. A balanced appraisal of the value of psychological therapy with this common condition requires a fuller description of sample characteristics and more systematic investigation of the clinical significance of treatment effects over the long term.
Alzheimer's Disease and Chromosome 14
Authors: Harrison Paul
Published: October 2008

Over the past three years, progress in the molecular genetics of familial Alzheimer's disease has been fast and fundamental. The seminal finding that some cases are due to a mutation in the β-amyloid precursor protein (APP) gene has been followed by the discovery of a major additional locus for the disease on chromosome 14. The combined data suggest that the genetic sites accounting for most early-onset familial Alzheimer's disease cases have now been located. In addition, research is revealing the mechanisms by which the genes exert their pathogenicity. This promises to provide the explanatory link between the genes and the clinicopathological syndrome. The ultimate goal, an understanding in similar terms of the much commoner senile, sporadic form of Alzheimer's disease, is now a realistic target.
Befriending Young Mothers
Authors: Cox A. D.
Published: October 2008

The context of voluntary befriending schemes to help mothers of young children is outlined. There is evidence that two main UK voluntary befriending schemes to help mothers of young children engage families where there is significant psychosocial morbidity. It is concluded that well conducted befriending schemes can make a significant contribution to the mental health of mothers and children. Whether they do so will depend on their experience and training and the elements they incorporate.
Psychiatric Morbidity and Compulsory Admission Among UK-Born Europeans, Afro-Caribbeans and Asians in Central Manchester
Authors: Thomas Christopher S. , Stone Kit , Osborn Madeline , Thomas Philip F. , Fisher Mark
Published: October 2008

Psychiatric admissions in Central Manchester of Europeans, Afro-Caribbeans, and Asians (within three age-bands) were studied over four years. Among the Afro-Caribbean group there were more single or unemployed persons than in either the Asian or European groups, which suggested greater socio-economic disadvantage. Rates for first admissions and readmissions among Afro-Caribbeans were greater; among Asians they were similar except for the 16–29-year age-group, who tended to have lower rates than Europeans. A higher proportion of Afro-Caribbeans and Asians were psychotic. In the Afro-Caribbean group, the raised rates of admission were largely attributable to increased rates of schizophrenia. The highest rate occurred in second-generation (UK-born) Afro-Caribbeans and was nine times that among Europeans. The police were more frequently involved in the admissions of Afro-Caribbeans compared with Europeans or Asians. Higher proportions of Afro-Caribbeans and Asians who were readmitted were detained under the Mental Health Act 1983, when compared with Europeans.
The Safety and Efficacy of Clozapine in Severe Treatment-Resistant Schizophrenic Patients in the UK
Authors: Adams C. E. , Barnes T. R. E. , Essali M. A. , Hirsch S. R. , MacKay A. V. P. , Corrigan F. M. , Cutting J. C. , Ekdawi M. Y. , McKenna P. J. , Milln P. T. S. , Parker A. L. , Lader M. , Brownsey R. L.
Published: October 2008

In order to assess the safety and some efficacy aspects of clozapine under UK conditions, 54 in-patients with severe treatment-resistant schizophrenic disorders were evaluated using several scales before and during treatment. Of the 54 evaluated, 26 completed the 26-week study. Of these patients, 20 showed improvement in psychopathology, often to a marked degree, involving both positive and negative symptoms. Some oral-facial extrapyramidal side-effects decreased as well. Two patients developed neutropenia, but recovered on discontinuation of clozapine. The most frequent adverse event was hypersalivation, and five patients suffered from seizures. It is concluded that clozapine is worth considering for the treatment of severe treatment-resistant patients in the UK.
A Single Photon Emission Computerised Tomography Study of Regional Brain Function in Elderly Patients with Major Depression and with Alzheimer-Type Dementia
Authors: Curran S. M. , Murray C. M. , Van Beck M. , Dougall N. , O'Carroll R. E. , Austin M.-P. , Ebmeier K. P. , Goodwin G. M.
Published: October 2008

The uptake, at rest, of 99mTc-exametazime into different brain regions was compared using SPECT for 20 elderly subjects with major depressive disorder, 20 with Alzheimer-type dementia, and 30 age-matched normal volunteers. Uptake was referred to calcarine-occipital cortex as a reference sensory area. Cross-sectional differences between the three groups were highly statistically significant, but reflected primarily the reductions in cortical uptake in the Alzheimer group. A detailed comparison of depressed patients and controls identified decrements in anterior cingulate, temporal and frontal cortex and in caudate and thalamus in men only. These decrements were correlated with impairment of performance on a trail-making task, but were also associated with continuing treatment with antidepressants or benzodiazepines. However, most depressed patients had quantitatively normal scans for posterior parietal association cortex, and this suggests that SPECT may find a limited role in the differential diagnosis of depression and dementia. The reduced brain function in some depressed patients may parallel the findings from studies of brain structure in elderly depressives; there was a weak association between good outcome at 6–18 months and increased tracer uptake in subcortical areas.
A Single Photon Emission Computerised Tomography Study of Regional Brain Function Underlying Verbal Memory in Patients with Alzheimer-Type Dementia
Authors: Riddle W. , O'Carroll R. E. , Dougall N. , Van Beck M. , Murray C. , Curran S. M. , Ebmeier K. P. , Goodwin G. M.
Published: October 2008

Ten patients with Alzheimer-type dementia and nine age-matched normal controls were examined with SPECT, using split-dose 99mTc-labelled exametazime. The baseline condition involved repetition of the word ‘yes' or ‘no’. The activation condition involved recognition (indicated by a ‘yes' or ‘no’) of words from a previously learned list presented along with distractor words. Patients who performed this task successfully were selected, and efforts were made to match the patients with controls according to their performance on the task, although this was not fully achieved. Uptake of 99mTc-exametazime was estimated at baseline and during the word-recognition task for predetermined regions of interest drawn from a standard neuroanatomical atlas. The baseline task appeared to normalise tracer uptake for frontal, temporal and parietal cortex in the patient group. However, during the recognition task, controls but not patients showed activation effects. These were most prominent in dorsolateral frontal cortex and adjacent anterior cingulate cortex. Among patients, successful performance was correlated with activation of dorsolateral frontal and parietal cortex on the left side. The results confirm the central role of frontal mechanisms in a recognition memory task. The study highlights some of the difficulties of using cognitive challenge tests in clinical groups.
Depression Following Laryngectomy
Authors: Byrne Alan , Walsh Michael , Farrelly Mary , O'Driscoll Kieran
Published: October 2008

When a group of 10 patients who had received surgery for carcinoma of the larynx were compared with 10 control patients who had received radiotherapy for carcinoma of the larynx, four of the former but none of the latter were found to be suffering from depression, a statistically significant difference. Depression was associated with poor communication skills and geographical isolation. Psychiatric intervention is recommended for patients undergoing mutilating forms of surgery.
Mortality and Causes of Death in First Admitted Schizophrenic Patients
Authors: Mortensen Preben Bo , Juel Knud
Published: October 2008

Although many studies have shown an increased mortality in schizophrenic patients, the literature provides little information about mortality from specific causes in relation to age, gender, and duration of illness. This study examined mortality and causes of death in a total national sample of 9156 first admitted schizophrenic patients. Suicide accounted for 50% of deaths in men and 35% of deaths in women. Suicide risk was particularly increased during the first year of follow-up. Death from natural causes, with the exception of cancer and cerebrovascular diseases, was increased. Suicide risk during the first year of follow-up increased by 56%, with a 50% reduction on psychiatric in-patient facilities. The study confirms that mortality in schizophrenia is still markedly elevated, and the finding of an increasing suicide risk may be an indicator of some adverse effects of deinstitutionalisation.
A Mental Health Relief Programme in Armenia After the 1988 Earthquake
Authors: Goenjian Armen
Published: October 2008

An international mental health relief programme for children and adults was implemented in Soviet Armenia after the 7 December 1988 Spitak earthquake. This paper presents: (a) the steps considered essential in the selection, preparation and support of mental health workers for the relief work; (b) a method which facilitated the screening and treating of large numbers of students in their classrooms; (c) the rate of post-traumatic stress disorder (74%) and major depressive disorder (22%) of 582 victims clinically evaluated before entering treatment three to six months after the earthquake; (d) clinical observations of significant psychological problems that may be overlooked in brief crisis-orientated psychotherapy; (e) multiple severe post-earthquake adversities (such as the collapse of the social network, the recurrence of after-shocks, the delay of reconstruction and the ongoing political turmoil) which contributed to the psychological problems of the victims and delayed their recovery; (f) the extension of the outreach programme beyond its traditional therapeutic role to an advisory one to other relief organisations.
Psychiatric Aspects of Heart Transplantation
Authors: Mai François M.
Published: October 2008

There are many practical psychiatric, social, and ethical problems which accompany heart transplantation. These include pre- and postoperative anxiety and depressive conditions, postoperative delirium, and social and family dysfunctional syndromes. This paper reviews the literature critically in the following five areas: pre-transplant evaluation, coping with surgery, postoperative sequelae, rehabilitation, and management. Although most recipients have a good outcome from the physical and psychiatric points of view, a substantial minority experience family conflicts and sexual dysfunction after surgery. An average of 45% of patients from all studies returned to full-time employment. The distinctive role and contribution of the psychiatrist on the transplant team is discussed and important areas for future research are outlined.
Effects of a History of Heavy Alcohol Consumption on Alzheimer's Disease
Authors: Rosen Jules , Colantonio Angela , Becker James T. , Lopez Oscar L. , Dᴇkosky Steven T. , Moss Howard B.
Published: October 2008

Neuropsychological and psychiatric evaluations were made of 39 subjects with possible Alzheimer's disease and a history of excessive alcohol consumption (AD + ETOH), who had been abstinent or had drunk minimally for at least three months before evaluation, and 225 patients with probable Alzheimer's disease (PAD) of comparable age, years of education, and baseline global impairment. At baseline, there were no significant differences between the groups in terms of age of onset of dementia, neuropsychological test scores, or current behavioural or psychiatric symptoms. One year later, no differences in rates of decline between 20 abstinent AD + ETOH patients and 88 PAD subjects could be shown. Thus, past heavy alcohol consumption does not appear to modify the presentation of dementia of the Alzheimer's type, nor does it modify progression over a one-year interval.
Ritanserin, a Selective 5-HT2/1CAntagonist, and Negative Symptoms in Schizophrenia
Authors: Duinkerke S. J. , Botter P. A. , Jansen A. A. I. , Van Dongen P. A. M. , Van Haaften A. J. , Boom A. J. , Van Laarhoven J. H. M. , Busard H. L. S. M.
Published: October 2008

The effectiveness of ritanserin, a selective 5-HT2and 5-HT1cantagonist, in reducing negative symptoms in schizophrenia was investigated in a double-blind, placebo-controlled trial. Trial treatment was added to a stable neuroleptic treatment in 33 schizophrenic patients with predominantly negative symptoms. Ritanserin reduced the negative symptoms, as measured with the SANS. The main reduction was for the items facial expression, global affective flattening, and relationships with friends and peers. Also a reduction in total BPRS score was found, which approached statistical significance. Significant reductions were observed for the BPRS items emotional withdrawal and depressive mood. Ritanserin or other drugs blocking 5-HT2and/or 5-HT1creceptors could be important in reducing specific symptoms in schizophrenic patients.
The South London Somatisation Study
Authors: Craig T. K. J. , Boardman A. P. , Mills K. , Daly-Jones O. , Drake H.
Published: October 2008

In a two-year longitudinal study, a two-stage screening procedure was used to identify subjects in primary care with emotional disorder presenting with a recent onset of physical symptoms and a comparison sample of patients presenting with physical symptoms only. Somatisers (n = 44) were defined as subjects who had an emotional disorder but who presented with physical symptoms that could not be attributed to organic disease. The course and outcome of these conditions were compared with those of pure emotional disorder (n = 11), pure physical disorder (n = 90) and ‘mixed’ conditions (n = 39). The physical symptoms of somatisers were less likely to improve and lagged behind those of the other groups, and 16 of these acute somatisers went on to develop chronic somatoform disorders. Among somatisers, changes in physical symptom levels throughout the follow-up closely mirrored changes in emotional arousal. Emotionally disordered subjects reported more instances of parental lack of care, but somatisers were also more likely than other groups to report parental physical illness and to have had more physical illness themselves in childhood. A logistic regression suggests that adult somatisation is best modelled by parental lack of care followed by childhood illness.
Single Photon Emission Computerised Tomography in Elderly Patients with Alzheimer's Disease and Multi-infarct Dementia
Authors: Mckeith Ian G. , Cook Julia , Adams Ruth , Irvine E. Marjorie , Simpson Alan E. S. , Bartholomew Peter H.
Published: October 2008

Single photon emission computerised tomography (SPECT) was used to measure regional brain uptake of technetium-99m hexamethyl-propyleneamine oxine (Tc99m-HMPAO) in elderly patients with Alzheimer's disease (AD), multi-infarct dementia (MID) and normals (n = 20 in each group). Different patterns of uptake were found between groups when cortical uptake was normalised to cerebellar uptake. Reductions occurred in all regions in AD, being most marked in temporal and posterior parietal areas. Significant correlations were found in AD between memory impairment and decreased temporal uptake bilaterally, and between duration of illness and reduced uptake in most brain regions. MID patients showed higher uptake in the anterior parietal region than did the other groups. A variable comparing anterior to posterior uptake significantly discriminated the two patient groups.
The Psychosocial Impact of HIV Infection in Gay Men, Drug Users and Heterosexuals
Authors: Gala Costanzo , Pergami Andrea , Catalan Jose , Durbano Federico , Musicco Massimo , Riccio Massimo , Baldeweg Torsten , Invernizzi Giordano
Published: October 2008

The aim of this study was to establish the prevalence of current and past psychiatric morbidity in HIV seropositive asymptomatic subjects belonging to three transmission categories (gay men, intravenous drug users, and heterosexuals) compared with that found in HIV seronegative controls from the same groups. A cross-sectional, controlled study including 279 seropositive subjects belonging to groups II and III defined by the Center for Disease Control (94 gay men, 157 intravenous drug users, and 28 heterosexuals) and 159 seronegative subjects (38 gay men, 91 intravenous drug users, and 30 heterosexuals) is reported. Outcome measures included standardised, self-report questionnaires and a semistructured interview to assess current psychopathological status and past psychiatric history. In addition, a psychiatric diagnosis according to DSM-III-R criteria Axis I and II was made in the seropositive subjects. Results showed that these subjects differed very little from the controls and that overall levels of psychiatric disturbances in both groups were low and similar to those found in other life-threatening illnesses. Furthermore, intravenous drug users, regardless of HIV serological status, had the highest levels of psychological morbidity. Psychosocial distress was associated with previous and current lifestyle, independently of HIV status.
Screening and Psychological Debriefing of Adolescent Survivors of Life-Threatening Events
Authors: Stallard Paul , Law Fergus
Published: October 2008

There is a perceived need for schools and casualty departments to receive appropriate information and guidelines in order to minimise the effect of PTSD. A recommended screening battery for PTSD was administered at the start of a two-session debriefing group and again three months later to a group of seven young survivors of a minibus accident. No studies using this screen other than those of shipping disasters have been reported to date. Screen scores were compared with those of survivors of the cruise ship Jupiter. No significant differences were found between minibus survivors when assessed at six months (before intervention), and Jupiter survivors, who when assessed at five months had already undergone debriefing. Post-debriefing assessment of minibus survivors demonstrated significant reductions on all measures.
Fowkes et al's “Serum Cholesterol, Triglycerides, and Aggression in the General Population”
Authors: Bond Alyson J.
Published: October 2008

“A higher than expected number of violent deaths and suicides in coronary prevention trials has provoked interest in the possibility that low serum cholesterol concentrations are associated in the general population with personality characteristics predisposing to aggressive and suicidal behaviour. We have investigated this possibility in the Edinburgh Artery Study. We measured serum lipid concentrations in blood samples taken from fasting subjects and assessed personality characteristics on the Bedford Foulds Personality Deviance Scales in a random sample of 1592 men and women aged 55–74 years, selected from age-sex registers of ten general practices in Edinburgh. Serum cholesterol concentration was not significantly associated with aggression in men, but it was associated in multivariate analysis (though not univariate analysis) with denigratory attitudes towards others among women. However, serum triglyceride concentration was related, especially in men, to hostile acts (r = 0.13, P < 0.001) and domineering attitude (r = 0.12, P < 0.001) independently of age, total and HDL cholesterol, cigarette smoking, and alcohol consumption. Subjects taking part in prevention trials have higher triglyceride concentrations than the general population and the relation between serum triglyceride concentration and aggression merits further investigation.”
The Role of Gender in Understanding the Familial Transmission of Schizoaffective Disorder
Authors: Goldstein Jill M. , Faraone Stephen V. , Chen Wei J. , Tsuang Ming T.
Published: October 2008

The purpose of this study was to test the effect of gender on the familial risk for schizophrenia and affective disorders in probands with schizoaffective disorder. The sample consisted of 42 DSM–III schizoaffective probands and 149 first-degree relatives from the retrospective cohort family studies, the Iowa 500 and non-500. Survival analysis estimated differences in morbidity risks, analysed by sex of proband and of relative. Findings showed that, among probands, relatives of females had significantly higher rates of schizophrenia and unipolar disorder than relatives of males. Further, among relatives, males were at significantly higher risk for schizophrenia spectrum disorders than females. Results were similar when probands were subdivided into their primary symptom patterns, that is ‘mainly schizophrenic’ or ‘mainly affective’, as well as by ‘schizoaffective, depressed’ or ‘schizoaffective, manic’. Implications for the taxonomy of schizoaffective disorder suggest a stronger relationship with schizophrenia, although the relationship with affective disorder remains unclear.
Psychosis and Cannabis Abuse in the Gambia
Authors: Rolfe M. , Tang C. M. , Sabally S. , Todd J. E. , Sam E. B. , N'jie A. B. Hatib
Published: October 2008

Cannabis abuse is a major public health problem in The Gambia and other parts of West Africa, and the rise in the incidence of psychotic illness reflects the increased background use of cannabis by the local population. A case-control study was performed to determine the association between psychosis and cannabis abuse in The Gambia and the importance of other risk factors. Out of 234 patients admitted to Campama Psychiatric Unit over 12 months, 210 (90%) were enrolled in a case-control study. Urine was tested for cannabinoid substances and 38% were positive compared with 12% of matched non-psychotic control subjects. Analysis of the matched pairs showed that a positive urinary cannabinoid test, cigarette smoking, alcohol consumption, travel to Europe and family history of mental illness were all significant risk factors for psychotic illness; Koranic education reduced the risk. There was a positive correlation among the psychotic patients between a positive urinary cannabinoid test and the use of alcohol, ataya tea and cigarette smoking; a family history of mental illness showed a negative correlation.
Hyponatraemia and Inappropriate Secretion of Antidiuretic Hormone Associated with the Use of Imipramine
Authors: Colgate Robert
Published: October 2008

Hyponatraemia and persistent urinary excretion of sodium are associated with imipramine, used to treat an elderly woman with depressive illness, which resolved on withdrawal of the drug.
Cyclic Psychosis Associated with the Menstrual Cycle
Authors: Stein Daniel , Hanukoglu Aharon , Blank Slulamit , Elizur Avner
Published: October 2008

Psychotic symptoms are not included under accepted definitions of premenstrual syndrome (PMS). We present a 14-year-old girl with PMS, who developed a late luteal cyclic psychosis during two consecutive premenstrual periods, which resolved completely after the onset of menses. She was treated with dehydroxyprogesterone for two cycles, and later with placebo for the next three consecutive cycles. Psychotic symptoms did not reappear following two psychotic cycles, and the PMS resolved within the next menstrual cycle. We suggest that cyclic psychoses associated with the menstrual cycle may be a specific benign entity, not included under the recognised functional psychoses. In some cases these psychoses could be classified as a subgroup of PMS.
Sex Differences in Patterns of Drug Taking Behaviour
Authors: Gossop Michael , Griffiths Paul , Strang John
Published: October 2008

This study investigates sex differences in patterns of drug taking and related injecting and sexual behaviour among 355 patients attending a London community drug team. The majority of cases attending the service presented with heroin problems. Men were more likely to use heroin by injection and women were more likely to use heroin by inhaling/smoking (‘chasing the dragon’); there was no sex difference in the overall incidence of needle sharing. The delay between first use of the problem drug and first presentation to services was the same for both men and women. Women were more likely to have a sexual partner who was a drug user and to be living with another user than men. This closer social attachment to other drug users was seen as presenting a high risk factor for women with regard to prognosis and treatment.
Effectiveness in Psychiatric Care
Authors: Glick Ira D. , Burti Lorenzo , Okonogi Keigo , Sacks Michael
Published: October 2008

This hypothesis-generating study had the objective of dissecting the process of psychiatric care in an attempt to understand outcomes for patients and their families. In all, 24 patients who carried a DSM–III diagnosis of major affective disorder were identified 12–18 months after hospital admission. The patients, their families, and their doctors were interviewed using instruments measuring delivery of treatment and achievement of treatment goals; findings were then correlated with resolution of the index episode and patient global outcome. Delivery of patient and family psychoeducation was associated with better resolution of the index episode and better global outcome.
Is There a Delay in the Onset of the Antidepressant Effect of Electroconvulsive Therapy?
Authors: Rodger Colin R. , Scott Allan I. F. , Whalley Lawrence J.
Published: October 2008

The severity of depression in 11 drug-free unipolar patients diagnosed with definite major depressive disorder was assessed using the Hamilton Rating Scale for Depression during a course (5–10 treatments) of bilateral electroconvulsive therapy (ECT). The degree of improvement after three treatments of ECT was six times greater than the improvement that occurred over the remainder of the course. Although depressed patients who recover with ECT require repeated treatments, the treatments early in a course of ECT can have marked antidepressant effect.
Social Adjustment in Panic-Agoraphobic Patients Reconsidered
Authors: Perugi G. , Akiskal H. S. , Musetti L. , Simonini E. , Cassano G. B.
Published: October 2008

Forty-eight depressed panic-agoraphobic patients - clinically matched for severity of depression with 35 primary chronic depressives - had significantly better adjustment in most areas of social functioning, especially those related to interpersonal contact, work, leisure activities, and sexual life. Even when depressed, panic-agoraphobic patients appear to possess sufficient interpersonal skills - that is, by leaning on significant others - to engage in a range of social activities, both at home and beyond. These data, which are open to different interpretations, nonetheless suggest that anxiety and mood disorders differently affect certain key areas of social adjustment.
The Omnipotence of Voices
Authors: Chadwick Paul , Birchwood Max
Published: October 2008

We offer provisional support for a new cognitive approach to understanding and treating drug-resistant auditory hallucinations in people with a diagnosis of schizophrenia. Study 1 emphasises the relevance of the cognitive model by detailing the behavioural, cognitive and affective responses to persistent voices in 26 patients, demonstrating that highly disparate relationships with voices - fear, reassurance, engagement and resistance - reflect vital differences in beliefs about the voices. All patients viewed their voices as omnipotent and omniscient. However, beliefs about the voice's identity and meaning led to voices being construed as either ‘benevolent’ or ‘malevolent’. Patients provided cogent reasons (evidence) for these beliefs which were not always linked to voice content; indeed in 31 % of cases beliefs were incongruous with content, as would be anticipated by a cognitive model. Without fail, voices believed to be malevolent provoked fear and were resisted and those perceived as benevolent were courted. However, in the case of imperative voices, the primary influence on whether commands were obeyed was the severity of the command. Study 2 illustrates how these core beliefs about voices may become a new target for treatment. We describe the application of an adapted version of cognitive therapy (CT) to the treatment of four patients' drug-resistant voices. Where patients were on medication, this was held constant while beliefs about the voices' omnipotence, identity, and purpose were systematically disputed and tested. Large and stable reductions in conviction in these beliefs were reported, and these were associated with reduced distress, increased adaptive behaviour, and, unexpectedly, a fall in voice activity. These changes were corroborated by the responsible psychiatrists. Collectively, the cases attest to the promise of CT as a treatment for auditory hallucinations.
Premorbid Personality in First-Onset Psychosis
Authors: Dalkin Tim , Murphy Patrice , Glazebrook Cris , Medley Ian , Harrison Glynn
Published: October 2008

The data presented are those from a two-year prospective study of 69 patients identified in the Nottingham field centre of the WHO Study of Determinants of Outcome of Severe Mental Disorders. Premorbid personality, childhood adjustment and adolescent adjustment were assessed at the patients' first presentation to psychiatric services with a psychotic illness. Ratings were made blind to diagnosis. Premorbid explosive and paranoid traits were commoner in patients with schizophrenia than in patients with other non-organic psychoses, and these traits were associated with later onset of schizophrenia. Premorbid schizoid traits were significantly commoner in patients with schizophrenia compared to patients with other psychoses, but only in those patients for whom a parent was the informant. Schizoid traits were no commoner in men with schizophrenia than in women, and were not associated with earlier age of onset. The findings suggest that premorbid personality, in men and women, may shape the expression of symptoms produced during an illness episode.
Lithium Prophylaxis of Bipolar Illness
Authors: Peselow Eric D. , Fieve Ronald R. , Difiglia Constance , Sanfilipo Michael P.
Published: October 2008

Using a longitudinal life-table analysis, we assessed the efficacy of lithium alone, administered within the context of a naturalistic clinical setting, by calculating the probability of patients remaining free of an affective episode (manic or depressive) over a five-year course. In addition, for those who suffered a manic or depressive relapse, we attempted to analyse the subsequent course of patients who suffered a manic/hypomanic or depressive relapse and were then restabilised on lithium plus either a neuroleptic, carbamazepine, or a benzodiazepine, or lithium plus an antidepressant. Lithium alone offered an average 83% probability against an affective relapse after one year, 52% after three years, and 37% after five years. For patients who failed on lithium alone, it appeared that combination treatment offered greater protection against subsequent affective relapse than the initial course on lithium alone.