bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflections on the Management of Parasuicide
Authors: Kreitman Norman
Published: August 2008

It is ironic that one of the most difficult tasks confronting the psychiatrist is to assess a parasuicidal patient, while the conditions under which he is commonly obliged to do so may be the least favourable that can be imagined. Often he is asked to see the patient, who as likely as not is drunk and just getting over a stomach wash-out, in a crowded corner of a teeming Casualty Department; this is analogous to asking a surgeon to operate in the lavatory. Even if the patient has been admitted, he or she is likely to have been grudgingly lodged in an emergency ward with harassed staff whose hostility surfaces all too easily. It might be a valuable use of time to explore with medical colleagues how to provide the optimal environment for the patient and psychiatrist alike, and to review policy constantly. But the parasuicide violates all the rules of the medical game and rarely fits the culture of the general hospital. Attempts to change staff attitudes will probably have limited success if the social realities remain unaffected. A ward designed for patients with perforated ulcers and broken limbs generates its own values; mores reflect function as well as vice versa.
Psychiatric Aspects of Sterilization: A Prospective Survey
Authors: Smith Anne H. W.
Published: August 2008

Patients consecutively referred for sterilization were examined at the time of referral, two months and one year after operation.

Twenty-five per cent of the sample were identified as psychiatric cases at the time of referral, and rates of disturbance were even higher in some subgroups of women. The rate of disturbance fell in all these groups by one year after operation.

New psychiatric disturbance following sterilization was similar in amount to that found in the community and was not related to any groups of women said in the literature to be at risk apart from those divorced or separated at the time of referral.

Many experienced improvement in their marital and sexual relationships and only 3 per cent expressed feelings of regret.
Sexual and Marital Problems in a Psychiatric Out-Patient Population
Authors: Swan Marion , Wilson Leonard J.
Published: August 2008

The study aimed to identify those patients referred to a psychiatric out-patient clinic who had sexual or marital difficulties and who could be offered help with these problems, although none of the patients had been referred primarily for sexual or marital therapy. The methods of assessment formed a series of filtering devices for screening the sample, and possible reasons for discrepancies in the results are discussed. Twelve per cent of the sample had sexual or marital problems and were offered treatment, and it is suggested that this proportion may be an underestimate of the ‘true’ frequency of such problems in the sample. Implications of this finding for the provision of treatment resources in the psychiatric out-patient setting are considered.
Somnambulistic-like Episodes Secondary to Combined Lithium-Neuroleptic Treatment
Authors: Charney Dennis S. , Kales Anthony , Soldatos Constantin R. , Nelson J. Craig
Published: August 2008

Ten of 114 psychiatric patients undergoing combined lithium-neuroleptic treatment exhibited somnambulistic-like episodes. These episodes are differentiated from nocturnal wanderings and epileptic attacks during sleep; they occurred within two to three hours after sleep onset and were characterized by the patients appearing confused and walking about in a quiet, detached and clumsy manner. Generally, there was amnesia for the event. Since sleepwalking occurs out of slow wave sleep, the increase in slow wave sleep induced by lithium and certain neuroleptics may represent a neurophysiological mechanism responsible for these patients’ somnambulistic behaviour. The occurrence of grand mal seizures in two patients was probably unrelated to the somnambulistic-like episodes. However, persistence of the latter appears to be associated with drug-induced EEG irregularity.
Psychological Construing in Schizoid Children Grown Up
Authors: Chick Jonathan , Waterhouse Lorraine , Wolff Sula
Published: August 2008

Twenty former male patients who in childhood had been diagnosed as having schizoid personality were followed up in adulthood. In comparison with controls, they used psychological ways of construing infrequently. Interpretations of this finding are discussed, in particular its relationship to impaired empathy.
The Prediction of the Course of Minor Psychiatric Disorders
Authors: Huxley P. J. , Goldberg D. P. , Maguire G. P. , Kincey V. A.
Published: August 2008

Recent studies have suggested that psychosocial factors play an important part in the prediction of the course of minor psychiatric disorders. Fifty-nine new psychiatric out-patients suffering from minor disorders were assessed, using standardized clinical and social interviews, and 52 were followed up after one year and the clinical assessment repeated. Social and clinical factors were equally important predictors of the number of months ill in the survey year, but social and constitutional variables were superior in the prediction of percentage change in symptoms over the year.

The results of correlation, factor and multiple regression analyses suggest that the course of minor psychiatric disorder is best predicted by three sets of variables which are, in order of importance, the patient's material social circumstances, his clinical symptoms and his ‘genetic risk’ scores.
Reported Parental Characteristics of Agoraphobics and Social Phobics
Authors: Parker Gordon
Published: August 2008

The clinical impression that phobic patients perceive their parents as being uncaring and overprotective was investigated in a controlled study of eighty-one phobic patients. Those assigned to a social phobic group scored both parents as less caring and as overprotective, while those assigned to an agoraphobic group differed from controls only in reporting less maternal care. Intensity of phobic symptoms in the pooled sample was examined in a separate analysis. Higher agoraphobic scores were associated with less maternal care and less maternal overprotection, while higher social phobic scores were associated with greater maternal care and greater maternal overprotection.
Clomipramine and Exposure for Obsessive-Compulsive Rituals: 1
Authors: Marks I. M. , Stern R. S. , Mawson D. , Cobb J. , McDonald R.
Published: August 2008

Forty chronic obsessive-compulsive ritualizers were randomly assigned to treatment with oral clomipramine or placebo for 8 months. During weeks 4 to 7 these two groups were each randomly split into treatment by relaxation or by exposure in vivo, and during weeks 7 to 10 all patients had exposure in vivo. Double blind assessments were made at weeks 4, 7, 10, 18, 36, 62 and 114.

Results are reported to one year. Clomipramine produced significant improvement in rituals, mood and social adjustment, but only in those patients who initially had depressed mood. The clomipramine effect was maximum from weeks 10 to 18 and diminished thereafter. On stopping clomipramine patients often relapsed and improved again on restarting the drug. Relaxation produced little change. Exposure produced significant lasting improvement in rituals, but less change in mood; improvement generalized to social adjustment at follow-up. Clomipramine plus exposure had a slight additive but not interactional effect. Clomipramine enhanced compliance both with exposure and with relaxation.

Clomipramine is useful for compulsive ritualizers with depressed mood, but may need continuation for over a year and combination with exposure in vivo. Exposure in vivo remains the treatment of choice for rituals without depressed mood.
Social Deprivation Amongst Short Stay Psychiatric Patients
Authors: Ebringer Lorna , Christie-Brown J. R. W.
Published: August 2008

Two samples of newly admitted psychiatric patients were examined. Of 558 patients admitted during one year, 76 (13.7 per cent) came in from transitory accommodation or no fixed abode; of 456 patients discharged 131 (28.7 per cent) either changed address during their stay in hospital or left without known accommodation. Of 102 patients in the wards and day hospital on one day, 29 (28.4 per cent) came in from transitory accommodation or no fixed abode, 66 (64.7 per cent) were unemployed, 51 (50 per cent) were living alone. Of the 74 inpatients 30 (40.5 per cent) were homeless and 27 (36.5 per cent) had no visitors. These results indicate that many patients have lost their community supports by the time they reach hospital.
Patterns of Peptides and Protein-Associated-Peptide Complexes in Psychiatric Disorders
Authors: Trygstad O. E. , Reichelt K. L. , Foss I. , Edminson P. D. , Saelid G. , Bremer J. , Hole K. , Ørbeck H. , Johansen J. H. , B⊘ler J. B. , Titlestad K. , Opstad P. K.
Published: August 2008

Peptidic neurones may be considered as multisignal integrators and transducers. When formation or release of peptide outstrips genetically determined breakdown capacity, overflow of peptides to the body fluids and urine may be expected. In this paper, pathological urinary chromatographic patterns of peptides are shown for genetic, functional and mixed disorders. Part symptoms of the disorders may be induced with the biologically isolated and purified peptides as well as with chemically synthesized peptides.
Parental Loss in Childhood and Onset of Manic-Depressive Illness
Authors: Roy Alec
Published: August 2008

Among 231 cases of manic-depressive illness parental loss before 17 years was high but was not associated with earlier onset of illness.
Hypothyroidism, Psychotropic Drugs and Cardiotoxicity
Authors: Gomez Joan , Scott Geoffrey
Published: August 2008

The effects of hypothyroidism are protean, involving many systems. Electrocardiographic changes are almost invariable, and include bradycardia, low QRS voltage and flattened T waves: these are usually reversible with replacement therapy (McDonald, 1978). Psychiatric disturbances are also well known, although they are seldom the presenting feature and are notorious for mistakes in diagnosis (Lishman, 1978; Whybrow and Ferrell, 1974). Most such disturbances comprise apathy and depression, some an organic reaction and a few manifest as an acute schizophrenia-like psychosis. Phenothiazines, the most generally used neuroleptic medication, may interfere with cardiac conduction. When hypothyroidism presents as acute psychosis and the patient is hypersensitive to phenothiazines a dangerous situation can arise.
Myasthenia Gravis — the Difficult Diagnosis
Authors: Sneddon Joan
Published: August 2008

Twenty-six patients with proven myasthenia gravis were interviewed to assess the length of time between onset of symptoms, presentation to the general practitioner and diagnosis. In one third the initial diagnosis was psychiatric and the average time between presentation and correct diagnosis was 2.8 years for men, 1.2 years for premenopausal women and three weeks for postmenopausal women. Diagnosis could have been made much earlier if doctors had been familiar with early symptoms in this relatively rare disease. Symptoms and signs fluctuated and were at times absent, especially in the mornings.
Physical Illness and Psychosis
Authors: Cutting J. C.
Published: August 2008

One hundred psychotic patients referred to a consultation service in a general hospital were compared with 50 psychotic patients without physical illness in a psychiatric unit. Background, mental and cognitive state were evaluated. In addition to providing a list of likely causes of cerebral dysfunction in such a sample, the study revealed an increased incidence of prior depression in those with cerebral dysfunction, and identified a group where psychosocial factors appeared more significant than cerebral dysfunction in determining the psychosis. The various ways in which a psychosis can be associated with a physical condition, and the various forms that it can take even when cerebral dysfunction is present, are discussed.
Cushing's Syndrome, Tryptophan and Depression
Authors: Kelly William F. , Checkley Stuart A. , Bender David A.
Published: August 2008

Fifteen patients with active Cushing's syndrome have been compared with 15 other patients who had been treated successfully for Cushing's syndrome and with 13 patients with other pituitary tumours. Depression was the main psychiatric diagnosis made by the CATEGO programme after Present State Examinations. Patients with active Cushing's syndrome were significantly more depressed (Hamilton Rating Scores), than were the other patients. Compared with the control patients, those with active Cushing's syndrome had slightly lower plasma concentrations of total tryptophan, though the concentrations of freely diffusible tryptophan were not significantly changed.
An Extrapyramidal Syndrome after Lithium Therapy
Authors: Tyrer P. , Alexander M. S. , Regan Adrienne , Lee I.
Published: August 2008

Two patients developed an extrapyramidal syndrome after therapy with lithium carbonate. Although the clinical features of this syndrome were indistinguishable from those of drug-induced parkinsonism, it was made worse by the anti-parkinsonian drug, orphenadrine. These findings were reproduced later under laboratory conditions when extrapyramidal symptoms and physiological tremor were recorded before and after challenge doses of orphenadrine. This unwanted effect of lithium carbonate may be explained by selective blockade of dopamine receptors.
HLA Antigens in Schizophrenia: Differences between Patients with and without Evidence of Brain Atrophy
Authors: Luchins Daniel , Torrey E. Fuller , Weinberger Daniel R. , Zalcman Steven , Delisi Lynn , Johnson Armead , Rogentine Nicholas , Wyatt Richard Jed
Published: August 2008

A survey of 14 published studies found no consistent association between specific HLA antigens and schizophrenia. Since these studies lacked diagnostic or biological criteria, an investigation was undertaken using recognized diagnostic criteria and CT scan findings. Typing for HLA antigens at loci A, B and C was carried out on 130 patients. Among 92 black schizophrenic patients there was an increase of HLA-A2which remained significant even after correcting for the number of antigens studied. When the patients for whom CT scans were available were divided according to the presence or absence of evidence of brain atrophy, there was an increase of A2in the black schizophrenic patientswithoutevidence of atrophy, which remained significant after multiplying by the number of antigens studied. However, there was no significant increase of A2in thosewithevidence of atrophy. Similar trends held for the white population but they failed to reach significance. The need for HLA studies on biologically defined groups of schizophrenic patients is stressed.
Non-Organic Gastrointestinal Illness: A Medical and Psychiatric Study
Authors: Macdonald Alasdair J. , Bouchier Ian A. D.
Published: August 2008

One hundred consecutive referrals to a general medical out-patient clinic were evaluated psychiatrically under blind conditions in order to investigate the nature and occurrence of non-organic disease presenting as gastrointestinal illness. Twenty-eight patients had marked psychiatric illness with or without physical illness, and there was an association between psychiatric illness and the absence of organic disease, as determined by outcome at follow-up of 4–11 months. Patients with obsessional traits were more at risk of non-organic illness. Historical items indicating a likelihood of non-organic gastrointestinal illness included ‘nerves', ‘depression’, unhappy childhood, early parental loss and early separations from parents during childhood. Psychiatric illness often persisted after treatment for physical symptoms. Some of the techniques used in this study to identify psychiatric illness could be usefully employed in everyday practice.
A Study of Weight Reducing Diets in Psychiatric In-Patients
Authors: Knox Janet M.
Published: August 2008

Seventy-four overweight psychiatric in-patients were treated with weight reducing diets for periods varying from 6 months to 34 months. Seventy per cent lost weight and 18 per cent attained an ideal weight. Weight reducing diets should be considered an important aspect of treatment for the majority of obese patients in psychiatric hospitals regardless of the cause of obesity.
Psychometric Rating in the Assessment of Progress in Anorexia Nervosa
Authors: Gomez Joan , Dally Peter
Published: August 2008

Personality variables and psychiatric symptoms were each assessed by inventory in 42 patients with anorexia nervosa: as in-patients initially, and during a three-year follow up. The results were used to distinguish primary from secondary cases and to monitor the clinical progress of the disorder.
Life Events, Psychiatric Disturbance and Physical Illness
Authors: Murphy Elaine , Brown George W.
Published: August 2008

The relationship between life events and the onset of organic physical illness has been studied in a group of women in the general population. The link between severe events and the onset of organic illness, which held only for women of 50 years or younger, was not a direct causal association but mediated by an intervening psychiatric disturbance of an affective kind, all occurring within a six month period. The findings are discussed in the light of the high psychiatric morbidity found in physically ill patients.
Clinical and Pharmacokinetic Factors Affecting Response to Phenelzine
Authors: Tyrer Peter , Gardner Martin , Lambourn John , Whitford Mervyn
Published: August 2008

Sixty patients, 30 with depressive neurosis, 15 with anxiety neurosis and 15 with phobic anxiety states, were treated with the monoamine oxidase inhibitor, phenelzine, in two different dosage schedules for four weeks. All patients received an initial dose of 15 mg daily, increasing to 30 mg daily between the third and seventh day, but subsequently, using double-blind procedure, one group took the commonly prescribed dose of 45 mg daily and the other took 90 mg daily. Acetylator status was independently determined before the start of treatment. Each diagnostic group showed a similar response to treatment, but patients taking the higher dose improved significantly more than those taking normal dosage, and the rate of improvement, measured by weekly self-ratings, was also more rapid with higher dosage. Acetylator status did not affect clinical response. The results suggest that dosage is more important in determining clinical response to phenelzine in neurotic disorder than specific diagnosis or acetylator status.
Relationships in Healthy Volunteers Between Concentrations of Monoamine Metabolites in Cerebrospinal Fluid and Family History of Psychiatric Morbidity
Authors: Sedvall Göran , Fyrö Bengt , Gullberg Bo , Nybäck Henrik , Wiesel Frits-Axel , Wode-Helgodt Birgitta
Published: August 2008

In 60 physically and mentally healthy human subjects, lumbar cerebrospinal fluid was analysed by mass fragmentography for 5-HIAA, HVA and MOPEG. Individuals with a family history of psychiatric morbidity had significantly greater variation in monoamine metabolite concentrations than subjects without such a family history. In subjects with a family history of schizophrenic psychosis 5-HIAA and HVA concentrations were significantly higher than in subjects with depressive disorders within the family. For subjects with deviant 5-HIAA levels the probability of having a psychiatric family history was 2.7 times higher than in subjects with normal values. For HVA and MOPEG similar relationships, but of a lower significance level, were found. The results suggest that the cerebral monoaminergic transmitter amines play critical roles in the pathophysiology of psychotic and depressive disorders with a family disposition. They also indicate a value of monoamine metabolite determination in CSF for the prediction of family vulnerability for psychiatric morbidity in healthy subjects.
The Disabilities of Chronic Schizophrenia—their Nature and the Factors Contributing to their Development
Authors: Owens D. G. Cunningham , Johnstone Eve C.
Published: August 2008

Five hundred and ten patients receiving long-term in-patient care for schizophrenia were examined in terms of their current mental state, cognitive functioning, neurological status and behavioural performance. The abnormalities of these areas of their present state were related to historical factors, personal details, the features of the illness at its worst and physical treatment received. Significant associations between the present state and historical factors were few and mainly concerned time and the features of the illness at its worst. Current abnormalities were not related to past physical treatment, but highly significant correlations were found between the impairments of the four areas of the present state. It is concluded that these impairments are likely to be an integral part of the disease.
The Syndrome of Schizophrenia: Unresolved Questions and Opportunities for Research
Authors: Kety Seymour S. , Kety Seymour S.
Published: August 2008

The concept of mental illness which Henry Maudsley developed and espoused has a special significance at this time. Psychiatry appears to have entered a new phase in its evolution as a mental science, in which its dependence on both the biological and the psychosocial disciplines is recognized, in which clinical observations are made under carefully controlled conditions, and where hypotheses lead to research rather than conclusions. This maturation was encouraged and predicted by Henry Maudsley who, more than a century earlier, had synthesized from the knowledge of his time a prospectus of psychiatric progress which anticipates much of our present thinking, often in considerable detail and striking exactitude.
Eeg Spectral Analysis in Schizophrenia
Authors: Fenton G. W. , Fenwick P. B. C. , Dollimore J. , Dunn T. L. , Hirsch S. R.
Published: August 2008

Four channels of EEG (T4-T6, P4-02, T3-T5, P3-01) were recorded from several groups of control subjects and schizophrenia patients on analogue tape. They were later digitized and analysed by computer; power spectra were computed for 30 second epochs of EEG per channel; eyes closed, eyes open. No difference between normal controls and neurotic in-patients was apparent. An acute schizophrenic group had less alpha power, this change being confined largely to the temporal areas. A chronic outpatient sample showed less alpha and beta power, while chronic long-stay schizophrenic patients had an excess of delta power. The changes in both chronic patient groups were diffuse rather than local.
Sleep Disorder Over Time: Psychiatric Correlates Among Males
Authors: Sweetwood Hervey , Grant Igor , Kripke Daniel F. , Gerst Marvin S. , Yager Joel
Published: August 2008

This 18 month prospective study assessed the time course of sleep disturbances in 85 male psychiatric out-patients and 103 male non-patients. Over one-third of the patients and 5 per cent of the non-patients reported frequent symptoms of insomnia during at least 14 of the 18 months. Frequency and chronicity of insomnia were strongly associated with intensity of psychiatric symptomatology, but not with diagnosis. Minor tranquillizers and hypnotics were used frequently by patients and occasionally by non-patients, but there was little indication that they altered the course of insomnia.
Life Stress and Symptoms at the Climacterium
Authors: Greene J. G. , Cooke D. J.
Published: August 2008

Psychological and somatic symptoms presented by women in middle life are frequently attributed to the menopause. Many writers have questioned this assumption and have placed more emphasis on environmental and personality factors. Using a life event model and a multivariate analysis technique, life stress was shown to have a significantly more powerful influence on the elevation of symptoms in a normal population of women at that age than did the menopause. Furthermore, the elevation in symptoms occurred some considerable time before that event. The finding that there was no significant increase in total life stress at that time of life suggests the presence of a vulnerability or moderating factor.
Suicide in Opera
Authors: Feggetter Graeme
Published: August 2008

Atkinson (1971), in his chapter studying the role which coroners and research workers play in defining suicide, noted that by 1927 Hans Rost's bibliography of suicide cited nearly 4,000 works on the subject, while 2,000 further publications were listed by Schneidmann and Farberow between 1927 and 1961. He had personally traced another 300 studies subsequently. In the face of this vast output one hesitates to add yet another paper. However, historical surveys of popular views on suicide have received relatively scant attention, much of the most valuable work being carried out by historians.
Cyclic Amp Levels in Blood Cells from a Short-Cycle Manic-Depressive Subject
Authors: Buckley Dorothy E. , Naylor Graham J. , Stansfield David A. , Brown Richard A.
Published: August 2008

Erythrocyte and leucocyte numbers and cyclic AMP content were monitored weekly in a mentally defective short-cycle manic-depressive woman. The erythrocyte count remained relatively constant but cyclic AMP content when manic was significantly higher than when depressed, and the mood and biochemical data appeared to have the same periodicity, with coincident peaks and troughs. Total leucocytes were related to mood, with peaks in the manic phase. Mononuclear cyclic AMP content varied without relation to manic or depressive phases.
A Pilot Study of Plasma Thioridazine and Metabolites in Chronically Treated Patients
Authors: Papadopoulos A. S. , Chand T. G. , Crammer J. L. , Lader S.
Published: August 2008

Plasma concentrations of thioridazine, mesoridazine, sulphoridazine and thioridazine ring sulphoxide have been measured individually by specific gas-liquid chromatographic (GLC) methods, and collectively by a radio-receptor assay, in 16 elderly in-patients during chronic treatment. The sulphoridazine level was above 0.135 μg/ml in 5 out of 6 symptomatically well-controlled patients, and below this level in 9 out of 10 who were poorly controlled. No such division was so clear for the other substances measured. A new assay for the total dopamine receptor-blocking activity of the plasma correlated highly at lower levels with the sum of drug plus metabolites obtained by GLC, but exceeded the sum at higher values. Both sulphoridazine and neuroleptic levels need further study.
Klinefelter's Syndrome and Schizophrenia
Authors: Pomeroy John C.
Published: August 2008

The prevalence of Klinefelter's Syndrome in new-born males in large surveys throughout the world has shown a scatter of 1.4 to 1.9 per thousand. Forssman (1970) accepted by pooling results a figure of 0.17 per cent as the average proportion of males born with at least one too many X chromosomes in some or all cell lines. Studies of mental hospital populations have consistently shown a higher prevalence of extra X chromosomes in males, averaging 0.54 per cent. The two largest studies, in Great Britain (Maclean et al, 1968) and in Sweden (Hambert, 1966) made no differentiation in the psychiatric diagnosis of the patients, although Hambert stated that the high prevalence did not stem from the mentally retarded population.
Sleep, Activity, Nutrition and Mood
Authors: Crisp A. H.
Published: August 2008

For the past fifteen years we have been studying aspects of relationships between sleep, activity, nutrition and mood. This paper comprises a brief statement of some of this research and our views to date.
A Comparison of Information Sources in the Study of Psychotic Illness
Authors: Downing A. R. , Francis A. F. , Brockington I. F.
Published: August 2008

The clinical features shown by 50 psychotic patients were documented by interviews held with the patient and next-of-kin, brief videotaped interviews and nurse rating in addition to the hospital case record. Three raters studied all the available material and made master ratings. Comparison of the ratings made at mental state interview with these master ratings showed that this interview missed a great deal of the pathology agreed to be present. The interview with the next-of-kin was helpful in identifying manic symptoms. Nurse rating based on an 8-hour period of observation was less effective overall, but highly significant associations with the master ratings were achieved in 29/57 areas studied. In four areas (uncooperative behaviour, concern for others, agitation and distractibility) it was superior to either interview.
Anticipatory Grief: A Psychosocial Concept Reconsidered
Authors: Fulton Robert , Gottesman David Jay
Published: August 2008

Formerly anticipatory grief was viewed as a potential coping mechanism for a prospective loss. More recently it has been studied in preventive psychiatry as a determinant of the severity of post-mortem grief. The authors in a critical analysis of methodological and theoretical inconsistencies recommend a reconsideration of the concept within a psychosocial context.
Emotional Disturbance in Hearing Clinic Patients
Authors: Singerman Burt , Riedner Erwin , Folstein Marshal
Published: August 2008

A group of outpatients scheduled for hearing evaluation were screened for psychiatric morbidity using the General Health Questionnaire (GHQ-30). There was an association between objective hearing loss and elevated GHQ-30 score. An association was also found between the presence of tinnitus and vestibular symptoms and elevated GHQ-30 score.
Affect and Verbal-Nonverbal Discrepancy in Schizophrenic and Non-Schizophrenic Family Communication
Authors: Hall Judith A. , Levin Smadar
Published: August 2008

Verbal and nonverbal communication of affect was examined in schizophrenic and control families, using audio tapes and transcripts of family interactions. In Study 1, data were available for parents interacting with their schizophrenic child (index session) or with a well child (well-sibling session), and for two parent-child sessions in normal families. In Study 2, data consisted of index sessions only with schizophrenic, non-schizophrenic psychiatric, and normal families. Audio tapes were electronically filtered, and ratings were obtained on nonverbal (filtered speech) and verbal (transcript) samples. The double-bind hypotheses of different nonverbal expression of affect and greater verbal-nonverbal discrepancy in schizophrenic as compared to normal families were not supported. In both studies no overall differences were found between diagnostic groups in terms of nonverbal ratings, indicating that clinical perceptions of inappropriate and conflicted affect in schizophrenic families are not based on spontaneously produced simultaneous discrepancy between verbal and nonverbal channels of spoken communication.
ECT: I. Patients' Experiences and Attitudes
Authors: Freeman C. P. L. , Kendell R. E.
Published: August 2008

One hundred and sixty-six patients who had ECT in either 1971 or 1976 were interviewed. The 1976 sample represented 89 per cent of those available for interview. Their experiences of ECT and their attitudes to it are described. They found ECT a helpful treatment and not particularly frightening, but side-effects, especially memory impairment, were frequent.
Using ECT to Study Hemispheric Specialization for Sequential Processes
Authors: Horan M. , Ashton R. , Minto J.
Published: August 2008

Two studies are reported, citing the effects of unilateral versus bilateral electroconvulsive shock therapy on the performance of short cognitive tests. In Study 1, seven tests were administered before and after three treatment sessions The most interesting finding was that performance improved significantly on the Knox Cube Imitation test following right unilateral shock. Study 2 replicated this unexpected finding. These results were interpreted as demonstrating that the left cerebral hemisphere is specialized for the processing of sequential time-dependent information.
48-Hour Depressive Cycling induced by Antidepressant
Authors: Lerer B. , Birmacher B. , Ebstein R. P. , Belmaker R. H.
Published: August 2008

Several cases of increases in frequency of mood cycling have recently been reported in women as a result of tricyclic antidepressant treatment (Siris et al, 1979; Wehr and Goodwin, 1979). We report here the occurrence of 48-hour rapid cycling in a man with recurrent unipolar depression after treatment with dibenzepin (Noveril), an atypical tricyclic antidepressant. Alterations in urinary cyclic adenosine monophosphate (AMP) have been reported with mood changes and were therefore evaluated at the same time.
A Diagnostic Pointer to Adult Metachromatic Leucodystrophy
Authors: Besson John A. O.
Published: August 2008

Adult metachromatic leucodystrophy (MLD) is a rare demyelinating disease of the central nervous system caused by a genetic autosomal recessive defect and mediated through a deficiency in the enzyme arylsulphatase A (Peiffer, 1970). The initial manifestation may take the form of symptoms suggestive of schizophrenia or dementia (Sourander et al, 1962; Austin et al, 1968).
A Longitudinal Study of Urinary Excretion of N,N,-Dimethyltryptamine in Psychotic Patients
Authors: Checkley S. A. , Murray R. M. , Oon M. C. H. , Rodnight R. , Birley J. L. T.
Published: August 2008

The excretion of N,N,-dimethlytryptamine (DMT) has been measured in longitudinal studies of five patients with schizophrenic illnesses and in four patients with rapidly or slowly cycling manic-depressive illness. The excretion of DMT was frequently raised in patients when they were psychotic but was usually normal when they had recovered. However, rapid changes in the severity of illness or sudden switches from one mood state to another were not accompanied by changes in the excretion of DMT. These findings contrast with the immediate hallucinogenic effects of an injection of DMT, and suggest that the extracerebral production of DMT (as measured by its urinary excretion) does not provoke the experience of hallucinations in psychotic patients.
Epileptic Psychosis—Diagnostic Comparison with Process Schizophrenia
Authors: Perez M. M. , Trimble M. R.
Published: August 2008

The mental states of 23 epileptic psychotic patients and 10 patients with process schizophrenia were compared, using the Present State Examination. The epileptics displayed marked heterogeneity of psychiatric diagnoses. Disturbances of affect underlying the psychosis or presenting as manic-depressive psychosis were frequent and independent of the type of epilepsy. Schizophrenic psychosis, classified with psychopathological criteria similar to those used in the non-epileptic schizophrenic group, was significantly associated with temporal lobe epilepsy. Psychoses other than schizophrenia, however, were present in 5 out of 16 patients with temporal lobe epilepsy. These results support a relationship between schizophrenic symptoms and temporal lobe pathology and emphasize the need to use reproducible methods of diagnosis in psychiatric research.
Psychiatric Disturbance in Mentally Handicapped Patients
Authors: Craft M. J. , Schiff A. A.
Published: August 2008

One hundred and two mentally handicapped and severely mentally handicapped patients with behaviour disorders and superadded mental illnesses which, in most cases, had not responded adequately to oral medication, entered a 12-week study of fluphenazine decanoate depot injections. Some of the patients had the additional complications of epilepsy, organic brain damage, and physical handicap. Highly significant overall improvements occurred, irrespective of such factors as the patient's age, sex, degree of mental handicap, or co-existence of epilepsy, or brain damage. Hyperpyrexia was not encountered. Extrapyramidal disturbance in 22 of the patients, were mostly well controlled by antiparkinson medication; eight of the 12 patients with pre-trial extrapyramidal abnormalities lost these during the study. Fluphenazine decanoate injections proved a reliable drug-delivery system, which may improve difficult behaviours and enable the mentally handicapped patient to be more receptive to behaviour-shaping exercises, aimed at improving long-term personality adjustment.
Perceptual Deficit in Schizophrenia: A Defect in Redundancy Utilization, Filtering or Scanning?
Authors: Caudrey D. J. , Kirk K. , Thomas P. C. , Ng K. O.
Published: August 2008

The perception by schizophrenic patients of stimuli with more than one feature (dimension) was investigated using psychiatric and non-psychiatric control groups. Indices of the ability (a) to make use of redundant stimulus cues, (b) to ‘screen out’ or filter irrelevant stimulus features, and (c) to scan the perceptual field for relevant stimulus features, indicated that only filtering was consistently poor in schizophrenia. It has been suggested that the schizophrenic patient may tend to perceive his environment in an undifferentiated holistic manner rather than in an analytic manner and the implication for the theory of left hemisphere pathology in schizophrenia is discussed. However, the performance of the schizophrenic subjects did not differ significantly from that of the group of depressed patients, which suggests that the selective attention deficits previously observed in schizophrenia are not specific to the disorder.
Mental Health Work in Sichuan
Authors: Liu Xiehe
Published: August 2008

Sichuan is the biggest province of the People's Republic of China, with a broad area of over 560 thousand square km and a population of over 90 million people. The central portion of it is a big basin about 200 thousand square km in area, surrounded by many mountains with average altitude between 1,000 and 3,000 m above sea level. About 90 per cent of the population of the province lives in this area. The west portion of the province, called West Sichuan Plateau with average altitude of over 3,000 m, is relatively unpopulated. According to a census of a district of Zigong in 1973, 39.2 per cent of the population was below age 15 and 4.3 per cent above age 65. [In Britain (1975) the corresponding figures were 25 per cent and 14 per cent—Editor].
Personality Change Following Accidents the Report of a Double Murder
Authors: Parker Neville
Published: August 2008

A monozygotic twin assaulted his wife and daughter, killing both in an extremely brutal manner. Three years previously he had been like his co-twin today: a dutiful husband and father, an extremely hard-working and successful farmer, and a devout Christian known throughout the district for his gentle and considerate manner. His life changed following two frightening accidents after which he developed severe anxiety symptoms necessitating in-patient psychiatric treatment. This highlights the importance of psychological effects from an accident in producing marked personality change.
Agoraphobia: The Long-Term Follow-up of Behavioural Treatment
Authors: Munby Mary , Johnston Derek W.
Published: August 2008

Sixty-six agoraphobic patients were followed up five to nine years after their treatment in three clinical trials of behaviour therapy. The main outcome measures used in the original trials were repeated by an assessor who interviewed the patients. Ninety-five per cent of patients were interviewed and partial information was obtained on a further two patients. The measures taken at follow-up were compared with those obtained prior to treatment and six months after treatment ended. On most measures of agoraphobia the patients were much better at follow-up than they had been before treatment. The assessor's ratings suggested that there had been little change in the patients' agoraphobia since six months after treatment. Some of the patients' self-ratings showed evidence of a slight improvement over this period. No evidence of symptom substitution was found.
Long-Term Monitoring of Tricyclic Antidepressant Plasma Concentrations
Authors: Loo Agrégé Henry , Benyacoub Kader , Rovei Vincenzo , Altamura Carlo A. , Vadrot Marthe , Morselli Paolo L.
Published: August 2008

Plasma levels of antidepressant drugs were measured in 17 depressed patients at roughly monthly intervals over follow-up periods of three to 26 months. Good results in seven were associated with small fluctuations in level from visit to visit, while big fluctuations were associated with poor outcome. Such fluctuations were probably from poor compliance or drug interaction from self-medication. Severe side effects and cardiotoxicity were associated with high levels.
Behavioural and Subjective Effects of Beta-Adrenergic Blockade in Phobic Subjects
Authors: Bernadt M. W. , Silverstone T. , Singleton W.
Published: August 2008

It has been suggested that reversal of stress-induced tachycardia by beta-adrenergic blockade might be of benefit in the treatment of phobias. This was tested in a double-blind cross-over trial by exposing 22 female volunteers with spider or snake phobias to their phobic object 1 ½ hours after administration of either tolamolol 200 mg, diazepam 10 mg or placebo. Although tolamolol abolished the stress-induced tachycardia, it had no beneficial behavioural or subjective effects. In contrast, diazepam, which had no significant effect on heart rate, improved behavioural performance. Subjective measures were more influenced by order effect than by medication.
Intermittent Pimozide versus Fluphenazine Decanoate as Maintenance Therapy in Chronic Schizophrenia
Authors: McCreadie R. G. , Dingwall J. M. , Wiles D. H. , Heykants J. J. P.
Published: August 2008

In a double-blind trial, 34 male chronic schizophrenic day-patients or in-patients in a hostel ward continued on fluphenazine decanoate given mostly once fortnightly or were switched to pimozide, given on four days each week. Over nine months relapse rates were similar for both groups, and while fewer patients on pimozide were prescribed antiparkinsonian drugs one quarter developed buccolingual-masticatory dyskinesia. Plasma pimozide levels suggested satisfactory drug compliance. Average plasma prolactin levels were within the normal range for untreated men in one quarter of non-relapsing patients on pimozide and three quarters on fluphenazine.
Relationships Between Pain and Schizophrenia
Authors: Watson G. D. , Chandarana P. C. , Merskey H.
Published: August 2008

In an examination of the phenomenology of pain in 78 patients with schizophrenia, 29 had current pain complaints. Of these 13 had an appropriate physical cause, leaving 16 with pain of seemingly psychological origin. The head, leg and back were the commonest sites. Complaints were most often described in sensory terms.

Pain plausibly related to a specific delusion or hallucinatory process occurred only once, and no gross examples of insensitivity to noxious stimuli or to self-mutiliation were seen. Patients with schizophrenia may have less pain than those with anxiety or depression but certainly do experience pain both from physical and psychological causes. The influence of phenothiazines on pain experience is uncertain.
Hypoalgesia in Depressive Illness
Authors: Ben-Tovim David I. , Schwartz Martin S.
Published: August 2008

Neurophysiological studies of experimental pain were carried out on two severely depressed patients who complained of an inability to experience emotion. They had normal thresholds for stimulus appreciation but markedly increased thresholds for pain. These abnormal pain thresholds normalized with clinical recovery.
Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives
Authors: Sturgeon David , Kuipers Liz , Berkowitz Ruth , Turpin Graham , Leff Julian
Published: August 2008

Measurements of spontaneous fluctuations in skin conductance in 20 acutely ill schizophrenic patients were made in a video-tape studio. Recordings were made initially with the patient talking to an interviewer, then during a video-taped interview conducted with the patient's key relative. The Expressed Emotion (EE) of the patient's key relative had been measured previously. Significant differences in the type of spontaneous fluctuation activity between patients who had low EE and high EE relatives were demonstrated when the relative was present, but not when the relative was absent. The findings were not related to phenothiazine medication.
The DSM-III Concept of Schizophrenia
Authors: Fox Herbert A.
Published: August 2008

The development of DSM-III is traced from the Feighner Criteria through Spitzer's Research Diagnostic Criteria. The specific criteria for the diagnosis of schizophrenia are listed, and the symptoms which contribute to the diagnosis are categorized. Differences from the DSM-II concept are highlighted, and the complicated question of schizoaffective disorder is discussed. The DSM-III resolutions to the major controversies in the study of schizophrenia are outlined. Finally, the major strengths and weaknesses of the DSM-III approach are assessed.
Solitary Psychosis — Three Cases of Monosymptomatic Delusion of Alimentary Stench Treated with Behavioural Psychotherapy
Authors: Beary M. D. , Cobb J. P.
Published: August 2008

Three cases of monosymptomatic delusion of alimentary stench are described. Each patient was referred for behaviour therapy as a last resort, after extensive medical investigation for halitosis or flatulence and failure of other psychiatric treatment. Two of the patients showed clinical improvement after treatment sustained at follow-up. Monosymptomatic delusion is now a treatable condition and is important to diagnose.
Pure Erotomania in Manic-Depressive Psychosis
Authors: Guirguis Waguih R.
Published: August 2008

Pure erotomania was first described in 1920 by the French psychiatrist de Clérembault. It is a delusional condition, usually in a woman who believes that a man, unattainable because of his much higher social class or married state, is very much in love with her. The belief has a precise onset and occurs suddenly in a state of clear consciousness. Enoch and his colleagues (1967) claim that ‘some instances of this syndrome may be distinct from ordinary paranoid psychoses and deserve a separate place in psychiatric nosology’, while Arieti thinks that it is not a clinical entity but a symptom of paranoia or paranoid schizophrenia (Arieti and Meth, 1959).
Thyroid Function Screening in Psychiatric In-Patients
Authors: Carney Michael W. P. , Macleod Shirley , Sheffield B. F.
Published: August 2008

During a two-year biochemical screening for thyroid disease amongst 191 psychiatric admissions, 38 (20 per cent) had an abnormal result, 5 were hyperthyroid and 7 hypothyroid. Thyroid dysfunction was associated with female sex and affective psychosis, but not with age. During the three weeks before admission the patients with an abnormal result had been prescribed significantly more phenothiazines, antiparkinsonian drugs and lithium than the patients with normal thyroid function. Almost half of those with abnormal function were physically ill on admission. Despite these findings we concluded that in most patients thyroid dysfunction was not a major determinant of the psychiatric disturbance.
Self-Report Measures of Mood and Morale in Elderly Depressives
Authors: Gilleard C. J. , Willmott M. , Vaddadi K. S.
Published: August 2008

Two self-report scales of mood and morale were administered to 45 elderly in-patient depressives and 45 non-patient controls, matched for age and sex. The responses of the two groups differed significantly in the predicted direction. When 18 patients from the depressive group were re-tested 6 to 8 weeks later, at discharge, significant declines in self-reported depression, and increases in ‘life-satisfaction’ were reported. Within the depressive group, there was a significant relationship between ‘overt’ depressive behaviour on the ward and self-reporting of greater depressive symptoms, and lower ‘life-satisfaction’. The importance of independent validation of self-report measures of mood and morale in elderly populations is discussed.